Your 2023 Benefit Information

Administered by BlueCross Blue Shield

PF Holdings offers two plan options to fit your needs: the PPO Plan and a High Deductible Plan. Each plan is designed to allow you to select the option that best fits your needs.

• Airrosti Muskoskeletal Benefit
• BCBSTX Holistic Health Management Clinical Management
• Virtual Visits
• Blue365 Discount Program

Summary of Benefits and Coverage (SBC)

• PPO Plan English
• PPO Plan Spanish
  
  
• High Deductible Plan English
• High Deductible Plan Spanish

Please reference your benefit guide for more detailed information on each plan. 

How to Find a Provider
To see a current list of BlueCross BlueShield of Texas network providers, visit www.bcbstx.com or call Customer Care at 800-445-2227 for assistance.

Administered by CVS Caremark

Pharmacy benefits are administered by CVS Caremark. You can fill prescriptions at CVS along with many other national pharmacy chains!

When you enroll in one of the medical plan options, you will receive one ID card for medical and prescription drug coverage.

Preventive Prescriptions:

Under both the PPO and High Deductible Plans, certain preventive medications will be covered at a 100%. Please go to www.caremark.com to review the preventive drug coverage.

CVS Caremark Home Delivery Service

CVS Caremark delivers your maintenance medicines anywhere in the U.S., and shipping is free! To order a prescription using the mail order option, log on to www.caremark.com and follow the guided steps to request a prescription. You can also call the toll-free number on your ID card. Home Delivery Service offers a 3-month supply for less than the retail cost and prescription management services are available 24/7 at www.caremark.com. 

Administered by Cares Program

PF Holdings knows the value of well rounded, balanced employees, which is why PF Holdings offers personal support services through the Cares Program to help you and your family.

The Care Coordinators will:

• Provide care for grief, family deaths and funerals
• Discuss confidential issues, such as stress, parenting, marriage, financial concerns, addiction, aging parents, serious illness, and more
• Upon your request, visit with you at your work, home or a location of your choosing.

The services are available 24/7/365 for all employees and immediate family members at no cost. The Care Coordinators will not:

• Break confidentiality
• Judge your lifestyle or person conduct
• Force a conversation
• Interfere with your work
• Report to management about your work
• Promote a particular religious organization

The services are confidential, and you choose if, when, where and what you want to discuss.

Administered by MetLife

Dental plan benefits are available to you on a voluntary basis. All out‑of‑network services are subject to Reasonable and Customary (R&C) limitations.

Premium contributions for dental will be deducted from your paycheck on a pre‑tax basis. Your tier of coverage will determine your bi-weekly contribution.

If you choose to use a dentist who doesn’t participate in your plan’s network, your out‑of‑pocket costs will be higher.

There are thousands of general dentists and specialists to choose from nationwide --so you are sure to find one that meets your needs. You can receive a list of these participating dentists online at www.metlife.com/dental or call 1-800-GET-MET8.

For more details, click here or the button below.

Administered by SuperiorVision by MetLife

Our Vision Plan provides you with coverage for eye exams, lenses and frames—vision care for the whole family. This coverage is offered to you on a voluntary basis.

For general questions, go to www.metlife.com/mybenefits
or call 1-833-EYE-LIFE (1-833-393-5433).

For more details, click here or the button below.

Find a Superior Vision provider at www.metlife.com/vision and select ‘Superior Vision by MetLife’.

Administered by HSA Bank

When you enroll in the High Deductible Plan, you have the option to open a Health Savings Account (HSA). HSA funds can be used to pay for eligible medical, dental and vision expenses for you and your eligible dependents, including deductibles, coinsurance, prescriptions, acupuncture and more, tax-free, now and in the future. Family members do not need to be covered under your plan in order to use the HSA funds.

With the HSA, you are in charge. You decide:

• How much you’ll contribute;
• When to pay for eligible expenses with HSA funds directly (you can also reimburse yourself from the account);
• How and if you want to invest your HSA funds (a balance of at least $3,000 is required to invest); and
• Whether to save HSA funds for future expenses or retirement.

Learn More:

• Overview
• Designating a Beneficiary
• Investment Options

Flexible Spending Accounts (FSAs) allow you to set aside pre-tax payroll deductions to pay for various out-of-pocket expenses.

The annual allowed maximum set by the IRS is $3,050 for 2023. You can contribute up to $3,050 for qualified medical, dental and vision expenses (deductibles, copays and coinsurance, for example) with pre-tax dollars, which will reduce the amount of your taxable income and increase your take-home pay. You can even pay for eligible expenses with an FSA debit card at the same time you receive them, so you don’t have to wait for reimbursement.

Please note: Over-the-counter (OTC) drugs are not eligible for reimbursement through an FSA without a doctor’s prescription.

Dependent Care Flexible Spending Account

The Dependent Care FSA allows you to set aside pre-tax funds to help pay for expenses associated with caring for elder or child dependents. Unlike the Healthcare FSA, reimbursement from your Dependent Care FSA is limited to the total amount that is deposited in your account at that time.

• With the Dependent Care FSA, you are allowed to set aside up to $5,000 per household per calendar year. ($2,500 per year if you are married and filing taxes separately)
• Eligible dependents include children under 13, a spouse, or other individuals who are physically or mentally incapable of self-care and has the same principal place of residence as the employee for more than half the year.
• Expenses are reimbursable if the provider is not your dependent.
• In order to be reimbursed, you must provide the tax identification number or Social Security number of the party providing care.

Short-Term Disability - New Carrier!
Administered by Allstate

Employee Paid
STD insurance replaces up to 60% of your income and is intended to help replace lost income if you are unable to work due to a covered accident or sickness.

You choose the monthly maximum benefit level that meets your needs (subject to plan maximums)
Benefits start on the 8th day for an accident or sickness
Premiums lock in at the age when you enroll
The plan is portable so you can take it with you if you no longer work for the company

Certain exclusions, along with a pre-existing condition limitation apply.

Long-Term Disability
Administered by The Hartford

Employer Paid
LTD insurance replaces 60% of your income if you become partially or totally disabled for an extended period of time. Certain exclusions, along with any preexisting condition limitations, may apply. Please refer to your plan documents for details or contact Human Resources for specific benefits.

Administered by The Hartford

Our Life/AD&D plan is a 100% employer-paid benefit that provides your family with financial protection in the event of your death or the death of a covered dependent (as long as you are enrolled in medical). The Accidental Death & Dismemberment (AD&D) plan protects you and your family in the event of your death or injury due to a covered accident in addition to the benefit provided by your Life coverage

Your Basic Life and AD&D insurance benefit is two times your annual base salary to a maximum of $1,000,000.

Administered by Allstate

Employees are eligible for the Universal life insurance by Allstate, which offers you a permanent life insurance option with guaranteed premiums based on your current age. In addition to Universal life insurance, this plan also includes a long term care (LTC) benefit which you can use in times of need.

• Employee: Maximum guarantee issue face amount of $150,000. Simplified issue for employees over age 65
• Spouse: Working spouse guarantee issue maximum $75,000. Non-working spouse up to $10,000*
• Child(ren): Guarantee issue of $20,000 (up to age 18). Simplified issue for children between the ages of 19 and 24

Portable—you own this policy; you can keep the policy if you leave or retire and you will pay the same premium
Level premiums—premiums are level for life and are locked in at your current age; the death benefit is level as well and remains the same throughout your lifetime
Cash value—this policy accumulates cash value; you can borrow funds from this value as needed
Tax-free benefit—premiums for this policy will be deducted on a post-tax basis which means any benefits you receive will not be taxed

Guaranteed issue—during this annual enrollment, coverage is offered to you without any medical questions; if you choose to enroll at a later date, you will be asked medical questions and may be denied coverage

Eligible employees may purchase Voluntary Life and AD&D insurance for themselves and their families. To purchase Life or AD&D coverage for your spouse or child, you must first purchase Life or AD&D coverage for yourself.

Additional AD&D insurance is also available for purchase with the same Life plan limits. You may purchase AD&D regardless of whether you purchase Life coverage. Premiums are paid through post-tax payroll deductions.

Administered by Allstate

Accidents happen. You can’t always prevent them, but you can take steps to reduce the financial impact. Accident coverage, available through Allstate, provides benefits for you and your covered family members if you have expenses related to an accident that occurs outside of work.

Health insurance helps with medical expenses, but this coverage is an additional layer of protection that can help you pay deductibles, copays, and even typical day-to-day expenses such as a mortgage or car payment. Benefits under this plan are payable to you to use as you wish.

Administered by Allstate

Critical Illness coverage through Allstate pays a lump-sum benefit if you are diagnosed with a covered disease or condition. You can
use this money however you like; for example: to help pay for expenses not covered by your medical plan, lost wages, child care,
travel, home health care costs or any of your regular household expenses.

Plan Highlights

• Guaranteed Issue Coverage (no medical questions)
• Children are covered at NO COST when you elect employee coverage
• Benefits are payable based on the date of the covered event occurring or the date of diagnosis. Illnesses or occurrences prior to the effective date of coverage will not be payable events
• $75 annual Wellness Benefit is payable for each covered member for completing certain wellness screenings such as a pap test, cholesterol test, mammogram, colonoscopy or stress test (once per year per covered person)

Administered by Allstate

Hospital Indemnity coverage through Allstate pays cash benefits directly to you if you have a covered stay in a hospital or intensive care unit. You can use the benefits from this policy to help pay for your medical expenses such as deductibles and copays, travel cost, food and lodging, or everyday expenses such as groceries and utilities.

• Benefits are payable for pregnancy after you have had the policy for 10 months
• Pre-existing condition limitations apply. Refer to plan document for details
• Coverage is guaranteed issue; no medical questions

Administered by Farmers Insurance

PF Holdings provides you access to discounted Auto and Homeowners insurance through Farmers Insurance. Your coverage will belong to you and stay with you, even if you leave the company, so you can always take advantage of low rates. Homeowners insurance includes coverage for your house, condo or rental property. Residency restrictions may apply.

Auto insurance includes coverage for your automobile, boat, motor home or recreational vehicle. You may start or stop your coverage at any time during the year. Call Farmers Insurance at 800-438-6381 to sign up today

Administered by Fidelity Investments

It’s never too early — or too late — to start planning for your retirement. Making contributions to a 401(k) account is the first step toward achieving financial security later in life. The PF Holdings 401(k) plan provides you with the tools and flexibility you need to retire comfortably and securely.

Administered by LifeLock

LifeLock™ with Norton™ Benefit Plans help protect your digital life by combining leading identity theft protection, device security, and more in an always-connected world. These plans are enhanced and exclusive with features and pricing only available through your employer.

Administered by MetLife 

As a PF Holdings employee, you may sign up for a discounted MetLife Legal plan. Telephone and in‑person legal consultations are available. Your coverage is portable, so you can continue to take advantage of low rates even if you leave PF Holdings.

Covered services include:

• Credit card debt or debt collection defense
• Traffic tickets
• Purchase of a home or condo
• Landlord negotiations and lease review
• Adoption
• Will and trust preparation
• Power of attorney
• Medicare/Medicaid questions
• Tax audits
• Refinancing
• Estate planning

For more information, visit info.legalplans.com and enter access code GetLaw or call 800-821-6400.
Coverage is available for $8.31 per paycheck (bi-weekly) and covers yourself as well as your dependents.

Employees and their families often face challenging daily demands, including issues at work, with family, finances and more. We will continue to offer an Employee Assistance Program (EAP) for you, your spouse, and your eligible dependents. With the EAP, you are provided with free, confidential counseling by experienced licensed counselors.

There is nothing to sign up for. All services FREE and confidential.

With the Travel Assistance Program, toll‑free emergency assistance is available to you and any dependent(s) 24 hours a day, seven days a week, when traveling 100 or more miles from your primary home for 90 days or less.

• Hospital admission guarantee
• Emergency medical evacuation
• Medically supervised return travel when medically authorized
• Transportation for a friend/relative if you expect to be hospitalized more than seven days
• Prescription replacement insurance
• Medical consultation and evaluation
• Medical referrals to Western-trained, English-speaking medical providers
• Care and transport of unattended minor children

For more information, call Europ Assistance USA at 800-243- 6108 and use ID Number GLD-09012.

PF Holdings knows that pets are valued members of the family. This insurance covers everything from preventive care to accidents or illness, including costs of x‑rays, office visits, medications, surgeries and hospital stays. You have the option of choosing your own vet or using a licensed in‑network vet. Cost depends on your pet’s age, species and coverage level selected.

For more information or to enroll, call MetLife at 800-438-6388 or visit www.metlife.com/PFH/.

• 2023 Required Notices
• Premium Assistance Under Medicaid and the Children’s Health Insurance Program (CHIP)

Click here to view the carrier contact sheet.