Nemours offers a Basic Term Life and Accidental Death & Dismemberment (AD&D) benefit of one times your base annual salary to a maximum of $500,000. Term Life insurance does not accrue a cash value and terminates when you leave employment. This benefit reduces by 50% at age 70. This benefit is Nemours-paid for all full-time and part-time benefits-eligible associates. Note that the IRS requires Nemours to tax you on the value of this benefit that exceeds $50,000.

Associates may elect Voluntary Term Life insurance through Reliance Standard. Contributions are taken on a post-tax basis. Voluntary Term Life Insurance is portable but not permanent. Term Life insurance does not accrue a cash value and the benefit reduces by 50% at age 70.

Associates may purchase Voluntary Term Life insurance in increments of $10,000 up to the lesser of $1,000,000 or five times your base annual salary. Guaranteed Issue coverage is available for newly eligible associates up to $500,000. Amounts over the Guaranteed Issue for newly eligible associates are subject to Evidence of Insurability (E of I). All elections for late enrollees are subject to E of I. During Annual Enrollment, associates currently enrolled in the plan may increase their election by one level ($10,000) without E of I, up to the Guaranteed Issue amount of $500,000. Any additional amounts elected over the Guaranteed Issue level will be subject to E of I.

Associates may purchase Term Life insurance for their spouse in increments of $10,000 to a maximum of $380,000. Coverage amounts for spouses are limited to 100% of the associate coverage amount. Guaranteed Issue coverage is available for newly eligible spouses in the amount of $100,000. Any late enrollments, any increases over $10,000 (allowed at Annual Enrollment) or amounts over $100,000 will be subject to E of I. All elections are subject to E of I for late enrollees.

Associates may purchase Term Life insurance for their child(ren) in units of $2,500 to a maximum of $10,000. All amounts are Guaranteed Issue for newly eligible children. Premiums for child life are per unit, which means that the payroll deductions will remain the same regardless of the number of children covered by the plan. Dependent Children may be covered until the end of the month during which they turn 26, but must be unmarried and financially dependent on the associate for support.

Associates may elect Voluntary Term AD&D insurance through Reliance Standard. Contributions are on a post-tax basis.

Associates may purchase additional AD&D for themselves, in increments of $10,000, up to the lesser of $500,000, or 10 times earnings for elections over $150,000 (i.e., if you earn $10,000 a year, you may still elect $150,000). This benefit reduces by 50% at age 75 and then to 25% of the original amount at age 80.

Coverage may also be purchased on a family basis, which covers you, your spouse and/or your dependent children as follows:

• A spouse with no dependent children is insured for 100% of the associate’s AD&D benefit. A spouse with dependent child(ren) is covered for 60% of the associate’s AD&D benefit, while each dependent child is covered individually at 10% of the associate’s AD&D benefit.
• If there is no spouse, each dependent child is insured for 15% of the associate’s AD&D benefit.

Nemours offers Long-Term Care (LTC) coverage through the convenience of post-tax payroll deductions for both associates and their spouses. Direct billed coverage is also available to the parents and grandparents of associates and their spouses. Coverage for LTC insurance is fully portable.

LTC coverage provides an allowance for custodial assistance to individuals who are unable to perform two of six Activities of Daily Living (ADL) due to a disability. ADLs include bathing, dressing, eating, toileting (grooming), continence (using the bathroom without help) and transferring (moving from the bed to a chair, or vice versa). LTC is also payable if the subscriber has a cognitive impairment.

Custodial assistance may be provided by any of the following: a skilled nursing facility, a home health care agency (called professional home care), an assisted living facility, or a member of the community (total home care, including your family members).

Newly eligible associates may elect LTC coverage without providing Evidence of Insurability (E of I) within 30 days of their eligibility effective date. All elections for late enrollees are subject to E of I determination; all elections made by eligible dependents are also subject to E of I.

*LTC pays a percent of the total Monthly Facility Benefit Amount, based on where services are received. For example, if a Facility Monthly Benefit Amount of $1,000 was elected, and services were received at a Skilled Nursing Facility, the benefit amount received would be 100% of $1,000; equaling $1,000 of benefit per month. However, if a Facility Benefit Monthly Benefit Amount of $1,000 was elected, and services were rendered at an Assisted Living Facility, the benefit amount received would be 60% of $1,000; equaling $600 of benefit per month.

**The Lifetime Maximum does not change based on where you receive services. If the Facility Benefit Amount elected is $1,000 for a 3-year Benefit Duration, the Lifetime Maximum is $36,000. For example, if the subscriber is confined to a Nursing Home, he/she would receive the benefit for a duration of three years; assuming the same election, but if services are received at Home, the benefit would be pro-rated accordingly, and $500 would be the benefit received for a maximum duration of six years.

Full and part-time associates are automatically covered by our STD plan that offers income protection for disabilities caused by illness, accident or injury that are not work-related. Coverage is 60% of the associate’s base weekly pay with no maximum weekly benefit amount. The benefit period is a maximum of 13 weeks, inclusive of a 7-day elimination period. Premiums are paid 100% by Nemours. Evidence of Insurability is not required and there are no pre-existing condition limitations. Please note that if you work in a state that has a state-provided disability benefit (for example, New Jersey), our benefit payments will be reduced by any disability benefits received from the state.

Nemours offers LTD insurance to associates through NY Life. Contributions are taken on a post-tax basis.

LTD insurance offers income protection for disabilities caused by illness, accident or injury. All benefits are subject to carrier approval. There are two plans offered to all. Note that Plan 3 is available only to associates earning more than $70,000 annually.

All LTD plans include a pre-existing condition limitation. Newly elected plans or plan changes will be subject to a pre-existing condition limitation.

Voluntary Accident

Nemours offers Aetna Accident Insurance through convenient post-tax payroll deductions for associates, spouses and dependents. Accident Insurance provides you and your eligible family members with payment for a covered accident. It also pays if you undergo testing, receive medical services, treatment or care for any one of more than 150 covered events as defined in your group certificate. This includes hospitalization resulting from an accident and accidental death or dismemberment.

There are two options – high and low – that vary in the amount of payment for each covered accident. Payments are made directly to you to use as you see fit. They can be used to help pay for medical plan deductibles and co-pays, out-of-network treatments, your family’s everyday living expenses, or whatever else you need while recuperating from an accident.

Your accident coverage is guaranteed, regardless of your health. You just need to be actively at work for your coverage to be effective. There are no medical exams to take and no health questions to answer.

Voluntary Critical Illness

Nemours offers Aetna Critical Illness Insurance through convenient post-tax payroll deductions for associates, spouses and dependents. Critical Illness coverage provides you with a lump sum payment if you or your covered family members are diagnosed with a serious medical condition. Critical Illness Insurance covers over 20 illnesses or conditions including cancer, heart attack, stroke, coronary artery bypass, kidney failure, major organ transplant and Alzheimer’s disease.

This insurance pays cash benefits directly to associates and their family members diagnosed with any of the covered conditions and in addition to any benefits paid through the health plan. It is designed to help offset the deductibles, co-pays and indirect costs associated with a serious illness.

You have a choice of three benefit levels – a payment of $10,000, $15,000 or $30,000 upon initial diagnosis. Your spouse is covered for 100% of the associate amount and children are covered for 50% of the associate amount. Included in the coverage is an annual $50 health screening benefit for each covered family member.

Coverage is guaranteed (no health questions asked) and there is no pre-existing condition limitation; however, you must be actively at work for your coverage to be effective. Premiums are based on the associate’s age and tobacco use.

Voluntary Hospital Indemnity

Nemours offers Aetna Hospital Indemnity Insurance through convenient post-tax payroll deductions for associates, spouses and dependents. Hospital Indemnity Insurance provides you and your eligible family members with payments when you are admitted or confined to a hospital due to an accident or illness. Typically, a flat amount is paid for admission and a daily amount is paid for each day of a hospital stay. It also pays extra benefits for admission to or confinement in an intensive care unit (ICU), and for other benefits and services. This coverage also includes a lump-sum benefit after the birth of your newborn. This will not pay for an outpatient birth.

There are two options – high and low. Payments are made directly to you to use as you see fit and independent of any benefits paid through the health plan. They can be used to help pay for medical plan deductibles and co-pays, for out-of-network stays, for your family’s everyday living expenses, or for whatever else you need while recuperating from an illness or accident.

Your Hospital Indemnity coverage is guaranteed. You just need to be actively at work for your coverage to be effective. There are no medical exams to take and no health questions to answer.

Nemours Retirement Plans has partnered with Transamerica Retirement Solutions as its record keeper. There is a 403(b) plan for Nemours associates and a 401(k) plan for associates of Children’s Health Alliance, LLC (CHA). Both have access to a 457(b) program based on salary requirements.

Full-time, part-time, casual, temporary, and seasonal associates of Nemours are automatically enrolled in the 403(b) plan with a 4% contribution rate. These tax-deferred contributions will begin as soon as administratively possible following 30 days of employment. Associates may opt out of the automatic enrollment or change their contribution rate at any time by contacting Transamerica Retirement Solutions.

The 401(k) plan for associates of CHA does not have an automatic enrollment feature. For more detailed information about these plans, including eligibility, contributions, investment options and plan limits, contact Transamerica Retirement Solutions at 800.755.5801 or visit Transamerica.com/portal.

Whether you are automatically enrolled in the 403(b) plan or you actively enroll in the 401(k) or 457(b) plans, please make sure you designate a beneficiary for your account. Taking this step in your estate planning will help give you peace of mind and improve your overall financial wellness.

Retirement Readiness Associate Toolkit

Nemours wants to help you be as prepared as possible as you navigate the path toward a successful retirement. The Nemours Benefits team has put together the Retirement Readiness Associate Toolkit that contains helpful information about the process of preparing for retirement, as well as checklists, contact lists, resources and frequently asked questions. This toolkit is a first step for you to review as you contemplate retirement.

Aetna Medicare Transition Services

Aetna offers an easier way to make sense of Medicare. Talk to a licensed insurance agent to help guide you through the decision-making process. Whether you are continuing to work beyond age 65 or if you are retiring, this is a free resource. Enrollment in one of the Nemours medical plans administered by Aetna is not required to use this service. Get help now at medicaretransitionservices.com.

Flexible Spending Accounts (FSAs)

FSAs are available to associates through convenient payroll deductions on a pre-tax basis to help cover the cost of eligible expenses (as defined by the IRS). There are several FSAs available. These accounts have been established to cover different needs, as follows:

• Health Care Spending Account: Covers expenses not covered or partially covered by health, dental, prescription drug and vision programs such as co-pays and deductibles for you and your eligible dependents.
• Limited Purpose Spending Account: This is a special health care spending account available only if you enroll in the High Deductible Health Plan (our Green Plan). It follows the same rules as the Health Care FSA but is only for dental and vision expenses.
• Dependent Care Spending Account: Covers expenses for day care or similar care to eligible dependents as defined by the IRS.
• Mass Transit Spending Account: Covers expenses for public transportation related to the commute to and from work.
• Parking Spending Account: Covers expenses for public parking related to the commute to and from work.

Associates may elect to participate in one or more of these accounts in any combination. Health Care, Limited Purpose and Dependent Care Spending Account elections are based on an ANNUAL election amount; you will need to calculate how much you want to set aside for the plan year of Jan. 1 – Dec. 31 in a lump sum. Mass Transit and Parking Spending Account elections are based on a MONTHLY election amount. This monthly election will remain in place throughout the plan year unless you change it.

Deductions will be taken semi-monthly on a pre-tax basis. Only those associates who elect these accounts will be enrolled. After you’ve enrolled, as you incur eligible expenses (as defined by the IRS) throughout the plan year, you pay yourself back with the pre-tax money in your FSA account.

If you terminate employment, or if you become ineligible for the plan, please refer to the Termination of Benefit Summary chart available online for information about how long you may incur additional claims and deadlines for submitting those claims for reimbursement. These time periods vary by account.

Tax Effect
Contributions to FSAs reduce the amount of taxable income. This results in savings of FICM, FICA, federal and state income taxes.

Health Care Flexible Spending Account

Health Care Flexible Spending Accounts (FSAs) help pay for expenses that are either partially covered or not covered by Medical/Prescription Drug, Dental or Vision insurance. You may contribute up to $3,050 in 2023 in the account. You may participate in this account even if you have not enrolled in a Medical/Rx Plan.

For extensive details on qualified expenses, log into the FSA/Commuter Portal by clicking the link for “FSA/Commuter Balance Inquiry” found on the Home Page of NemoursBenefits.com. Once you have been transferred to the FSA Portal, select the link for “Health Care Expenses Table” found at the bottom of the screen. In general, you may use a Health Care FSA to pay most health care expenses that qualify as a medical deduction for federal income tax purposes (as described in the IRS Publication 502) for yourself or your tax dependents. Health care expenses reimbursed through the FSA account cannot be claimed as deductions for federal income tax purposes.

Additional Claim Information
If you submit a claim for an amount higher than what you have contributed year-to-date to your FSA, you will be reimbursed up to the amount of your plan year election. Reimbursement consideration is based on when the service is rendered or a purchase is made, not when payment is submitted.

• You may use your debit card at an authorized vendor to avoid out-of-pocket costs for eligible expenses. (See FSA Debit Card section for more information on this option.) Alternatively, you may submit a paper claim via fax or email. We recommend scanning and e-mailing your claim form to your FSA vendor so that you have a record of the transmission.
• You may be required to provide an itemized receipt for your transaction. The IRS defines a valid receipt as a receipt that includes the vendor’s name, a description of the purchase, the amount of the purchase and the purchase date.

Worksheet to Calculate Health Care Contributions
Use the worksheet below to list the out-of-pocket expenses you expect to incur during the plan year (beginning with the coverage effective date). This worksheet will assist you in estimating the total amount to deposit into the Health Care FSA.

 

Dependent Care Flexible Spending Account (FSA)
Dependent Care FSAs allow you to set aside pre-tax dollars to provide care for your eligible dependents, so you (and your spouse) can work. This is for daycare expenses, not health care expenses for dependents.

Eligible dependents include anyone under age 13, your disabled spouse or other disabled person (including a parent or child), whom you can claim as a dependent for federal income tax purposes.

Costs for “activities” while a dependent is in a daycare are not eligible for reimbursement through the Dependent Care FSA. Examples of costs not eligible are: art, dance, piano and singing lessons. Only the cost for the actual daycare is eligible for reimbursement.

You may contribute up to $5,000 ($2,500 if you are married filing separately) per plan year into a Dependent Care FSA. You may be reimbursed for the cost of care given inside or outside your home by a professional caregiver. Participants must provide the provider’s EIN or Social Security number for reimbursement. Please note that the provider must report the monies paid as income and pay taxes on that income.

To enroll in a Dependent Care Account you must meet at least one of the following qualifications:

• You are a single parent who works full-time
• You and your spouse both work, and your spouse’s annual income is greater than the amount you are claiming for dependent care
• Your spouse is enrolled full-time at a college or university for at least five months of the year
• Your spouse is medically disabled and cannot care for himself/herself/themself or your dependents

Note: If your spouse is a full-time student at least five months a year, or disabled, federal law limits the maximum pre-tax amount you may contribute. Contributions from highly compensated individuals may also be limited or amended as a result of federally required non-discrimination testing.

Worksheet to Calculate Dependent Care Contributions
Use the worksheet below to list the out-of-pocket expenses you expect to incur during the plan year (beginning with the coverage effective date). This worksheet will assist you in estimating the total amount to deposit into the Dependent Care Flexible Spending Account.

 

Transportation Accounts
Transportation FSAs allow you to set aside pre-tax dollars to cover mass transit or parking expenses related to your commute to and from work. There are two types of accounts, mass transit and parking. You may elect to participate in one or both of these accounts. The maximum monthly election is $300 for the mass transit account and $300 for the parking account.

Mass Transit Accounts
Mass Transit eligible expenses include a transit pass, token, farecard, voucher or similar item (tolls are not reimbursable) entitling a person to transportation to and from work on a mass transit system. Some examples of mass transit include:

• Trains
• Subways
• Trolleys
• Buses

Expenses related to a commuter highway vehicle may also be eligible, ONLY if all of the following requirements are met:

• Must have seating capacity of six or more adults (not including the driver)
• At least 80% of the mileage use can reasonably be expected to be for purposes of transportation of employees between work and residences
• The number of employees carried is at least one-half of the adult seating capacity of such vehicle (not including the driver)

Accessing your Mass Transit Account funds:
Per IRS regulations, the debit card is the only method to access your available mass transit funds.

Your debit card will be accepted only at merchants coded as a mass transit facility in the MasterCard transaction system such as a SEPTA or NJ Transit station. A convenience store that sells bus passes would NOT be recognized.

Parking Account
Eligible parking expenses include the cost of parking your car at a facility at or near your office location (e.g. parking garage or lot), or the cost of parking at a facility located at or near a location from which you commute to work (e.g. Metro parking lot, train station parking lot).

Accessing your Parking Account funds:
You may access your Parking account funds in two ways:

1. Use your Debit card at a parking facility.
2. Paper Claims: Complete a request for reimbursement form and attach a statement of services. For parking boxes, a log of expenses including the date, amount of the charge and the facility name will be acceptable. Important: The IRS requires that you file for reimbursement within six months of the date the expense was incurred.

FSA Debit Card

All associates who participate in any FSA benefits will receive one debit card — called a Prepaid Benefit card — to pay for qualified medical, dependent care, mass transit or parking expenses. The Prepaid Benefit card looks like a regular MasterCard, but is only accepted at specific types of merchants or provider locations.

Once you’ve enrolled, be on the lookout for your card.
Debit cards will be mailed to your home in a plain unmarked white envelope. “Do Not Throw Away” will be written on the front of the envelope. Please read the cardholder agreement that is included with the card. Additional or replacement cards may be requested through the member site at no extra cost. Contact PayFlex Reimbursement Services at 855.516.8593.

Activation is easy…
Your new Prepaid Benefit cards will arrive with a sticker on the front of the cards, and you must call the number listed to activate them. One phone call will activate both cards.

Where can I use the card?
You may use your debit card at the following locations:

• Any doctors’ or dentists’ office, or any hospital or clinic setting
• A pharmacy, grocery store or discount store with an approved IIAS system (Inventory Information Approval System)
• A daycare provider (for the Dependent Care Account)
• A merchant coded as a mass transit or parking facility

If you use your card at an unqualified merchant, the transaction will be declined. You can download a list of merchants that have an IIAS system installed by entering the following web address in your browser: http://apps.sig-is.org/SIGISPublicRpts/IIASMerchantList.aspx.

What debit card transactions must be substantiated?
Certain debit card transactions will require you to submit physical documentation of the expense. Examples of such expenses include:

• Any transaction that is processed at a merchant that does not have an IIAS system (including doctors’ and dentists’ offices) IF the amount is not a standard Nemours co-pay amount
• Any transaction other than a Nemours co-pay amount that is not recurring

How do I substantiate a debit card transaction?
If documentation is needed, you will be notified of the item(s) that require substantiation. Sufficient substantiation must include: date the expense was incurred, the amount of the expense, a description of the service provided or item purchased, the name of the recipient (you, your spouse or dependent) and the name of the facility or provider. Examples of sufficient documentation include a detailed pharmacy receipt or an insurance Explanation of Benefits statement.

What happens if I do not submit documentation for my debit card transaction?
If documentation is not submitted, IRS regulations require that card access for that participant be temporarily suspended until you provide the applicable receipts or repay the plan. You will be responsible for reimbursing the plan — by check or through payroll deductions — for any unsubstantiated amounts. If recovery is not possible, you will be taxed on the value of the unsubstantiated expenses.

How long can you use your card?
Your Prepaid Benefit debit cards will be valid for five years. You will automatically receive new cards by mail during the month in which your card expires.

Other FSA Information

Please remember you can access your FSA through the internet. You may view detailed information such as your account balance, claim status and payment information. This information will be available to you 24-hours-a-day, seven days a week. If you have any questions regarding your account, please call PayFlex FSA Customer Service at 855.516.8593.

To access your account, follow the simple steps below:

• Go to www.nemoursbenefits.com.
• Log on using your benefits Username and Password.
• Click on the “FSA / Commuter Balance Inquiry” link.

You will be automatically and securely transferred to the FSA / Commuter Portal. Here you can:

• Check your FSA, Transit or Parking plan balances
• Input or update your Direct Deposit information
• Check the approval and payment status of the claims you have submitted
• Submit new claims for reimbursement (NOTE: substantiation for debit card claims should not be uploaded through the FSA/Commuter Portal)

Income-Based Health Reimbursement Arrangement

This benefit is used to help eligible associates and their dependents to pay for co-pays, deductibles, coinsurance and prescriptions. Nemours will fund up to $1,000 for single and $2,000 for family coverages. Since this is funded by Nemours, associate contributions are not permitted and unused funds do not roll over year to year. This arrangement is available for associates who meet household income limits (see eligibility chart) and are enrolled in either the Red, Blue or White Plans. Associates enrolled in the Green Plan and SAVI are not eligible for this benefit.

Participation in this benefit is voluntary and requires completion of a one-page application along with your prior year tax return.

Nemours provides a financial education/planning benefit through Financial Finesse. This is a Nemours-paid benefit, provided at no cost to all benefits-eligible associates. You will be automatically enrolled in this program. Financial Finesse offers unbiased and expert financial education, delivered by on-staff certified financial planners. This program is designed to help you understand and take charge of your financial “health” and to put in place strategies that can help you achieve your financial goals. The program includes online education and tools as well as live workshops and webcasts designed to reduce your overall stress, increase your financial knowledge and, with that knowledge, help you make informed financial decisions.

As part of this program, Nemours associates have 24/7 access to Financial Finesse’s Online Financial Learning Center located at http://flc.im/nemours as well as unlimited access to phone-based financial guidance from a Certified Financial Planner through the Financial Helpline. The Helpline is open Monday through Friday, from 9 a.m. to 8 p.m. ET, and can be reached by calling 877.234.1782.