TO: All Benefits-Eligible Employees
FROM: Meghan Bultema, Benefits Administrator
DATE: November 18, 2011
SUBJECT: IMPORTANT: Annual Benefits Open Enrollment November 18, 2011 – December 9, 2011
The annual benefits open enrollment period is the one occasion each year when employees have the opportunity to make voluntary change to their enrollment elections for their health, dental and vision insurances as well as to their election to participate in the medical and/or dependent care Flexible Spending Accounts (FSA). All benefit election changes are effective January 1, 2012. Please read the letter below highlighting some important information regarding this year’s open enrollment.
All employees must complete the Benefits Election Form to confirm coverage choices for 2012 even if you are not making any changes.
Martin Transportation Systems, Inc. offers one type of Major Medical through Blue Cross Blue Shield. It is a 80/20 plan with deductable. Below are plan summaries of the medical and prescription drug plan. You may also visit www.bcbsm.com for more information.
3. BCBS Benefit Chart – Medical
4. BCBS Benefit Chart – Prescription
5. Triple-Tier Plan Member Guide
6. Custom Formulary Quick Guide
If you would like to elect medical coverage you will need to complete the following form.
7. BCBS Subscriber New Enrollment Form
If you would like to add/drop dependents from your medical coverage you will need to complete the following form.
Martin Transportation Systems, Inc. offers two types of dental plans though Humana Dental and one vision plan through EyeMed Vision Care. Below are plan summaries of the plans offered. You may also visit www.humanadental.com for more information.
10. Traditional Preferred Dental
If you would like to elect, add or drop coverage/dependents from your dental or vision you will need to complete the following form.
12. Humana Employee Enrollment Form – Dental, Vision
Martin Transportation Systems, Inc. also offers voluntary life insurance through Humana. Employees can add/increase voluntary life at any time but Humana requires a completed “Evidence of Insurability” form with the enrollment form to be completed and it needs to be approved through Humana’s underwriting for the coverage amount requested. Please contact me for proper forms.
After 1 year of employment employees may participate in Martin Transportation Systems, Inc. Flexible Spending Account (FSA). FSA is a pretax benefit allowable under Internal Revenue Code (IRC) Section 125. The plan allows eligible employees to set aside a specific pretax dollar amount for unreimbursed medical, dental, vision, orthodontia, and dependent care expenses. If you have predictable out-of-pocket expenses, you may want to consider opening an FSA. Below is FSA employee enrollment information and an enrollment form. You may also visit www.benefits.paychex.com for more information.
13. FSA Employee Enrollment Information
After 6 months of employment employees may participate in Martin Transportation Systems, Inc. 401(k) Plan through American Funds. Employees are 100% vested upon entry and you will receive a 25% match of your contribution up to 15% of your gross pay. Below are the retirement plan enrollment form and beneficiary designation form. You may also visit www.retirement.americanfunds.com for more information.
15. American Funds Retirement Plan Enrollment Form
16. American Funds Beneficiary Designation Form
Below are a few mandatory notices Martin Transportation Systems, Inc. must make accessible to employees.
17. Women’s Health Cancer Rights/Privacy Notice
18. Creditable Coverage Disclosure
20. Summary Annual Report for 401(k) Plan
21. Qualified Default Investment Alternative Notice
Open enrollment for the 2012 benefit programs will take place between now and December 9, 2011. Any changes you make will become effective January 1, 2012.
If you have any questions please email me at meghan.bultema@mtstrans.com or call me at (616) 455-8850 ext. 115.
Return all completed forms no later than December 9, 2011 via fax (616) 281-7553, give to your terminal manager or mail to:
Martin Transportation Systems, Inc.
Attn: Meghan Bultema – Benefits
7300 Clyde Park Ave. SW
Byron Center, MI 49315
