What's New
Things to Consider
Insurance Plans
Support Benefits
Contact
Thank you for your dedication to Haworth and bringing your best to work each day. We’re grateful for your contributions and commitments to delivering services, products, and solutions that help our customers achieve their goals. Your health, well-being, and future are important to us, and we recognize your benefits are important to you.
To help you make informed benefits decisions, the Benefits Enrollment Guide, a web-based experience, provides an overview of Haworth’s medical insurance offerings and other voluntary elections available to you. We’re also pleased to announce premium rates for most plans remain unchanged from 2021.
I encourage you to thoroughly review this Open Enrollment site before making your 2022 benefits selections and hope you’ll find it helpful in choosing the benefits package that fits your needs. Please be sure to complete your open enrollment by November 19, 2021. Thank you again for all the great work you do.
Ann Harten
VP of Global Human Resources
Beginning 2022 deductions for purchased vacation will be taken out after taxes, making this benefit a post-tax deduction. Additionally, on your paystub you will notice the hours coded as “Purchased Vac”. Finally, deduction and redemption value will be static, based on your rate of pay as of November 8, 2021. These changes are made to ensure Haworth remains in compliance with applicable rules and regulations.
Open Enrollment Dates
Are You New This Year?
Virtual Doctor Visits
Priority Health is partnering with national healthcare provider Cigna to offer nationwide coverage. Members getting care in Michigan will continue to use the Priority network. However, now if you travel or live outside Michigan you can access care through the Cigna network as in-network benefits. This is a great enhancement as it makes Blue Cross Blue Shield and Priority Health wonderful options for all our members regardless of where you live or receive care.
Things To Consider
The advantage with the CDHP/HSA (Consumer-driven Health Plan with a Health Savings Account) plan is that your bi-weekly premium is lower and you have access to a triple tax-free account (HSA)—tax-free when money is deposited, when it grows, and when withdrawn as long as it is used to cover qualified medical expenses. And, Haworth will contribute money into your HSA.
Where Do You Live?
CDHP/HSA
The advantage with the PPO (Preferred Provider Organization) plan is that you can predict what some of your medical costs will be. For example, there are defined copays for visits to your primary doctor or a specialist. The downside is that your bi-weekly premium is higher than with the CDHP/HSA.
PPO
Blue Cross Blue Shield and Priority Health
Members living outside Michigan have historically only had BCBS as a medical option. New for 2022 you have a choice—to stay with BCBS or choose Priority Health. If you choose Priority you will be able to access the Cigna network nationwide with in-network copays, deductibles, etc. Your Priority Health medical card will be co-branded with Cigna to aid providers in processing claims.
Blue Cross Blue Shield and Cigna (through the Priority Health partnership)
Members living in Michigan have the choice of BCBS or Priority for their medical coverage. These are the same great plans that we have offered in the past with one small expansion. Members choosing BCBS have always had the choice of getting medical care in or out of Michigan. New for 2022 that is a choice with Priority as well. Care in Michigan is provided by Priority. Care outside of Michigan will be provided through the Cigna network; Priority Health members can access the Cigna network outside of Michigan with in-network copays, deductibles, etc.
Benefits Guide
Medical Plans
Here is a breakdown of our benefits and break down of costs for Medical, Dental, Vision, and additional coverage. Haworth strives to make it as easy as we can for you and your loved ones. There can be other copy going into more depth here about our coverage.
The summary below is intended to provide you with a quick overview of the Haworth medical plan offerings for PPO/EPO. For a complete listing of covered services and out-of-network coverage, please review the Blue Cross Blue Shield (BCBS) and Priority Health “Benefits-at-a-Glance” posted on Hometown > Haworth Departments > Human Resources (US) > Benefits > Health Benefits Documents link.
HR Shared Services Enrollment Support
Phone: 616.393.1600
Email: hr.sharedservices@haworth.com
Hours: Mon-Friday 8-4:30 EST
Contact Information
Download PDF
Purchased Vacation Changing from Pre-tax to Post-tax Deduction
What's New This Year
Contact HR Shared Services
Do I Need To Enroll?
FAQs
Enroll Now
Enroll Now
All full-time U.S. new hire Members MUST complete a Benefit Election/Dependent Certification Form. Even if you’re electing not to enroll in any company-provided benefits, you MUST complete the form and actively opt out.
You still need to opt out of coverage. Haworth is required to make sure every eligible Member was offered coverage and made a selection—even if you choose to decline coverage.
The Affordable Care Act requires you to have insurance.
What If I Don't Want Insurance?
You must enroll within 30 days of your first day of employment at Haworth. This is your once-a-year opportunity to elect your benefit plans. The benefits you select will be effective your first day of employment through December 31, 2022.
When May I Enroll?
Each Member's needs are unique to specific circumstances—we cannot tell you which option(s) to select. We can offer guidance, however, the final plan selection must be made by you. Feel free to call us at 616.393.1600 if you need assistance.
How Do I Enroll?
Enroll using our self-service portal on Hometown Worldwide at: https://sapportal.haworth.com/irj/portal
Use your Haworth User ID and password. We’ll have a banner featured front and center to help you find it. You will be asked to review your information and select your coverage. It won’t take long if you’ve already decided what you want before you log on.
How Do I Know What's Best for Me?
Do you have other qualified coverage available to you through a spouse/domestic partner? You can opt out of Haworth’s medical and prescription drug coverage. The payroll credit for opt out is $25 per pay period. This equals $650 for the plan year!
How Do I Opt Out of Medical Insurance?
You’re eligible! If you work 30+ hours a week, you can get your medical, dental, and vision through Haworth at subsidized rates. Your spouse/domestic partner and children can be covered, too. See our chart below to get specifics on who can be covered and how.
Who is Eligible?
You may choose to cover your children up to age 26 on your medical plan or your spouse/domestic partner's plan. You may do the same for dental and vision benefits. You are not required to cover your children through one employer for all your benefits.
May I Cover My Children?
You’re making a lot of choices during Enrollment.
They are:
• Medical Coverage
• Dental Coverage
• Vision Coverage
• Life, Disability, Accident, Legal and Illness
• Account Contribution Information
What Am I Choosing?
After enrolling, you are permitted to make only limited changes per IRS regulations. You cannot change your plan mid-year based on a medical diagnosis or family budget changes. To find out what you CAN change and how, contact HR Shared Services.
What if My Needs Change?
Medical
Dental
Vision
Voluntary Life Insurance and AD&D Coverage
Tobacco Usage Surcharge
You have access to dental coverage through Delta Dental. You can enroll in dental coverage for yourself and your eligible dependents, even if you are not enrolled in medical coverage through Haworth. The Delta Dental Plan provides you with a range of covered services and preventive care is covered by your insurance at 100%.
This dental summary is intended to provide you with a quick overview of the Haworth dental plan offerings. For a complete listing of covered services and out-of-network coverage, please review the Delta Dental “Benefits at a Glance” posted on Hometown > Haworth Departments > Human Resources (US) > Benefits.
Dental Plans
The Haworth vision plan helps you pay for routine eye exams, eyeglasses, contact lenses, and related supplies. Our plan is offered by VSP, a nationwide network that provides a convenient and easy-to-use benefit. When you visit a VSP provider, you receive discounted services, and the plan pays a percentage of the costs. You can enroll for vision coverage without participating in medical coverage through Haworth.
This vision summary is intended to provide you with a quick overview of the Haworth vision plan offering. For a complete listing of covered services and
out-of-network coverage, please review the VSP Benefits Summary posted on Hometown > Haworth Departments > Human Resources (US) > Benefits.
Vision Plans
Haworth provides Life Insurance and Accidental Death and Dismemberment (AD&D) coverage for all full-time Members at no additional cost, equal to 1x their annual salary. All eligible full-time Members may choose to purchase additional amounts from the following options.Voluntary Life InsuranceIf you are enrolling in this plan for the first time, you must complete and provide an Evidence of Insurability (EOI) form to Haworth’s insurance carrier, UNUM.If you are currently enrolled in the plan, you may increase one level without submitting the EOI form. If you wish to increase by more than one level, or over $50,000 for spousal life, you must complete the EOI form. For a complete explanation of the Voluntary Life and AD&D coverage, please consult the Life and AD&D Plan Documents posted on Hometown > Haworth Departments > Human Resources (US) > Benefits.
Voluntary Life Insurance and AD&D Coverage
Which Plan is Right for Me?
The following section highlights the medical, dental and vision plans and costs, as well as additional coverage offered by Haworth. If you are participating in Open Enrollment and do not log in to make elections, you will be re-enrolled in the same coverage you elected for 2021, but will automatically waive Vacation Buy and other Benefit Accounts. If you are a new hire and do not make a benefit election by enrolling or waiving coverage within 30 days of your hire date, you will automatically be enrolled in the Consumer Driven Health Plan at the Member Only level.
Please use the left and right arrows to navigate through the different plans and cost tables. Use the menu below to jump to specific coverages. Select "Download All" to download a printable pdf of all coverage tables.
Insurance Plans
What's New This Year
Open Enrollment Dates for 2022 Elections
Are You New This Year?
Virtual Doctor Visits
Getting sick is never convenient. Pink eye, allergies, bee stings, cold, flu, back pain, and more can happen anytime, anywhere—most often making a visit to your doctor’s office impossible.
To accommodate these scenarios—from non-life-threatening illnesses to addressing coronavirus concerns—health care providers Priority Health and Blue Cross Blue Shield of Michigan offer telehealth or telemedicine apps enabling you to see a board-certified doctor through a virtual visit—anytime, anywhere. And, the information from your virtual visit will be sent to your primary doctor and a prescription, if you need one, will be sent to your preferred pharmacy.
Nov 8
Open Enrollment Begins
Remember to print or screen shot your benefits confirmation statement when finished.
Nov 19
Open Enrollment Ends
The system closes at 5:00 pm EST
Dec 1
Did you increase your life insrance?
If so, complete an Evidence of Insurability form and submit it directly to the insurance carrier.
Jan 1
New Benefits
Elections Effective
Virtual Doctor Visits
Open Enrollment Dates
What's New This Year
Are You New This Year?
Virtual Doctor Visits
Dates for Open Enrollment
What's New This Year
Are You New This Year?
You will be subject to a tobacco surcharge if you and/or your spouse/domestic partner has been a regular user of tobacco within the last six months. Regular use includes any use of cigarettes, e-cigarettes, cigars, pipes, or chewing tobacco—whether it is daily, weekly, or monthly. Your status as a tobacco user will only be used in conjunction with determining your medical plan premiums. You must declare and certify your status and that of your spouse/domestic partner as tobacco users or non-tobacco users. It is your responsibility to respond truthfully.
Coverage
Member Only
Member +1
Family
Tobacco Usage Surcharge
Which Plan is Right for Me?
Tobacco Usage Surcharge
Which Plan is Right for Me?
Deductibles
Member Only
Member +1
Family
$1,500
$3,000
$3,000
$1,500
$3,000
$3,000
CDHP/HSA
Deductible
Member Only
Member +1
Family
Out-of-Pocket Maximum
Member Only
Member +1
Family
$700
$1,400
$2,100
$2,500
$5,000
$7,500
$700
$1,400
$2,100
$2,500
$5,000
$7,500
PPO
CDHP/HSA
In-Network Services Only
PPO 2022 Prescription Drug Copays
Generic
Brand Name Preferred
Brand Name Non-Preferred
$10
$20/$45
$40/$75
$10
$20/$45
$40/$75
Member Only
Member +1
Family
$100
$200
$300
PPO 2022 Prescription Drug Deductibles
Member Only
Member +1
Family
$40.20
$103.97
$146.45
$36.13
$90.59
$133.71
PPO 2022 Rates: Bi-Weekly Per-Pay-Period Premium
$100
$200
$300
Generic
Brand Name Preferred
Brand Name Non-Preferred
$10 after deductible is met
$20/$45 after deductible is met
$40/$75 after deductible is met
$10 after deductible is met
$20/$45 after deductible is met
$40/$75 after deductible is met
PPO/EPO 2020 Prescription Drug Copays
Member Only
Member +1
Family
$21.47
$47.60
$66.64
$20.85
$46.24
$64.73
CDHP 2022 Rates: Bi-Weekly Per-Pay-Period Premium
CDHP Prescription Drug Copays
Member Only
Member +1
Family
Up to $500
Up to $1,250
Up to $1,250
HSA 2022 Contribution from Haworth
PPO
Up to $500
Up to $1,250
Up to $1,250
Deductible*
Member Only
Member +1
Family
Coinsurance**
$1,500
$3,000
$3,000
80%
$700
$1,400
$2,100
80%
PPO
CDHP/HSA
Plan Feature
What You Pay
Where Do You Live?
Where Do You Live?
Where Do You Live?
Things To Consider
Which Plan is Right for Me?
Things To Consider
Tobacco Usage Surcharge
Deductibles
Basic
Premium
Maximum Annual Benefit per Person (excluding Preventive Services)
$1,000
$800
Orthodontia Lifetime Maximum
(up to age 19)
$1,500
No Orthodontia Coverage
Class 1 Services
This class includes: Diagnostic & Preventive Treatment; X-rays; Sealants; Emergency Palliative Treatment
100%
100%
Class 2 Services
This class includes: Endodontic & Periodontic Services; Extractions; Minor Restorative Services
80%
50%
Class 3 Services
This class includes: Prosthodontic Services; Major Restorative Services; all Other Surgery
Class 4 Services
Orthodontia (up to age 19)
No Orthodontia Coverage
Basic
Premium
60%
50%
50%
Member Only
Member +1
Family
$1.76
$2.76
$3.82
Dental Premium
Focuses on your eyes and overall vision wellness
Well Vision Exam
$20
Prescription Glasses
$20
See frames and lenses
Every calendar year
Basic
Premium
Benefit
Plan Features
Copay
Frequency
Contacts
(instead of glasses)
$120 allowance for contacts
Contact lens exam (fitting & evaluation)
Up to $60
Every calendar year
Diabetic Eyecare Plus Program
Services related to diabetic eye disease, glaucoma, and age-related macular degeneration (AMD)
Retinal screening for eligible Members with diabetes
Limitations and coordination with medical coverage may apply
$20
As needed
Out-of-Pocket Maximum
Member Only
Member +1
Family
Rx Deductible
Member Only
Member +1
Family
Premium Savings
Haworth contribution to the HSA
Included in medical deductible
Included in medical deductible
Included in medical deductible
$2,075
Up to $500 Member
Up to $1,250 Member +1 and Family
$3,750
$7,500
$7,500
$2,500
$5,000
$7,500
$100
$200
$300
$0
$0
Office Visit Copay
Specialist Office Visit Copay
Urgent Care Copay
Emergency Room Copay
Preventive Services (insurance pays)
Coinsurance Percentage (insurance pays)
$30
$45
$150/$60 (then 100% after deductible)
$175 (then 100% after deductible)
100%
80% (after deductible met)
$30
$45
$60
$175 (after deductible met)
100%
80% (after deductible met)
Office Visit Copay
Specialist Office Visit Copay
Preventive Services
Coinsurance Percentage
Emergency Room Copay
Urgent Care Copay*
included in deductible and/or coinsurance
included in deductible and/or coinsurance
Plan covers 100%
80% after deductible is met
included in deductible and/or coinsurance
included in deductible and/or coinsurance
included in deductible and/or coinsurance
included in deductible and/or coinsurance
Plan covers 100%
80% after deductible is met
included in deductible and/or coinsurance
included in deductible and/or coinsurance
Out-of-Pocket Maximum
Member Only
Member +1
Family
Copay
Frames
20% off amount over allowance
$150 allowance for retail frames
Included in
prescription glasses
Every calendar year
Lenses
Single vision, lined bifocal, and lined trifocal lenses
Polycarbonate lenses for dependent children
Included in
prescription glasses
Every calendar year
Frequency
Plan Features
Benefit
Basic
Premium
Bi-Weekly Per-Pay-Period Vision Premium
Member Only
Member +1
Family
$4.21
$6.10
$10.94
Medical Plans
Medical Plans
You have access to dental coverage through Delta Dental. You can enroll in dental coverage for yourself and your eligible dependents, even if you are not enrolled in medical coverage through Haworth. The Delta Dental Plan provides you with a range of covered services, and preventive care is covered by your insurance at 100%. This dental summary is intended to provide you with a quick overview of the Haworth dental plan offerings.
Dental Plans
Dental Plans
The Haworth vision plan helps you pay for routine eye exams, eyeglasses, contact lenses, and related supplies. Our plan is offered by VSP, a nationwide network that provides a convenient and easy-to-use benefit. When you visit a VSP provider, you receive discounted services, and the plan pays a percentage of the costs. You can enroll for vision coverage without participating in medical coverage through Haworth. This vision summary is intended to provide you with a quick overview of the Haworth vision plan offering.
Vision Plans
Vision Plans
Medical Plans
Medical Plans
Medical Plans
Our Members are vital to our business. Your health, well-being and future are important to us. Studies have shown lifestyle choices have the greatest impact on your well-being. In offering the following services, most at no cost to our Members, our hope is you will be able to enjoy an active, fulfilling life and enhance your time with family and friends.
Support Benefits
Some of the information contained in this New Hire / Open Enrollment Guide is a summary of other written documents, or documents in process. Although Haworth attempts to keep these materials as complete and accurate as possible, this Guide is a summary and cannot be a full restatement of other documents. If there is any conflict between the language of this Guide and other documents, the provisions of the Summary Plan Descriptions will be the official source. The Summary Plan Descriptions takes precendence over any conflicting oral or written representation.
There are multiple account types designed to help you pay for care with pre-tax dollars. On the following slides you will find brief overviews and charts explaining the account types.
Health Savings Account
Limited Flexible Spending Account
Flexible Spending Account
Dependent Care FSA
Limited Flexible Spending Account
Flexible Spending Account
Dependent Care FSA
Health Savings Account
Limited Flexible Spending Account
Flexible Spending Account
Dependent Care FSA
Health Savings Account
Benefit Accounts
What's New
Things to Consider
Insurance Plans
Support Benefits
Contact
FAQs
What's New
Things to Consider
Insurance Plans
Support Benefits
Contact
Rethink
Trying To Quit Tobacco?
Basic
Premium
Member Life
$0.046
Additional Life Coverage
Age
Cost Per $1,000 of Coverage
Haworth provides Life Insurance and Accidental Death and Dismemberment (AD&D) coverage for full-time Members at NO additional cost, equal to 1x their annual salary. All eligible full-time Members may choose to purchase additional amounts from the following options.
Voluntary Life Insurance and AD&D Coverage
Basic
Premium
Contacts
(instead of glasses)
• $120 allowance for contacts
• Contact lens exam (fitting & evaluation)
Up to $60
Every calendar year
Every calendar year
Diabetic Eyecare Plus Program
• Services related to diabetic eye disease, glaucoma, and age-related macular degeneration (AMD)
• Retinal screening for eligible Members with diabetesLimitations and coordination with medical coverage may apply
$20
As needed
Benefit
Plan Features
Copay
Frequency
The Haworth vision plan helps you pay for routine eye exams, eyeglasses, contact lenses, and related supplies. Our plan is offered by VSP, a nationwide network that provides a convenient and easy-to-use benefit. When you visit a VSP provider, you receive discounted services, and the plan pays a percentage of the costs. You can enroll for vision coverage without participating in medical coverage through Haworth.
This vision summary is intended to provide you with a quick overview of the Haworth vision plan offering. For a complete listing of covered services and
out-of-network coverage, please review the VSP Benefits Summary posted on Hometown > Haworth Departments > Human Resources (US) > Benefits.
Vision Plans
Under 30
$0.056
30-34
$0.065
35-39
$0.093
40-44
$0.148
45-49
$0.227
50-54
$0.424
55-59
$0.651
60-64
$1.253
65-69
$2.032
70+
$0.140
$0.156
Spouse Life
Child Life
Note: Spousal insurance may not be elected unless the Member life is elected. Spousal insuance may not exceed Member's total Life Insurance amount.
Voluntary Life Insurance and AD&D Coverage Plan Highlights
Haworth provides Life Insurance and Accidental Death and Dismemberment (AD&D) coverage for full-time Members at NO additional cost, equal to 1x their annual salary. All eligible full-time Members may choose to purchase additional amounts from the following options.
Voluntary Life Insurance and AD&D Coverage
Voluntary Life Insurance and AD&D Coverage Plan Highlights
Additional Member
Coverage
You can purchase up to 4x your annual base pay. No evidence of insurability (EOI) required for 1x increase. If higher levels elected an EOI will be required.
Voluntary Spouse
Coverage
You can purchase up to $100,000 in coverage. Member must have elected voluntary coverage before spouse can be covered. Can’t exceed Member Basic Plus Member Voluntary. NO EOI required for up to $50,000 if elected at hire.
Dependent Child(ren)
Coverage
You can purchase up to $20,000 in coverage. No EOI is required. Member must have elected voluntary coverage before child(ren) can be covered.
Voluntary AD&D Coverage
You can purchase coverage for yourself and your family up to 5x your annual base pay. No EOI required.
Basic
Premium
Family AD&D Coverage
$0.05
Download All
Accident and Critical Illness Coverage
UNUM Accident Insurance pays you a sum of money in the event you experience a covered off-the-job injury. There is an expansive list of eligible injuries and treatments available. You and anyone covered by Accident Insurance will also be eligible for UNUM’s Be Well Benefit—paying you $50 for every covered family member who receives their annual physical screening or Be Well exam.
Accident and Critical Illness Coverage
Coverage
Per-Pay-Period Deduction
Member Only
$4.75
Member + Spouse
$8.38
Member + Children
$12.47
Family
$16.09
Age
UNUM Critical Illness Insurance pays you a sum of money in the event you are diagnosed with a covered illness. The payout can be used however you see fit and is received for each eligible condition you are diagnosed. You may elect $10,000, $20,000 or $30,000 of coverage. Covered illnesses include heart attack, stroke, organ failure, cancer and Parkinson's Disease.
Accident and Critical Illness Coverage
Under 25
25-29
30-34
35-39
40-44
45-49
50-54
60-64
55-59
80-84
85+
75-79
65-69
70-74
Employee
$1.80
$2.70
$4.00
$8.60
$12.80
$5.80
$19.20
$59.00
$88.70
$40.20
$27.50
$173.50
$273.80
$124.50
Spouse
$0.90
$1.35
$2.00
$4.30
$6.40
$2.90
$9.60
$29.50
$44.35
$20.10
$13.75
$86.75
$136.90
$62.25
UNUM Voluntary Critical Illness Coverage (2022 Monthly Rates per $10,000 of Coverage)
UNUM Voluntary Accident Coverage
Haworth offers a free program to help you quit tobacco use. Quit for Life provides coaching over the phone, and is available to Members, spouses, domestic partners, and dependent children. If you complete the program by June 30, 2022, you will be eligible to receive a refund of tobacco surcharges paid during the current plan year. Additional rules apply.
Trying To Quit Tobacco?
Rethink’s award-winning, research-based program provides support to parents raising children with learning or behavior challenges or developmental disabilities and is available to members at NO COST.
Parents can take advantage of live teleconsultation with master’s and PhD-level behavior experts to answer questions and provide guidance as they support their children in reaching their top potential. Teleconsultations can take place over the phone or via video chat, day or night, weekday or weekend.
Rethink provides parents with a variety of resources, training, and support in a simple web-based format. Parents have access to printable materials such as flashcards, worksheets, schedule templates, and token boards. They can watch hundreds of easy-to-follow videos from an expansive library depicting behavior experts and educators teaching children skills.
You can add as many family / team members to your account as you would like. Sign up today for access to the free consultations, free e-learning library, and free printable resource materials. To get started simply go to haworth.rethinkbenefits.com, scroll to the bottom of the page and sign-up with the code “haworth”.
What is Rethink Benefits?
Advocacy in navigating health care system complexities to help Members and families save precious time.
Health Advocate
What Is Health Advocate?
Problem Resolution
Clinical Support
Navigation
Support Benefits
FAQs
FAQs
PPO/EPO
CDHP/HSA
• Focuses on your eyes and overall vision wellness
WellVision Exam
Basic
Premium
$20
Prescription Glasses
$20
See frames and lenses
Frames
• $150 allowance for retail frames
• 20% off amount over allowance
Included in
prescription glasses
Every calendar year
Lenses
• Single vision, lined bifocal, and lined trifocal lenses
• Polycarbonate lenses for dependent children
Included in
prescription glasses
Every calendar year
Every calendar year
Benefit
Plan Features
Copay
Frequency
$4.21
$6.10
$10.94
Portable After Termination
Tax Treatment
Tax-free
Tax-free
Tax-free
Tax-free
Carryover of Unused Funds to Next Year
Yes
Up to $550
Up to $550
No
Yes
No
No
No
Yes, after you reach a $500 balance; earnings grow tax-free and can be used at any time in the future for medical expenses.
No
No
No
Investable Account
Benefit Accounts
Benefit Accounts
Created at financial institutions in Member’s name and allows Members to save and pay for medical expenses, tax-free.
Must be enrolled in a CDHP/HSA Plan.
Limited FSA allows Members to pay for dental, vision, and post-deductible medical expenses only on a tax-free basis.
Must be enrolled in a CDHP/HSA Plan.
Allows Members to pay for medical, dental and vision expenses tax-free (deductibles, co-pays, and services) not covered by the plan.
Overview
Who May Contribute
Maximum Annual Contribution
Member or Haworth
$3,650 (Member Only)
$7,300 (Family)
$2,750*
$2,750*
Member
Member
A reimbursement account that allows members to use pre-tax dollars to pay for eligible Dependent FSA expenses, such as day care, preschool, or after-school care for a qualified individual, (such as children and dependent adults).
$5,000
Member
Premium
Overview
Limited Flexible
Spending Account
Flexible
Spending Account
Dependent
Care FSA
Health Savings Account
No
Catch-Up Contributions Allowed for Members over the age of 55
Eligibility
Requirements
Account Owner
Must be enrolled in a “Qualified” HighDeductible Health Plan(same as CDHP).
Member
Haworth
Haworth
Does not require medical enrollment.
Does not require medical enrollment.
Member
Your dependent care expenses must be for qualified individuals, including: a dependent child under the age of 13 who lives with you for more than half the year; and/or a spouse or other tax dependent who is physically or mentally incapable of self-care and lives with you for more than half the year.
No
No
FSA — You can enroll in a Preferred Provider Organization (PPO) and contribute to a Flexible Spending Account, but you cannot take the money with you if you leave employment with Haworth. Flexible Spending Accounts allow you to pay for services out-of-pocket, such as qualified expenses that aren’t covered by your insurance plan, or prescription glasses. Money is withheld from your paycheck pre-tax.
LFSA — Limited FSA allows Members to pay for dental, vision, and post-deductible medical expenses only on a tax-free basis. You cannot use it to pay for medical co-pays or prescriptions. Like other plans, money is withheld from your paycheck pre-tax.
DCA — Dependent Care Accounts can be used to pay for dependent services, such as daycare. Money is withheld from your paycheck pre-tax, but must only be used for specific purposes. Money may be spent for care on either children or adult dependents. It cannot be used for medical co-pays.
Flexible Spending Account
The Limited Flexible Spending account pairs with a CDHP/HSA Plan to allow participants to set aside additional tax-free dollars to pay for predictable, out-of-pocket qualifying dental and vision expenses—for you, your spouse, and eligible dependents.
Also, you can withdraw your full annual LFSA election any time regardless of how much you have deposited to date. This gives you accessible cash to pay for your dental and vision expenses now and pay the plan back on a per-pay basis throughout the benefit plan year.
Limited Flexible Spending Account
Health Savings Account
The traditional, general-purpose health FSA allows you to be reimbursed for eligible medical, prescription, dental and vision care expenses incurred during the benefit plan year.
HSA’s allow you to contribute your own money through payroll deduction without paying taxes. You can then invest that money and it can grow, again without paying taxes. Finally, you can use that money later to pay medical providers for things like doctor’s office visits and prescription drugs, still without paying taxes! In addition, Haworth will also contribute up to $500 for single coverage and $1250 for Member +1 and Family coverage to your HSA account through contribution and a match program. The money is placed in an account that you own. Should you leave Haworth, the HSA account is yours to keep.
Dependent Care Accounts can be used to pay for dependent services, such as daycare. You may elect from $200 to $5,000. Money is withheld from your paycheck pre-tax, but must only be used for specific purposes. It may be spent for care on either children or adult dependents. They cannot be used for medical co-pays.
Dependent Care Account
Overview
Limited Flexible
Spending Account
Flexible
Spending Account
Dependent
Care FSA
Health Savings Account
Overview
Limited Flexible
Spending Account
Flexible
Spending Account
Dependent
Care FSA
Health Savings Account
*At the time of publication.
Benefit Accounts
HSA — Health Savings Accounts allow you to pay medical providers for things like doctor’s office visits and prescription drugs. Money is placed in an account that you own. Funds in your HSA (your contributions plus any Haworth contributions) can be invested and grow tax free. You must be enrolled in the CDHP/HSA to enroll in HSA.
Benefit Accounts
Spousal Surcharge
Spousal Surcharge
Spousal Surcharge
You will be subject to a $50 bi-weekly surcharge if your spouse or domestic partner is enrolled in Haworth’s medical plan and they have qualifying medical coverage through their employer. You will be asked to certify the current status of your spouse or domestic partner during the Open Enrollment process. Please make sure you read the certification language carefully!
Things To Consider
Spousal/Domestic Partner Surcharge
Member Only LTD Coverage
$0.173
Member Only AD&D Coverage
$0.03
Additional AD&D Coverage
Cost Per $1,000 of Coverage
2022 Voluntary Ltd Rates
Your spouse or domestic partner
Eligible Dependent
Your child(ren), stepchild(ren), or a child for whom you are legally obligated to provide coverage under a court order, up to age 26, regardless of marital or student status
Required Documents
Affidavit of Domestic Partnership and Proof of Joint Ownership or Residence.
Court Order
Marriage Certificate OR
Birth Certificate OR
CDHP/HSA
Hyatt Legal Plans
Prescription Drug
Prescription Drug Plan
When you enroll in either Haworth medical plan, you automatically get prescription drug coverage. You do not need to enroll separately.
Haworth partners with Express Scripts to manage our prescription drug plan. Visit www.express-scripts.com to create a user ID and password and access your account, request ID cards, view lists of covered drugs and costs and more!
If you were enrolled in Express Scripts in 2021, you will not receive a new ID card, continue to use the original that was issued.
PPO
By choosing a PPO plan, you can predict what some of your medical costs will be. For example, there are defined copays for visits to your primary doctor or a specialist. The downside is that your bi-weekly premium is higher than with the CDHP/HSA.
Resolving escalated claims across Medical, Dental, and Vision while also answering your basic benefit questions—bringing swift answers and Members peace of mind!
Medical professionals providing Members and their families with a real voice and real support for their health care needs.
Connecting Members to valuable, relevant programs and services.
Call: 866.799.2655
Hyatt Legal Plans
Rethink
Trying To Quit Tobacco?
Support Benefits
Hyatt Legal Plans
Rethink
Trying To Quit Tobacco?
Support Benefits
Hyatt Legal Plans
Finding an affordably priced lawyer to represent you when you have a need can be a challenge. Now there is an easy solution to help with the cost. Hyatt Legal Plans for Haworth Members. With Hyatt Legal Plans, you can receive legal advice and fully covered services for a wide range of legal matters.
The Hyatt Legal Plans include coverage for you, your spouse and your dependents. It’s convenient, affordable AND payroll deducted.
Visit: www.legalplans.com
By choosing a CDHP/HSA plan, your bi-weekly premium is lower and you have access to a "triple tax free" HSA account that includes Haworth contributions. The downside is that your deductibles are higher than a PPO.
For more information, please visit the Benefits SharePoint.site.
For more information, please visit the Benefits SharePoint site.
CDHP/HSA
PPO
By choosing a PPO plan, you can predict what some of your medical costs will be. For example, there are defined copays for visits to your primary doctor or a specialist. The downside is that your bi-weekly premium is higher than with the CDHP/HSA.
By choosing a CDHP/HSA plan, your bi-weekly premium is lower and you have access to a "triple tax free" HSA account that includes Haworth contributions. The downside is that your deductibles are higher than a PPO.
CDHP/HSA
PPO
By choosing a PPO plan, you can predict what some of your medical costs will be. For example, there are defined copays for visits to your primary doctor or a specialist. The downside is that your bi-weekly premium is higher than with the CDHP/HSA.
By choosing a CDHP/HSA plan, your bi-weekly premium is lower and you have access to a "triple tax free" HSA account that includes Haworth contributions. The downside is that your deductibles are higher than a PPO.
CDHP/HSA
PPO
By choosing a PPO plan, you can predict what some of your medical costs will be. For example, there are defined copays for visits to your primary doctor or a specialist. The downside is that your bi-weekly premium is higher than with the CDHP/HSA.
By choosing a CDHP/HSA plan, your bi-weekly premium is lower and you have access to a "triple tax free" HSA account that includes Haworth contributions. The downside is that your deductibles are higher than a PPO.
For a complete listing of covered services and out-of-network coverage, please review the VSP Benefits Summary posted on the Benefits SharePoint site.
For a complete listing of covered services and out-of-network coverage, please review the VSP Benefits Summary posted on the Benefits SharePoint site.
For detailed information about Accident coverage including the list of dollar amounts paid out for each type of accident, please visit the Benefits SharePoint site.
For detailed information about Accident coverage including the list of dollar amounts paid out for each type of accident, please visit the Benefits SharePoint site.
Read more about the Quit for Life tobacco cessation Program and the Haworth Tobacco Policy by visiting the Benefits SharePoint Site.
Additional detailed information, including contribution and match amounts, can be found on the Benefits SharePoint site.
Additional detailed information, including contribution and match amounts, can be found on the Benefits SharePoint site.
The Haworth vision plan helps you pay for routine eye exams, eyeglasses, contact lenses, and related supplies. Our plan is offered by VSP, a nationwide network that provides a convenient and easy-to-use benefit. When you visit a VSP provider, you receive discounted services, and the plan pays a percentage of the costs. You can enroll for vision coverage without participating in medical coverage through Haworth. This vision summary is intended to provide you with a quick overview of the Haworth vision plan offering.
For a complete listing of covered services and out-of-network coverage, please review the VSP Benefits Summary posted on the Benefits SharePoint site.
For a complete listing of covered services and out-of-network coverage, please review the VSP Benefits Summary posted on the Benefits SharePoint site.
More information about the LFSA can be found on the Benefits SharePoint site.
HSA — Health Savings Accounts allow you to pay medical providers for things like doctor’s office visits and prescription drugs. Money is placed in an account that you own. Funds in your HSA (your contributions plus any Haworth contributions) can be invested and grow tax free. You must be enrolled in the CDHP/HSA to enroll in HSA.
FSA — You can enroll in a Preferred Provider Organization (PPO) and contribute to a Flexible Spending Account, but you cannot take the money with you if you leave employment with Haworth. Flexible Spending Accounts allow you to pay for services out-of-pocket, such as qualified expenses that aren’t covered by your insurance plan, or prescription glasses. Money is withheld from your paycheck pre-tax.
DCA — Dependent Care Accounts can be used to pay for dependent services, such as daycare. Money is withheld from your paycheck pre-tax, but must only be used for specific purposes. Money may be spent for care on either children or adult dependents. It cannot be used for medical co-pays.
HSA — Health Savings Accounts allow you to pay medical providers for things like doctor’s office visits and prescription drugs. Money is placed in an account that you own. Funds in your HSA (your contributions plus any Haworth contributions) can be invested and grow tax free. You must be enrolled in the CDHP/HSA to enroll in HSA.
FSA — You can enroll in a Preferred Provider Organization (PPO) and contribute to a Flexible Spending Account, but you cannot take the money with you if you leave employment with Haworth. Flexible Spending Accounts allow you to pay for services out-of-pocket, such as qualified expenses that aren’t covered by your insurance plan, or prescription glasses. Money is withheld from your paycheck pre-tax.
DCA — Dependent Care Accounts can be used to pay for dependent services, such as daycare. Money is withheld from your paycheck pre-tax, but must only be used for specific purposes. Money may be spent for care on either children or adult dependents. It cannot be used for medical co-pays.
CDHP/HSA
PPO
By choosing a PPO plan, you can predict what some of your medical costs will be. For example, there are defined copays for visits to your primary doctor or a specialist. The downside is that your bi-weekly premium is higher than with the CDHP/HSA.
For a complete listing of covered services and out-of-network coverage, please visit the Benefits SharePoint site.
By choosing a CDHP/HSA plan, your bi-weekly premium is lower and you have access to a "triple tax free" HSA account that includes Haworth contributions. The downside is that your deductibles are higher than a PPO.
Read more about the Quit for Life smoking cessation Program and the Haworth Tobacco Policy by visiting the Benefits SharePoint Site.
Accident and Critical Illness Coverage
Voluntary Life Insurance and AD&D Coverage
Vision
Dental
Prescription Drug
Medical
Accident and Critical Illness Coverage
Voluntary Life Insurance and AD&D Coverage
Vision
Dental
Prescription Drug
Medical
Benefit Accounts
Benefit Accounts
Forms can be obtained from Hometown > Haworth Departments > Human Resources (US) > Benefits
Forms can be obtained from Hometown > Haworth Departments > Human Resources (US) > Benefits
More information about the LFSA can be found on the Benefits SharePoint site.
More information about the FSA can be found on the Benefits SharePoint site.
More information about the FSA can be found on the Benefits SharePoint site.
More information about the DCA can be found on the Benefits SharePoint site.
More information about the DCA can be found on the Benefits SharePoint site.
For a complete listing of covered services and out-of-network coverage, please visit the Benefits SharePoint site.
For a complete listing of covered services and out-of-network coverage, please visit the Benefits SharePoint site.
For a complete listing of covered services and out-of-network coverage, please visit the Benefits SharePoint site.
For a complete listing of covered services and out-of-network coverage, please visit the Benefits SharePoint site.
For a complete listing of covered services and out-of-network coverage, please visit the Benefits SharePoint site.
For a complete listing of covered services and out-of-network coverage, please visit the Benefits SharePoint site.
For a complete listing of covered services and out-of-network coverage, please visit the Benefits SharePoint site.
For a complete listing of covered services and out-of-network coverage, please visit the Benefits SharePoint site.
For a complete listing of covered services and out-of-network coverage, please visit the Benefits SharePoint site.
For a complete listing of covered services and out-of-network coverage, please visit the Benefits SharePoint site.
For a complete listing of covered services and out-of-network coverage, please visit the Benefits SharePoint site.
You have access to dental coverage through Delta Dental. You can enroll in dental coverage for yourself and your eligible dependents, even if you are not enrolled in medical coverage through Haworth. The Delta Dental Plan provides you with a range of covered services, and preventive care is covered by your insurance at 100%. This dental summary is intended to provide you with a quick overview of the Haworth dental plan offerings.
For detailed information about Voluntary Life Insurance and AD&D please visit the Benefits SharePoint site.
For detailed information about Voluntary Life Insurance and AD&D please visit the Benefits SharePoint site.
For detailed information about Voluntary Life Insurance and AD&D please visit the Benefits SharePoint site.
For detailed information about Voluntary Life Insurance and AD&D please visit the Benefits SharePoint site.
For detailed information about Accident coverage including the list of dollar amounts paid out for each type of accident, please visit the Benefits SharePoint site.
For detailed information about Accident coverage including the list of dollar amounts paid out for each type of accident, please visit the Benefits SharePoint site.
Read more about the Quit for Life tobacco cessation Program and the Haworth Tobacco Policy by visiting the Benefits SharePoint Site.
Visit: www.healthadvocate.com
Visit: www.healthadvocate.com
Visit: www.legalplans.com
Haworth Members with existing FSA accounts can roll over up to $550 of unspent general-purpose health monies. This balance will automatically carry over to the new benefit plan year (after March 31, 2022). The IRS allows you to contribute between $200 and $2,750 for the year to the general-purpose FSA.
For a complete listing of covered services and out-of-network coverage, please visit the Benefits SharePoint site.
For a complete listing of covered services and out-of-network coverage, please visit the Benefits SharePoint site.
Individual
Family
$25
$75
$50
$100
Cost Per $100 of Coverage
Member Only
Family
$5.48
$7.38
2022 Group Legal Plan Rates (Per-Pay-Period Deduction)
2022 Monthly Rates
$3,750
$7,500
$7,500
$3,750
$7,500
$7,500
Yes, $1,000.
$4,650 (Member Only)
$8,300 (Family)
2022
If you are participating in Open Enrollment and do not log in to make elections, you will be re-enrolled in the same coverage you elected for 2021, but will automatically waive Vacation Buy and other Benefit Accounts. If you are a new hire and do not make a benefit election by enrolling or waiving coverage within 30 days of your hire date, you will automatically be enrolled in the Consumer Driven Health Plan at the Member Only level.
We are excited to introduce to Haworth members the Benefits Guide web experience. We hope it allows you to find the information you want more quickly. More in-depth information about your benefits can be found by visiting the Benefits SharePoint site.
Important Enrollment Notice
Virtual Doctor Visits
Apple
Download the App
Android
Virtual Doctor Visits
Download the App
Apple
Android
Contact Benefit Partners
401k, HSA, LFSA, FSA, Dependent Care Account
Commuter Account
Dental
Legal
Voluntary Life
Spouse/Child AD&D
Member Assistance Program (EAP)
Vision
Smoking Cessation
Medical
Prescriptions
Bank of America / Merrill Lynch
Group Number: 603800
myhealth.bankofamerica.com
800.228.4015
Hyatt Legal
Group Number: N/A
www.legalplans.com
800.821.6400
Encompass
Group Number: N/A
myassistanceprogram.com/encompass
800.788.8630
Bank of America
Group Number: N/A
myhealth.bankofamerica.com
800.305.5109
UNUM Life/AD&D LTD
Group Number: N/A
www.unum.com
866.679.3054
VSP—Member Services
Group Number #12011566
www.vsp.com
800.877.7195
Delta Dental— Customer Service
Group Number: 9090
www.deltadentalmi.com
800.524.0149
Express-Scripts: Prescriptions
Group Number: N/A
www.express-scripts.com
800.690.4028
Blue Cross Blue Shield of Michigan
Group Number: 71553
www.bcbsm.com
800.775.2583
Online Visits
Group Number: 71553
www.bcbsmonlinevisits.com
844.606.1608
24/7 Nurse Help Line
Group Number: 71553
www.bcbsm.com
800.775.2583
Mental Health/Substance Abuse
Group Number: 71553
www.bcbsm.com
800.762.2382
Priority Health
Group Number: 567100
www.priorityhealth.com
800.956.1954
Mental Health/Substance Abuse
(Pre-Certification)
Group Number: 567100
www.priorityhealth.com
800.673.8043
Optum
Group Number: #940290
www.quitnow.net
866.784.8454
Do you have other qualified coverage available to you through a spouse/domestic partner?You can opt out of Haworth’s medical and prescription drug coverage. The payroll credit for opt out is $25 per pay period. This equals $650 for the plan year!
You may choose to cover your children up to age 26 on your medical plan or your spouse/domestic partner's plan. You may do the same for dental and vision benefits. You are not required to cover your children through one employer for all your benefits.
You’re making a lot of choices during Enrollment.
They are:
• Medical Coverage
• Dental Coverage
• Vision Coverage
• Life, Disability, Accident, Legal and Illness
• Account Contribution Information
After enrolling, you are permitted to make only limited changes per IRS regulations. You cannot change your plan mid-year based on a medical diagnosis or family budget changes. To find out what you CAN change and how, contact HR Shared Services.
Each Member's needs are unique to specific circumstances—we cannot tell you which option(s) to select. We can offer guidance, however, the final plan selection must be made by you. Feel free to call us at 616.393.1600 if you need assistance.
Enroll using our self-service portal on Hometown Worldwide at: my.haworth.com
Use your Haworth User ID and password. We’ll have a banner featured front and center to help you find it. You will be asked to review your information and select your coverage. It won’t take long if you’ve already decided what you want before you log on.
You must enroll within 30 days of your first day of employment at Haworth. This is your once-a-year opportunity to elect your benefit plans. The benefits you select will be effective your first day of employment through December 31, 2021.
You still need to opt out of coverage. Haworth is required to make sure every eligible Member was offered coverage and made a selection—even if you choose to decline coverage.
The Affordable Care Act requires you to have insurance.
All full-time U.S. new hire Members MUST complete a Benefit Election/Dependent Certification Form. Even if you’re electing not to enroll in any company-provided benefits, you MUST complete the form and actively opt out.
Priority Health Enhanced Through Cigna Partnership
For 2022 we have two changes to benefits:
Blue Cross Blue Shield of Michigan
Priority Health
Virtual Doctor Visits
Apple
Android
Virtual Doctor Visits
Apple
Android
Virtual Doctor Visits
Apple
Android
Virtual Doctor Visits
Apple
Android
$4.71
$8.69
$18.57
Download Purchased Vacation PDF
Per-Pay-Period Surcharge
$15
$30
$45
LFSA — Limited FSA allows Members to pay for dental, vision, and post-deductible medical expenses only on a tax-free basis. You cannot use it to pay for medical co-pays or prescriptions. Like other plans, money is withheld from your paycheck pre-tax.
LFSA — Limited FSA allows Members to pay for dental, vision, and post-deductible medical expenses only on a tax-free basis. You cannot use it to pay for medical co-pays or prescriptions. Like other plans, money is withheld from your paycheck pre-tax.
@ 2023 Haworth, Inc.
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