Page 30 - 2021 Mid Year Open Enrollment Guide

Tobacco Cessation Accident Coverage

Team members who are enrolled in a BCBS of Texas medical plan and paying a tobacco surcharge Accidents happen. You can’t always prevent them, but you can take steps to reduce the financial
will have the surcharge removed upon completion of five Quit Calls with the program. impact. Accident coverage, available through Voya, provides benefits for you and your covered family
members if you have expenses related to an accident that occurs outside of work. Health insurance
The Quit for Life® Program is the nation’s leading tobacco and nicotine cessation program. It can helps with medical expenses, but this coverage is an additional layer of protection that can help you
assist you in overcoming physical, psychological and behavioral addictions to tobacco and/or pay deductibles, copays, and even typical day-to-day expenses such as a mortgage or car payment.
nicotine through coaching, a customized quitting plan and a supportive online community. Benefits under this plan are payable to you, to use as you wish.

Expert Quit Coaches® help participants gain the knowledge, skills and behavioral strategies to quit
for life. Participants have unlimited access to phone- and web-based coaching as well as to Web SUMMARY OF BENEFITS
Coach®, an online community for e-learning and social support. Participants also receive a workbook Hospital Admission $1,000
that helps guide them through the quitting process.
Hospital Confinement $300 per day, up to 365 days
Call 1-866-QUIT-4-LIFE (1-866-784-8454)
or log on to www.quitnow.net for details Critical Care Unit Confinement $475 per day, up to 15 days
or to enroll.
Rehabilitation Facility Confinement $150 per day, up to 90 days
When accessing the program on the website: Dislocations and Fractures Up to $7,700
www.quitnow.net
Ambulance Ground: $325 / Air: $1,125
1. Enter “Builders FirstSource” as the Employer. Initial Doctor Visit, Urgent Care Facility Treatment or $175
Emergency Room Treatment
2. Skip to item 3 and enter your zip code.
Follow-Up Doctor Treatment $75
3. Follow the remaining steps to register.
Chiropractor Treatment $45 (up to 6 per accident)
The program uses the 4 Essential Practices to Quit For Life:
X-Ray $75
• Quit At Your Own Pace – Quit on your own terms, but get the help you need, when you need it. Major Diagnostic Exams $225
• Conquer Your Urges to Smoke – Gain the skills you need to control cravings, urges and Burns
situations involving alcohol. Up to $15,000
• Use Medications So They Really Work – Outpatient Surgery $200
Learn how to supercharge your quit attempt with the proper use of nicotine substitutes or Concussion $225
medications.
• Don’t Just Quit, Become a Non-Tobacco User – Once you’ve stopped using tobacco, learn to Coma $15,000
never again have that “first” cigarette. Surgery (open abdominal or thoracic) $1,000
• You could be the next person we help quit tobacco.
Surgery (exploratory or without repair) $175
The program is free, confidential, and it works! Blood, Plasma, Platelets $400

WEEKLY PAYROLL DEDUCTION BI-WEEKLY PAYROLL DEDUCTION
Employee Only $1.12 $2.23
Employee + Spouse $1.99 $3.98
Employee + Child(ren) $1.83 $3.67

Employee + Family $2.71 $5.42

*This list is a summary. Refer to plan documents for a comprehensive list of covered benefits.

28 • 2021 BUILDERS FIRSTSOURCE MID-YEAR BENEFITS GUIDE 2021 BUILDERS FIRSTSOURCE MID-YEAR BENEFITS GUIDE • 29