NSB 2024 Benefits Booklet
5-30-24
2024 Benefits Guide
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NORTH STATE BANK | 2024 BENEFITS GUIDE
2024 Summary of Benefits
North State Bank is pleased to offer a comprehensive benefits package that is customizable to best meet your needs.
New, benefits-eligible employees may receive benefits on the first day of the month following your date-of-hire, or, if your date-of-hire is on the first day of the month, your benefits begin that day. When making benefits selections, note that you are enrolling through December 31, 2024. Changes may only be made prior to that date if you have a qualifying “life-changing event.” The IRS defines a “life-changing event” as marriage or divorce, birth or adoption of a child, a change in the employment status of an employee or the employee’s spouse, and a significant change in the coverage of a spouse’s benefits plan. All such changes must be submitted to Human Resources within 31 days of the change. Other changes are not permitted until the next open enrollment period. For new employees, benefits enrollment must be completed within 30 days of date eligibility. After your initial enrollment, you may make changes to your selections during the company’s open enrollment period. This Summary of Benefits is intended to provide an overview of North State Bank’s benefits program and as such does not include all plan terms, disclosures and conditions. North State Bank reserves the right to make changes to its benefits program from time to time. Benefits with pre-tax deductions are governed by the IRS Section 125 guidelines.
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NORTH STATE BANK | 2024 BENEFITS GUIDE
Health Care
Plan details below are based on in-network services and providers.
PPO 70
HDHP 1750
HDHP 3250
Deductible
Individual
$2,000
$1,750
$3,250
Family
$4,000
$3,500
$6,500
Coinsurance
70%
80%
100%
Coinsurance Maximum Individual
$3,250 $6,500
$3,500 $7,000
n/a n/a
Family
Out-of-Pocket Maximum Individual
$5,250
$5,250
$3,250 $6,500
Family
$10,500
$10,500
Preventative/Wellness
100%
100%
100%
Office Visits Primary Office Visits Specalist Office Visits
$30 copay $50 copay
80%, after ded. 80%, after ded.
100%, after ded. 100%, after ded.
Prenatal Care
$200 copay
80%, after ded.
100%, after ded.
Hospitalization
100%, after ded. 100%, after ded.
Emergency Room
$250 copay $50 copay 30 day supply: $9/$35/$65/ 25% up to $150 90 day supply mail order: $27/$105/$195
80%, after ded. 80%, after ded.
Urgent Care
Rx
80%, after ded.
100%, after ded.
Monthly Employee Deduction
Employee & Spouse
Employee & Child(ren)
Employee & Family
Plans
Employee
PPO 70
$0.00 $0.00 $0.00
$462.21 $422.58 $409.79
$218.50 $199.76 $193.72
$693.31 $633.86 $614.68
HD 1750 HD 3250
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NORTH STATE BANK | 2024 BENEFITS GUIDE
Health Savings Account (HSA): Interactive Medical Systems Available in conjunction with a High Deductible Health Plan (HDHP 1750 or HDHP 3250). Health Savings Account Key Attributes: • Provides insurance coverage along with a tax-advantaged way to save for medical expenses. • 100% employee-owned and portable. • Employees age 55 or better may contribute an additional $1,000 annually to their HSA. • Provides first-dollar coverage for medical care and prescriptions. If qualified expenses exceed your HSA balance, you are responsible for bridging the difference between your HSA balance and your plan’s deductible. After satisfying your deductible, the in-network plan benefit for covered services, including prescriptions, is 80% for the HDHP 1750 and 100% for the HDHP 3250. Employee Only The total annual contribution limit for an employee-only HSA in 2024 is $4,150, inclusive of North State Bank’s contribution to your account. All employee contributions are deducted from your wages pre-tax. Family Coverage If enrolled as an employee with dependents in an HDHP, the total annual contribution to your HSA in 2024 is $8,300, inclusive of North State Bank’s contribution to your account. All employee contributions are deducted from your wages pre-tax.
Employer Contribution (paid as a lump sum)
Plan
Base $300
Per Remaining Number of Months
HDHP 3250 & 1750
$75
Health Reimbursement Plan (HRA): Interactive Medical Systems
For employees who elect the PPO 70 medical plan, the HRA will provide up to a $1,000 reimbursement per family for medical expenses incurred after the satisfaction of $1,000 of the $2,000 individual deductible.
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NORTH STATE BANK | 2024 BENEFITS GUIDE
Flexible Spending Accounts: Wage Works Funds contributed to an FSA are for use during the plan year. See the plan document for carryover amounts.
Health Care FSA
Limited Purpose FSA Dependent Care
Available to employees enrolled in
HDHP with a Health Savings Account
No enrollment required
PPO 70
Annual employee contribution limit
$3,200
$3,200
$5,000
Qualified health care expenses not covered by insurance (i.e. co-pays, payments applied toward a deductible, etc.)
Qualified childcare or adult care for dependents living in your home
Dental and vision expenses
Funds can be used towards
Telemedicine: TeleDoc Employees and their eligible dependents participating in a North State Bank medical plan may enroll in TeleDoc. This service allows employees and their eligible dependents to make a virtual trip to the doctor’s office using an internet connection to seek treatment for common, non-life threating issues such as allergies, cold and flu, ear infections, fever, sore throats and more for a $10 copay for those enrolled in the PPO plan. For those with a HDHP, the visit will apply toward your deductible. Prescriptions: Prime Therapeutics • Available at no cost to eligible employees, Prime Therapeutics is a prescription benefit plan provider. Many people find filling prescriptions through Prime Therapeutics to be more affordable than without prescription benefit coverage. • Offers a national network of pharmacies, including Walgreens and CVS, as well as through the MedsYourWay with Amazon Pharmacy for home delivery service.
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NORTH STATE BANK | 2024 BENEFITS GUIDE
Dental:
Plan details below are based on in-network services and providers in the Delta Dental network.
Basic Dental
Enhanced Dental
Lifetime Deductible
$100 per covered person
$100 per covered person
Annual Maximum
$1,500 per covered person
$2,000 per covered person
Carryover Benefit
Participants can carry over $400 of unused benefits if annual expenses were under $800. Carryover benefits can be accumulated up to $1,500 maximum. Exams & Cleaning X-Rays (bite-wing & full mouth) Emergency Pain Fluoride & Sealants to age 16 Space maintainers to age 16 Oral Cancer screening over 40 Fillings & Simple Extractions Periodontics Endodontics Anesthesia Oral Surgery Inlays & Onlays Crowns, Bridges, Dentures Implants
None
Diagnostic & Preventative 100% after Deductible
Exams & Cleaning X-Rays (bite-wing & full mouth) Emergency Pain Fluoride & Sealants to age 16 Space maintainers to age 16 Oral Cancer screening over 40
Basic Service
Fillings & Simple Extractions
80% after Deductible
Major Services
Anesthesia Oral Surgery Periodontics Endodontics Inlays & Onlays Crowns, Bridges, Dentures Implants
50% after Deductible
Orthodontics
Under age 19 $1,500 lifetime limit
Under age 19 $2,000 lifetime limit
50% with no Deductible
Monthly Employee Deduction
Employee & Spouse
Employee & Child(ren)
Employee & Family
Dental Plans
Employee
Dental- Basic Plan
$0.00
$19.28
$27.83
$52.84
Dental- Enhanced Plan
$4.56
$28.35
$40.39
$71.53
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NORTH STATE BANK | 2024 BENEFITS GUIDE
Vision:
Basic Plan Enhanced Plan In-Network Out-of-Network In-Network Out-of-Network
Copay
Exam
$10
$10
Materials
$25 $25
$10 $25
Contact Lense Fitting
Benefits
Exam (MD) Exam (OD)
Covered in Full Covered in Full
Up to $44 Up to $39
Covered in Full Covered in Full
Up to $44 Up to $39
Contact Lense Fitting(Std) Contact Lense Fitting(Spc)
Covered in Full
Not Covered Covered in Full
Not Covered
$50 Retail Allowance $130 Retail Allowance
$50 Retail Allowance $175 Retail Allowance
Not Covered
Not Covered
Frames
Up to $64
Up to $89
Lenses Single Vision - Basic Covered in Full
Up to $34 Up to $48 Up to $64
Covered in Full Covered in Full Covered in Full Covered at retail lined trifocal level
Up to $34 Up to $48 Up to $64
Bifocal - Basic Trifocal - Basic
Covered in Full Covered in Full Covered at retail lined trifocal level
Up to $64
Up to $64
Progressive - Basic
$120 Retail Allowance
$200 Retail Allowance
Contact Lenses
Up to $100
Up to $100
Basic/standard lenses do not include tinting or special coatings such as scratch, ultraviolet, reflective, etc. Monthly Employee Deduction
Employee & Spouse
Employee & Child(ren)
Employee & Family
Vision Plans
Employee
Vision Plan- Basic Plan
$0.00
$3.05
$3.25
$6.34
Vision Plan- Enhanced Plan
$1.60
$6.22
$6.34
$11.05
With both the Basic and Enhanced plans, eye exams are covered every plan year (services do not need to be 12 months apart) . Contact lenses, in lieu of frames and glass lenses, are covered every plan year as well. Frames are covered once every-other plan year.
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NORTH STATE BANK | 2024 BENEFITS GUIDE
Supplemental and Life Insurance Supplemental Insurance: Aflac
As an optional enhancement to your health and disability insurances, we offer access to supplemental insurance through Aflac. Supplemental insurance protection is currently available for cancer, hospitalization, personal accidents, and specified health events. Employees work directly with Aflac to determine eligibility and obtain premium quotes. Life & Disability Insurance Basic Life Insurance: The Standard Company North State Bank provides Basic Life insurance as well as accidental death and dismemberment coverage of $100,000 for all eligible employees. This benefit is Employees may purchase Supplemental Life Insurance, pending evidence of insurability, equal to an additional one, two, three, four or five times your annual salary, up to a combined basic and supplemental coverage maximum of $900,000. Evidence of insurability is required for supplemental coverage in excess of $100,000 for new hires. Exisiting employees must submit evidence of insurability for any amount requested. If you elect Supplemental Life Insurance, your spouse is also eligible to elect Supplemental Life Insurance pending evidence of insurability for coverage in excess of $50,000. Exisiting employees are required to submit evidence of insurability for any amount requested for spouses. Your spouse is eligible for up to 100% of the amount of your Supplemental Life Coverage in $25,000 increments up to $200,000. Paid with post-tax dollars based on employee’s age (regardless of coverage for employees or spouse) 0-29 years old $0.10 50-54 years old $0.49 30-34 years old $0.13 55-59 years old $0.61 35-39 years old $0.15 60-64 years old $0.88 40-44 years old $0.28 65-69 years old $1.36 45-49 years old $0.37 70 years or greater $2.45 Supplemental Life Insurance Monthly Contributions per $1,000 of coverage automatic and the premiums are 100% employer paid. Supplemental Life: The Standard Company
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NORTH STATE BANK | 2024 BENEFITS GUIDE
Dependent Life: The Standard Company The Dependent Life plan provides optional life insurance coverage for dependent family members at low group rates. The plan offers three options for coverage:
Option 1: Spouse $2,000; Child $2,000
$0.42
Option 2: Spouse $10,000; Child $5,000 Option 3: Spouse $25,000; Child $10,000
$2.50 $6.00
Disability Insurance: Lincoln Financial A combination of Short-Term and Long-Term Disability insurance is available to all benefit-eligible employees. Premiums are 100% employer paid and employees are automatically enrolled for these benefits. Short-Term Disability (STD) benefits are payable on the 15th day of disability through day 90. The STD plan pays 60% of your weekly base earnings, up to a maximum weekly benefit of $2,500. This total may be reduced by other benefits you may be entitled to receive. Long-Term Disability (LTD) benefits are payable on the 91st day of disability. The LTD plan pays 60% of your monthly base earnings, up to a maximum monthly benefit of $15,000. This totally may be reduced by other benefits you may be entitled to receive.
Retirement Savings 401(k): American Trust
Employees may contribute up to $23,000 of all eligible compensation to their 401(k). If age 50 or better, you may contribute an additional $7,500 annually. Online account information is available 24/7 at americantrust.com. To enroll for online account access, Contact American Trust at 1-866-401-5247.
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NORTH STATE BANK | 2024 BENEFITS GUIDE
Employee Assistance Program: SentryHealth SentryHealth is designed to support you as you pursue your personal health and well-being goals. Services are offered at no charge to adults and dependents 18+ enrolled in a health plan offered by North State Bank. SentryHealth can assist with: Lifestyle & Wellbeing Coaching: Set and achieve goals to improve your overall health. SentryHealth covers everything from diet and exercise to tobacco cessation. Chronic Condition Support: SentryHealth provides education and support for managing conditions like prediabetes, diabetes, high cholesterol, and high blood pressure. Mental Health Support: SentryHealth provides confidential support from licensed therapists to address burnout, life changes, stress, depression, anxiety, grief, and more. Participation is strictly confidential, and your personal health information is never shared. Learn more at MySentryHealth.com. To register, click “Activate your account” and use your @NorthStateBank.com email address to successfully enroll. Once your account is activated, you may update your email to a non-North State Bank address.
Other Benefits Employee Banking Packages
North State Bank offers a comprehensive banking package exclusively to employees. It includes free and discounted products and services, such as: • Two interest-bearing Personal Banking accounts with no minimum balance requirements and no monthly service charges. • Free Visa debit card and personalized checks (limit one box of checks per order). Unlimited ATM fee reimbursements domestically and internationally. • Administration fee waived for Visa® Gift Card purchases. • Discounts on wealth and retirement planning through Guardian Wealth Partners.
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NORTH STATE BANK | 2024 BENEFITS GUIDE
2024 Company Holidays All eligible North State Bank employees receive the following paid company holidays: New Year’s Day Monday, January 1 Martin Luther King Jr. Day Monday, January 15 Presidents’ Day Monday, February 19 Good Friday Friday, March 29 Memorial Day Monday, May 27 Labor Day Monday, September 2 Columbus Day Monday, October 14 Veterans Day Monday, November 11 Thanksgiving Thursday, November 28 Friday, November 29 Christmas Wednesday, December 25 Employees with 12 consecutive months of service and a minimum of 1,250 hours worked within the last 12 months, are eligible for six weeks of paid parental leave if serving as the primary caregiver following the birth or adoption of a child. Employees not serving as the primary caregiver are eligible for up to two weeks of paid parental leave. • Cashier’s checks, 3” X 5” safe deposit box and domestic wire transfers at no charge. • Discounted fee and/or interest rate on loans/credit cards. Subject to credit approval; available for select products. Parental Leave
Juneteenth Wednesday, June 19 Independence Day Thursday, July 4
Amanda Lloyd Chief People Officer 919.645.3191 ALloyd@NorthStateBank.com Tina Gleeson Payroll & Benefits Specialist 919.526.1712 TGleeson@NorthStateBank.com
Kathy Nall Human Resources Director 919.723.2965 KNall@NorthStateBank.com
Ronda Firstbrook Human Resources Assistant 919.526.1713 RFirstbrook@NorthStateBank.com
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