1/22
Benefits for the Road Ahead
2023 Benefits
Program eGuide
UAW Active Union
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2/22
Benefits Website
Your One-Stop for Benefits Information!
You now can single sign on to your benefits through Workday! Just go to http://dtna.info/adp, and use
your Workday credentials. You can now use Single Sign On (SSO) from your Daimler Truck North America
(DTNA) Workday to access your DTNA Benefits Website.
If you prefer, you can still use https://mybenefits.adp.com to obtain your benefits information.
To register for the ADP site, please use DTNA.LLC-DTNA then enter your name, Social Security number,
and date of birth. Additional security verification will be required.
Access on the go: Stay better connected with your mobile device by searching “ADP Mobile”
on Google Play, the Apple App Store, and Amazon.
My Total Rewards Website
Stay current with live updates of your pay, health, wellness, retirement, and other benefits. You will
receive a customized view of the contributions Daimler makes to your professional, health, and financial
success as recognition for the contributions you make to the company’s success. The My Total
Rewards website also provides links and phone numbers for all your Daimler Truck benefit providers.
You can access My Total Rewards two ways:
• V i s i t www.DTNATotalRewards.com and follow the login instructions
• Visit the My Wealth and Discounts page on the DTNA Workday website
Benefit Alerts
Sign up for Daimler benefit alerts via text message
on your smartphone to receive tips and alerts about
important benefits program deadlines and events.
You may incur charges from your wireless carrier for
receiving messages.
If you have questions, email dtnabenefits@daimler.com.
To sign up for text message
alerts, text bene3 to 31996.
To stop receiving text message
alerts, text STOP to 31996.
For help, text HELP to 31996.
Inside
Introduction...................................3
2023 Benefits At-a-Glance .......................3
Eligibility and Enrollment .........................4
Verifying Dependent Eligibility .................4
Qualified Status Changes .....................4
How to Enroll ..............................5
2023 Medical Plan..............................6
Blue Cross Blue Shield PPO Plan ...............6
Save Money on Prescription Drugs .............7
Medical Plan At-a-Glance .....................8
Medical Resources ............................11
Abenity Discount Program.......................13
Wellness Program .............................14
Dental ......................................15
Vision ......................................16
Health Care Spending Account ...................17
Dependent Care Spending Account................18
Life and Accidental Death & Dismemberment (AD&D) ...19
Disability ....................................20
Employee Assistance Program (EAP) ..............20
Voluntary Benefits.............................21
Contact Information ...........................22
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3/22
Introduction
The Daimler Truck North America LLC Benefit
Program offers you and your family benefit
options to help maintain and improve your
health as well as provide financial security.
The program offers health care, life insurance,
and disability benefits that are comprehensive,
flexible, and competitive.
This eGuide provides you with an overview
of your health and welfare benefits as a
Union employee. It is important that you review
your benefit options so that you can make an
informed decision about the coverage that is
right for you. For more information, you may go
online to https://mybenefits.adp.com or call
the Benefits Service Center at 800-605-6031
Monday through Friday 8:00 am to 6:00 pm ET.
In addition to the benefits described in this
eGuide, you can choose to save pre-tax dollars
toward retirement in the 401(k) plan. For more
information, visit the plan administrator’s
website at https://daimler.voya.com.
2023 Benefits At-a-Glance
Benefit Options
Medical
• Blue Cross Blue Shield (BCBS) PPO Plan
Dental
(Included with Medical coverage)
• Moda Health
Vision
(Included with Medical coverage)
• Vision Service Plan (VSP)
Flexible Spending Accounts
• Health Care and Dependent Care Spending Accounts
Health Care Flexible Spending Account
• Pay for eligible health care expenses with pre-tax dollars
Basic Life Insurance
• Company-provided benefit: 2 times base pay plus $10,000
Optional Life Insurance
(Paid for by employee)
• You may purchase additional coverage for yourself as well as coverage
for your spouse and dependent children
Optional AD&D (Paid for by employee)
• You may purchase coverage by level for you and your dependents
Short-Term Disability
• Company-provided benefit: 70% of weekly base pay up to 182 calendar days
Long-Term Disability
• Company-provided benefit of 66 2/3% of eligible monthly pay after 182 days of disability
Employee Assistance Program
• Confidential, comprehensive, free resource for assistance with personal, financial, and family issues
Doctor on Demand
• Connect with a doctor 24/7 on a computer, smart phone, or tablet
Premise Health Onsite Health Clinics
• Local health care center for you and your family
Castlight
• Online medical services shopping tool, meQuilibrium stress management app, and company provided wellness program
Wellness Program, powered by Castlight
• Company-provided wellness program
Voluntary Benefits
• You may purchase Home and Auto Insurance, Critical Illness Insurance, Pet Insurance, and the MetLaw Legal Plan
Abenity Discount Program
• Discounts from thousands of national companies
None of the information contained herein
is intended to be legal or tax advice.
Employees should consult with their own tax
advisor or attorney with regard to questions
about their personal tax situation.
Virtual Benefits Fair
For information, visit the Virtual Benefits
Fair. Login to Workday and click on the
Benefits & Rewards app, or login to
the Total Rewards site and click on the
Virtual Benefits Fair banner. You will be
able access benefits information about all
of the 2023 plans. You will also be able to
ask the insurance carriers questions!
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4/22
Eligibility
NEW HIRES AND NEWLY ELIGIBLE EMPLOYEES
You are eligible to participate in the DTNA Benefit Program on the first day of the month following 60 days
of employment.
DEPENDENTS
You can cover your legal spouse and dependent children (children by birth or adoption and stepchildren) up to
age 26.* Dependent children remain eligible for coverage until the end of the month in which they turn age 26.
Note: Insurance for a dependent child may be continued past the age limit if the child is incapable of self-
sustaining employment because of a mental or physical handicap as defined by applicable law. Proof of such
handicap must be provided to the Company prior to the date the child attains the age limit. You may be
required to confirm this information at reasonable intervals after such date.
* See page 19 regarding eligibility for optional child life and spouse life insurance.
QUALIFIED STATUS CHANGES
Generally, you can only change your benefit elections during the Open Enrollment period unless you have a qualified
status change. Qualified changes include:
• Marriage, divorce, birth or adoption of a child, or change in child custody
• Death of your spouse or child
•
Employment status change for you or your spouse
that affects benefits coverage
Note: Making changes to covered dependents does not change or drop life insurance coverage.
You must make changes online within 30 days of the qualifying event. Benefit Election Changes are made
at https://mybenefits.adp.com. If you miss the notification deadline, you may contact the Benefits Service
Center at 800-605-6031 and request an appeal. You will be notified by the Service Center when a decision is made.
Verifying Dependent Eligibility
Verifying dependent eligibility can save significant benefit dollars. With that goal in mind,
DTNAhas partnered with ADP to conduct an ongoing Dependent Eligibility Verification
process for all new hires as well as any added dependents or changes at Open
Enrollment. When you enroll or make additions, you will be asked to provide appropriate
documentation (e.g., marriage license, birth certificate, current tax return) to substantiate
a family member's eligibility for dependent coverage. Having ineligible dependents on
coverage will result in disciplinary action up to, and including, termination.
You may submit dependent information electronically when you enroll on
https://mybenefits.adp.com. If you do not submit the information when you enroll, you
will be sent a letter requesting this information with instructions; if documentation is not
provided, the dependent will be removed from coverage the effective day of the event. If
you need assistance, please call the Benefits Service Center at 800-605-6031.
Benefits Tip
If you have a family change, you may want to change your beneficiary for life insurance
at https://mybenefits.adp.com or by calling 800-605-6031.
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5/22
Enrollment
HOW TO ENROLL
You have two ways to enroll:
• Online Enrollment 24 hours a day, 7 days
a week at https://mybenefits.adp.com.
When you register on the site using the
registration code DTNA.LLC-DTNA your
name, Social Security number, and date of
birth, you will select a User ID and Password.
Select “annual enrollment event” to start the
enrollment process.
• Telephone Enrollment through the Benefits
Service Center at 800-605-6031 Monday
through Friday, 8:00 am – 6:00 pm ET.
If you enroll online, you can print your
confirmation statement or request it be emailed
to you when you have completed enrollment.
If you enroll by telephone, a confirmation
statement will be mailed to you. Remember to
review your confirmation statement carefully.
If you have questions about enrollment or
need to make changes, call the Benefits
Service Center at 800-605-6031.
Enrollment Confirmations
When enrollment is
complete you will be
mailed a confirmation that
provides your 2023 benefit
elections, dependents and
beneficiaries.
Follow these steps to
make sure you are enrolled
for the correct benefits:
• Step 1: Review your
enrollment confirmation
• Step 2: On the first paycheck of
2023 check your deducitons to make
sure they match your enrollment
confirmation
If you need to make changes,
immediately contact the Benefits
Service Center at 800-605-6031.
Appeals Process
Contact the Benefits Service
Center at 800-605-6031 to request
an appeal if you need to make a
change to your benefit elections or
dependents.
First Class
US Postage
PAID
Louisville, KY
Permit #317
Sam Sample
1234567 Anywhere Street
Any Town, Kentucky
12345
Daimler Truck North America
Freightliner Service Center
P.O. Box 25187
Salt Lake City, UT 84119
BENEFITS ENROLLMENT
Time-Sensitive Information Enclosed
Please Open Immediately
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6/22
Tools & Resources
Blue Cross Blue Shield PPO Plan
866-322-4784
www.bcbsm.com
2023 Medical Plan
BLUE CROSS BLUE SHIELD (BCBS) PPO PLAN
Staying in good health is one of the most important goals we can have. The BCBS PPO Plan provides comprehensive services and prescription
drug coverage to treat illness or injury as well as preventive benefits to help you stay healthy. And when you enroll in the medical plan, you
also receive dental and vision coverage (see pages 15 and 16).
Covered services include medically necessary treatment from licensed providers such as doctors, hospitals, skilled nursing facilities, physical
therapists, hospice care, private duty nursing, outpatient radiology facilities and laboratories, and ambulatory surgical facilities.
If you enroll in the BCBS PPO Plan, you and each member of your family enrolled in the plan may choose to receive care from network
or non-
network providers. Your costs will be significantly less if you choose a network provider. Locate network providers online at
www.bcbsm.com, or call 866-322-4784.
The medical plan offers prescription drug benefits at Express Scripts (Medco) participating retail pharmacies as well as other pharmacies,
and through the Express Scripts mail order program. To find Express Scripts retail pharmacies near you or learn more about the mail order
program, visit the Express Scripts web site at www.expressscripts.com.
Read more about the plan on the next pages.
Benefits Tip
If you have coverage available through your
spouse, compare the costs and benefits
of both programs. In most cases, having
coverage through two plans does not result
in higher benefits.
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7/22
SAVE MONEY ON PRESCRIPTION DRUGS
Review your prescriptions with your provider. This may allow you to change to
a lower-cost alternative:
• Generic drugs are proven by the FDA to be safe and effective. They
have the same active ingredients, dosage, safety, strength, quality, and
performance as their brand name counterparts. The copay for a generic
drug is less than the copay for a brand name drug.
• Brand Formulary drugs are brand name drugs at a lower price.
• Brand Non-Formulary drugs are not on the list of approved drugs. These
drugs may not have a proven record for safety, or their clinical value may
not be as high as the drugs in Tier 1 and Tier 2. These drugs may also have
the option of generic available. Depending on drug coverage, you may pay
a higher copayment or even the entire cost of these drugs.
• Compound type drugs may be less expensive if purchased separately rather than as one compound drug.
• Mail service is a convenient, cost-effective way to purchase long-term maintenance prescriptions. Using mail order will
maximize your benefit dollars and your medication is delivered free to your home. By using our Mail Order Incentive program
for long-term maintenance prescriptions you get the best price on the medication. Find out more about mail service
at www.expressscripts.com.
Terms to Help You Understand Your Medical Coverage
Annual deductible: Amount you pay each year toward covered services before the plan begins making payments.
Coinsurance: The percentage of a covered service you must pay for a specified service, such as for hospitalization.
Copay: The fixed dollar amount you must pay for a specified service, such as a visit to a network doctor’s office.
Out-of-Pocket Maximum: The most you are required to pay in a calendar year before covered expenses are
paid at 100%. Penalties and non-covered expenses do not count toward the out-of-pocket maximum.
2023 Pharmacy Benefits
Express Scripts
• 800-818-1030
• www.expressscripts.com
• Express Scripts Mobile App
— Order refills, check on prescription
status, or find a pharmacy.
Download the free app available
on Google Play, the Apple App
Store, and Amazon.
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8/22
2023 Medical Plan At-a-Glance
Your Monthly Cost Share
Coverage
Employee Only
$78.00
Employee Plus One
$156.00
Employee Plus Family
$234.00
BCBS PPO Plan
GENERAL PROVISIONS
In-Network
Out-of-Network
Service Area
Call BCBS at 866-322-4784 No restrictions
Choice of Providers
Network providers Any licensed provider
Annual Deductible
$600/person;
$1,200 family
3
$1,200/person;
$2,400 family
3
Out-of-Pocket Maximum
2
$1,800/person;
$3,600 family
2,3
$2,400/person;
$4,800 family
2,3
Maximum Lifetime Benefit
None
Pre-Admission Certification
Required Required
PREVENTIVE CARE (Age, frequency and/or dose restrictions may apply.)
Routine Physical
Covered at 100% Not covered
Immunizations, Inoculations
Covered at 100% Covered at 75%
1
Routine Pap Smear (lab)
Covered at 100% Covered at 75%
1
Routine Mammogram
Covered at 100% Covered at 75%
1
EMERGENCY/URGENT CARE
Hospital Emergency Room
• Emergency
• Non-emergency
You pay $125 copay
4
Covered at 80%
You pay $125 copay
4
Covered at 70%
1
Urgent Care (emergency)
You pay $50 copay
4
Covered at 70%
1
if non-emergent
1
Subject to calendar year deductible. Benefits based on reasonable and customary charges or contracted amounts.
2
Out-of-pocket expenses include coinsurance, deductibles and medical and prescription drug copays.
3
Family annual deductible and out-of-pocket maximum can be divided among all family members but no one family member can contribute more than the individual amount.
4
Waived if admitted.
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9/22
2023 Medical Plan At-a-Glance (continued)
BCBS PPO Plan
HOSPITAL INPATIENT
In-Network
Out-of-Network
Semiprivate Room
Covered at 80%
1
Covered at 70%
1
Doctor/Surgeon/Anesthesia
Covered at 80%
1
Covered at 70%
1
OUTPATIENT OR SURGERY FACILITY
Physician Office Visits
You pay $30 copay/visit for PCP Covered at 70%
1
Doctor on Demand
(see page 11)
Covered at 100% Covered at 100%
Facility Services
Covered at 80%
1
Covered at 70%
1
X-Ray/Lab at Hospital, Facility
Covered at 100% Covered at 70%
1
MATERNITY COVERAGE
Delivery (doctor, hospital)
Covered at 80%
1
Covered at 70%
1
Prenatal Office Visits
Covered at 100% Covered at 70%
1
MENTAL HEALTH/SUBSTANCE ABUSE
Mental Health
• Inpatient
• Outpatient
Covered at 80%
1,2
You pay $30 copay/visit
Covered at 70%
1,2
Covered at 70%
1,2
Substance Abuse
• Inpatient
• Outpatient
Covered at 80%
1,2
You pay $30 copay/visit
Covered at 70%
1,2
Covered at 70%
1,2
Doctor on Demand
(see page 11)
Covered at 100%
1
Subject to calendar year deductible. Benefits based on reasonable and customary charges or contracted amounts.
2
Out-of-pocket expenses do not apply to maximum; coinsurance never increases to 100%.
More
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10/22
2023 Medical Plan At-a-Glance (continued)
BCBS PPO Plan
OTHER SERVICES
In-Network
Out-of-Network
Skilled Nursing Facility
Covered at 80
% Covered at 70%
1
60 days/cal year max
Home Health Services
Covered at 100% Covered at 70%
1
Unlimited visits in-network; out-of-network limited to 40 visits/cal yr
Chiropractic Services
You pay $30 copay/visit
Covered at 70%
60 visits/cal year max combined with Other Therapies
3
Other Therapies
(See Summary Plan Description for details)
You pay $30 copay/visit
Covered at 70%
1
60 visits/cal year max combined with Chiropractic Services
3
PRESCRIPTION DRUGS
Out-of-Pocket Maximum for Pharmacy
(In Network)
Express Scripts Pharmacy
$4,800/person
$9,600/family
n/a
n/a
Retail (30-day supply)
• Generic
• Brand Formulary
• Brand Non-Formulary
Express Scripts Pharmacy
You pay $10 copay
You pay $35 copay
You pay $60 copay
You pay $10 copay or 20% (whichever is greater)
2
You pay $35 copay or 20% (whichever is greater)
2
You pay $60 copay or 20% (whichever is greater)
2
Mail Order (90-day supply)
• Generic
• Brand Formulary
• Brand Non-Formulary
Express Scripts Mail Service
You pay $20 copay
You pay $70 copay
You pay $120 copay
1
Subject to calendar year deductible. Benefits based on reasonable and customary charges or contracted amounts.
2
Out-of-pocket expenses do not apply to maximum; coinsurance never increases to 100%.
3
In and out-of-network visits accumulate separately.
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11/22
Doctor on Demand
Doctor on Demand is a virtual (facetime) doctor service that lets users visit with
a board-certified physician or licensed psychologist from the comfort of home.
Some of the conditions treated are:
Costs for Medical
Plan Members
Medical visits:
BCBS PPO: no charge
Behavioral visits:
BCBS PPO: no charge
Medical
• Cold & Flu
• Asthma & Allergies
• Bronchitis & Sinus Issues
• Rashes & Skin Issues
• Eye Issues
• Pediatric Issues
• UTI & Yeast Infections
• Pharmacy Prescriptions
Behavioral
• Anxiety & Stress
• Depression
• Mood Swings
• Alcohol & Tobacco
• Trauma
• Grief
• Relationship Issues.
To get started, download the Doctor on Demand app to your smartphone or tablet
from the App Store for iOS or the Google Play Store for Android. The average wait
time is 3-5 minutes to connect with a board-certified Doctor on Demand provider.
Your cost for a visit will vary depending on your medical plan and the type of
service being received. Doctor On Demand accepts all major credit cards. You
may also pay using your FSA, or bank debit card, as long as it has a VISA or
MasterCard logo.
FOR MORE INFORMATION
To find more information, visit www.doctorondemand.com/dtna. You may also
contact the Doctor on Demand Customer Support line at 800-997-6196 or send an
email to support@doctorondemand.com.
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12/22
Onsite Primary Health Care Centers
Now Partnered With Premise Health
Premise Health has partnered with Daimler Truck to provide you and your family with a local health and
wellness center. The centers treat both acute and chronic conditions such as the common cold and the
flu, high blood pressure, and diabetes. They also provide annual physicals, health coaching, lab work, and
much more. The Premise Health centers are considered network providers under all of the Daimler Truck
medical plans; their deductibles apply and you will pay the usual plan copays. Some of their services are
shown below.
To find a location near you and to register and schedule appointments log in to: www.mypremisehealth.com
or download the My Premise Health app to complete the self-sign-up process. Simply click the Sign up now
button under New User to get started. You’ll be asked to enter your full name, date of birth and last four digits
of your social security number (SSN). You may call Premise Health at 877-685-5886.
Medical and Health Services
• Primary, acute, and episodic care
• On-site pharmaceutical dispensary
• Immunizations
• Sports physicals, physical therapy
Wellness
• Personalized wellness programs
• Weight, nutrition, and exercise counseling
• Stress, mental health, and addiction management
• Cardiovascular risk reduction
• Biometric screening assessment
• Tobacco cessation
Need Medical Advice?
Assistance is always available:
Premise Health 24/7 Nurse Line: 877-423-1330
BCBSM 24/7 Nurse Line: 800-775-2583
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13/22
Abenity Discount
Program
Join the Employee Discount
Program and start saving
money!
1. Register Online
V i s i t https://DTNA.abenity.com/perks/register
or visit Workday site to register and select your
Username and Password. Be sure to enter the
Daimler Registration Code DTNA1.
2. Log in to the Abenity site to start taking advantage
of national discounts!
Log in at www.prks.co/DTNA or visit Workday
site using your Username and Password.
Easy mobile access
Download the Abenity Android or iPhone app by
searching “Abenity” in the appropriate app store.
You must register at the website first, then you
can access the app.
Castlight Online Medical Services Shopping Tool
Shop smart for medical care! Those enrolled in the Daimler Blue Cross Blue Shield PPO
Plan can use the Castlight online resource at no charge, to:
• Know what is covered under your medical plan, from screenings to preventive care options
• Compare pricing, location, and quality information on doctors, hospital,
and medical services
• Check your plan deductible status and past expenses
• Connect with other Daimler benefit programs
• View your healthcare ID cards with the app
Visit www.mycastlight.com/dtna to get started. You can download the mobile app at www.mycastlight.com/mobile.
If you have questions, you can call a Castlight Guide at 866-960-0872.
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14/22
Wellness Program
POWERED BY CASTLIGHT
Our wellness platform is through Castlight. This health app is designed to support your wellness journey. You choose from
programs that target key health behaviors. Track your progress on the Castlight app and get rewarded! You can also engage
in some friendly competition.
Employees and their spouse are eligible to participate in the program.
The Castlight App — Connect to All
Your Benefit Resources!
With the Castlight app, you can connect to all of
your Daimler benefits, making it quick and easy to
find what you need.
Follow the steps under “Get Started Using the
Castlight App!” in the right column on this page.
Castlight meQuilibrium App
DTNA is pleased to offer you meQuilibrium — a stress
management app designed to help you discover
simple techniques to build your resilience and shift
your response to stressful thoughts and situations.
meQuilibrium is HIPAA compliant and all information
is confidential.
You’ll get a personalized program created from
over 20 years of research in positive psychology,
resilience training, and integrative medicine
spearheaded by psychologists.
Redeem Your Points For Sweepstakes
Earn points on the Castlight app by tracking
healthy activities, watching instructional videos and
participating in quarterly step challenges. Unused
points earned and redeemed in 2022 will not roll over
to 2023.
Every 10 points earned will qualify for sweepstakes
entries.
Spouses can redeem points for sweepstakes!
Get Started Using the Castlight App!
• Download the Castlight app, available through the Apple App Store,
or Google Play. Or you can visit the website www.mycastlight.com.
1 Download the Castlight app www.mycastlight.com/dtna
2 Click on Register
3 Enter your email address, phone number, create a password.
4 Verify your name birthday, zip code, and last 6 digits of SSN.
• Log in points for health activities on the Castlight app.
If You Have Questions
• About the Castlight app or website, visit the
Help Center at www.mycastlight.com.
• About the Wellness program: email
momentum@daimler.com.
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15/22
Maximize Your
Dental Benefits
Use network providers
Network providers agree to charge contracted
amounts, so you don’t need to pay excess
amounts that non-network providers may
charge over the allowed amounts.
Ask for a pre-treatment estimate
You can avoid surprises and know your
share of the costs.
Get preventive care
These services are paid at 90% or 100%,
and can prevent or fix dental issues
before they are more costly.
Dental
Dental coverage is an important part of your health care package.
When you enroll in the BCBS PPO medical plan, you also receive the
dental benefits.
If you receive care from a Moda Health network dentist, your out-of-
pocket costs will be less. The plan allows you to use a PPO, Premier
or Out-of-Network provider.
• Premier and PPO providers are considered in-network and allow
you to maximize your dental benefits. You will not receive a
secondary bill and the providers will process claims for you.
Dental Benefits Overview
Moda Health
Deductible
None
Preventive Care
(oral exams, x-rays, prophylaxis treatments,
fluoride treatments)
Covered at 100%
Basic Care
(fillings, endodontic treatment, periodontic
treatment, oral surgery)
Covered at 80%
Major Care
(crowns, veneers & cast restorations,
prosthodontics – bridges and dentures)
Covered at 80%
Maximum Annual Benefit*
$1,900 per person
Orthodontia
80% up to $1,900 lifetime max
Based on reasonable and customary charges or contracted amounts.
* Does not apply to Pediatric (up to age 19) patients
• Out-of-Network dentists may require you to
file your own claims. You may be subject
to secondary billing in addition to your plan
coinsurance.
The table below summarized benefits if you use a
network dentist. For a list of network dentists, got
to www.modahealth.com or call 877-425-9808.
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Tools & Resources
VSP
800-877-7195
www.vsp.com
The Daimler Truck North America Benefit Program includes vision coverage if you elect medical coverage.
The vision care plan is offered through Vision Service Plan (VSP), one of the nation’s largest
providers of vision care coverage. The plan includes coverage for routine exams and eyewear
through a large national network of VSP providers.
The following chart is a brief summary of the benefits available under the vision care plan if you use
network providers. Limited out-of-network benefits are also available. For more information and
to find VSP providers, go to www.vsp.com and use your 9-digit BCBS ID number (found on your
medical ID card) to access the VSP system, or call 800-877-7195.
Vision
Maximize Your
Vision Benefits
Use network providers
You must use network
providers to receive maximum
benefits under the plan.
Contact VSP to find providers
near you.
Get your annual exam
Your need for vision correction
can change each year — make
sure you and your family can
perform well at work and
at school with up-to-date
eyeglasses or contact lenses.
The annual eye exam can also
identify eye health issues that
you should address with your
medical provider.
Vision Benefits Overview
General Provisions VSP In-Network
E x a m s
$25 copay
1
Lense s
$75-$150
1, 2
Frames
Up to $75 per 24 months
Contact Lenses
3
Up to $215 per 12 months
$250 if medically necessary
1
Exams and lenses every 12 months.
2
Reimbursed up to predetermined amount based on lens type.
3
In lieu of eyeglasses
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FSA Administrator
Z e n i t h
833-876-4964 or 503-486-2112
Website: www.zenithflex.com
Mobile app: Zenith Flex
(for Apple and Android)
Use the Zenith website or mobile app to easily:
• File a claim online
• Upload receipts and track expenses
• View up-to-the-minute account balances
• View your account activity, claims, and payment
(reimbursement) history
• Report a lost/stolen card and request a new one
• Update your personal profile information
• Change your login ID and/or password
• Enroll for direct deposit reimbursements
• Enroll in text notifications for account updates
• Download plan information, forms, and notifications
To get started:
1. Go to the website or use the mobile app
2. Select Card Number from the dropdown menu and
enter your FSA Card Number
3. Enter Your ID, which is your Social Security Number
4. Follow the online screen instructions
The DTNA Benefit Program offers two separate flexible spending accounts: the Health Care Spending Account and the Dependent Care
Spending Account. These accounts are available based on employee participation. The purpose of these accounts is to save you money for
certain health and dependent care expenses by letting you pay for them with pre-tax dollars.
You may use one or both accounts. When you enroll, you decide how much money you will contribute to your accounts for the upcoming year:
• Up to $2,000 in the Health Care Spending Account
• Up to $5,000 in the Dependent Care Spending Account (or up to $2,500 if you are married and you and your spouse file separate income
tax returns)
Eligible Health Care Expenses
The following is a partial list of eligible expenses that may
be reimbursed from the HCFSA. You may use the HCFSA
for yourself and your eligible dependents, as defined under
IRS Section 152. To be eligible for reimbursement, the
expense cannot be covered by other insurance. See
IRS Publication 502 for more information. Some examples
of eligible expenses:
• Medical plan deductibles, copays and coinsurance
• Laboratory fees
• Acupuncture
• Chiropractor fees
• Hearing aids
• Medical charges over the usual and customary limits
• Orthodontia expenses not covered by a dental plan
• Vision care, lenses, frames and contact lenses not covered
by a vision plan
• Over-the-counter drugs (such as cold or allergy
medications) if prescribed by a doctor
Flexible Spending Accounts
HEALTH CARE SPENDING ACCOUNT
The Health Care Flexible Spending Account (HCFSA) gives you a tax break
on many health care expenses that are not covered by other plans. By
anticipating your expenses and arranging for deductions to be made
from your paycheck, you can lower your tax bill.
When you incur an eligible expense during the year, you file a claim
form for reimbursement.
You must enclose a copy of the receipt
showing the expense has been
incurred. Your receipt must
include the name and address
of the person for whom the
expense was incurred, date
of service, description
of services obtained or
product purchased, and
the amount charged.
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Benefits Tip
Because the IRS is allowing you to lower your taxes, certain
restrictions apply. When you decide on your annual contribution
to either or both accounts, be conservative in your estimate.
Do not contribute more than you are certain you will use during
the calendar year for eligible expenses. Any money that is left
over after reimbursements are made for claims incurred during
the year will be forfeited. If you are a new hire, be sure to only
contribute the amount(s) you are certain you will use as of your
hire date through the end of the calendar year in which you were
hired.
• Household services related to the care of an eligible dependent.
• FICA and other taxes you pay on behalf of the day care provider.
• Generally, any other expense that qualifies as dependent care under
IRS regulations.
Before enrolling in the Dependent Care Spending Account, take a
careful look at whether federal or state income tax benefits on your
income tax returns will save you more money than the Dependent Care
Spending Account.
DEPENDENT CARE SPENDING ACCOUNT
You can use the Dependent Care Spending Account (DCSA) to be
reimbursed for:
• Dependent care at nursery schools, day camps and licensed day care
centers. The day care center must comply with state and local laws
and receive a fee for its services. The portion of schooling expenses
that is strictly care-related may be eligible; tuition expenses for
education are not.
• Services from individuals who provide day care in your home, except
when the provider is the parent of the child, your dependent or your
child under age 19.
Flexible Spending Accounts
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Life insurance helps protect your family from a sudden loss of income resulting from your death. AD&D insurance pays benefits for accidental
death and certain serious bodily injuries.
Life and Accidental Death & Dismemberment (AD&D) Insurance
Eligible Child(ren) for Optional Life
and AD&D Coverage
To be eligible for coverage, a child must be your natural
child, adopted child, or stepchild who is:
• under age 19, unmarried, and supported by you; or
• under age 26 and who is a full-time student at an
accredited school, college, or university that is
licensed in the jurisdiction where it is located, is
unmarried, is supported by you, and is not
employed on a full-time basis.
The child may not be:
• in the military of any country or subdivision of any
country;
• living outside the United States or Canada; or
•
insured as an employee under a Daimler
Truck North
America LLC group policy.
Benefits Tip
You are required to name a beneficiary for your life
insurance. It is also your responsibility to update as
necessary if you have a family change. The process
is paperless — you make a beneficiary change online
at https://mybenefits.adp.com or by phone at
800-605-6031.
Will Preparation and Estate Resolution Services
Will preparation and estate resolution services are available if you are enrolled in
optional life insurance. Services are provided through Hyatt Legal Plans and are
fully paid when a Hyatt participating attorney is used.
Call Hyatt Legal Plans at 800-821-6400 and provide the Daimler name,
117550 group number, and your Social Security number.
Type of Insurance Coverage Notes
Basic Life Insurance
Company paid
2x Base Salary + $10,000 You name a beneficiary.
Coverage is reduced to 65% when you reach age 70 and reduces to
50% when you reach age 75.
Optional Employee Life Insurance
You pay the full cost of coverage
1-3x Base Salary Evidence of insurability may be required before coverage is
approved.
You name a beneficiary.
Coverage is reduced to 65% when you reach age 70 and reduces to
50% when you reach age 75.
Optional
Dependent Life
Insurance
You pay the full
cost of coverage
Spouse
$10,000 - $100,000 Evidence of insurability may apply before coverage is approved.
Spouse coverage ends at age 70.
You are the beneficiary for spouse life insurance.
Child
$2,000, $5,000 or $10,000 You are the beneficiary for child life insurance.
Optional Accidental Death &
Dismemberment (AD&D) Insurance
for Employee and/or Family
Members
You pay the full cost of coverage
Employee coverage:
$25,000 - $500,000
Family coverage: 100% of employee
coverage for spouse only, 20% for
children only and 60% for spouse
and children (spouse 50%, children10%)
If death is the result of an accident the full amount of the AD&D benefit
is paid. If the insured person is seriously injured in an accident, all or
part of the AD&D benefit is paid depending on the nature of the injury.
You name a beneficiary for employee coverage; you are the
beneficiary for dependent coverage.
• If you and your spouse both work for Daimler, only one of you can cover each child, and neither of you can cover the other under Optional Dependent Life Insurance.
• Life Insurance rates are based on age and salary and may change during the year.
• Updating your beneficiary information in ADP will not transfer over to Voya 401(k) or Health Equity (H.S.A.).
No Cost
to You!
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Tools & Resources
Employee Assistance Program
Help when you need it, 24/7
877-251-9695
www.myCigna.com
Balancing life’s challenges is not always easy. Fortunately, there is a
place to turn for help when you need it — the Employee Assistance
Program. This confidential, comprehensive resource is available to
all employees and anyone residing with them by calling 877-251-
9695. You will also find resources and information on their website
at www.myCigna.com. The EAP is designed to provide fast,
convenient answers on a wide range of topics such as managing
stress, substance abuse, finding child care, consumer resources,
legal and financial issues, and emotional well-being.
Examples of how the company-paid EAP can
help with life’s challenges:
• Counseling by phone or in person (up to 3 visits per issue at no
cost to you)
• Up to 30 minute free consultation with an attorney and 25%
discount on select fees
• Help finding child care, elder care and pet care
• Educational guidance information, from online degrees to
financial aid
• Identity theft consultation with a fraud resolution specialist
• Answers to financial questions
Employee Assistance
Program (EAP)
As an eligible employee, you automatically receive Short-Term
Disability (STD) and Long-Term Disability (LTD) coverage after 12
months of service. If you’re ill or injured and unable to work due
to a non-occupational illness or injury, STD and LTD benefits
work together to ensure that your pay continues while you are
disabled. You must file a claim to receive benefits. To initiate a
claim, please contact Sedgwick at 866-530-2280.
SHORT-TERM DISABILITY
Pays 70% of your weekly base pay for up to 182 days after a
seven day waiting period. Daimler Truck North America pays the
full cost of this coverage. You are eligible for coverage after one
year of service.
LONG-TERM DISABILITY
Daimler Truck North America provides LTD coverage equal to
66 2/3% of your monthly base pay, with benefits beginning after
26 weeks of disability. See your union contract for details.
Disability
Benefits Tip
Report time away from work due to
disability immediately to make sure benefits
are paid in a timely manner. You can also
call Sedgwick with questions about disability
and medical leave claims.
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Enroll in voluntary benefits
through Corestream at
https://mybenefits.adp.com.
Customer Service
855-990-4400
email: customerservice@corestream.com
Enrollment Customer Service
855-952-1200
email:
enrollmentcustomercare@corestream.com
To help meet your personal and family insurance needs, you may enroll in one or more voluntary plans. You pay the premiums for these plans with after-tax
payroll contributions. The descriptions provided below are brief overviews only and do not include all coverage details, including limitations and exclusions;
the insurance documents and policies govern the payment of benefits.
METLIFE CRITICAL ILLNESS
INSURANCE
The signs pointing to a critical illness are not
always clear and may not be preventable, but
Group Voluntary Critical Illness Insurance can
help offer financial protection in the event you
are diagnosed. This insurance pays benefits
that can be used for non-medical expenses that
health insurance might not cover. You select
the benefit coverage amount that you want
based on your individual need and your budget.
If you have covered family members, coverage
also provides cash benefits for them. If
diagnosed with a covered critical illness — such
as heart attack, cancer or stroke — you will
receive a cash benefit based on the percentage
payable for the condition.
AUTO & HOME INSURANCE
WITH AUTO QUOTING
With the Auto & Home Insurance program
offered through your employer, you will enjoy
special employee savings. Complete one online
form and instantly compare real-time, side
by side auto insurance quotes from leading
national carriers. Apply for additional coverage
for your home, condo, vacation property, boats,
recreational vehicles, and more. By bundling
your insurance, you could save even more
when you insure with the same carrier. Take
advantage of convenient payment options,
including automatic payroll deduction and
through an escrow account for home insurance.
Coverage can begin as early as the next day.
ID WATCHDOG IDENTITY
THEFT PROTECTION
Enroll in proactive credit and identity protection
from ID Watchdog. Advanced identity
monitoring scours billions of public records
to search for signs of potential identity theft.
If your identity is stolen, dedicated resolution
advocates fully manage your case until it is
resolved. You will also get up to $1 million
Identity Theft Insurance that helps pay certain
out-of-pocket expenses. 24/7 customer care
specialists are there when you need them.
LEGAL SERVICES
The MetLaw plan provides you and your family
legal advice and representation on a wide range
of personal legal matters, including estate
planning, traffic offenses, juvenile matters,
and more. Access a nationwide network of
14,000 experienced plan attorneys and pay one
low, monthly cost no matter how many times
you use a plan attorney for covered services.
(Program subject to annual enrollment terms.)
NATIONWIDE PET HEALTH
INSURANCE
Get up to 90% back on vet bills with the My
Pet Protection® plan from Nationwide. This
program is exclusively for employees and gives
your pet superior protection at an unbeatable
price. Visit any vet, anywhere! Members have
access to a 24/7 vet helpline. Policies cover
common illnesses, including ear infections,
vomiting, and diarrhea, as well as serious/
chronic illnesses, including cancer, diabetes,
hereditary and congenital conditions, and more.
Sign up multiple pets and receive a discount for
even more savings. There are coverage options
for avian and exotic pets too!
Voluntary Benefits
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Need Some Help?
Benefit Contact Information
Contact Telephone Number Website/eMail
Benefits Service Center
800-605-6031
https://mybenefits.adp.com
Blue Cross Blue Shield PPO Plan
866-322-4784
www.bcbsm.com
Express Scripts Pharmacy
800 -818-1030
www.expressscripts.com
Moda Health
877-425-9808
www.modahealth.com
Vision Service Plan (VSP)
800 -877-7195
www.vsp.com
Zenith (Health Care FSA)
833-876-4964 or 503-486-2112
www.zenithflex.com
401(k) Plan
855-401-5205
https://daimler.voyaplans.com
Employee Assistance Program (EAP)
877-251-9695
www.myCigna.com
Sedgwick (Disability and FMLA)
866-530-2280
www.mysedgwick.com/Daimler
Doctor on Demand
800-997-6196
www.doctorondemand.com/dtna
Premise Health Onsite Health Clinics
877-685-5886
www.mypremisehealth.com
Castlight Online Medical Services Shopping Tool
866-960-0872
www.mycastlight.com/dtna
Wellness Program, powered by Castlight
n/a
www.mycastlight.com/dtna
momentum@daimler.com
Abenity Discount Program
n/a
To register: https://dtna.abenity.com
(Use Registration code: DTNA1)
Voluntary Benefits, powered by Corestream
Customer service: 855-990-4400
Enrollment customer service:
855-952-1200
customerservice@corestream.com
[email protected]
Additional Information
available at https://mybenefits.adp.com
• Summary Plan Descriptions
for all benefit plans
• Summary of Benefits and Coverage
(SBC) for each medical plan option
• Carrier links
About This Communication
The official plan documents govern the terms and conditions of the plans and will control in the event of any discrepancy between this communication
and the official plan documents. Daimler Truck North America LLC retains the rights to change, modify, suspend, interrupt, or terminate in whole
or in part any of the published or unpublished employee benefit plans of Daimler Truck North America LLC that are not controlled by a collective
bargaining agreement, without advance notice, at its sole discretion.
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