 | Dear Former MATRIX Teammate,
I hope your experience with MATRIX was productive and enjoyable. Because you are no longer on our payroll, we have assembled this packet for you to better understand how your MATRIX benefit coverage will be affected by your permanent or temporary separation from our Company. If you were enrolled as an active employee in any of the benefit plans on the date of your termination, you may be able to continue the coverage. Please read the enclosed information, and feel free to contact us if you have any questions.
- MEDICAL/DENTAL INSURANCE: If you were enrolled in the Medical/Vision or Dental Plans, coverage will remain in effect until the last day of the month in which your active, full-time employment ends. If you are rehired at MATRIX within ninety (90) days of your termination date, you may re-enter these plans with the same coverage you had previously on the date of your rehire, and the normal waiting period will be waived.
COBRA: You will receive COBRA information from COBRA Solutions within 30 days of your termination date. If you elect to continue your Medical/Vision or Dental coverage under COBRA, you must notify COBRA Solutions within sixty (60) days from the date of your qualifying COBRA event, or the date of your notification letter, whichever is later. The cost of the COBRA premium is 102% of the total group policy premium.
If you do not receive your COBRA enrollment information from COBRA Solutions within 30 days of your termination date, please contact COBRA Solutions at (800) 292-5615. Their fax number is (404) 842-8040 and their email is cobrasolutions@bcbsga.com. All COBRA payments should be mailed directly to COBRA Solutions at the following address:
BLUE CROSS BLUE SHIELD OF GEORGIA
COBRA Solutions
P.O. Box 404145
Atlanta, GA 30384-4145
CONVERSION: The Medical Plan does have a conversion option. If you are interested in converting your group medical plan to an individual policy, you will be required to enroll in COBRA for the maximum time allowed. You must contact Blue Cross/Blue Shield at (800) 441-2273 within thirty (30) days of your COBRA expiration date to enroll for a conversion plan. Please note: Conversion policies do not contain the same features nor the same rates.
- OPTIONAL LIFE INSURANCE: If you enrolled in the Optional Life Plan, coverage will remain in effect until the last day of your full-time employment.
- 401(k): If you were enrolled in the MATRIX Resources, Inc. 401(k) Plan and would like to take a distribution of your funds, please contact Great West and request a Distribution/Withdrawal Form. Your distribution check will be mailed within ten (10) to fifteen (15) business days from the date your form was received. If you have any questions about your 401(k) account, balance, status of your distribution, etc. please call Great West at 800-338-4015.
If you have an outstanding 401(k) Loan, please remit a check made out to Great West Life and Annuity Insurance Co. for the outstanding amount to avoid penalties. Your loan will go into default on the first day of the calendar quarter following the quarter in which you missed payments. This check may be mailed to:
Great West Life and Annuity Insurance Company
Attention: 401(k) – 8T3
8525 East Orchard Road
Englewood, CO 80111
If you would like the remaining loan balance to be deducted from any outstanding paychecks, please contact the MATRIX Benefits Department at (800) 382-5533.
- SECTION 125 DEPENDENT CARE REIMBURSEMENT ACCOUNT: This Plan will terminate on the day in which your full-time employment ends. You may submit claims for eligible expenses incurred through your last day of employment only. You have 90 days following your termination from MATRIX to submit claims incurred while you were participating. For questions about your account, please call 800-278-9799.
- VOLUNTARY SHORT-TERM DISABILITY POLICIES: If you were enrolled in this Plan, your coverage will terminate thirty-one (31) days following your full-time employment termination date. The Sun Life Disability Coverage ends at midnight on your last day of employment and is not portable.
This Plan is portable. If you would like to exercise your portability option, please contact Colonial Life Insurance at (770) 649-1407 within thirty (30) days of your full-time employment termination date.
- OPTIONAL LONG-TERM DISABILITY: If you were enrolled in the UNUM or Mass Mutual Long-Term Disability Plans, you will receive a letter and a phone call from a representative within thirty (30) days of your termination date to give you an opportunity to continue your coverage after your termination with MATRIX. You may continue the same premium cost, but will have the option to be billed monthly or have your bank account automatically charged. Your coverage will remain in force until your payments cease. The Sun Life Disability Coverage will end at midnight on your last day of coverage and is not portable.
If you do not receive a phone call from a representative within thirty (30) days of your MATRIX termination date, please call Roth & Associates at (770) 804-5578.
- OPTIONAL LONG-TERM CARE: If you elected Long-Term Care coverage and would like to continue the policy after you leave MATRIX, you should contact John Hancock at (800) 482-0022 within thirty (30) days of your MATRIX termination date and request that you be direct billed for your policy going forward.
If you do not contact John Hancock and you stop submitting your insurance premiums, your coverage will end at the end of the month in which you terminate employment.
- OPTIONAL PRE-PAID LEGAL AND/OR IDENTITY THEFT PROTECTION: If you elected the Pre-Paid Legal and/or Identity Theft protection coverage and would like to continue the policy after you leave MATRIX, you should contact Dean Young at (404) 805-5558 within thirty (30) days of your MATRIX termination date.
Should you have any questions on the above information, please feel free to contact the MATRIX Benefits Department at (800) 382-5533. We wish you much luck in your career endeavors.
Sincerely,
Susanne Baskin
Benefits Manager
MATRIX Resources, Inc.
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