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<br /> IT’S ABOUT<br /> you! <br /> <br /> 2024<br /> BENEFITS GUIDE<br /> U.S. BENEFITS ELIGIBLE ASSOCIATES <br /> <br /> Here’s where to find ...<br /> Connect With Your Benefits 3<br /> About This Benefits Book 6<br /> Coverage and Enrollment 8<br /> Medical 12<br /> Pharmacy 33<br /> Preventive Health Services 36<br /> Health Advocate 38<br /> Dental 39<br /> Vision 43<br /> Flexible Spending Accounts (FSA) 47<br /> Mental Wellbeing 50<br /> Life Insurance 51<br /> Disability Coverage 53<br /> Group Legal Plan <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 1" href="https://secure.viewer.zmags.com/publication/21197067?page=1"> IT’S ABOUT you! 2024 BENEFITS GUIDE </a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 2" href="https://secure.viewer.zmags.com/publication/21197067?page=2"> Here’s where to find ... Connect With Your Benefi</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 3" href="https://secure.viewer.zmags.com/publication/21197067?page=3"> 2024 BENEFITS GUIDE Connect With Your Benefits </a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 4" href="https://secure.viewer.zmags.com/publication/21197067?page=4"> ANTHEM’S WELLNESS SERVICES AND CONDITION MANAGEME</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 5" href="https://secure.viewer.zmags.com/publication/21197067?page=5"> 2024 BENEFITS GUIDE SAVINGS AND FINANCES (CONT.</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 6" href="https://secure.viewer.zmags.com/publication/21197067?page=6"> About this Benefits Book Thorough attention to de</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 7" href="https://secure.viewer.zmags.com/publication/21197067?page=7"> 2024 BENEFITS GUIDE The Bath & Body Works Program</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 8" href="https://secure.viewer.zmags.com/publication/21197067?page=8"> Coverage and Enrollment Eligibility and Enrollmen</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 9" href="https://secure.viewer.zmags.com/publication/21197067?page=9"> Family We care about the wellbeing of your family</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 10" href="https://secure.viewer.zmags.com/publication/21197067?page=10"> How to Enroll Enroll online through HR Access 24/</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 11" href="https://secure.viewer.zmags.com/publication/21197067?page=11"> Making Changes During the Year You must experienc</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 12" href="https://secure.viewer.zmags.com/publication/21197067?page=12"> Medical We want to be sure you have choices when </a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 13" href="https://secure.viewer.zmags.com/publication/21197067?page=13"> 2024 BENEFITS GUIDE Medical Plan Benefits At a G</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 14" href="https://secure.viewer.zmags.com/publication/21197067?page=14"> Medical Biweekly Premiums Here’s a look at your </a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 15" href="https://secure.viewer.zmags.com/publication/21197067?page=15"> 2024 BENEFITS GUIDE Check if Your Doctor is I</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 16" href="https://secure.viewer.zmags.com/publication/21197067?page=16"> Use the Wellness Center at DC 3 We want you to h</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 17" href="https://secure.viewer.zmags.com/publication/21197067?page=17"> 2024 BENEFITS GUIDE Save with the Wellness Cente</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 18" href="https://secure.viewer.zmags.com/publication/21197067?page=18"> Anthem’s Wellness Services and Disease Management</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 19" href="https://secure.viewer.zmags.com/publication/21197067?page=19"> Get Help with Multiple Conditions: ComplexCare Yo</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 20" href="https://secure.viewer.zmags.com/publication/21197067?page=20"> Autism Spectrum Disorder Program Autism Spectrum </a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 21" href="https://secure.viewer.zmags.com/publication/21197067?page=21"> 2024 BENEFITS GUIDE Medical Plan Benefits: The D</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 22" href="https://secure.viewer.zmags.com/publication/21197067?page=22"> Covered Services & Supplies Lower Premium </a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 23" href="https://secure.viewer.zmags.com/publication/21197067?page=23"> 2024 BENEFITS GUIDE Covered Services & Supplie</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 24" href="https://secure.viewer.zmags.com/publication/21197067?page=24"> Covered Services & Supplies Lower Premium </a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 25" href="https://secure.viewer.zmags.com/publication/21197067?page=25"> 2024 BENEFITS GUIDE Covered Services & Supplie</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 26" href="https://secure.viewer.zmags.com/publication/21197067?page=26"> Covered Services & Supplies Lower Premium </a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 27" href="https://secure.viewer.zmags.com/publication/21197067?page=27"> 2024 BENEFITS GUIDE Covered Services & Supplie</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 28" href="https://secure.viewer.zmags.com/publication/21197067?page=28"> Covered Services & Supplies Lower Premium </a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 29" href="https://secure.viewer.zmags.com/publication/21197067?page=29"> Health Care Management – Precertification Your Pl</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 30" href="https://secure.viewer.zmags.com/publication/21197067?page=30"> General Exclusions and Limitations The plan does </a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 31" href="https://secure.viewer.zmags.com/publication/21197067?page=31"> 2024 BENEFITS GUIDE SERVICES NOT COVERED BY THE</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 32" href="https://secure.viewer.zmags.com/publication/21197067?page=32"> SERVICES NOT COVERED BY THE PLAN ADDITIONAL INFOR</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 33" href="https://secure.viewer.zmags.com/publication/21197067?page=33"> 2024 BENEFITS GUIDE Pharmacy We have your pres</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 34" href="https://secure.viewer.zmags.com/publication/21197067?page=34"> Understand How the Tiers Work What are Tiers, and</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 35" href="https://secure.viewer.zmags.com/publication/21197067?page=35"> „ CONNECT WITH OPTUMRX. Find a pharmacy with th</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 36" href="https://secure.viewer.zmags.com/publication/21197067?page=36"> Preventive Health Services The Bath & Body Works</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 37" href="https://secure.viewer.zmags.com/publication/21197067?page=37"> 2024 BENEFITS GUIDE PREVENTIVE SERVICE Child (B</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 38" href="https://secure.viewer.zmags.com/publication/21197067?page=38"> Health Advocate We want to help you better navig</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 39" href="https://secure.viewer.zmags.com/publication/21197067?page=39"> 2024 BENEFITS GUIDE Dental Bath & </a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 40" href="https://secure.viewer.zmags.com/publication/21197067?page=40"> Dental Plan Benefits: At a Glance Both dental pla</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 41" href="https://secure.viewer.zmags.com/publication/21197067?page=41"> 2024 BENEFITS GUIDE Delta Dental Plus Plan Del</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 42" href="https://secure.viewer.zmags.com/publication/21197067?page=42"> Bi-weekly Dental Premiums Delta Dental Base Pla</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 43" href="https://secure.viewer.zmags.com/publication/21197067?page=43"> 2024 BENEFITS GUIDE Vision We offer flexibility</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 44" href="https://secure.viewer.zmags.com/publication/21197067?page=44"> Vision Plan Benefits: At a Glance Both options pr</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 45" href="https://secure.viewer.zmags.com/publication/21197067?page=45"> 2024 BENEFITS GUIDE VSP Vision Signature Plus Be</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 46" href="https://secure.viewer.zmags.com/publication/21197067?page=46"> Vision Plan Expenses Not Covered We offer a compr</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 47" href="https://secure.viewer.zmags.com/publication/21197067?page=47"> 2024 BENEFITS GUIDE Flexible Spendin</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 48" href="https://secure.viewer.zmags.com/publication/21197067?page=48"> Accessing your FSAs Throughout the year, you’ll h</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 49" href="https://secure.viewer.zmags.com/publication/21197067?page=49"> Making Changes During the Year Other than open en</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 50" href="https://secure.viewer.zmags.com/publication/21197067?page=50"> Mental Wellbeing We care about the whole you, tha</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 51" href="https://secure.viewer.zmags.com/publication/21197067?page=51"> 2024 BENEFITS GUIDE Life Insurance Bath & Body </a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 52" href="https://secure.viewer.zmags.com/publication/21197067?page=52"> Optional Dependent Life Insurance Spouse/Domestic</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 53" href="https://secure.viewer.zmags.com/publication/21197067?page=53"> 2024 BENEFITS GUIDE Disability Coverage If you </a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 54" href="https://secure.viewer.zmags.com/publication/21197067?page=54"> How LTD Benefits are Paid LTD benefits will conti</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 55" href="https://secure.viewer.zmags.com/publication/21197067?page=55"> 2024 BENEFITS GUIDE Group Legal Plan We make it</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 56" href="https://secure.viewer.zmags.com/publication/21197067?page=56"> Leaves of Absence Applying for a Family/Medical L</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 57" href="https://secure.viewer.zmags.com/publication/21197067?page=57"> DEFINITION OF SERIOUS HEALTH CONDITION: For purpo</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 58" href="https://secure.viewer.zmags.com/publication/21197067?page=58"> PARENTAL LEAVE FOR BIRTH MOTHERS (6 ADDITIONAL WE</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 59" href="https://secure.viewer.zmags.com/publication/21197067?page=59"> Bath & Body Works Parental Leave for Non-Birth Pa</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 60" href="https://secure.viewer.zmags.com/publication/21197067?page=60"> PLEASE NOTE: f you want to cover your child in th</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 61" href="https://secure.viewer.zmags.com/publication/21197067?page=61"> BENEFIT COVERAGE WHILE ON A MILITARY SERVICE LEAV</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 62" href="https://secure.viewer.zmags.com/publication/21197067?page=62"> Emergency Leave Full-time benefits-eligible Assoc</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 63" href="https://secure.viewer.zmags.com/publication/21197067?page=63"> IF YOUR FORMER POSITION IS NO LONGER AVAILABLE: I</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 64" href="https://secure.viewer.zmags.com/publication/21197067?page=64"> Key Terms AB ACCIDENTAL INJURY: Bodily Injury su</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 65" href="https://secure.viewer.zmags.com/publication/21197067?page=65"> COORDINATION OF BENEFITS: A provision that is int</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 66" href="https://secure.viewer.zmags.com/publication/21197067?page=66"> „ share the same permanent residence </a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 67" href="https://secure.viewer.zmags.com/publication/21197067?page=67"> Any service not deemed Experimental/ Investigativ</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 68" href="https://secure.viewer.zmags.com/publication/21197067?page=68"> by those laws. It must provide a program of treat</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 69" href="https://secure.viewer.zmags.com/publication/21197067?page=69"> N NETWORK PHARMACY: A registered and licensed ph</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 70" href="https://secure.viewer.zmags.com/publication/21197067?page=70"> R REASONABLE AND CUSTOMARY CHARGES: The benefits</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 71" href="https://secure.viewer.zmags.com/publication/21197067?page=71"> 2024 BENEFITS GUIDE Administrative Information </a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 72" href="https://secure.viewer.zmags.com/publication/21197067?page=72"> In addition to creating rights for Plan participa</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 73" href="https://secure.viewer.zmags.com/publication/21197067?page=73"> BENEFIT PLANS INFORMATION NAMES AND NUMBERS All b</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 74" href="https://secure.viewer.zmags.com/publication/21197067?page=74"> How to File/Appeal a Claim ANTHEM CLAIM DECISION </a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 75" href="https://secure.viewer.zmags.com/publication/21197067?page=75"> Administrator at (the number shown on your identi</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 76" href="https://secure.viewer.zmags.com/publication/21197067?page=76"> appeal decision, a voluntary second level appeal </a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 77" href="https://secure.viewer.zmags.com/publication/21197067?page=77"> PRESCRIPTION DRUG CLAIMS If a pharmacy (retail or</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 78" href="https://secure.viewer.zmags.com/publication/21197067?page=78"> or appropriate), the reviewer will consult a dent</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 79" href="https://secure.viewer.zmags.com/publication/21197067?page=79"> Person may review, during normal working hours, a</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 80" href="https://secure.viewer.zmags.com/publication/21197067?page=80"> You or your authorized representative will be not</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 81" href="https://secure.viewer.zmags.com/publication/21197067?page=81"> reasonable access to and copies of all documents,</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 82" href="https://secure.viewer.zmags.com/publication/21197067?page=82"> LIFE INSURANCE CLAIMS PROCEDURES Processing a Cla</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 83" href="https://secure.viewer.zmags.com/publication/21197067?page=83"> An explanation of a denial of an appeal of a medi</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 84" href="https://secure.viewer.zmags.com/publication/21197067?page=84"> Rule #1: You must provide any facts about coverag</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 85" href="https://secure.viewer.zmags.com/publication/21197067?page=85"> Associate has current employment status</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 86" href="https://secure.viewer.zmags.com/publication/21197067?page=86"> repay benefits paid by the Plan. „ If</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 87" href="https://secure.viewer.zmags.com/publication/21197067?page=87"> Uniformed Services Employment and Reemployment Ri</a> <a title="BBW_2024 Benefits Guide_US Benefits Eligible_FINAL page 88" href="https://secure.viewer.zmags.com/publication/21197067?page=88"> The descriptions of the benefits are not guarante</a>