pasco sheriff’s office · sample of continental benefits id cards 7 ... the pasco sheriff’s...
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Benefits Coordinator Office 8700 Citizens Drive ⬧ New Port Richey, Florida 34654
Phone: (727) 844-7737⬧ Fax: (727) 844-7728
PASCO SHERIFF’S OFFICE
Employee Benefits at a Glance
2016-2017
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Table of Contents
Pasco County Sheriff’s Office Benefits
Open Enrollment ⬧ Qualifying Events 2
Pre-Tax Benefits 3
Eligibility 4
Definitions 5
Provider Search 6
Sample of Continental Benefits ID cards 7 – 8
Continental Benefits Medical Plan Comparisons 9 – 12
Surviving Spouse / Child(ren) Insurance 12
Health Insurance Premiums 13
Example of How Health HMO Deductible and Coinsurance Apply 13
WellDyneRx 14 – 16
CareHere! ⬧ Healthcare Blue Book Pricing Tool 17 – 18
MDLive 18 – 19
Flexible Spending Account (FSA) 20 – 21
Dental Premiums ⬧ Dental Plan Comparisons 22 – 24
Vision Plan Comparisons and Premiums 25 – 26
Employee Assistance Program (EAP) 27 – 28
Aflac 29 – 30
Long-Term Care & Life Insurance 31 – 32
Florida Retirement System (FRS) ⬧ Deferred Compensation 33
Incentive Pay ⬧ Workers’ Compensation 34
Legal Aid ⬧ ID Theft ⬧ Home & Auto Ins ⬧ Chaplain 34
Regulatory Notices 35 – 36
Contact Information 37 – 38
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Pasco Sheriff’s Office 2016-2017 Benefits Guide
The Pasco Sheriff’s Office offers an impressive array of benefits from which to choose. We encourage you to study this booklet thoroughly and give careful consideration to your personal benefits needs. The benefit package provided for you is an extremely valuable part of the compensation you receive as an employee and thoughtful review of it will enable you to obtain the greatest return from this opportunity.
OPEN ENROLLMENT The annual Open Enrollment is held in August, and the benefits elected during the Open Enrollment period go into effect on October 1st and are effective through September 30th of the following year.
The open enrollment period for fiscal year 2016-2017 begins on August 13 and ends on August 26. ALL CHANGE FORMS, ELECTION FORMS, APPLICATIONS, ETC. MUST BE RECEIVED BY THE BENEFITS COORDINATOR NO LATER THAN AUGUST 26. This year requires Active benefit enrollment. Because we are using a new health insurance provider this year all employees must enter their selection. Additionally, due to the new Affordable Care Act, we must collect data for all members of your family regardless of your selection or declination of our benefits. The benefits coordinator MUST receive all change forms, elections forms, applications, etc., no later than August 26, 2016. The Open Enrollment period is the only opportunity enrollees in pre-tax plans have to change plan participation unless they experience a Qualifying Status Change (QSC) event (next page). The open enrollment period may also be the only opportunity during the year to enroll in most post-tax plans.
During the annual Open Enrollment period, you will be able to review all of your current coverage. At this time, you can enroll, change or cancel any of your policies, and renew or sign up for any new coverage you wish to participate in. The Flexible Spending Account is also offered at this time, but does not go into effect until Calendar year 2017.
QUALIFIED STATUS CHANGES Generally, you may change your benefit elections only during the annual open enrollment period. However, you may change your benefit elections during the year if you experience a qualified life event, including:
Marriage, legal separation or divorce
(marital status change)
Birth/adoption/legal guardianship of a child
(dependent changes)
Dependent satisfies or ceases to satisfy eligibility
requirements
Spouse’s employer’s Open Enrollment
Termination of your spouse’s employment
Unpaid leave of absence
Change in full or part time status
Changes due to a judgment,
decree or court order
Entitlement to Medicare or Medicaid
You must provide copies of supporting documents – marriage certificates, birth certificates, adoption papers, court orders, divorce decrees, etc., to the Benefits Coordinator to verify eligibility for a “qualified status change".
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SECTION 125 PRE-TAX BENEFITS Pursuant to Section 125 of the Internal Revenue Code, many of the Sheriff’s benefit plans are offered on a pre-tax basis for active, full-time employees whose premiums are paid through payroll deduction. Pretax treatment may be elected using the One Solution Employee Online Benefits selection tool. Please see the chart below for the tax treatment of your payroll deductions:
ADDRESS CORRECTIONS Important information, including benefit plan changes, documentation for proof of coverage, claims payments, and tax information, may not reach enrollees if their records do not contain accurate addresses. It is extremely important that employees notify Human Resources of any address changes at: Pasco Sheriff Human Resources 8700 Citizens Drive OR [email protected] OR (727) 844-7791 New Port Richey, FL 34654 Benefit provider change of address form may also need to be completed if you participate in Deferred Compensation or Medical or Dependent Care Flexible Spending Accounts.
Benefit Tax Treatment
Medical Coverage Pre-tax
Dental Coverage Pre-tax
Vision Coverage Pre-tax
Basic Life and AD&D Insurance N/A—paid by PCSO
Supplemental Life and AD&D Insurance After-tax
Long Term Disability After-tax
Flexible Spending Accounts Pre-tax
AFLAC Voluntary Plans Pre -tax
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BENEFIT ELIGIBILITY Employees may obtain valuable information about their benefits on the agency Internet at:
http://pascosheriff.com/employee-benefits/
EMPLOYEES All active, full-time (30 hours or more) members qualify for coverage under the benefit plans described in this guide. All part-time members will be covered under Workers Comp Benefits if injured on the job.
DEPENDENTS Dependents are eligible for coverage as follows:
Employee’s legal spouse
Dependent children are eligible for coverage to the end of the month they attain age 26. Dependent children include member’s natural children, stepchildren, legally adopted children, stepchildren, foster children (under 18), and children placed in the home for the purpose of adoption in accordance with Chapter 65, Florida Statutes and children for whom the member has established legal guardianship pursuant to Chapter 744, Florida Statutes, or court-ordered temporary custody.
Disabled children: Children who are mentally or physically disabled are eligible to continue coverage (if already enrolled) after they attain age 26 while the subscriber’s family coverage is in effect, provided that the child is incapable of self-sustaining employment because of their mental or physical disability and are chiefly dependent upon the subscriber for support and maintenance.
SPOUSE PROGRAM When both spouses are active, full-time members within the agency and have dependents, they are eligible for family health insurance coverage at a reduced cost. The agency will make two single contributions toward a family premium. Employees must complete the following steps in order to enroll in the Spouse Program: 1. The employee who will have the deduction made from his/her paycheck for the coverage must complete an enrollment form for coverage, listing the spouse and any other dependents to be covered on the enrollment. 2. New enrollees in the spouse program must provide a copy of their marriage certificate with enrollment form. 3. On the annual Open Enrollment Election form, the employee who will pay the cost of the coverage will select Family, Married w/Dependents. 4. The spouse will waive coverage on the completed health form for IRS purposes.
PART-TIME EMPLOYEE BENEFITS Employees normally scheduled to work fewer than 30 hours per week do not qualify for healthcare benefits, but do fall under the workers’ compensation laws. The agency does however contribute to all permanent part-time employees Florida Retirement System benefits. To find out more about part-time benefits, contact the Human Resource Office at extension 7791.
VOLUNTEER MEMBER BENEFITS Volunteer members do not qualify for healthcare benefits, but do fall under the workers’ compensation laws.
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KEY DEFINITIONS
Self-Insured Health Plan: This is different from fully insured plans where the employer contracts with an
insurance company to cover employees and dependents. In self-funded health care, also known as a self-insured plan, the employer assumes the direct risk for payment of the claims for benefits. Deductible: The amount you pay towards medical and dental expenses each calendar year before the plan
begins paying benefit. Co-insurance: The percentage of the covered charge that you pay after you’ve met the deductible. Co-payment: A flat dollar amount that you pay for medical or prescription drug services, regardless of the
actual amount charged by your doctor or another provider. In-Network: A health care provider that participates in the plan’s network. In-network providers will lower your
out-of-pocket expenses because the plan pays a higher percentage of covered expenses. Out-of-Network: Use of a health care provider that is not in the provider network. The medical plans generally
pay reduced benefits for out-of-network services, except in the event of an emergency. You may also be subject to “balance billing” if your provider charges more than what is considered reasonable and customary among most providers in a specific geographic area.
Out-of-Pocket Maximum: The maximum amount you will pay for health care costs in a plan year. Once you
have paid the out-of-pocket maximum, consisting of your deductible, coinsurance, and co-pays, the plan will cover the remaining eligible medical expenses at 100% of the allowed amount for the rest of the plan year. HMO (Health Maintenance Organization): An organization that provides comprehensive health care
to voluntarily enrolled individuals and families in a particular geographic area by member physicians with limited referral to outside specialists and that is typically financed by fixed periodic payments determined in advance. Note: Using out of network physicians is not reimbursable under an HMO plan.
PPO (Preferred Provider Organization): A managed care organization of medical doctors, hospitals,
and other health care providers who have agreed with a third-party administrator to provide health
care at reduced rates. Note: PPO Networks give the insured the ability to use in and out of network
providers, but using in-network providers will be more cost effective.
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PROVIDER SEARCH - CONTINENTAL BENEFITS MEDICAL PLAN
Please note that while the medical benefits are provided by Continental Benefits, the Aetna Signature Administrators network is utilized to find a doctor or facility located near you:
1. Go to: www.aetna.com/asa and click on “start a new search.”
2. Fill in the (*) Require Selections for searching and ensure the Aetna Signature Administrators (SM)
plan is displayed under “Select a Plan.” Then click “Search” to start looking for a Provider near you!
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EXAMPLES OF YOUR CONTINENTAL MEDICAL AND RX ID CARDS:
Below and on the next page are examples of the Continental Benefits ID cards. After 10/1 you and your doctors can call (855) 303-0834 to confirm medical eligibility or ask benefit questions at any time.
Your Benefit card includes the reference to the network of contracted providers that are Aetna Signature Administrators.
Please note the WellDyneRx logo on the Pharmacy Plan card. Customer Service support for pharmacy questions/concerns should be directed to WellDyneRx. The phone number for members is (888) 479-2000. Your pharmacy would need to call (888) 886-5822.
HMO Plan:
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SILVER PPO Plan:
GOLD PPO Plan:
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PASCO SHERIFF’S OFFICE COVERAGE COMPARISONS
Summary of Health Insurance Benefits 2016-2017
Plan HMO PPO PPO Plan Option HMO PLAN Gold Plan Silver Plan Effective Date 10/01/2016 10/01/2016 10/01/2016 Cost Sharing - Member's Responsibility
Deductible (DED) – See Note 1 (Per Person/Family Aggregate)
In-Network $500 / $1,500
$1,500 / $3,000 $2,000 / $4,000
Out-of-Network NA / NA $2,500 / $5,000 $3,000 / $6,000
Coinsurance – See Note 1
(Plan pays / Member pays)
In-Network 80% / 20% 80% / 20% 80% / 20%
Out-of-Network NA / NA 50% / 50% 60% / 40%
Out of Pocket Maximum (Per Person/Family Aggregate)
In-Network $1,500 / $4,500 $3,000 / $6,000 $4,000 / $8,000
Out-of-Network NA / NA $3,500 / $6,000 $6,000 / $12,000
Medical / Surgical Care by a Physician
Office Services In-Network Family Physician $30 Copayment $30 Copayment $30 Copayment
In-Network Specialist $60 Copayment $60 Copayment $60 Copayment
Out-of-Network Not Covered DED + 50% DED + 40%
Maternity Office Services In-Network Family Physician $30 Copayment $30 Copayment $30 Copayment
In-Network Specialist $60 Copayment $60 Copayment $60 Copayment
Out-of-Network Not Covered DED + 50% DED + 40%
Convenient Care Center In-Network $30 Copayment DED + 20% DED + 20%
Out-of-Network Not Covered DED + 50% DED + 40% Radiology, Pathology and
Anesthesiology Provider Services at
In-Network $0 Copayment DED + 20% DED + 20%
Out-of-Network Not Covered INN DED + 20% INN DED + 20% Preventive Services-Adult/Child
Wellness Services
Office Services In-Network Family Physician $0 Copayment $0 Copayment $0 Copayment
In-Network Specialist $0 Copayment $0 Copayment $0 Copayment
Out-of-Network Not Covered 50% 40%
Mammograms In-Network $0 Copayment $0 Copayment $0 Copayment
Out-of-Network Not Covered $0 Copayment $0 Copayment
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Plan HMO PPO PPO Plan Option HMO PLAN Gold Plan Silver Plan Effective Date 10/01/2016 10/01/2016 10/01/2016
Colonoscopies
In-Network $0 Copayment $0 Copayment $0 Copayment
Out-of-Network Not Covered $0 Copayment $0 Copayment
Medical / Surgical Care at a Facility
Ambulatory Surgical Center (ASC)
In-Network $600 Copayment DED + 20% DED + 20%
Out-of-Network Not Covered DED + 50% DED + 40%
Inpatient Hospital Facility (per admit) – See Note 2
In-Network $500 per day / $1,500 Max DED + 20% DED + 20% Out-of-Network Not Covered $500 PAD + DED + 50% DED + 40%
Outpatient Hospital Facility (per visit) (Surgical)
In-Network $600 Copayment DED + 20% DED + 20% Out-of-Network Not Covered DED + 50% DED + 40%
Outpatient Hospital Facility (per visit) (Non-Surgical)
In-Network $0 Copayment DED + 20% DED + 20%
Out-of-Network Not Covered DED + 50% DED + 40%
Emergency and Urgent Care
Emergency Room Facility (per Visit) (Copay waived if admitted)
In-Network $100 Copayment DED + 20% DED + 20%
Out-of-Network $100 Copayment DED + 20% DED + 20%
Other emergency room services and physician’s fees
• Out-of-Network only covered for emergencies.
In-Network DED + 20% DED + 20% DED + 20%
Out-of-Network DED + 20% INN DED + 20% INN DED + 20%
Urgent Care Centers In-Network $60 Copayment DED + 20% DED + 20%
Out-of-Network Not Covered DED + 50% DED + 40%
Ambulance
• Out-of-Network only covered for emergencies.
In-Network DED + 20% DED + 20% DED + 20%
Out-of-Network DED + 20% INN DED + 20% INN DED + 20%
Diagnostic Testing (e.g., Lab, x-ray)
Physician Office In-Network Family Physician $30 Copayment DED + 20% DED + 20%
In-Network Specialist $60 Copayment DED + 20% DED + 20%
Out-of-Network Not Covered DED + 50% DED + 40%
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Plan HMO PPO PPO Plan Option HMO PLAN Gold Plan Silver Plan Effective Date 10/01/2016 10/01/2016 10/01/2016 Physician Services at Locations other
than Office, Hospital and ER
In-Network Family Physician $0 Copayment $0 Copayment $0 Copayment
In-Network Specialist $0 Copayment $0 Copayment $0 Copayment
Out-of-Network Not Covered 50% 40%
Other Special Services and Locations
Durable Medical Equipment
In-Network DED + 20% DED + 20% DED + 20%
Out-of-Network Not Covered DED + 50% DED + 40%
Skilled Nursing Facility
In-Network DED + 20% DED + 20% DED + 20%
Out-of-Network Not Covered DED + 50% DED + 40%
Home Health Care
In-Network $0 Copayment DED + 20% DED + 20%
Out-of-Network Not Covered DED + 50% DED + 40%
Prescription Drug
- Retail
Generic/Brand/Non-Preferred $10/$30/$50 $10/$30/$50 $10/$30/$50
- Mail Order
Generic/Brand/Non-Preferred $20/$60/$100 $20/$60/$100 $20/$60/$100 Note 1: On the HMO plan, the deductible then coinsurance apply only to the following services:
Ambulance service
Provider services rendered in a hospital or emergency room
Skilled nursing facility services
Hospice services
Durable medical equipment Note 2: A separate admission deductible applies to every hospitalization, unless the out-of-pocket maximum is reached.
NEW! Surviving Spouse / Child(ren) Health Insurance Effective June 1, 2016 the Pasco Sheriff’s Office has chosen to offer the surviving spouse and child(ren) health insurance benefits in the event of a member’s line-of-duty death. Coverage will continue, regardless of future marital status, until the surviving spouse attains Medicare eligibility and dependents age out (currently 26 years old) or lose eligibility for another reason. The surviving spouse and/or dependents must be continuously on the plan in order to qualify for the benefits. Coverage will not be offered to a future spouse or dependent children of the surviving spouse. If the surviving wife is pregnant at the time of the spouse’s death the child(ren) resulting from that pregnancy are covered.
NEW!!
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HEALTH INSURANCE EMPLOYEE PREMIUMS FOR 2016 – 2017
Pasco Sheriff’s Office offers you three medical plan options from which to choose.
The HMO Plan, Silver PPO Plan, or Gold PPO Plan all of which are administered by Continental Benefits using the Aetna Network of Providers:
Continental Benefits-HMO Plan Monthly Rate Bi-Weekly Rate (24 pay periods)
Employee Only $ 51.70 $ 25.85 Employee + Spouse $ 204.74 $ 102.37 Employee + Child(ren) $ 173.90 $ 86.95 Family Coverage $ 430.50 $ 215.25 Family, Married (both members work here) $ 51.74 $ 25.87
Continental Benefits-Gold PPO Plan Monthly Rate Bi-Weekly Rate (24 pay periods)
Employee Only $ 28.42 $ 14.21 Employee + Spouse $ 151.16 $ 75.58 Employee + Child(ren) $ 131.96 $ 65.98 Family Coverage $ 358.30 $179.15 Family, Married (both members work here) $ 0.00 $ 0.00
Continental Benefits-Silver PPO Plan Monthly Rate Bi-Weekly Rate (24 pay periods)
Employee Only $ 0.00 $ 0.00 Employee + Spouse $ 85.82 $ 42.91 Employee + Child(ren) $ 80.82 $ 40.41 Family Coverage $ 270.22 $ 135.11 Family, Married (both members work here) $ 0.00 $ 0.00
EXAMPLES OF HOW HMO DEDUCTIBLE AND COINSURANCE APPLY
Example – Hospital Admission with Surgery
John Doe is a deputy in the HMO. It’s the start of the plan year and his doctor has determined he needs a minor
surgery that will require two days in the hospital. The hospital will cost $45,000. He is using an in-network provider
that will charge an additional $1,500. You might think that John’s total bill is $1,700 ($500 x 2 days in the hospital,
$500 deductible for provider, and $200 to cover 20% coinsurance of remaining $1,000 provider charge).
However, since $1,500 is his out-of-pocket maximum for the plan year, this hospital visit will cost John $1,500
and he owes nothing else for the remainder of the plan year.
Example – Outpatient Surgery
Sally Smith is a employee in the HMO and is scheduled for outpatient surgery. She will see her primary care
provider twice, once before the surgery and once after, where she will pay her $30 copay each visit. She will see
the in-network specialist performing the surgery once before the surgery. She pays a $60 copay for the specialist
visit. The outpatient surgical facility copay is $600, which Sally pays prior to the procedure. Her total out-of-
pocket expenses are $720 ($30+$30+$60+$600). Assuming these are the only medical appointments Sally has
had this year she has now met nearly half of her $1,500 out-of-pocket maximum for the year. She will continue
to pay deductibles, coinsurance, and copays until she reaches $1,500 for the plan year.
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Prescription Benefits Administered by WellDyne Rx WellDyneRx makes it easy to understand and manage your pharmacy benefits through their secure online member portal www.WellDyneRx.com. By using the portal, you can order prescription refills, get copay estimates, and access your personal health and prescription information any time, day or night.
To Utilize the WellDyneRx website you need to register your Continental Benefits ID Card with WellDyneRx as follows: Step One: Go to www.WellDyneRx.com and click the “New member? Start Here” link. For more information about your pharmacy benefits, visit www.WellDyneRx.com or call the Member Services number shown on your member ID card. Step Two: Provide your member information and create a username and password. You can find your member ID# on your Continental Benefits ID card. Step Three: Accept the Terms of Use and click the “Register Now” button. It’s that easy! And, remember, your privacy is our first priority. Your personal health information is always private and protected by state and federal laws. Affordable and convenient prescription drugs If you take a medication on an ongoing basis, you can save time and money by having it delivered to you. No more driving to the pharmacy or waiting at the counter for your prescriptions to be filled! Here are some of the benefits of using the WellDyneRx Prescription Delivery Service:
Convenience
Prescriptions delivered to the address of your choice
Medications ordered your way – online, over the phone or through the mail
Savings
90-day supply of medication means fewer refills, saving time and possibly copays
Standard shipping at no cost to you
WellDyneRx fills prescriptions with lower-cost generic alternatives, when possible
Service
Notification of order status by e-mail or phone
24/7 access to a pharmacist by phone
Easily order medications and refills and find answers to your questions on the portal l
Refill reminder notifications
Flexible payment options
Provide a major credit card in secure system to quickly and conveniently pay for prescriptions
Other payment options available based on your preference
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CAREHERE! – no deductible or copays for Center visits We are pleased to offer a FREE & CONFIDENTIAL path to wellness for all employees and their families that are on the Sheriff’s medical insurance plan. Some of the benefit and services that you have access to include: If you participate in one of the Pasco Sheriff’s Office health insurance plans you can go to one of the
CareHere! Centers for acute, chronic, and wellness visits.
Your assigned physicians, ARNP’s and PA’s will treat you for acute and chronic medical problems or concerns. The providers treat patients’ age 8 years old and up.
No co-pays for generic medicines at the center (requires establishing a relationship with a CareHere! medical provider).
No co-pays for laboratory testing ordered at the CareHere! center (outside lab orders require establishing a relationship with a CareHere! medical provider).
Health Risk Assessment – Provides a current evaluation of your overall health through a 28 panel blood draw. Helps identify high cholesterol, diabetes, liver functions, chemistry levels, nutrition, prostate cancer, hypertension and more.
CareHere Health Coaches – Dietician, Exercise, Mental Health and Weight Management.
Centennial Gulf (Centennial Elementary/Middle School Campus) (Gulf High School Campus) 38503 Centennial Road 5323 School Road Dade City, FL 33525 New Port Richey, FL 34652 Land O’Lakes Hudson Bay (District Office Company) (Hudson Middle & High School Campus) 20306 Gator Lane 14730 Cobra Way Land O’Lakes, FL 34638 Hudson, FL 34669
Wesley Chapel (Thomas E. Weightman Middle School Campus) 30833 Wells Road Wesley Chapel, FL 33545
Before you will have access to the CareHere! Centers, you need to register with CareHere!. Each individual must be registered separately in the CareHere! system. 1. Logon to www.carehere.com and click Member Login 2. On the next screen click “I need to register for the first time with my Access Code.” 3. Beside “First time registration” enter the following Access Code for the Pasco Sheriff’s Office and
click “Go.” ACCESS CODE: PCSD2 4. Confirm you have entered the correct Access Code according to your chosen Health Plan, then
click “Next”.
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YOUR PATH TO COST EFFICIENT CARE:
Healthcare is expensive. By being an educated consumer, you can reduce your medical costs in many ways. Consider the following to lessen the effect on your wallet and the agency:
1. Pay the applicable deductible or copay under your medical plan when you go
to your primary physician - $30 COPAY
2. NEW!! Call MDLive, a new program in 2016 for a virtual, non-emergency consult that costs less than the copay of your medical plan - $20 COPAY
3. Finally, if you participate in one of the Pasco Sheriff’s Office health insurance
plans you can go to one of the CareHere! Centers for acute, chronic and wellness visits – NO COPAY!!
HEALTHCARE BLUEBOOK
A healthcare pricing tool that helps you find procedures and providers at a fair price. www.healthcarebluebook.com
MDLive – New For 2016! $20 Copay for a Telehealth Visit MDLIVE provides anytime access to board certified doctors and pediatricians from where it’s most convenient for you – home, office, or on the go. After registering, within 15 minutes you can have a virtual consult to diagnose non-emergency medical issues over the phone or through secure video on your computer or smartphone.
(888) 201-9458 www.mdlive.com
Lowest
Cost
Low Cost
NEW!!
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FLEXIBLE SPENDING ACCOUNT
What is a Flexible Spending Account (FSA):
This plan, authorized by the IRS, allows you to tax-deduct (for federal income tax and social security tax) certain
expenses you know you will incur during the plan year which runs January 1st through December 31st. When
you elect to payroll deduct dependent care expenses or unreimbursed medical expenses, flexible spending
accounts are set up on your behalf.
When can I make changes to my FSA?
Because the FSA calendar operates on a calendar year you can make changes to your FSA in November of
each year. The HR department will send out information at a later date reminding all employees when the window
opens. New employees can make changes for 60 days after the month in which they are hired.
There are two types of accounts available:
Medical FSA - for medical expenses of the employee or his/her tax dependents that are not covered by
insurance or otherwise reimbursed by another source. The annual maximum for Medical Reimbursement
Accounts is $2,500.
Dependent Care FSA – for day-care expenses incurred for an employee’s child or adult dependent while
the employee works. For Dependent Day Care Reimbursements Accounts the annual minimum is $120
and the maximum is $5,000 ($2,500 if married filing separately).
Important Information about FSAs:
No more use-it-or-lose-it rule. With recent changes to FSA rules, you have another great reason to
contribute to an FSA. In addition to saving on taxes you would otherwise pay on your FSA contributions,
you can now rollover up to $500 of unused funds at the end of the year.
Save on Your Taxes. Here is an example of how much you can save when you use the FSAs to pay
for your predictable health care and dependent care expenses.
*This is an example only, and may not reflect your actual experience. It assumes a 25% federal income tax rate marginal rate and a 7.7% FICA marginal rate. .
With FSA Without FSA
Your taxable income $50,000 $50,000
Pre-tax contribution to Health Care FSA $2,000 $0
Federal and Social Security taxes* $11,701 $12,355
After-tax dollars spent on eligible expenses $0 $2,000
Spendable income after expenses $36,299 $35,645
Tax savings with the Medical FSA $654
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Here are 8 essential tips for using your FSA Debit Card 1. Know where you can use your card Here is a map of stores with IIAS. When you use your FSA debit card at any of these stores, your purchase is verified as eligible automatically at the cash register: https://www.sig-is.org/card-holders/store-locator 2. Know what you can buy with the card Here is a list of eligible and ineligible items: https://www.sig-is.org/publications/eligible-product-list-criteria 3. Why might your card be cancelled? Your Health Care FSA terminates or the card was used inappropriately for ineligible expenses too many times 4. Why your card might be declined? • The merchant may not accept the Benefits Card • Your purchase may not be eligible • The card might be temporarily suspended for an ineligible expense 5. Get our mobile app With My Mobile Account Assistant, if a transaction needs documentation, you will receive an email. You’ll be able to view your account balance, submit claims and you can take a photo of expense or Benny™ documentation and send it to EBC using the app. 6. Always save your receipts If your transaction is not verified at the cash register, you will receive a Receipt Request Letter requesting expense documentation. 7. Expense documentation requires: • Date of Service • Type of expense • Amount of the expense incurred • Name of Service Provider 8. Using Benefit Cards at health/dental/vision providers Your transaction may not be verified at your health, dental or vision providers like it is at retailers or pharmacies with IIAS. You will receive a Receipt Request Letter asking you to provide documentation of the expense. Who should I call if I have questions? Please contact the EBC Participant Services Team between 7 a.m. and 5 p.m. CST at 800 346 2126 and choose option 1. For additional important information, please review your Benefits Card brochure. It’s available as a download when you log into My Account Assistant. Choose “Forms and Materials” from the menu.
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METLIFE DENTAL
Pasco Sheriff’s Office offers you three MetLife dental plans from which to choose. The MetLife Dental (DHMO) requires that you use a MetLife network dentist to access coverage, and provides set copayments, no annual deductibles and no maximums for covered benefits. The MetLife PPO plans are preferred provider organization (PPO) plans that gives employees access to a larger network of dentists. PPO dentists agree to accept reduced fees for covered procedures when treating PPO patients. This means your out-of-pocket costs are usually lower when you visit a PPO dentist than when you visit a non-MetLife dentist, but you have the freedom to visit any licensed dentist under a PPO plan.
The plans are compared side-by-side on the next page. The payroll deductions for each plan are:
METLIFE PLAN (DHMO) Monthly Bi-Weekly (24 pay periods)
Employee Only $12.60 $ 6.30 Employee + One $22.10 $11.05 Family Coverage $34.70 $17.35
PPO LOW OPTION Monthly Bi-Weekly (24 pay periods)
Employee Only $15.80 $ 7.85 Employee + One $28.00 $14.00 Family Coverage $47.00 $23.50
PPO HIGH OPTION Monthly Bi-Weekly (24 pay periods)
Employee Only $25.60 $12.80 Employee + One $49.30 $24.65 Family Coverage $82.70 $41.35
To search for participating providers visit: www.metlife.com and choose the Dental HMO Managed Care Network for the DHMO Met245 Plan.
To search for participating PPO providers visit:
www.metlife.com and choose PDP Plus network (High & Low Plan) Orthodontic treatment in progress Your MetLife DHMO plan offers orthodontic benefits. If you are currently receiving orthodontic treatment prior to the effective date of this plan, you may be eligible for benefits under your new plan. Your dentist must submit the treatment plan and information on payments already made to MetLife to determine benefits. On the website, www.metlife.com, you can:
Find a dentist
Review benefits
Verify eligibility
Print an ID card and much more
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PLAN OPTION 1
High Plan
PLAN OPTION 2
Low Plan
Coverage Type In-Network
% of Negotiated Fee*
Out-of-Network
99th Percentile of R&C Fee
In-Network
Negotiated Fee Schedule
Out-of-Network
99th Percentile of R&C Fee
Type A: Preventive
(cleanings, exams, X-rays) 100% 80% 80% 80%
Type B: Basic Restorative
(fillings, extractions) 80% 60% 50% 50%
Type C: Major Restorative
(bridges, dentures) 50% 40% 35% 35%
Type D: Orthodontia 50% 40% Not Covered Not Covered
Deductible†
Individual $50 $50 $50 $50
Family No Limit No Limit No Limit No Limit
Annual Maximum Benefit
Per Person $1,500 $1,500 $750 $750
Orthodontia Lifetime Maximum
Per Person $1,500 $1,500 Not Covered Not Covered
Child(ren)’s eligibility for dental coverage is from birth up to age 26.
Provided by MetLife
Dental PPO Coverage – HiGH & Low Plans
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*Full list of covered procedures can be found on the website for MetLife at www.metlife.com
Dental Services In-Network Only
Office Visit Copay $5
PREVENTATIVE PROCEDURES:
Teeth Cleaning –1110
Fluoride Treatments-1203
Bitewing X-Ray-0210
Sealant (per tooth)-1351
Oral Ezam-9491
$0 Copay
$0 Copay
$0 Copay
$0 Copay
$5 Copay
BASIC PROCEDURES:
Fillings (permanent teeth):
Amalgam (1 surface)-2140
Amalgam (2 surfaces)-2150
Amalgam (3 surfaces)-2160
Oral Surgery:
Simple Extraction-7111
Surgical Extraction-7210
$0 Copay
$0 Copay
$0 Copay
$5 Copay
$30 Copay
MAJOR PROCEDURES:
Single Root Canal-Anterior-3310
Periodontal Deep Scaling-4341
Osseous Surgery-4261
Crowns-2751/2791
Bridges6212
Denture-5110
$100 Copay
$50 Copay
$225 Copay
$245 Copay
$325 Copay
$325 Copay
Orthodontic Procedures:
Dependent Children 8070/8080
Adult Children 8090
$1850 Copay
$1850 Copay
Provided by MetLife
Dental Coverage – DHMO
Met245 PLAN
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VISION INSURANCE
COVERAGE
IN-NETWORK BENEFITS
OUT-OF-NETWORK BENEFITS
IN-NETWORK BENEFITS
OUT-OF-NETWORK BENEFITS
Comprehensive Examination with Dilation
$15 copayment Reimbursed up to $40 (less applicable copayment)
$10 copayment
Reimbursed up to $40 (less applicable copayment)
Eyeglass Lenses
Standard Plastic CR39 Lenses $25 copayment includes:
Single Vision
Bifocal
Trifocal
Lenticular
Reimbursed (less applicable copayment)
Single Vision up to $20
Bifocal up to $40
Trifocal up to $60
Lenticular up to $100
Standard Plastic CR39 Lenses $20 copayment includes:
Single Vision
Bifocal
Trifocal
Lenticular
Reimbursed (less copayment)
Single Vision up to $20
Bifocal up to $40
Trifocal up to $60
Lenticular up to $100
Polycarbonate Lenses $0 member cost for members age 19 and younger; $30 over age 19
No reimbursement available
Polycarbonate Lenses $0 member cost for members age 19 and younger; $30 over age 19
No reimbursement available
Standard Progressive Lenses $50 copayment
No reimbursement available
Standard Progressive Lenses $50 copayment
No reimbursement available
Transitions (Photochromic) Lenses $60 copayment
No reimbursement available
Transitions (Photochromic) Lenses $60 copayment
No reimbursement available
Eyeglass Frames (in lieu of Contact Lenses)
$25 copayment includes $125 eyeglass frame allowance towards any frame. Copayment waived if included with Eyeglass Lenses.
Reimbursed up to $40 (less applicable copayment; no copayment if included with Eyeglass Lenses)
$20 copayment includes $150 eyeglass frame allowance towards any frame. Copayment waived if included with Eyeglass Lenses.
Reimbursed up to $60 (less applicable copayment; no copayment if included with Eyeglass Lenses)
Contact Lens Examination
$30 allowance No reimbursement available
$30 allowance No reimbursement available
Contact Lenses - Elective (in lieu of Eyeglasses)
$25 copayment $125 materials allowance
Reimbursed up to $60 (less applicable copayment)
$20 copayment $150 materials allowance
Reimbursed up to $80 (less applicable copayment)
SELECT PLUS 125 PLAN SELECT PLUS 150 PLAN
26
VISION INSURANCE
SELECT PLUS 125 PLAN SELECT PLUS 150 PLAN
Contact Lenses - Medically Necessary
$25 copayment $250 materials allowance
Reimbursed up to $250 (less applicable copayment)
$20 copayment $250 materials allowance
Reimbursed up to $250 (less applicable copayment)
Laser Vision Correction
Discount Pricing No reimbursement available
Discount Pricing No reimbursement available
Discount Plan
Plan includes savings on additional purchases once the initial benefit has been used.
No discounts available
Plan includes savings on additional purchases once the initial benefit has been used.
No discounts available
Frequency
Eye Examination: Once every 12 months Lenses: Once every 12 months Frames: Once every 24 months Contact Lenses: Once every 12 months
Eye Examination: Once every 12 months Lenses: Once every 12 months Frames: Once every 24 months Contact Lenses: Once every 12 months
Monthly Rate Employee Only $5.52 Employee Only $7.20
Employee + Family $13.86 Employee + Family $18.10
Biweekly Rate (24 pay periods)
Employee Only $2.76 Employee Only $3.60
Employee + Family $6.93 Employee + Family $9.05
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EMPLOYEE ASSISTANCE PROGRAM (EAP)
Personal problems can have a dramatic impact on an individual’s job performance and productivity. The EAP offers help with the resolution of problems that are affecting work. These problems, however, do not have to be caused by workplace issues. The EAP is a confidential, short term, counselling service for employees with personal problems that affect their work performance.
Our EAP provided through BayCare helps employees manage the stress and strains of everyday life affecting one’s well-being at work and at home. The program provides up to six completely confidential counselling sessions at no charge to the employee and benefit eligible family member.
The program is available 24/7/365 and to access these services and to speak with an EAP professional please call 1-800-878-5470. You can also access EAP online resources for help and guidance.
Whether you’re trying to balance work and family life, looking for care for a child or an older relative, or coping with a personal issue, the BayCare EAP offers free, confidential help with personal and work-related issues whenever you need it, 24/7. You can call toll-free to speak with a professional BayCare consultant, or you can visit the website listed below to find the help and resources you need. From help with a relationship to handling stressful times at work, BayCare EAP can help you with almost any issue, including: Life Family Money Work
Stress and overload Addiction and recovery Relationships Depression Grief and loss Divorce and separation Finding time for you Moving Home improvement Legal issues
Parenting Finding child care Adoption Discipline and safety Teenagers Single parenting Blended families Education Planning for college Financial aid Caring for older relatives Caregiver resources
Budgeting Debt management Credit and collections Saving and investing Basic tax planning Buying a car Home buying and renting Saving for college Bankruptcy Estate planning, wills
Time management Career development Getting along at work Communication Job stress and burnout Relocation Networking Retirement planning Managing people Handling change at work
Starting on October 1, 2016 – to access the new Employee Assistance website please log on to: https://pascosheriff.personaladvantage.com/landing.jsp and use Passcode: PASCO
NEW!!
On October 1, 2016 BayCare will begin providing
our new Employee Assistance Program.
Prior to October1, 2016 continue using LifeWorks
at: www.lifeworks.com
user ID: pasco; password: lifeworks
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29
AFLAC (AMERICAN FAMILY LIFE ASSURANCE COMPANY) Supplemental insurance benefits are provided by AFLAC. Most health plans do not specifically pay for out-of pocket expenses. Supplemental plans pay for benefits directly to the insured, unless assigned, regardless of any other insurance. This optional benefit can be spent or used any way the employee chooses. Depending on circumstances, an employee may or may not have the financial resources to live for a month or more without pay. Supplemental insurance products are designed to help bridge the gap between the cost of treatment for a serious illness or accident and the actual payment by major medical or any other health plans. Therefore, optional supplemental insurance plans to safeguard your family’s well being are offered. These options include Accident Disability Insurance, Hospital Plan, Critical Illness Care and Short Term Disability as well as Cancer Plans. See the product brochures for more information.
GROUP ACCIDENT PLAN
♦ Emergency Treatment ♦ Injury Benefits up to $4,000 ♦ Initial Hospitalization ♦ Hospital Confinement ♦ Physical Therapy ♦ $50 Wellness benefit per person
Group Critical Illness Plan ♦ Guaranteed Issued up to $5,000 employee/$5,000 spouse ♦ Higher amounts available based on eligibility ♦ Children covered at 25% of benefit at no additional cost ♦ Covered Illnesses: Heart Attack, Stroke, Cancer, Renal Failure, Major Organ transplant ♦ Wellness Benefit $50 – this benefit is payable for covered employee and spouse
Cancer Care Plan Classic ♦ First Occurrence of Internal Cancer Benefit $4,000 ♦ Hospital Confinement ♦ Radiation and Chemotherapy ♦ Immunotherapy ♦ Guaranteed Renewable ♦ Cancer Wellness Benefit $75 per person
Hospital Advantage Preferred Plan ♦ Hospital Confinement Benefit ♦ Emergency Room Benefit ♦ Short Stay Benefit ♦ Guaranteed Issued – no underwriting (First 2 Options only) ♦ Physician Visit Benefit ♦ Medical Diagnostic and Imaging Benefit ♦Guaranteed Renewable
Short Term Disability Plan ♦ Selection of monthly benefit amount ♦ Guaranteed Issued – no underwriting ♦ Cash Benefit paid directly to you
♦ Guaranteed Renewable
Please refer to product information distributed by HR Dept or
contact your AFLAC representative Jeannine Macko at (727) 376-6553 or [email protected] for more information
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2016 AFLAC Plans & Semi-Monthly Rates
Accident Plan Employee Emp & Spouse Emp & Children Family $9.59 $14.43 $16.79 $21.63
Cancer Plan Employee Emp & Spouse Emp & Children Family
$19.05 $32.37 $19.05 $32.37
Group Critical Illness Plan “Guaranteed Issued up to $20,000 for new employees (hired after 2/01/2016)
Children are covered at 50% of the employees benefit amount at no additional cost
NON-TOBACCO
AGES $5,000 $10,000 $15,000 $20,000 $25,000 $30,000 $35,000 $40,000 $45,000 $50,000
18-39 $2.56 $4.56 $6.56 $8.56 $10.56 $12.56 $14.56 $16.56 $18.56 $20.56
40-49 $4.59 $8.61 $12.64 $16.66 $20.69 $24.71 $28.74 $32.76 $36.79 $40.81
50-54 $6.68 $12.55 $18.43 $24.30 $30.18 $36.05 $41.93 $47.80 $53.68 $59.55
55-59 $8.78 $16.75 $24.73 $32.70 $40.68 $48.65 $56.63 $64.60 $72.58 $80.55
60-64 $11.95 $23.10 $34.25 $45.40 $56.55 $67.70 $78.85 $90.00 $101.15 $112.30
65-69 $12.98 $25.15 $37.33 $49.50 $61.68 $73.85 $86.03 $98.20 $110.38 $122.55
TOBACCO
AGES $5,000 $10,000 $15,000 $20,000 $25,000 $30,000 $35,000 $40,000 $45,000 $50,000
18-39 $5.34 $10.11 $14.89 $19.66 $24.44 $29.21 $33.99 $38.76 $43.54 $48.31
40-49 $10.06 $19.56 $29.06 $38.56 $48.06 $57.56 $67.06 $76.56 $86.06 $95.56
50-54 $14.50 $28.20 $41.90 $55.60 $69.30 $83.00 $96.70 $110.40 $124.10 $137.80
55-59 $19.40 $38.00 $56.60 $75.20 $93.80 $112.40 $131.00 $149.60 $168.20 $186.80
60-64 $26.83 $52.85 $78.88 $104.90 $130.93 $156.95 $182.98 $209.00 $235.03 $261.05
65-69 $29.20 $57.60 $86.00 $114.40 $142.80 $171.20 $199.60 $228.00 $256.40 $284.80
Spouse may elect 50% of employee benefit
Hospital Advantage Plan – Preferred – Available to ages 18 - 75
SHORT TERM DISABILITY 0/14 ELIMINATION PERIOD 6 MONTH BENEFIT PERIOD
Office
MONTHLY BENEFIT
Annual Income $1,000
$19,000 $1,500
$29,000 $2,000
$39,000 $2,500
$49,000
18-49 $9.10 $13.65 $18.20 $22.75
50-64 $11.05 $16.58 $22.10 $27.63
65-69 $13.65 $20.48 $27.30 $34.13
Field
MONTHLY BENEFIT Annual Income
$1,000 $19,000
$1,500 $29,000
$2,000 $39,000
$2,500 $49,000
18-49 $11.05 $16.58 $22.10 $27.63
50-64 $14.30 $21.45 $28.60 $35.75
65-69 $18.20 $27.30 $36.40 $45.50
Level Employee Emp & Sp Single Parent Family
Option 1 $16.32 $24.18 $22.17 $27.37
Option 2 $20.28 $32.44 $29.58 $36.99
Option 3 $23.92 $39.20 $33.74 $43.68
Option 4 $28.80 $48.23 $38.81 $50.90
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TRUSTMARK UNIVERSAL: LONG TERM CARE COVERAGE
The enrollment of Universal LifeEvents® is underwritten by Trustmark Insurance Company. Trustmark Universal LifeEvents® is permanent life insurance that is designed to match your needs throughout your lifetime. It pays a higher death benefit during your working years when expenses are high and you need maximum protection. Then, at age 70 when your financial needs are lower, your death benefit reduces. However, your Living Benefit for Long Term Care (LTC) never reduces. That means you’ll have maximum protection during retirement when you are more likely to need it. Your LTC Benefit helps supplement the cost of home healthcare, assisted living, adult day care and nursing home care. Contact Mark Macko at 813-245-8921 or email at [email protected]
LIFE INSURANCE / ACCIDENTAL DEATH & DISMEMBERMENT (AD&D)
The Pasco Sheriff’s Office provides all Full-Time Employees $50,000 of life insurance. This coverage is provided at no cost to eligible employees. This coverage was initially insured through MetLife effective October 1, 2012. As an employee of Pasco County Sheriff’s Office you have the option to purchase additional coverage for yourself, spouse and dependents as noted on the following page.
All Certified employees are entitled to an added life insurance policy through American International Group, Inc. The Board of County Commissioners pays for this policy in the event you are killed in the line of duty. This policy pays out $50,000.00 for In Line of Duty, if Accidental, $75,000.00 in line of duty in fresh pursuit, and $100,000.00 if the death was intentional.
BENEFICIARIES: Death benefits will be paid to the employee’s designated beneficiary (ies) (a designation that may be changed at any time during the year). If a beneficiary is not designated in writing, the insurance proceeds will be paid to the policyholder’s estate. Payments made to an estate, however, may result in a reduction in total benefits due to taxes and probate costs.
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METLIFE VOLUNTARY EMPLOYEE PAID TERM LIFE INSURANCE
Employee Optional— Group Voluntary Life and AD&D – Reduced rates below Pasco Sheriff’s Office provides you with the opportunity to purchase group term life insurance coverage for yourself in increments of $10,000 up to 5x salary or $500,000.
*Age banded rates are expressed per $1,000 of coverage per month. They are noted below the ages in the header of the chart. For your convenience, we have computed the approximate premium you will pay per payday in the body of the chart. Final premium calculations will be completed by MetLife. Calculation: To calculate your own premium, note the rate under your age. Take the amount of insurance you want to purchase, divide it by 1,000. Multiply the result by the rate. Multiply the result by 12 (annual) and then divide by 24 (paydays). (Minimum coverage is $10,000 and maximum amount of coverage is the lesser of 5 times basic annual earnings) Example: 1.) Employee is age 35 and wants to purchase $50,000 in coverage 50,000 / 1000 = 50 x 0.14 = $7.00 per month X 12 = $84 / 24 = 3.50 2.) Employee is age 50 and wants to purchase $150,000 in coverage 150,000 / 1000 = 150 x 0.52 = $78 per month x 12 = $936 /24 = 39 Optional Dependent Life: You may purchase voluntary life for your spouse in $5,000 increments up to $100,000, and $2,000 increments up to $10,000 for your child(ren) 1 year to 19 years of age or up to 26 years of age if they are a full time student; child(ren) 15 days to 1 year will receive $2,000.
Evidence of Insurability: As a new hire, you can purchase 3x your salary, up to $200,000, of additional life Insurance without completing medical questions. Purchasing over 3x salary ($200k), will require the completion of a MetLife Evidence of Insurability form (called a Statement of Health).
Conversion and Portability: When your employment ends, under certain circumstances you may be allowed to convert your employer paid life insurance or your voluntary life insurance at the time of your separation with Pasco Sheriff’s Office. Please see your Human Resources Section for more information.
Age Band Rate:
< 30
0.07
30— 34
0.09
35— 39
0.14
40— 44
0.21
45— 49
0.35
50— 54
0.52
55— 59
0.77
60—64
1.08
65—69
1.61
70 +
3.00
Coverage
$10,000 $0.35 $0.45 $0.70 $1.05 $1.75 $2.60 $3.85 $5.40 $8.05 $15.00
$20,000 $0.70 $0.90 $1.40 $2.10 $3.50 $5.20 $7.70 $10.80 $16.10 $30.00
$50,000 $1.75 $2.25 $3.50 $5.25 $8.75 $13.00 $19.25 $27.00 $40.25 $75.00
$80,000 $2.80 $3.60 $5.60 $8.40 $14.00 $20.80 $30.80 $43.20 $64.40 $120.00
$100,000 $3.50 $4.50 $7.00 $10.50 $17.50 $26.00 $38.50 $54.00 $80.50 $150.00
$150,000 $5.25 $6.75 $10.50 $15.75 $26.25 $39.00 $57.75 $81.00 $120.75 $225.00
$200,000 $7.00 $9.00 $14.00 $21.00 $35.00 $52.00 $77.00 $108.00 $161.00 $300.00
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FLORIDA RETIREMENT SYSTEM
The Florida Retirement System offers you the option of participating in the two FRS retirement plans: the FRS Investment and The FRS Pension Plan.
FRS PENSION PLAN (850-488-6491) is a defined benefit plan, in which you are promised a benefit at
retirement if you meet certain criteria. The amount of your future benefit is determined by a formula, based on
your earnings, length of service, and membership class. Your benefit is pre-funded by contributions paid by your
employer. The Pasco Sheriff’s Office contributes to a defined benefit pension plan. An employee is vested
after 8 years of creditable service.
FRS INVESTMENT PLAN (866-446-9377, Option 4) is a defined contribution plan in which employer and employee contributions are defined by law, but your ultimate benefit depends in part on the performance of your investment funds. The FRS Investment Plan is funded by employer and employee contributions that are based on your salary and FRS membership class. The Investment Plan directs contributions to individual member accounts, and you allocate your contributions and account balance among various investment funds. An employee is vested in the FRS Investment Plan after one year of creditable service. CONTACT INFORMATION FOR “FRS” (866)-446-9377 www.MyFRS.com More information and a comparison of the plans is available in the “MyFRS Financial Guidance Program” (informational packet sent directly to the employee from FRS or by calling the MyFRS Financial Guidance line at the above number.) DEFERRED COMPENSATION: Nationwide Retirement Solutions, The Hartford and American Funds all offer personal retirement programs that can be payroll deducted.
Mass Mutual and American funds are administered by Jody Clayton 813-482-9415 (office); 813-294-3201 (cell); 866-374-1995 (fax)
2130 Ashley Oaks Circle, Suite 101
Wesley Chapel, Fl. 33544
www.jclaytonfinancial.com
Nationwide Rep. Sandy J. Andavderde can be reached at (877) 677-3678 or 863-258-0321 or email: [email protected]
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ADDITIONAL BENEFITS: INCENTIVE PAY (CERTIFIED PERSONNEL ONLY): This Florida state funded program to promote higher education and furthering education in certified personnel. It is paid at a maximum of $130 per month. Additional information on this program is available by calling the Training Division at 352-458-0024. Workers’ Compensation If you are Injured at work you must report it to Human Resources at 727-844-7737. Unless an injury is serious or occurs after hours you must seek treatment at a Pasco County Employee Wellness Center. The last resort is to go an emergency room.
LEGAL SHIELD Plan coverage includes but is not limited to:
Consultations for personal, business and job related matters.
Letter & phone calls written or made on your behalf.
Review and consultation on any form of legal papers or documents.
Comprehensive Will preparation and updates.
Traffic violations and tragic accident representation for all covered family members.
Trial defense coverage for criminal and civil matters on and off the job.
$6.90 per pay period covers you and your spouse/significant other on and off your job,
dependent children up to age 21, up to 23 if full time college students and businesses.
IDENTITY THEFT BENEFIT Services are provided by Kroll, the largest investigation company in the world, and includes:
Continuous Credit Monitoring-Suspicious Activity will be brought to your attention.
Identity Investigation and Restoration: A trained expert will take the steps to investigate and restore your name and credit for you.
Proactive searches of applicable local and national databases.
$5.98 per pay period covers you and your spouse/significant other.
BOTH PLANS (Legal Shield and Identity Theft): $11.49 per pay period.
STAR & SHIELD Auto and homeowners insurance Exclusively for the Law Enforcement/Corrections, Fire Rescue/EMS Communities and their families. Star & Shield is a reciprocal (member-owned) insurance company, dedicating to providing coverage and value to Pasco County Sheriff’s Office deserving professionals who put their lives on the line every day. To find out more information or a quote call: (866) 942-9822 CHAPLAIN CORPS PROGRAM: (727) 847-5878 The Pasco Sheriff’s Office Chaplain Corps Program is comprised of volunteer clergy from multiple denominations to assist our members and their families in any way possible. They can provide guidance and support with the utmost confidentiality. If you require the services of the Chaplain Corps, please contact Cpl. Alan Wilkett at the above number.
New Port Richey Dade City 7421 Ridge Rd., Unit 110 Port Richey, FL 34668 36739 State Rd 52, Suite 104 Hours: Mon – Fri 7 am to 6 pm Dade City, FL 33525 Sat 7am – 12pm (noon) Hours: Tues & Thurs 7am – 6pm
35
Regulatory Notices Related to Your Health Plan Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985
The right to COBRA continuation coverage was created by a federal law, the Consolidated Omnibus Budget
Reconciliation Act of 1985 (COBRA). COBRA continuation coverage can become available to you when you
would otherwise lose your group health coverage. It can also become available to other members of your
family who are covered under the Plan when they would otherwise lose their group insurance. Your Employer’s
COBRA administrator will provide you inform of your continuation of coverage opportunities or you may contact
your Human Resource Department.
Notice About Your Prescription Drug Coverage and Medicare
This notice has information about your prescription drug coverage through Florida Blue and about options
under Medicare’s Part D prescription drug coverage. The information can help individuals eligible for Part D
decide on whether or not to join a Medicare drug plan. Prior to November 15th, a Medicare Part D Notice will
be provided to you with details and creditable coverage information.
Newborn’s and Mothers’ Health Protection Act
Group health plans and health insurance issuers generally may not, under Federal law, restrict benefits for any
hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours
following a vaginal delivery, or less than 96 hours following a cesarean section. However, Federal law
generally does not prohibit the mother's or newborn's attending provider, after consulting with the mother, from
discharging the mother or her newborn earlier than 48 hours (or 96 hours as applicable). In any case, plans
and issuers may not, under Federal law, require that a provider obtain authorization from the plan or the
insurance issuer for prescribing a length of stay not in excess of 48 hours (or 96 hours).
SPECIAL ENROLLMENT NOTICE
If you are declining enrollment for yourself or your dependents (including your spouse) because of other health
insurance or group health plan coverage, you may be able to enroll yourself or your dependents in this plan if
you or your dependents lose eligibility for that other coverage (or if the employer stops contributing towards
your or your dependents’ other coverage). However, you must request enrollment within 30 days after you or
your dependents’ other coverage ends (or after the employer stops contributing toward the other coverage).
In addition, if you have a new dependent as result of marriage, birth, adoption, or placement for adoption, you
may be able to enroll yourself and your dependents. However, you must request enrollment within 30 days
after the marriage, birth, adoption, or placement for adoption. Special enrollment rights also exist if you gain or
lose eligibility under a Medicaid or CHIP program. See the following notice.
Premium Assistance Under Medicaid and the Children’s Health Insurance Program (CHIP)
If you/your children are eligible for Medicaid or CHIP and you are eligible for health coverage from your
employer, the State of Florida has a program that can help pay for coverage. Florida uses funds from their
Medicaid or CHIP programs to help people who are eligible for these programs, but also have access to health
insurance through their employer. If you or your children are not eligible for Medicaid or CHIP, you will not be
eligible for these premium assistance programs. If you or your dependents are NOT currently enrolled in
Medicaid or CHIP, and you think you or your dependents might be eligible for either of these programs, contact
the State Medicaid or CHIP office at (877) 357-3268 or (877) KIDS NOW or www.insurekidsnow.gov to find
out how to apply. If you qualify, ask if there is a program that can help you pay the premiums for an employer-
sponsored plan.
36
Once it is determined that you or your dependents are eligible for premium assistance under Medicaid or CHIP, as well as eligible under your employer plan, your employer must permit you to enroll in your employer plan if you are not already enrolled. This is called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance. If you have questions about enrolling in your employer plan, you can contact the Department of Labor electronically at www.askebsa.dol.gov or by calling toll-free (866) 444-EBSA (3272).
WOMEN’S HEALTH & CANCER RIGHTS ACT OF 1998
The Women’s Health and Cancer Rights Act (WHCRA) requires group health plans to provide participants with
notices of their rights under WHCRA, to provide certain benefits in connection with a mastectomy, and to
provide other protections for participants undergoing mastectomies.
If you have had or are going to have a mastectomy, you may be entitled to certain benefits under the Women’s
Health and Cancer Rights Act of 1998 (WHCRA). For individuals receiving mastectomy-related benefits,
coverage will be provided in a manner determined in consultation with the attending physician and the patient,
for:
All stages of reconstruction of the breast on which the mastectomy was performed;
Surgery and reconstruction of the other breast to produce a symmetrical appearance;
Prostheses; and
Treatment of physical complications of the mastectomy, including lymphedema.
These benefits will be provided subject to the same deductibles and coinsurance amounts applicable to other
medical and surgical benefits provided under the health plan offered by your employer.
Notice of Privacy Practices This notice describes the medical information practices of all group health plans (collectively, The “Plan”)
maintained by Pasco Sheriff’s Office (the “Plan Sponsor”) and that of any third party that assists in the
administration of Plan claims.
We understand that medical information about you and your health is personal. We are committed to
protecting medical information about you. This notice applies to all of the medical records we maintain.
Your personal doctor or heath care provider may have different policies or notices regarding the use and
disclosure of your medical information created in the doctor’s office or health provider’s facility.
This notice will tell you about the ways in which we may use and disclose medical information about you. It
also describes our obligations and your rights regarding the use and disclosure of medical information. We
are required by law to:
make sure that medical information that identifies you is kept private;
give you this notice of our legal duties and privacy practices with respect to medical information about
you; and
follow the terms of the notice that is currently in effect.
The complete Notice of Privacy Practices is available through your Human Resource Department.
37
CONTACT INFORMATION
Insurance Contacts: Address Phone Number Website
MEDICAL Continental Benefits
Continental Benefits, 422 S. Kings Ave., Brandon, FL 33511
(877) 352-2583
www.continentalbenefits.com
WellDyneRx (888) 479-2000 www.welldynerx.com
DENTAL MetLife
MetLife Dental Claims P.O. Box 981282 El Paso, TX 79998-1282
(844) 263-8336 www.metlife.com/dental
VISION Advantica
Arbor Shoreline Office Park 19321-C US HWY 19N Suite 320 Clearwater, Fl 33764
Service Center: (866) 425-2323 Toll Free: (866) 354-2020 Fax: (727) 538-4255
www.advanticabenefits.com
RETIREMENT FRS Pension Plan
(850) 488-6491 www.myfrs.com
RETIREMENT FRS Investment Plan
(850) 446-9377, Option 4
LIFE INSURANCE Metlife
Mark Macko (813) 245-8921 [email protected]
LIFE INSURANCE Metlife - CLAIMS
(800) 638-6420
opt. 2 for life claims www.metlife.com
LIFE INSURANCE Metlife - CONVERSION
(877) 275 6387 for conversion application
www.metlife.com
SSN ADMINISTRATION
SSA Office of Earnings Operations P.O. Box 33026 Baltimore, MD
www.socialsecurity.gov or www.socialsecurity.gov/mystat
ement
The Valery Agency (for retiree medical & RX options)
2113 Gulf Blvd., Indian Rocks Beach, FL 33785
(727) 517-8888 Fax: (727) 517-8887
[email protected] www.valeryagency.com
Mass Mutual and American Fund
2130 Ashley Oaks Circle,
Suite 101
Wesley Chapel, Fl. 33544
813-482-9415 (office);
813-294-3201 (cell);
866-374-1995 (fax)
www.jclaytonfinancial.com
Nationwide Deferred Comp
Sandy Andaverde (863) 258-0321 [email protected]
AFLAC Jeannine Macko (727) 0376-6553 [email protected]
38
Human Resources Contact Information
Benefit Contacts Name Phone Number / Fax Email
Pasco County Sheriff Office HR Representatives: Human Resources fax #: 727-844-7728
Rachel Vizner Benefits Coordinator (727) 844-7737
Luanne McGill Human Resources Technician
(727) 847-5878 x7654
About this Guide This guide describes the benefit plans available to you as an employee of Pasco Sheriff’s Office. The details of
these plans are contained in the official Plan documents, including some insurance contracts. This guide is meant
only to cover the major points of each plan. It does not contain all of the details that are included in your
Summary Plan Descriptions (SPD) (as described by the Employee Retirement Income Security Act).
If there is ever a question about one of these plans, or if there is a conflict between the information in this guide
and the formal language of the Plan documents, the formal wording in the Plan documents will govern.