Pinellas County Sheriff’s Office 2013 – 2014 Benefits Plan YearBenefits Enrollment: 7/29/13 - 8/9/13

2

Welcome!

Benefit Options:– Medical – Choice of 2 plans with POS network– Dental – Preventive Only or Direct Reimbursement– Vision – United Healthcare Vision (Spectera)– Employee Assistance Program (EAP)– Life and Disability – The Standard– Flexible Spending Accounts (FSA’s)

Dependent Care Account Health Care Account

3

What Is Not Changing Your premium contributions

Medical, pharmacy, dental and vision deductibles, out-of-pocket maximums, co-insurance and co-pays

UnitedHealthcare continues as claims administrator for medical

United Concordia continues as claims administrator for dental

UnitedHealthcare (Spectera) continues as claims administrator for vision

The Standard continues as our carrier for life and disability

4

What IS Changing OptumRX (a partner with UHC) will replace

Medco/Express Scripts as our Pharmacy Benefits Manager

A new employer paid Short-Term Disability benefit through The Standard is being added

The Direct Reimbursement Dental benefit is being enhanced

The maximum contribution to a healthcare Flexible Spending Account is reduced to $2,500

5

– Add health, dental or vision coverage

– Change your current health plan and/or dental plan

– Add dependents to your coverage

– Delete dependents from your coverage

– Increase supplemental life by $20,000 (restrictions apply)

– Change your life insurance beneficiary designation

– Enroll in FSA for 2013-2014 Plan Year

Open Enrollment - July 29th to August 9th

6

What you MUST do during open enrollment

– You must confirm and/or elect your benefit coverage for the new plan year of October 1, 2013 – September 30, 2014 using the on-line enrollment platform

– You must provide documents to HR for any newly added dependents (by August 9th)

– You must enroll and elect your FSA contributions every year — prior year elections do not carry over

Open Enrollment

United HealthcareMedical Benefits

8

Medical Plan

Choice of two medical plans– CPOS Platinum – Includes coverage for acupuncture, infertility, and

weight reduction surgery – CPOS Gold – Does not provide coverage or follow-up care for

acupuncture, infertility, or weight reduction surgery

Both plans use the same network of doctors and providers

Both plans are open access and do not require a primary care doctor or a referral to visit a specialist

9

Platinum Plan Gold PlanIn Network Out of Network In Network Out of Network

DeductibleIndiv. / Family

$750 / $1,500 $1,500 / $3,000 $1,000 / $2,000 $2,000 / $4,000

Out of Pocket MaximumIndiv. / Family

$2,500 / $5,000 $5,000 / $10,000 $2,850 / $5,600 $5,700 / $11,200

Office Visits - General Practice

$15 Copay 40% after deductible

$20 Copay 50% after deductible

Office Visits - Specialist

$35 Copay 40% after deductible

$40 Copay 50% after deductible

ER Visits $150 Copay $150 Copay $150 Copay $150 CopayOutpatient Surgery 20% after

deductible40% after deductible

30% after deductible

50% after deductible

Outpatient Diagnostics (Lab & X-ray)

20% after deductible

40% after deductible

30% after deductible

50% after deductible

Preventative/Routine Mammograms

Paid at 100% 40% after deductible

Paid at 100% 50% after deductible

10

Visit Your Personal Website On myuhc.com

11

Tools on myuhc.com

• Check claims status and history

• Learn about benefits and coverage

• Find in-network physicians and hospitals • Online statements

• View account balances

• Estimate and compare treatment costs

• Access discounts

• Print temporary ID card/request new card

• Research health topics & read articles

• Chat with a nurse in real-time

12

ComPsychEmployee Assistance Program

www.guidanceresources.com, password: PCSO

13

EAP Benefits

Information and assistance with life and work issues

24 hours a day, 7 days a weekLife/work issues impact job performanceCompletely confidentialAll members in home may access benefit

14

EAP Services Up to Six (6) free face-to-face sessions

— per family member, per issue, per plan year Employee Assistance Specialists, Certified Employee

Assistance Professional, 3-5 years clinical experience EAP benefits include:

Family, marital and relationship problems Emotional difficulties such as depression, anxiety, guilt Online personal health info, news and resource tools Drug and alcohol dependence Job stress Child and elder care research and referrals Legal and financial concerns

15

OptumRxYour Pharmacy Benefit Manager

16

Drug Co-payments

Participating Retail Pharmacies

Up to a 30-day supply*

Participating RetailPharmacies

Up to a 30-day supply*

1½ x copay on 3rd fill

Participating Retail Pharmacies

Up to a 90-day supply*

1½ x copay 3 months

OptumRX by Mail

Up to a 90-day supply*

2 x copay

Generic drugs $10.00 $15.00 $45.00 $20.00

Brand-name drugs (Preferred) $25.00 $37.50 $112.50 $50.00

Brand-name drugs (Non-preferred)

$40.00 $60.00 $180.00 $80.00

* As prescribed by your doctor.

OptumRx by Mail Can Save You Money

17

Drug Coverage Retail Coverage

- Use retail pharmacy for short-term medications

- Go to www.myuhc.com or call Member Services at 800-377-5108, Group Number 712474

OptumRx By Mail – For maintenance/long-term

medications– No charge for standard shipping– Cost-effective and convenient,

medication delivered to your door– Continue to use retail pharmacy

for short term medications

Generics and plan-preferred medications will cost you less than non-preferred medications

Consider using OptumRx by Mail for long-term (maintenance) medications

Money Saving Tips

18

How to use OptumRx Mail Service Pharmacy

1. Talk to your doctor

- Request up to a 3-month supply of your prescription, with refills up to a year (if appropriate)

2. Pass your information to the mail service pharmacy

By fax or electronicallyBy fax or electronically:

- Your doctor can call 1-800-788-4863 for instructions to fax prescriptions directly to OptumRx Mail Service Pharmacy (only doctor can fax prescription)

- Ask your doctor to send immediately by using ePrescribe

19

How to use OptumRx Mail Service Pharmacy

OnlineOnline:

-Log on to myuhc.com

-Click on “Manage my Prescriptions”

-Select “Transfer Prescriptions” and select the medications you would like to transfer to mail service

By mailBy mail:

-As your doctor for a new prescription for up to a 3-month supply, plus refills for up to one year (if appropriate)

-Go to myuhc.com and download an order form

20

How to use OptumRx Mail Service Pharmacy

Mail the new prescription and order form to the address provided

NOTE: Most prescriptions arrive within 7 days from the date your completed order is received. If you need your medication right away, ask your doctor to write a prescription for a 1-month supply that can be immediately filled at a participating retail pharmacy.

21

Visit www.myuhc.com Locate participating retail pharmacies by zip code

View information about possible lower-cost medication alternatives

Compare medication prices and options

Manage your mail order account

View your prescription history

Access drug information

Set up email or text message reminders to take medications and order refills

22

United ConcordiaDental Benefits

23

Dental Plan Options Preventative Only plan

– Reimburse the first $200 of preventative care – Procedures covered are:

Routine oral exams Cleaning and scaling of teeth Two bite wing x-rays per year One panoramic x-ray per 36 month period Fluoride treatments

24

Dental Plan Options

Preventative Only Direct ReimbursementPlan * Full Dental Plan

Covered service 100% of the first $200100% of the first $20050% of the next $3,600

Maximum Benefit $200 $2,000

Deductible None None

* Out of Network benefits reimbursed at the 90% of Usual and Customary charge

25

Dental Plan Administration

Contact United Concordia for dental claim questions – Customer Service : 1-800-332-0366– Website: www.ucci.com– Network: Advantage Plus

United Healthcare VisionVision Benefits

27

United Healthcare Vision Providers No change in vision benefits from last year

Large provider network– Over 30,000 providers nationwide– Private practice and retail chain providers

28

Schedule of Vision BenefitsCovered Services In-Network Out-of-NetworkExam every 12 months $10 copay $25 allowanceFrames $130 retail, $50

wholesale$50 allowance

Lenses Single Vision Lens $20 copay $20 allowance Bifocal Lens $20 copay $30 allowance Trifocal Lens $20 copay $40 allowance

UV Coating $15 Not CoveredTint (Solid) $13 Not CoveredTint (Gradient) $16 Not CoveredScratch Resistance $0 Not CoveredBasic Polycarbonate $25 Not CoveredStandard Anti-Reflective $45 Not CoveredOther Add-ons and Services 20% off retail price Not Covered

Medically Necessary 100% after $10 exam & $20 material copay

$200 allowance

Standard (includes clear, spherical, biweekly disposables)

$20 copay* includes fitting fee, 6 boxes of contacts and up to 2

follow-up visits

$50 allowance

Other Services Allowance AllowanceLasik $562.50 per eye $562.50 per eye

Lens Options

Contact Lenses

Custom (includes toric, gas permeable and bifocal)

$150 allowance toward fitting, materials and up

$50 allowance

29

Accessing Vision Benefits Internet www.myuhcvision.com or www.myuhc.com

24-hour access Provider Locator & FAQ Claims and eyewear order tracking Nominate a provider to join network

Customer Service Center 8:30 a.m. to 8:00 p.m. ET Monday - Friday 9:00 a.m. to 5:00 p.m. ET Saturday

The StandardLife Insurance Accidental Death & Dismemberment Long Term DisabilityShort Term Disability

31

Life and AD&D Benefits

32

Life and AD&D Benefits Accelerated benefit for terminally ill

Waiver of premium - 6 months total disability

Repatriation Benefit up to $5,000

MEDEX Travel Assist

Seat belt benefit - Up to $10,000

Air bag benefit - Up to $5,000

AD&D Family Benefits Package– Higher education benefit – Up to $20,000– Child care benefit – Up to $10,000 – Career adjustment benefit - Up to $10,000 for spouse training

33

Life and AD&D Benefits Line of duty benefit - Up to $50,000 result of action performed in

the course of controlling or reducing crime and assigned duties

AD&D covers variety of accidental losses:– Loss of speech or hearing in both ears– Disappearance – Quadriplegia, Hemiplegia, Paraplegia– Occupational Assault– Public Transportation

34

Short Term Disability Benefit New employer-paid benefit

60% of weekly earnings for up to 26 weeks, maximum of $2,300 paid per week

30 day qualifying period

Must exhaust sick leave before becoming eligible

35

Long Term Disability Provisions

Waiting Period: 180 Days

Benefit: 60% of the first $10,000 of monthly pre-disability earnings

Maximum Benefit: $6,000

Minimum Benefit: $100

Maximum Benefit Period: To age 65 or Social Security Normal Retirement Age

36

LTD Benefits Return to work incentive

$25,000 reasonable accommodation benefit

Standard SecureCard

Social Security assistance

3 months survivor benefits

Assisted Living Benefit - 80% of pre-disability earnings, adds up to $2,000 (month) to LTD benefit, not reduced by deductible income

Lifetime Security Benefit - Income for severely disabled employees beyond maximum benefit period

37

The Standard Customer Service

Medical underwriting: 888-456-3505

STD claim questions: 800-368-2859

LTD claim questions: 800-368-1135

Life claim questions: 800-628-8600

Visit the website at www.standard.com

.

PayFlexFlexible Spending Accounts

39

PayFlex Flexible Spending Account (FSA)

— Funded with pre-tax dollars

Two kinds of eligible expenses:

Healthcare - Medical FSA

— Maximum Contribution: $2,500

Dependent care - Dependent care FSA

—Maximum contribution: $5,000 or $2,500 if married and filing separately

FSA results in lower taxable income and more take-home pay

Flexible Spending Account

40

– Medical FSA eligible expenses include: Prescription co-pays Doctor visit and ER co-pays Health plan deductible and coinsurance Dental services and orthodontics Lasik surgery, glasses, contacts

– Dependent care expenses - Dependent children & adults Elderly parent or disabled spouse Daycare, camps

Flexible Spending Account (FSA)

41

Examples of Ineligible Health Care Expenses

– Diet Foods

– Cosmetics, Cotton Balls, Teeth Whitening

– Vitamins, Supplements, Aromatherapy

– Shampoo, Toothpaste, Suntan Lotion

– Cosmetic Surgery (unless medically necessary and approved by the plan)

– Shaving cream, Razors, Soap and Hand lotions

– Over the Counter Medications without a prescription

Refer to IRS Publication 502 for more information about eligible and ineligible expenses

What is NOT covered under an FSA?

42

Tax Savings ExampleBased on $30,000 annual salary

No Flexible Spending Account Flexible Spending Account

Gross Monthly Income $2,500 $2,500

Pre-tax Dependent Care $0 $867

Pre-tax Health Care Expenses

$0 $100

Taxable Income $2,500 $1,533

Federal Tax (15%) $375 $229

FICA (7.65%) $191 $117

After-tax Dependent Care $867 $0

After-tax Health Care Expenses

$100 $0

Monthly Take Home Pay $967 $1,187

Estimated Savings for Member who Participates in the Healthcare and Dependent Care Flexible Spending Accounts = $220 per month or $2,640 per year

43

Using your FSA Debit Card Use your FSA Debit Card like a regular debit or credit card for

your FSA eligible expenses– At your Physician’s office or the Pharmacy for copays– NOTE: You can no longer receive

reimbursement for over-the-counter

medicine without a doctor’s prescription

based on the new healthcare law

No Credit Check needed

Benefits of using the Debit Card include:– Instant Reimbursement– Reduction in receipt submission– Up to 80% of total claims are auto-adjudicated

44

PayFlex Contact Information 1-800-284-4885

Web Access – 24/7 secure site– Check account claims status– Look up qualified expenses– Download claim forms– Interactive tool to calculate tax savings– Online at www.healthhub.com

What’s Next?

46

Action Steps for Members Prior to August 9th at 5:00 pm:

Active members must submit changes and/or confirm all elections in Ebonline, and provide documents for newly added dependents to HR

Retired members who wish to make a change must do so by: submitting changes in EBOnline, or by mailing form to HR-Benefits (must be received by 8/9/13 at 5pm), or by faxing completed enrollment form to (727) 582-5893, or by e-mailing the completed enrollment form to InsuranceBenefits@pcsonet.com. If no change, no action is required.

Questions? Contact HR - Benefits at (727) 582-2835