2020-2021 benefits enrollment guide · 2020. 10. 13. · welcome to enrollment for your 2020-2021...

2020-2021 Benefits Enrollment Guide

2 2020-2021 Benefits Enrollment Guide

Who is Eligible?

Full time regular employees and their eligible dependents. Please make your benefit elections carefully. NO CHANGES are allowed during the plan year, unless the member experiences a qualifying life event.

WELCOME TO ENROLLMENT

FOR YOUR 2020-2021 BENEFITS!

We know that quality benefits and the opportunity to choose are important to you and your family. With that in mind, The City of Apopka maintains a high quality benefits program. On the following pages you will find information on the benefits that are in effect through September 30, 2021.

What’s in the Guide?

Enrollment Process……………………….………..…….3

Mobile App...…………...…………………….……..……..4

Login Instructions………………………………………...5

Medical………………………………………..……...….6-12

Dental………………………………………………….…..…13

Vision………………………………...………..………..……14

Life Insurance………………………………….…….……15

Voluntary Disability………………..……...………16-17

Identity Theft Protection……..…………………..…18

Additional Benefits.…………...……………………....19

Transamerica Voluntary Benefits…………..20-23

British-American Chamber of Commerce…...24

Important Contacts……………….…………………….25

2020-2021 Benefits Enrollment Guide 3

Enrollment Process

Reminders

Be sure to review this 2020-2021 Benefit Guide and plan summaries prior to going through the enrollment process.

Be prepared by gathering dependent and beneficiary information (i.e. Social Security Numbers and Dates

of Birth).

The City of Apopka provides electronic enrollment through Explain My Benefits. Explain My Benefits provides eligible employees the ability to make group insurance benefit elections and changes online during the annual open enrollment, new hire orientation and qualifying events. Enrollment has never been easier. Accessible 24 hours a day, information about all of your employee benefits election options, including premiums and carrier contact information, are also available to help you make informed decisions. You can also log into the Explain My Benefits portal at anytime or download the Mobile App, to review your benefits, access carrier links, update your personal information for yourself and dependents, update your beneficiaries and process qualifying life events.

Options to Enroll

Decide which of these convenient enrollment options best fits your needs:

Self-Service

Visit www.explainmybenefits.com/apopka, click on the green “Log Into Your Benefit System” button and move through the enrollment system at your own pace.

Login instructions are on page 5.

Be sure to click “Checkout” at the end of the process and make note of your confirmation. If you do not receive a confirmation, you have not completed your enrollment.

Return to the system anytime to view your confirmation statement.

Mobile App - You can enroll through the EMB Mobile app, review the benefit guide and benefits, and see important documents. Sign in using the company code: [apopka]

http://www.explainmybenefits.com/apopka


Mobile App


Login Instructions


DEPENDENTS You may also elect coverage for your dependents. Eligible dependents may include the following:

• Your Legal Spouse

• Dependent of you or your spouse; legally adopted children; children for which legal guardianship has been awarded

• Disabled dependent children who are supported primarily by you, and who are incapable of self-sustaining employment by reasons of mental or physical handicap (proof of their condition and dependence must be submitted) Medical - Dependent children up to age 26 regardless of financial dependency, residency, student status, employment or martial status or up to age 30 if they meet ALL of the following requirements:

- Unmarried and does not have a dependent of his or her own

- A resident of this state or a full-time or part-time student; and

- Is not provided coverage as a named subscriber, insured, enrollee, or covered person under any other group, blanket, or franchise health insurance policy or individual health benefits plan, or is not entitled to benefits under title XVIII of the Social Security Act. *See HR if you are enrolling a dependent over the age of 26* Dental - Dependent children are covered until the end of the year in which they reach age 30 (unless disabled). Vision - Dependent children are covered until the end of the year in which they reach age 25 (unless disabled).

We have a BlueOptions plan which is a PPO and the city contributes 100% of the employee cost for this plan. We also have two “buy-up” plans, a BlueChoice PPO and a BlueCare HMO. With coverage under the PPO plans, your care is self-directed. With coverage under the HMO plan, your care is managed by your primary care physician (PCP) and has a more narrow network. Emergency services while traveling domestically or internationally are covered under the broader BCBS network for both plans.

Medical


BlueOptions 03559 Plan At-A-Glance BlueOptions 03559 Plan

In Network Out of Network

Deductible

Single $750 Combined w/ In-Network

Family $2,250 Combined w/ In-Network

Coinsurance

Member Responsibility 20% 40%

Out-of-Pocket Maximum

Single $3,000 Combined w/ In-Network


What Applies to the Out-of-Pocket Maximum? Co-pays, Deductible, Coinsurance and Rx

Physician Services

Physician Office Visit $20 Deductible + 40%

Specialist Office Visit $35

Preventive Care $0 40%

Diagnostic Services (Freestanding Facility)

Clinical Lab (Blood Work) at Independent Facility $100

Deductible + 40% X-rays at Independent Facility $100

Advanced Imaging (MRI, PET, CT) $100

Hospital Services

Inpatient $750 per admission $2,000 per admission

Outpatient Surgery (Ambulatory Surgical Center) $100 Deductible + 40%

Physician Services at Hospital Deductible + 20% In Network Deductible + 20%

Emergency Room $100 + 20% $100 + 20%

Urgent Care Center $35 $35

Mental Health / Alcohol & Substance Abuse

Inpatient (30 days max) Deductible + 20% In Network Deductible + 20%

Outpatient $35 Deductible + 40%

Prescription Drugs (Rx)

Generic $10

50% Coinsurance Preferred Brand Name $25

Non-Preferred Brand Name $60

Mail Order Drug (90 Day Supply) $20 / $50 / $120

Medical


BlueChoice 0727 (PPO) Plan At-A-Glance BlueChoice 0727 (PPO) Plan


Deductible

Single $500 Combined w/ In-Network


Coinsurance

Member Responsibility 20% 40%


Single $1,500 Combined w/ In-Network


What Applies to the Out-of-Pocket Maximum? Co-pays, Deductible, Coinsurance and Rx

Physician Services

Physician Office Visit $15 Deductible + 40%

Specialist Office Visit $15

Preventive Care $0 30% (no deductible)


Clinical Lab (Blood Work) at Independent Facility Deductible + 20%

Deductible + 40% X-rays at Independent Facility $15


Hospital Services

Inpatient Deductible + 20% $300 PAD + Deductible + 40%

Outpatient Surgery Deductible + 20% Deductible + 40%

Physician Services at Hospital Deductible + 20% Deductible + 20%

Emergency Room Deductible + 20% Deductible + 20%



Inpatient (30 days max) Deductible + 20% $300 PAD + Deductible + 40%

Outpatient Deductible + 20% Deductible + 40%


Generic $5

50% of allowance Preferred Brand Name $35


Mail Order Drug (90 Day Supply) $10/$70/$70

Medical


BlueCare 59 (HMO) Plan At-A-Glance

BlueCare 59 (HMO) Plan


Deductible

Single N/A N/A

Family N/A N/A

Coinsurance

Member Responsibility N/A N/A


Single $1,500 N/A

Family $3,000 N/A

What Applies to the Out-of-Pocket Maximum? Co-pays, including Rx N/A

Physician Services

Physician Office Visit $15 (PCP)

Not Covered Specialist Office Visit $35

Preventive Care $0


Clinical Lab (Blood Work) at Independent Facility $0

Not Covered X-rays at Independent Facility $0


Hospital Services

Inpatient $150 per day up to $750 Not Covered

Outpatient Surgery $200 Not Covered

Physician Services at Hospital $0 Not Covered

Emergency Room $50 $50



Inpatient (30 days max) $150 per day up to $750 Not Covered

Outpatient $35 Not Covered


Generic $10

N/A Preferred Brand Name $25


Mail Order Drug (90 Day Supply) $20/$50/$120

Medical


Health Insurance - Per Pay Period Payroll Deduction

Employee Health and Wellness Center—CareHere! (paid by City)

Employees have access to no cost general medical care at the medical facility provided by the City. There are no charges for examinations, no charge for prescriptions dispensed, no charge for lab work, and any other service available on-site. The facility also offers access to wellness programs, including weight-loss programs, tobacco cessation programs and other wellness initiatives. CareHere should not be considered a replacement for your primary care physician should you enroll in the HMO.

Coverage Tier

Plan Employee w/ Spouse Only w/ Child(ren) Family

BlueOptions 03559 $0.00* $106.04 $66.28 $144.28

BlueChoice 0727 (PPO) $10.68 $130.98 $88.42 $184.50

BlueCare 59 (HMO) $17.39 $142.02 $99.95 $200.48

Medical

*100% of the employee premium is paid by the City.

Benefits • No cost to you, no co-pays or deductible for your

visit.

• No cost to you for on-site labs.

• No cost to you for select generic medications.

• Certified Health Coaching at no cost to you.

• Sort or no time in a waiting room.

• Schedule appointments online with your computer, smartphone or tablet, or by calling our 24/7 help line.

• Private and secure, your records will not be shared with your employer or anyone else without your direction.

GET REGISTERED Each eligible family member must be registered separately. Eligible patients can register by calling 877.423.1330 or follow these steps:

1. Go to CareHere.com/Register

2. Enter your Access Code

APKA2 Employees

3. Provide responses to all of the questions on the short health questionnaire, including Contact Data and Health and Behavioral Data.

Learn more at CareHere.com

https://www.myhealthguide.com/lab/reg2/reg0.asp


Medical

MEET OUR DOCTORS Teladoc is simply a new way to access qualified doctors. All Teladoc doctors:

• Are practicing PCPs, pediatricians, and family medicine physicians

• Average 20 years experience

• Are U.S. board-certified and li-censed in your state

• Are credentialed every three years, meeting NCQA standards

GET THE CARE YOU NEED Teladoc doctors can treat many medical conditions, including:

• Cold & flu symptoms

• Allergies

• Sinus problems

• Urinary tract infection

• Respiratory infection

• Skin problems

• And more!

WHY TELADOC? It is a convenient and affordable option for quality care.

• When you need care now

• If you’re considering the ER or urgent care for a non-emergency issue

• On vacation, on a business trip, or away from home

• For short term prescription re-fills

Your Teladoc visit copay is the same as your PCP visit copay.

A welcome kit is being mailed to your home with instructions for setting up your Teladoc® account, completing your medical history and requesting a consult. Once you’re set up, a Teladoc doctor is always just a call or click away.

Teladoc gives you access 24 hours, 7 days a week to a U.S. board certified doctor through the convenience of phone, video or mobile app visits. Set up your account so when you need care now, a Teladoc doctor is just a call or click away.

SET UP YOUR ACCOUNT Set up your account by phone (toll free), web, mobile app or by texting “Get Started” to 469-844-5637

Online: Go to Teladoc.com and click “set up account”.

Mobile App: Download the app and click “Activate account”. Visit teladoc.com/mobile to download the app.

Call Teladoc: Teladoc can help you register your account over the pone.

PROVIDE MEDICAL HISTORY Your medical history provides Teladoc doctors with the information they need to make an accurate diagnosis.

REQUEST A CONSULT Once your account is set up, request a consult anytime you need care. An talk to a doctor by pone, web or mobile app.

Teladoc can treat Cold & flu symptoms Respiratory infection Sinus problems And more!

Use Teladoc when You need care now. You’re considering the ER or urgent care for a non-emergency issue Traveling out of town

Teladoc’s wait time

Talk to a doctor In less than 10 minutes

Talk to a doctor now

Teladoc.com | 1-800 –Teladoc (835-2362)


Medical


BlueDental Choice Plus High Plan BlueDental Choice Standard Plan Plan

In Network Out of Network In Network Out of Network

Deductible Individual / Family

$50 / $150 $50 / $150 $50 / $150 $50 / $150

Annual Maximum $1,500 $1,000

Preventive Services Exams, Cleanings, X-Rays, etc.

Plan pays 100% Deductible is

waived.


waived.


waived.


waived.

Basic Services Fillings, Simple extractions, Periodontics, Root Canals, etc.

90% covered 80% covered 80% covered 50% covered

Major Services Crowns, Dentures, Fillings, etc.

60% covered 50% covered 50% covered 25% covered

Orthodontics Lifetime Max BlueDental Pays

$1,500 50%

$1,000 50%

Employees have a choice between two plans. Both plans are PPOs and have “open access” within the network, plus you have the option to go outside the network. The low option, BlueDental Choice Plan, is a good basic plan. The high option plan, BlueDental Choice Plus, might be a better choice if you expect to have heavier utilization of the dental plan.

Locate a Dentist within the BCBS/Florida Combined network at

www.bcbsfl.com

Tier of Coverage Payroll Deduction Per

Pay Period High Plan Payroll Deduction Per

Pay Period Standard Plan

Employee $8.16 $5.31

w/ Spouse Only $17.88 $11.52

w/ Child(ren) $23.02 $15.86

Family $30.68 $20.75

Dependent children are covered until the end of the year in which they reach age 30 (unless disabled).

Dental

http://www.bcbsfl.com


You may use any provider you wish, but your benefits are higher when you use a participating provider. You may locate a provider at www.vsp.com.

Benefit Participating Provider Non-Participating Provider

(Reimbursement) Frequency

WellVision Exam $10 Co-pay Up to $45.00 Every Plan Year

Frames & Lenses (single/lined bifocal/ lined trifocal)

(Polycarbonate lenses for dependent children)

$30 Co-pay

Frames - up to $70.00 Single - up to $30.00

Lined bifocal - up to $50.00 Lined trifocal—up to $65.00

Frames - Every Other Plan Year

Lenses - Every

Plan Year

Lens Enhancements

Scratch Resistant - $0 Standard Progressive - $55

Premium Progressive - $95-$105 Custom Progressive - $150-$175

Progressive - up to $50.00 Every Plan Year

Contacts (in lieu of glasses)

$130 Allowance (contacts and contact lens

exam) Up to $105.00 Every Plan Year

Dependent children are covered until the end of the year in which they reach age 25 (unless disabled).


Employee $1.58

w/ Spouse Only $2.53

w/ Child(ren) $2.58

Family $4.16

Vision

http://www.vsp.com/


Basic Term Life and AD&D The City of Apopka provides Basic Life and AD&D Insurance through Cigna for all eligible employees at no cost to the employee. The Basic Life and AD&D insurance benefit is $30,000.

Term Life Insurance

Voluntary Supplemental Life Employees have the opportunity at the time of hire or open enrollment to purchase extra life insurance for themselves and their dependents. How much can I get? Employee: You may purchase in $10,000 increments up to 5x your annual salary to a maximum of $350,000. Spouse (to age 70): You may purchase for your spouse a flat amount of $15,000. Child(ren): This benefit is $5,000 for dependent children* age 14 days to 19 years (25 years if a full time student). *Dependent Child Your unmarried child if they meet the following requirements: 1. A child 14 days of age but less than 19 years old; 2. A child who is 19 or more years old but less than

26 years old, enrolled in school as a full-time student and primarily supported by you;

3. A child who is 19 or more years old, primarily supported by you and incapable of self-sustaining employment by reason of mental or physical handicap.

The term “child” means a child born to or legally adopted by you. It includes a child during any waiting period prior to finalization of the child’s adoption. It also means a stepchild living with and financially dependent upon you.

Guarantee Issue at Initial Eligibility Only Employee - $200,000 (not to exceed 3x annual salary)

Spouse - $15,000

Child(ren) - $5,000 If coverage is applied for at a later date (or if an increase in coverage is requested at a later date), “Evidence of Insurability” must be provided, including health questions.

Costs for Voluntary Supplemental Life Insurance

Coverage Tier Rate

Employee $0.56 per each $1,000 per month

Spouse $4.50 per month

Child(ren) $1.15 per month

You must elect supplemental term life on yourself in order to elect coverage for your spouse and/or dependents.

Age Reduction

Benefits will reduce:

• 65% at age 65

• 50% at age 70

• 25% at age 75

Example: An employee wants to purchase $50,000 of term life insurance.

.56 50 $28.00 X =

Rate per $1,000 # of units/$1,000 Monthly Premium


Voluntary Short Term Disability

What is Short Term Disability?

Short Term Disability Insurance through our new carrier, Cigna, helps protect your income for a short duration. If you become disabled and are unable to work, disability insurance can help replace some of your lost income, help you pay bills and protect your long-term savings. How does the benefit work?

All eligible employees have the opportunity to enroll in Short Term Disability Insurance. Short Term Disability benefits begin on the 1st day of disability due to an accident and on the 8th day for an illness (including pregnancy). Short Term Disability will pay 60% of your weekly salary to a maximum of $1,500 per week and you may receive this benefit for up to 26 weeks. How much does the benefit cost?

Monthly Premium Factor

Age Rate per $10 of weekly

covered benefit

<45 $0.46

45 - 49 $0.48

50 - 54 $0.60

55 - 59 $0.75

60 - 64 $0.91

65+ $1.00

Example: A 36 year old with an annual salary of $31,200 wants to purchase Short Term Disability.

600 10 60 / = X 0.46 = $27.60

Weekly Salary Premium Factor Monthly Premium


What is Long Term Disability?

Long Term Disability Insurance through Cigna, helps safeguard your financial security by replacing a portion of your income while you are unable to work. LTD benefits are intended to protect your income for a long duration after you have depleted short-term disability or available paid time off. LTD will take effect if your accident or illness prevents you from returning to work beyond your Short Term Disability period or 180 days. How does the benefit work?

All eligible employees have the opportunity to enroll in Long Term Disability Insurance. If you injury or illness prevents you from returning to work for 180 days, your Long Term Disability benefits will pay 60% of your monthly salary but no more than $5,000 per month. Your LTD benefits are payable for the period of time during which you continue to meet the definition of disability and if necessary, may continue to the latter of your SSNRA (Social Security Normal Retirement Age) or the following schedule, depending on your age at the time you become disabled.

Voluntary Long Term Disability

The plan has a Two-Year “Own Occupation” benefit. This important provision means that for the first two years of disability, the policy will pay you benefits as long as you can’t work at the position for which you’ve been educated or trained and will continue to pay benefits after the first two years if you are still unable to work at any occupation due to disability. (Some LTD policies don’t pay any benefits unless you are completely disabled and unable to perform any gainful employment.) Cost: $.37/mo. per $100 of monthly salary, not to exceed $8,333

Age at Commencement of Disability

Duration of Benefit Period

Age 62 or younger

63 years 64 years 65 years 66 years 67 years 68 years

69 years or older

To age 65 or the date the 42nd monthly benefit is payable, if

later 36 monthly payments 30 monthly payments 24 monthly payments 21 monthly payments 18 monthly payments 15 monthly payments 12 monthly payments


Identity theft in the United States is a major problem that continues to be on the rise. Professional protection and assistance have become important tools in fighting the identity theft epidemic.

Thieves today can get a hold of your personal information from trash cans, dumpsters, stolen mail, and even shoulder surfing. Once thieves have your information, it’s a simple matter to open new fraudulent accounts and make purchases in your name.

When you enroll in LifeLock, you can be confident knowing that they are available 24 hours a day, 7 days a week, and committed 100% to helping protect your information as if it were their own.

LifeLock offers Proactive Protection in both of the plans offered:

Benefit Elite Plan

• LifeLock Identity Alert System

• Lost Wallet Protection

• Address Change Verification

• Black Market Website Surveillance

• Live Member Service Support

• LifeLock Privacy Monitor

• Reduce Pre-Approved Credit Card Offers

• Identity Restoration Support

• Stolen Funds Replacement - up to $100,000

• Fictitious Identity Monitoring

• Court Records Scanning

• Data Breach Notifications

• Investment Account Activity Alerts

Ultimate Plan

Provides all of the benefits of the Benefit Elite Plan plus:

• Stolen Funds Replacement - up to $1,000,000

• Credit Card, Checking & Savings with Account Activity Alerts

• Online Annual Credit Report

• Online Annual Credit Score

• Checking & Savings Account Application Alerts

• Bank Account Takeover Alerts

• Credit Inquiry Alerts

• Online Annual Tri-Bureau Credit Reports & Scores

• Monthly Credit Score Tracking

• File Sharing Network Searches

• Sex Offender Registry Reports

• Priority Live Member Service Support

$1 Million Total Service Guarantee LifeLock’s proactive approach works to help stop identity theft before it happens. As a LifeLock member, if you become a victim of identity theft because of a failure in their service, they will help fix it at their expense, up to $1,000,000.


Pay Period

Payroll Deduction Per

Pay Period

Plan Benefit Elite Plan Ultimate Plan

Employee $1.96 $5.88

w/ Spouse Only $3.92 $11.76

w/ Child(ren)* $3.43 $8.33

Family* $5.39 $14.22

*Employee & Children and Family Tiers: You may enroll up to 8 children with 4 of those children between the ages of 18 and 26.

Identity Theft Protection


Flexible Spending Account Each employee is allowed to make tax-sheltered contributions to a Flexible Spending Account which may be used to pay for qualified Medical Expenses. “Over the counter” medications and supplies no longer qualify as eligible expenses. Your contribution is made on a Pre-Tax basis. The employee contribution maximum is $2,000/plan year ($38.46 per week). Medical Expense Reimbursement Account Carryover “Left-over” balances from the current plan year (10/1 - 9/30) between $100 and $500 will be carried over to the new plan year; balances of less than $100 revert to the employer, as will balances over $500 - i.e.: a $96 balance will not carry over, a $695 balance will carry over only to the $500 limit. Carryover funds will be used first to satisfy expenses incurred in the previous plan year which are claimed in the new plan year after 10/1, but before 12/31. Current year funds will be depleted before carryover funds are used for current plan year expenses, however, at the end of the plan year the roll-over provision will apply, regardless of which plan year the funds came from.

Employee Assistance Program (City Paid)

Additional Benefits

Resources for Living

Employee Assistance Program (EAP)

To access services:

1-800-272-3626

www.resourcesforliving.com

Username: PRM

Password: 8002723626

Public Risk Management of Florida

Resources for Living is an employer sponsored program, available at no cost to you and all members of your household. That includes dependent children up to age 30, whether or not they live at home.

Services are confidential and available 24 hours a day, 7 days a week.

http://www.resourcesforliving.com


What are Voluntary Benefits? Voluntary Benefits are being offered to strengthen your over-all benefits package. You customize the benefit based on need and affordability.

• Ownership – Policies are fully portable and belong to you if you leave your employer, same price and same plan

• Benefits are payroll deducted

• Cash benefits are paid directly to you, not to a hospital or doctor

• Benefits are paid regardless of any other coverage you may have

• Level premiums—Rates do not increase with age

• Guaranteed Renewable

• Designed to provide additional cash flow to assist with out of pocket medical costs and other bills

Voluntary Benefits

Accident Plan A plan, through Transamerica, that helps pay for the unexpected expenses that result from an accident.

On and Off the Job Coverage Family coverage available Sports related injuries covered as well. If you or a covered dependent play organized sports, injuries incurred while playing are covered.

Just a few examples of benefits included in the plan:

• Emergency Room Visits - $200

• Hospitalization - $1,950 admission benefit, $200 per day benefit, $600 per day ICU

• Fractures - up to $8,000

• Dislocations - up to $6,400

• Accident Follow-up Treatment - $50

• Health Screening Benefit - $50 per insured per year

See brochure for a complete list of benefits.

Employee Employee & Spouse Employee & Child(ren)* Family*

Weekly Deductions

$3.82 $5.97 $4.92 $7.25

*Dependent children up to age 26 can be covered regardless of student status.


Voluntary Benefits

Critical Events Critical Events through Transamerica is a benefit that will pay you a lump sum of money if you are diagnosed with a critical illness, heart attack or stroke. The cash benefit is provided upon the first diagnosis of a covered condition to help you with associated costs and beyond.

Guaranteed Issue

$25,000 employee / $12,500 spouse / $12,500 children Regardless of other coverage in force, the benefit is paid out in a full lump sum. Examples of covered conditions: Heart Attack, Stroke, Renal (Kidney) Failure, Major Organ Transplant, 8 Miscellaneous Diseases, Alzheimer’s Disease (30% benefit), Coronary Artery Disease (surgery) (25% benefit), Angioplasty/Stents (5% benefit) A Health Screening Benefit is included in your Critical Events Policy and pays $50 for each insured. Each covered person will get one screening test per calendar year.

Mammography Stress Test Serum Cholesterol Bone Marrow

Pap Smear Colonoscopy Prostate Specific Antigen Chest X-ray

Also included is a Recurrent Benefit that provides an amount equal to 50% of the plan benefit amount if the covered person is diagnosed with the same covered condition after a 12 month separation period. Rates This benefit is customized by each employee so rates vary, but can start as little as a few dollars a week. Your specific rate will be calculated for you on the electronic enrollment system. See brochure for more details.

Sample Weekly Rates (Non-Tobacco)

Employee Only

Age $10,000 $20,000 $25,000

18-29 $1.75 $2.63 $3.07

30-39 $1.82 $2.77 $3.24

40-49 $2.63 $4.38 $5.26

50-59 $4.18 $7.48 $9.13

60-64 $7.66 $14.45 $17.84

65+ $9.62 $18.37 $22.74

Sample Weekly Rates (Tobacco)

Employee Only

Age $10,000 $20,000 $25,000

18-29 $2.54 $4.20 $5.03

30-39 $2.65 $4.43 $5.32

40-49 $4.38 $7.89 $9.65

50-59 $7.32 $13.75 $16.97

60-64 $12.51 $24.14 $29.95

65+ $14.05 $27.23 $33.82


Voluntary Benefits

Hospital Select III

Employee Employee & Spouse Employee & Children* Family*

$9.44 $20.81 $15.71 $24.91 Weekly Deductions

Hospital Select through Transamerica is a policy that pays a specified amount for each day a covered person is confined to the hospital, is transported by ambulance or has surgery.

*Dependents up to age 26 can be covered regardless of student status.

Daily In-Hospital Benefit $250 per day Maximum: $5,000 per calendar year

Ambulance Benefit $350 per day Maximum: 3 days per calendar year/6 per lifetime

Hospital Confinement $1,500 Maximum: 1 day per calendar year per insured

Inpatient Surgery $1,000 per day Maximum: 1 day per calendar year per insured

Outpatient Surgery $500 per day Maximum: 1 day per calendar year per insured

Outpatient Minor Surgery $100 per day Maximum: 1 day per calendar year per insured

Anesthesia (if administered) 30% of the surgical benefit

CancerSelect Plus CancerSelect Plus through Transamerica will pay benefits to you if you are diagnosed with cancer. This plan pays you directly. Some benefits pay by the day or treatment, while others reimburse you for expenses you incur. Either way, it can be a source of financial support just when you and your family need it most!

Just a few examples of benefits included in the plan:

An Annual Cancer Screening Benefit is included in your policy and Transamerica pays $100 for each insured. Each covered person will get one cancer screening test per calendar year. Examples of Cancer Screenings:

• Initial Diagnosis - $4,000

• Hospital Confinement - $400 per day

• Surgery - up to $5,000 (Inpatient), up to $7,500 (Outpatient)

• Radiation & Chemotherapy - $15,000 per 12 month period

• Bone Marrow and/or Stem Cell - $15,000 per 12 month period

• New/Experimental Treatment - $15,000 per 12 month period

• Mammogram

• Pap Smear

• Prostate-Specific Antigen Test (PSA)

• Chest X-ray

• Bone Marrow Testing

*Dependent children up to age 26 can be covered regardless of student status.

Employee Employee & Spouse Employee & Children* Family*

$9.11 $16.27 $10.29 $16.27 Weekly Deductions


Voluntary Benefits

Universal Life with Living Benefit Transamerica TransElite Universal Life Insurance policy is designed to help provide financial protection for your family, with a death benefit that an be used for final expenses, college tuition, living expenses or as an inheritance. Universal Life is a great supplement to term life insurance because it helps protect for an entire lifetime. • Universal Life with Living Benefit is a permanent life insurance that is designed to match your needs

throughout your lifetime.

• The Universal Life with Living Benefit is priced to remain the same cost to you until age 100.

• The Living Benefit is 4% of the death benefit per month for up to 25 months.

• If you use the Living Benefit, your death benefit amount reduces.

• The policy also provides an Accelerated Death Benefit that will pay $100,000 or 75% of the death benefit (whichever is less), when the insured is diagnosed with a terminal illness.

Guaranteed Issue

Up to $100,000 employee / up to $15,000 spouse / $25,000 children Rates: This benefit is customized by each employee so rates vary, but can start as little as a few dollars a week. Your specific rate will be calculated for you in the electronic enrollment system.

Sample Weekly Rates (Non-Tobacco)

Employee

Age $25,000 $50,000 $100,000

40 $4.07 $8.14 $16.28

45 $5.19 $10.39 $20.77

50 $6.84 $13.69 $27.38

55 $9.11 $18.22 $36.44

60 $12.93 $25.85 $51.70

65 $19.82 $39.63 $79.26

70 $28.93 $57.87 $115.74

75 $45.25 $90.49 $180.98

80 $55.71 $111.43 $222.86

Sample Weekly Rates (Tobacco)

Employee

Age $10,000 $20,000 $25,000

40 $6.32 $12.64 $25.28

45 $8.20 $16.39 $32.78

50 $10.83 $21.65 $43.30

55 $14.49 $28.98 $57.96

60 $20.30 $40.60 $81.21

65 $28.67 $57.33 $114.66

70 $41.79 $83.58 $167.15

75 $62.70 $125.40 $250.80

80 $73.85 $147.69 $295.38


British-American Chamber of Commerce

British-American Chamber of Commerce Membership (New for 2020)

All eligible employees have the opportunity to enroll the British Chamber of Commerce at a special discounted rate for the City of Apopka. Your membership would include the following benefits.

Cost: $4.00 per week

Roadside Assistance

• Run out of gas

• Get a flat tire

• Locked keys in car

• Need a boost or a tow

• Average cost of a tow is $109

Legal Services

• Free legal letters

• Free legal will

• Free living will

• Free legal forms

• Free initial call & face to face meetings

Tax & Financial Services

• Free tax return preparation

• Tax related advice

• Review of prior year’s tax return

RX Discount

• Savings up to 75%

• Covers entire family

• 60,000 pharmacies

• No paperwork

Personal Concierge

• World-wide services provided by our concierge team

• Savings measured in time & convenience

• Same benefits provided to AmEx Platinum cardholders!

ID Theft Protection

• Financial education

• Credit counseling

• $1,000,000 theft insurance

• Keylogging Defense System

Telemedicine

• Offering medical consultations 24 hours a day, 7 days a week

• Avoid lost work & crowded doctor’s office

• A co-pay is required

• A prescription will be call to the pharmacy of your choice

Wellcard Discount Card

• Discounts on:

• Dental Care

• Hearing

• Vision Care

• Prescriptions

• MRI & Imaging

• And much more…

Pet Club Services

• Pet club members receive 25% discount every time you visit an in network vet

• Up to 50% discount from national and local participating retailers on food, supplements, medications, toys, kitty litter, boarding, grooming, pet sitting, training and other services

• Free Lost Pet Recovery Service where you receive a Pet ID tag to identify each of your pets electronically in our Pet Services database

Entertainment Discount Card Discounts up to 60% at:

• Universal Orlando Resort

• Walt Disney World Resort

• Cirque du Soleil

• SeaWorld Parks

• Disneyland

• Six Flags

• Broadway Shows

• Las Vegas Shows

• Citypass Nationwide

• Dinner Shows

• Sightseeing Tours

• Movie Tickets

• Rental Cars

• Sporting Events


Vendor Phone Number Website

Medical Florida Blue

800-352-2583 www.floridablue.com

Teladoc 800-835-2362 www.teladoc.com

Dental Florida Combined Life

888-223-4892 www.floridabluedental.com

Vision VSP

800-877-7195 www.vsp.com

Voluntary Benefits Transamerica

888-763-7474

www.transamericaemployeebenefits.com

Basic & Supplemental Life, Short & Long Term Disability Cigna

800-732-1603 www.cigna.com

Identity Theft Protection LifeLock

800-543-3562 www.lifelock.com

British-American Chamber of Commerce

www.baccorlando.com [email protected]

Employee Assistance Program (EAP) Resources for Living

800-272-3626 www.resourcesforliving.com

Transamerica Claims Help Explain My Benefits

888-734-6937, Option 2

[email protected]

Important Contacts

http://www.floridablue.com

http://www.teladoc.com

http://www.floridabluedental.com

http://www.vsp.com/

http://www.transamericaemployeebenefits.com/

http://www.cigna.com

http://www.lifelock.com

http://www.baccorlando.com

mailto:[email protected]

http://www.resourcesforliving.com

mailto:[email protected]

Benefit Guide Description

This summary of benefits is not intended to be a complete description of the City’s insurance benefit plans. Please refer to the plan document(s) for a complete description. Each plan is governed in all respects by the terms of its legal plan document, rather than by this or any other summary of the insurance benefits provided by the plan.

In the event of any conflict between a summary of the plan and the official document, the official document will prevail. Although the City maintains its benefit plans on an ongoing basis, the City reserves the right to terminate or amend each plan in its entirety or in any part at any time.

For questions regarding the information provided in this overview, please contact your human resources representative.

2020-2021 benefits enrollment guide · 2020. 10. 13. · welcome to enrollment for your 2020-2021...

Documents