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Pinellas County Sheriff’s Office 2013 – 2014 Benefits Plan Year Benefits Enrollment: 7/29/13 - 8/9/13. Welcome!. Benefit Options: Medical – Choice of 2 plans with POS network Dental – Preventive Only or Direct Reimbursement Vision – United Healthcare Vision (Spectera)
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Pinellas County Sheriff’s Office 2013 – 2014 Benefits Plan YearBenefits Enrollment: 7/29/13 - 8/9/13
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
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
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
Open Enrollment - July 29th to August 9th • 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 • 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
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
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
ComPsychEmployee Assistance Program www.guidanceresources.com, password: PCSO
EAP Benefits • Information and assistance with life and work issues • 24 hours a day, 7 days a week • Life/work issues impact job performance • Completely confidential • All members in home may access benefit
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
Drug Co-payments OptumRx by Mail Can Save You Money * As prescribed by your doctor.
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 Money Saving Tips • Generics and plan-preferred medications will cost you less than non-preferred medications • Consider using OptumRx by Mail for long-term (maintenance) medications
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 electronically: • Your doctor can call1-800-788-4863 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
How to use OptumRx Mail Service Pharmacy Online: • 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 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
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.
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
United Concordia Dental Benefits
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
Dental Plan Options * Out of Network benefits reimbursed at the 90% of Usual and Customary charge
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 Vision Providers • No change in vision benefits from last year • Large provider network • Over 30,000 providers nationwide • Private practice and retail chain providers
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 & DismembermentLong Term Disability Short Term Disability
Life and AD&D Benefits Basic Life Benefit: 1 x annual salary, not to exceed $250,000 – PCSO paid Additional Life Benefit: $5,000 increments, not to exceed the lesser of 5 x annual salary or $250,000 Dependent Life Benefit: Option 1 - $10,000 Spouse / $5,000 Child(ren) Option 2 - Spouse - $2,500 increments, not to exceed 50% of members’ basic + additional life Option 2 - Child - $2,500 increments, not to exceed $10,000 or 50% of member’s basic + additional life Guarantee Issue: Member not previously denied coverage may elect up to $20,000, no medical underwriting required • Member previously denied or amounts in excess of $20,000 or greater than 3 x base annual earnings are subject to medical underwriting • Spouse and children are subject to medical underwriting for all coverage
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
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
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
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
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
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 The Standard Customer Service .
Flexible Spending Account • 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 (FSA) • 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
What is NOT covered under an FSA? • 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
Tax Savings ExampleBased on $30,000 annual salary Estimated Savings for Member who Participates in the Healthcare and Dependent Care Flexible Spending Accounts = $220 per month or $2,640 per year
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
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
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