2014 plan changes Medical plan changes There are no significant changes to the medical benefits for 2014 Due to the Affordable Care Act, the emergency room copay will apply towards the total out of pocket maximum on the $500 deducble plan. Because of rising healthcare costs, the employee contribuons increased by 9% on every plan except $1,000 S. Dental plan changes Our goal was to restructure the dental plan to make them easier to understand. Aer facing a 17% renewal increase with our current opons, we also wanted to make them more affordable. Therefore we have created two new disnct plans—a Low Opon and a High Opon, as well as connuing the DHMO and the City‐paid Base plan. Delta Dental Changes: Added benefit: Prevenve services will not be deducted from your Annual Benefit Maximum so you’ll have more benefits available for basic or major services. 4 The waing period was removed. There is now no waing period for Major services on either plan! Orthodona is now only available for children to age 19, and only available on the High Plan. So if you have a dependent who is currently undergoing ortho treatment, you’ll want to enroll in the High Plan. Important note on dependent eligibility All dependents on the City’s medical, dental, vision and/or life insurance plans must meet the following dependent definion: NEW! The employee’s current legal spouse or qualified same or opposite gender domesc partner*, excluding a common‐law spouse . A dependent child, up to age 26, who is the employee’s or employee’s spouse’s or qualified domesc partner’s natural child, legally adopted child (including children placed for adopon), step‐child, or child for whom the employee or employee’s spouse is the legal guardian or legal custodian, or a child of the employees, employee’s spouse or qualified domesc partner for whom a Qualified Medical Child Support Order has been issued. An incapacitated child of the employee, employee’s spouse or qualified domesc partner. Dependents who permanently reside outside the United States are not eligible for coverage. The plan’s determinaon of eligibility under the terms of this provision shall be conclusive. The plan reserves the right to require proofof eligibility, including but not limited to a cerfied copy of any Qualified Medical Child Support Order, birth cerficate, and/or proofof court‐granted legal guardianship, legal custody and/or legal adopon. *The CityofKnoxville will now cover domesc partners. While the employee’s premium is deducted from your paycheck on a pre‐tax basis, any addional premium you are required to pay to cover your domesc partner will be deducted from your paycheck on an aer‐tax basis, and the addional cost of the plan to add your domesc partner or their children will be added to your taxable income. Please complete an affidavit, as well as provide proofof the relaonship through financial interdependence. (For more informaon about the affidavit and proof, please contact CityBenefits@cityonoxville.org.) REMEMBER: When adding a dependent to your plan, make sure you explore all available opons, as the City’s plans may not be the most economical for every family. If you have quesons on other available opons, please contact Employee Benefits at 865.215.2111.
Enrollment Reminders If you’re enrolling your Spouse or Domestic Partner for City medical coverage and they are not currently covered, there will be a certification form to complete in the online annual enrollment tool in Self Service. If your spouse or qualified domestic partner has medical coverage available through an employer, you may be required to pay a $50/paycheck surcharge in addition to your regular premium to cover your spouse or qualified domestic partner. If you decline the City’s medical coverage and can show proofof other medical coverage, the City will contribute $500 to a Health Care FSA for you (prorated based on your hire date). You can also contribute your own money to the FSA. See pages 17‐18. In addition, if you complete the annual health screening and participate in the physical activity requirement described on page 9, you will receive $20/month in a Health Care FSA. All enrollments and changes will be made online this year! Please log into People So and from the main menu, click on Self Service—Benefits— BenefitsEnrollment. Changing your benefits Generally, you cannot change your benefit elections during the year unless you experience a life event. Life events include, but are not limited to: ■ Change in employee’s legal marital status: marriage, divorce, legal separation, death of spouse ■ Change in number of dependents: birth, adoption, placement for adoption, death of dependent ■ Change in employee’s or dependent’s employment status: termination, commencement of employment, coverage of dependent, loss or gain of benefit eligibility of dependent ■ Dependent eligibility changes: dependent is newly or no longer eligible (i.e., reached age 26) ■ Material benefit change of employee or dependent, including dependent’s annual enrollment ■ Dependents gain or lose eligibility for Medicaid or SCHIP coverage Your benefit change must be consistent with the life event and must be within 60 days of the event. You will be able to make these changes on e‐Benefits, but please note addional paperwork may be requested. It’s My Health “My Health was the starng point for me. I had no goals in mind at the me. As I got older, I started looking at things differently. I changed the way I eat, I changed the foods I eat, I changed the poron sizes. And I found I was sll able to enjoy 90% of what I liked. If it’s something that I really like and I know it’s bad for me, I can eat just a lile poron of it, and I’m cool with that.” Mike Wilson Senior Codes Enforcement Officer 5