Benefits Enrollment Guide - City of Knoxville

Benefits Enrollment Guide - City of Knoxville

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



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 proof of eligibility, including but not limited to a cerfied copy of any Qualified Medical

Child Support Order, birth cerficate, and/or proof of court‐granted legal guardianship, legal custody and/or

legal adopon.

*The City of Knoxville 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 proof of the relaonship through

financial interdependence. (For more informaon about the affidavit and proof, please contact

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.

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