2016 Shawnee County Benefits Information

SHAWNEE COUNTY 2016 BENEFITS HIGHLIGHTS

2016 SHAWNEE COUNTY HEALTH INSURANCE ENROLLMENT SCHEDULE November 5th (Thursday )

9:00 to 11:00 1:00 to 3:30

Jail/Youth Center ADC Training Rm. A Jail/Youth Center ADC Training Rm. A

November 6th (Friday )

6:30 to 7:30 7:30 to 8:15 8:15 to 10:30 1:00 to 3:00

North Annex – Drivers & Collectors Only North Annex – Public Works Shops Only North Annex – All Other Employees Law Enforcement Center Break Room

November 9th (Monday)

9:00 to 11:00 1:00 to 3:00

Health Agency Sub-Basement

You can file through Employee Online (http://snsunweb/ifas7/emponline). On-line enrollment is available from November 1 through November 14 or you can attend any of the above sessions.

REMEMBER, YOU ARE RESPONSIBLE FOR SIGNING UP FOR YOUR INSURANCE BENEFITS EITHER ONLINE OR AT ONE OF THE OPEN ENROLLMENT SESSIONS. Benefits DO NOT carry forward from year to year.

If you are not participating in Shawnee County’s health plan, you may enroll online but you will also need to sign a waiver form.

(Do not call Payroll to sign a waiver.)

Representatives from Blue Cross/Blue Shield Kansas, Delta Dental, MedTrak, Surency Vision, Cancer Insurance, AFLAC, and KPERS 457 (Great West Financial) will be available.

BENEFIT CHOICES The Shawnee County Benefits Plan is flexible and allows you to design your own benefits plan based on your individual needs.

Your Benefit Choices include:        

Medical / Prescription Coverage Dental Coverage Voluntary Vision Coverage Flexible Spending Accounts – Unreimbursed Medical & Dependent Care Deferred Compensation Voluntary Cancer Insurance Voluntary Short-term Disability (post-tax) Voluntary Hospital Indemnity (post-tax)

Medical / Prescription Coverage Shawnee County uses the nationwide Blue Cross and Blue Shield BlueCard® PPO provider network for the medical plan. Call your doctor and ask if they are a BlueCard® PPO provider or you can locate a participating PPO provider by calling the BlueCard® doctor and hospital information line at 1-800-810-BLUE (2583). You can also locate this information by accessing the Blue Cross website at www.bcbsks.com and using the BlueCard – Doctor and Hospital finder function.

The PPO Option – The program offers a Preferred Provider Organization (PPO) plan choice: 80/60PPOPlan.

Under this plan medical services and benefits are paid at higher levels when you use participating providers. At the same time, the PPO options give you the freedom to utilize the services of any Out-Of-Network provider by paying higher deductibles and coinsurance.

Important Responsibility – When Using In-Network Providers The County plan does not require you to see a pre-selected Primary Care Physician or obtain a referral for specialty, hospital, laboratory services, or other provider’s care. You choose your doctors, specialists, hospitals and laboratories from the network whenever or wherever you need care. With this freedom comes an important responsibility: you must make sure you are receiving care from network providers in order for your expenses to be reimbursed at the in-network level. It is necessary to confirm with your provider that he/she belongs to the network before services are rendered.

Eligible Dependents

Eligible dependents include your spouse and natural, step, and adopted children. Children are eligible for coverage up to age 26, regardless of student or marital status or any employer sponsored coverage available to them.

Dental Coverage Our benefits include a dental plan administered by Delta Dental of Kansas. This coverage option is a stand-alone plan that you can elect without selecting Medical / Prescription Coverage.

Under the dental program, you and your family may use the licensed dentist or dental practice of your choice.

Eligible Dependents

Eligible dependents include your spouse and natural, step, and adopted children. Dependent children are eligible for coverage to age 26 regardless of student or marital status or any employer sponsored coverage available to them.

Benefits & Services

In-Network (PPO) & Premier Networks

Annual Deductible

None

Preventive Services - Oral Examination, X-rays, Fluoride Treatments, Cleanings

100%

Preventive Plus Program

Cleanings no longer included in Annual Maximum

Basic Services - Fillings, Endodontic (root canals), Peridontic (treatment to gums), Oral Surgery

50%

Major Services - Inlays & Onlays, Crowns, Dentures, Fixed Bridgework

50%

Orthodontia

Not Covered

Dental Plan Maximum

$1,500 Per Person Per Year Allowed to Rollover 25% of unused Maximum to the Next Calendar Year. Must have had at least 1 dental service during benefit year

Maximum Rollover Program

Shawnee County 2016 Contributions

Employee Blue Cross/Blue Shield Employer Contribution Employee Contribution Per Pay Period Cost Dental Only

$620.00 $600.00 $20.00 $10.00 $35.00

Employee Child $780.00 $600.00 $180.00 $90.00 $55.00

Employee Spouse $920.00 $600.00 $320.00 $160.00 $65.00

Employee Family $1060.00 $600.00 $460.00 $230.00 $75.00

Voluntary Vision Coverage Shawnee County offers a Vision Plan administered by Surency. Under this plan, you may use the eye care professional of your choice. However, when you use a Surency network provider, you receive higher levels of coverage under the In-Network benefit structure. To locate a network provider, contact Surency at 1-866-8188805 or visit the Surency website at www.surency.com.

Eligible Dependents Eligible dependents include your spouse and natural, step, and adopted children.

Dependent children are eligible for coverage until age 26 regardless of student or marital status or any employer sponsored coverage available to them.

Services

In-Network You Pay

Out-of-Network You Pay

$10 Co-pay

Up to $35

$130 Allowance

Up to $65

Single Lens

$25 Co-pay

Up to $25

Bifocal Lens

$25 Co-pay

Up to $40

Trifocal Lens

$25 Co-pay

Up to $55

100% After $25 Co-pay

Up to $200

$130 Allowance - Contacts/Exams

Up to $100

Eye Exam (once every 12 months) Frames (once every 12 months) Lenses (once every 12 months)

Contacts (In lieu of frames & lenses)(once every 12 months) Necessary Elective

Voluntary Vision Plan Rates

Employee Employee + Spouse Employee + Child(ren) Family

Monthly Rates $6.84 $15.21 $12.97 $21.38

Flexible Spending Account Unreimbursed Medical:  A pre-tax account funded through salary reduction used to receive pre-tax reimbursement for medically necessary out-of-pocket expenses.  Plan Year will run from January 1 through December 31  Plan carries a $2,550 Plan Year maximum (Increase for 2016)  Program allows a $500 carry over  Eligible Expenses include (but not limited to):  Plan deductibles, co-pays and co-insurance amounts  Dental and Orthodontic expenses  Vision Care Expenses

Dependent Care:

 A pre-tax account funded through salary reduction used to receive pre-tax reimbursement for child and adult daycare expenses.  Plan Year will run from January 1 through December 31  Plan carries a $5,000 calendar year maximum.  You must be using daycare services so that you and your spouse can work.  Your provider of care must provide you with either his/her Social Security Number or Tax Identification Number.  Eligible expense include(but not limited to):  Day care for children up to kindergarten  Pre-school and after-school day care to age 13  Non-residential summer camps to age 13  Elder care expenses provided in your home  Adult day care expense (non-residential)

2016 Open Enrollment Information What Changes Can I Make Now? For the Medical (including prescription drug) and Dental

· Enroll, change or drop coverage. · Add or drop dependents. Remember dependent children are now eligible until age 26 regardless of student or marital status or any employer sponsored coverage available to them.

All new employees will be eligible for insurance coverage the first day of the month after the 60-day waiting period ends.

The Board of County Commissioners will continue to offer employees other options for benefits under Section 125 of the Internal Revenue Code. The health and dental insurance, voluntary vision, cancer insurance, flexible spending plan and deferred compensation plans are available to you as an employee of Shawnee County. Federal law allows the use of pre-tax dollars to purchase any or all of these benefits. This, in turn, will reduce the amount of your taxable income and therefore save your tax dollars.

The flexible spending plan allows you to put pre-tax dollars into an account for unreimbursed medical expenses (office co-pay, prescription drug co-pays, vision co-pays, glasses, contact lenses, lasik surgery, and other out of pocket expenses like coinsurance in the medical and dental plans) and for dependent care expenses. There is a $2,550 per year limit for unreimbursed medical expenses. However, you are allowed to carry-over a maximum balance of $500 of your unreimbursed medical expense deduction to a subsequent plan year. The limit for dependent care is currently at $5,000 as allowed by federal law. The carry-over clause does not apply to dependent care reimbursement. When you incur an expense in either area, you may request reimbursement with the appropriate documentation. Receipts incurred prior to the end of the plan year can be sent to ASI for reimbursement up to 90 days past the end of the plan year, December 31, 2016.

The advantage of the flexible spending plan is if you were to pay for these expenses with post-tax dollars, you would be paying much more than if you used pre-tax dollars. Please remember, however, you may not be able to claim dependent care expenses on your income taxes if you use the flexible spending account to pay for dependent care. Be sure to consult with your tax preparer about this issue. If you have any questions about the flexible spending account, you may call Central Trust Bank/ASI at 1-800-659-3035.

Once you sign your election form, you cannot change your health insurance coverage under the cafeteria plan unless you have a qualifying change in status, cost or coverage as specified under Section 125 of the Internal Revenue Code. Some examples of changes in status are marriage, divorce, birth or death of a dependent, adoption, termination of employment of spouse, and in some cases, taking unpaid leave pursuant to the Family and Medical leave Act (FMLA). Please understand this is not a complete list and do not assume your circumstances would meet the requirements without first checking.

Your health insurance plan election is effective for all of 2016. All newly eligible employees must complete an enrollment form if they wish to activate their participation in the County’s health insurance plan and an election form for all other benefits under the cafeteria plan. You do have the right to waive health insurance coverage entirely, but you must sign an election to waive coverage insurance form. Employees who fail to enroll will be excluded from the County’s health insurance plan and thereby receive no group health insurance coverage.

A copy of the 2016 Cafeteria Plan is available for review in the County Clerk’s office.

What Can You Do To Help Lower Claim Costs?

ASK YOUR DOCTOR if a generic drug is available for any prescriptions written for you or your family. Our average cost for a 30-day generic prescription is $35 compared to $228 for a 30-day brand prescription. That means our self-insured plan pays the cost difference between the $10 (generic co-pay) and the $35 or $60 (formulary/nonformulary brand name co-pay) you pay at the pharmacy. That means the County pays $25 for every generic drug compared to $193 for every formulary brand name drug and $168 for every non-formulary brand name drug.

MedTrak may be contacting you through the Script Choice program if you are taking a brand name drug and there is a generic equivalent available. Take the information you receive to your doctor and see if you can make a change.

We can all save money!

ASK YOUR DOCTOR for samples. If your doctor is writing a prescription for you, stop and ask if he/she has any samples available to give you. Sometimes by taking the sample, you may avoid having a prescription filled for a medication that may not work for you. You and the plan save money!

TAKE ADVANTAGE OF THE MEDTRAK 90 PHARMACY BENEFIT You can get a 90-day supply of medications at participating MedTrak 90 retail pharmacies for 2.5 times the co-pay of a 30-day supply! There are also some medications that qualify for a 90-day fill with only a single co-pay.

PREVENTIVE CARE You can have lab and blood work up to $300 for every person covered under your plan at no cost to you. Also, preventive services (physical, immunizations, PSA, pap-smear, mammogram, colonoscopy) are paid at 100%. Please get these important preventive tests as needed.

HEALTH RISK ASSESSMENT You can take a health risk assessment on-line at www.bcbsks.com. You will receive a personalized report with health scores and information on how you can improve your health.

WORKER’S COMP If you have been injured on the job and are under a doctor’s care for that injury, please make sure you do not file any Worker’s Comp claims under the Shawnee County Health plan.

AFTER HOURS CARE The minimum out of pocket cost for a visit to the emergency room is $200. However, there are several after-hours medical care facilities in Topeka where you pay the same $30 co-pay you would at your doctor’s office. If you are in need of after-hours medical care for non-life threatening conditions, please visit one of these locations: Tallgrass Immediate Care, 601 SW Corporate, Ste 200 Phone: (785) 234-2400, Hours M-F 8-8 Sat 8-4, Sun 11-5:30 Med-Assist, 4011 SW 29th, Phone: (785) 272-2161, Hours: M-F 9-8:30, Sat 9-5:30, Sun 9-5 Minor Med, 1119 Gage Blvd, Phone: (785) 272-4000, Hours: M-F 9-8, Sat/Sun 1-5 Sunflower Prompt Care, 3405 NW Hunters Ridge Ter., Ste 100, Phone: (785) 246-3733, Hours: M-Sat 8-7; Sun 8-4 Cotton O’Neil Express Care, 6725 SW 29th St, Phone: (785) 354-5225, Hours M-F 9-8, Sat/Sun 11-5 Cotton O’Neil Express Care, 2909 SE Walnut Dr., Phone: (785) 267-0744, M-F 9-8, Sat/Sun, 11-5 Cotton O’Neil Express Care, 1130 N. Kansas Ave., Phone (785) 354-5225, M-F 9-6 Health Connections, (785) 354-5225, Call 4:30 p.m. to 7:30 a.m. Mon/Fri, 24-hrs availability Sat/Sun. to speak to a nurse for after-hours medical advice.

REMEMBER...THIS IS YOUR PLAN. YOU HAVE DONE A GREAT JOB IN HELPING TO KEEP OUR COSTS DOWN. KEEP UP THE GOOD WORK! YOU CAN CONTINUE TO CONTROL THE COSTS AND MAKE IT WORK FOR EVERYONE!

Important Plan Information:  The Shawnee County Benefits Plan runs on a January 1 through December 31 Plan Year.  Prior to the beginning of each Plan year you will have an Open Enrollment opportunity to consider changing your current benefit elections.  The benefit elections made during Open Enrollment will remain in place unless you experience a Qualified Life Event. If you request a benefit change mid-year due to a Qualified Life Event, the change:  Must be requested within 63 days of the event.  Must be consistent with the event.  Qualified Life Events Include:  Change in Status*  Spouse’s Or Dependent’s Open Enrollment  Dependent Care Changes  Cost Or Coverage Changes Within The Employer’s Plan  HIPAA Special Enrollment Rights  Judgment, Decree Or Court Order  Enrollment/Ceasing To Be Enrolled In Medicare Or Medicaid  Family Medical Leave Act (FMLA) Special Requirements  Loss of group coverage at another group’s open enrollment *Change In Status – includes change in marital status, change in number of dependents, change in employment status of the employee, spouse or dependent, change in residence, dependent satisfying or ceasing to satisfy Plan’s eligibility requirements.

Helpful Resources The world of employee benefits and insurance is complex and easily confusing. Here is a list of professionals who are partners with Shawnee County in our on-going commitment to deliver a quality benefits program that is there when you need it.

Medical Coverage – Blue Cross Blue Shield of Kansas 1-800-432-3990 – Customer Service www.bcbsks.com - Participating Providers

Prescription Coverage - MedTrak 1-800-771-4648 – Customer Service www.medtrakservices.com

Dental Coverage – Delta Dental of Kansas 1-800-234-3375 www.deltadentalks.com

Vision Insurance - Surency

1-866-818-8805 – Customer Service www.surency.com This guide describes the benefit plans available to you as an employee of Shawnee County. The details of these plans are contained in the official Plan Documents, including some insurance contracts. This guide is meant only to cover the major points of each plan. It does not contain all of the details that are included in your Summary Plan Description (SPD) (as described by the Employee Retirement Income Security Act)(ERISA). If there is ever a question about one of these plans, or if there is a conflict between the information in this guide and the formal language of the Plan documents, the formal wording in the Plan Documents will govern. Please note that the benefits described in this guide may be changed at any time and do not represent a contractual obligation on the part of Shawnee County