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HomeMy WebLinkAboutRFP - 8283 BENEFITS CONSULTANTAddendum 1 – 8283 Benefits Consultant Page 1 of 7 ADDENDUM NO. 1 SPECIFICATIONS AND CONTRACT DOCUMENTS Description of RFP 8283: Benefits Consultant OPENING DATE: 3:00 PM (Our Clock) April 25, 2016 To all prospective bidders under the specifications and contract documents described above, the following changes/additions are hereby made and detailed in the following sections of this addendum: Exhibit 1 – QUESTIONS & ANSWERS Exhibit 2 – BENEFITS COMMUNICATION MATERIALS Please contact Jill Wilson, Buyer at (970) 221-6216 with any questions regarding this addendum. RECEIPT OF THIS ADDENDUM MUST BE ACKNOWLEDGED BY A WRITTEN STATEMENT ENCLOSED WITH THE RFP STATING THAT THIS ADDENDUM HAS BEEN RECEIVED. Financial Services Purchasing Division 215 N. Mason St. 2nd Floor PO Box 580 Fort Collins, CO 80522 970.221.6775 970.221.6707 fcgov.com/purchasing Addendum 1 – 8283 Benefits Consultant Page 2 of 7 EXHIBIT 1 QUESTIONS & ANSWERS 1. Q: Please provide the name of current consulting firm. A: Hays Companies of Denver. 2. Q: Date/month that the current consulting services agreement became effective. A: 12/1/2011. 3. Q: For each of the two most recently completed contract years: a. total hours reported as being incurred by the in-force consulting/actuarial firm b. total compensation for those services, considering all sources A: Hours incurred are not tracked or reported. Compensation is $70,000/yr. 4. Q: An indication as to how the contemplated services going forward compare to those provided during the past two years, commenting in detail on any differences. A: The City is exploring other options of service levels provided by benefits consultants based on submitted proposals and interviews. Services going forward closely mirror services outlined in the Scope of Services. 5. Q: Irrespective of the number of meetings held in any given day, how many onsite meeting days, on average, might reasonably be contemplated annually for all of the services that would be considered within the core scope of services? A: No less than quarterly, may increase given current scope of projects as developed in annual strategic plan. 6. Q: Please provide a schedule of the anticipated timing for RFPs, by year and by coverage/service to be bid. A: See table outlined in question 14. 7. Q: Can you confirm those benefit offerings for which monthly reporting is desired? A: There may be a desire to have all benefits reported on a monthly basis but medical, dental and Rx are of high priority. The City is open to discussing reporting formats and schedules, possibly a quarterly dashboard of all plans. 8. Q: It appears that retirees are eligible for benefits. Does this raise the need for GASB actuarial work? Are those services that we should be contemplating? If so: a. Please provide a copy of the most recently completed valuation. b. Indicate any changes to retiree provisions that have occurred since this valuation. c. What is the timing of the desired valuations going forward? A: N/A – Retirees are not eligible. A hand- full have been grandfathered in and remain covered. There is no need for GASB actuarial work for the City. 9. Q: What is the effective date of the contract that you are contemplating? A: The anticipated effective date of the contract pursuant to this RFP will be at the end of May, 2016. 10. Q: Please clarify your preference as it relates to page limitations for this proposal. In Section III, Submittal Requirements the RFP document states, “Proposals shall be limited to 30 pages, excluding sample reports required in the attached Questionnaire”. Please clarify if Addendum 1 – 8283 Benefits Consultant Page 3 of 7 this is 30 pieces of paper, which could be printed on one side or both sides; or if this is thirty (30) pages of text, which would limit the proposal to 15 sheets of paper if printed on both sides? A: 30 pages total, on an electronic file type specified in the RFP. 11. Q: We would like to provide team bios/resumes for each person on the proposed team. Is it acceptable to include these items in an appendix without having this count towards the maximum page limitation for the proposal? A: Yes. 12. Q: Question 6 of the Vendor Questionnaire states, “Submit a sample of annual and periodic reports you provide to similar clients”. We understand that these report samples are not counted in the 30 page proposal limit. However, we are not certain if the Sustainability, Cost and Work Hours and Vendor Statement sections are considered in the page limits, or if they have separate guidelines. A: All these sections should be incorporated in the 30 page limit. 13. Q: Are there any additional reports currently provided by your current consultant other than those listed in question 10 of your proposal? Are there any specific additional reports that are desired? A: The City would like to know what the standard and non-standard reporting packages that you offer to your clients looks like. 14. Q: Please indicate the year in which the City of Fort Collins anticipates an RFP solicitation for each of the following services, by placing an “x” below or listing the lines of coverage to include the year in which an RFP is anticipated: Coverage Remainder of 2016 2017 2018 2019 2020 2021 Third-Party Administrator (medical) X Self-Funded Medical Network Bundled with medial Insured HMO N/A Unbundled Pharmacy (PBM) N/A Clinic Operator X Wellness Program vendor Bundled with clinic Dental X Vision X Disability X Stop Loss (reviewed annually) X X X X X X Health Plan Consulting Services X FMLA X FSA X Basic & Supplemental Term Life & AD&D X Addendum 1 – 8283 Benefits Consultant Page 4 of 7 Voluntary life and AD&D X Employee Assistance Program (EAP) X 15. Q: Please indicate the year of your last self-funded medical claims audit. A: 10 years or more, may be interested in conducting an audit in the next couple of years. 16. Q: Please indicate the year of your last PBM audit. A: N/A – the City does not have a PBM, this is bundled with medical. 17. Q: Has the City of Fort Collins ever conducted a dependent eligibility audit? A: Yes. 18. Q: Does the City require verification of dependent eligibility associated with new enrollments or other status changes? A: Yes, during open enrollment and status changes. 19. Q: What resources does the City currently use to benchmark your plan against your competitors? A: MSEC, Local surveys of Front Range communities, Mercer Annual Survey. 20. Q: Which other government entities and/or private employers are included in current benchmarking? A: Front Range and participants in other surveys listed in question 19. 21. Q: What benchmarking information is desired that is not currently available? A: The City may be interested in evaluating changes to benefit start and end date as well as wellness incentive changes. Benchmark data would be used to analyze these program elements. 22. Q: Does the City offer a high deductible health plan? A: No, not currently. 23. Q: If the City sponsors a Health Reimbursement Arrangement (HRA) or Health Savings Account (HSA), please describe what is offered and how and when contributions are made to these accounts? A: N/A. 24. Q: Please provide, briefly describe or direct us to communication materials available to employees and retirees regarding the City Health and Wellness Clinic and their benefit plans. This might include an employee benefits booklet, benefits website, newsletters or other information. A: Please see Exhibit 2 for the following examples of communication materials: Benefits Guide, Well Days Brochure and CityCare Services flyer. New employees are introduced to benefits plan options during new employee orientation. Open enrollment seminars are conducted to provide information on plan changes and to promote benefit programs. Also available to employees is complete up-to-date plan materials on the City’s internal web site. 25. Q: Who currently updates your Summary Plan Description and other employee communications? Addendum 1 – 8283 Benefits Consultant Page 5 of 7 A: Communication materials are updated by City staff, benefit providers and/or our benefit consultant depending on the particular piece of communication. The City values a collaborative approach to communications. 26. Q: Please describe the assistance that is desired from your consultant in the communication regarding changes or new benefit offerings. A: Assist with developing communications materials, print flyers and posters, and assist with mailings to home. Review overall communications plan, develop annual communication strategy to include a monthly communication plan. 27. Q: Are there any specific communication materials that your consultant would develop on your behalf? A: Benefit guide, possibly other materials. 28. Q: What types of employee communication materials that are developed by others would the consultant be asked to review? A: We envision utilizing our consultant in a way that would create a holistic and cohesive approach to overall employee communications. Possibly to review materials and assist in creating an overall annual communication plan to include outreach to family members. 29. Q: Is the PPO Plan offered by the City grandfathered with respect to the Affordable Care Act? A: No, the City meets all ACA requirements and is not a grandfathered plan. 30. Q: Which wellness tasks are linked to incentives? Please briefly describe the incentive. A: Completing an annual Health Risk Assessment is incentivized with a $50 gift card. Employees can participate in a voluntary points- based incentive program and can earn up to 3 days of vacation time by meeting program requirements. 31. Q: Are any of the City’s wellness program incentives “outcome” based? A: No, not at this time. 32. Q: We understand that health plan consulting and other professional services are subject to public procurement guidelines that often require periodic marketing. We understand this RFP may have been issued in part as a result of these requirements. Please help us understand your readiness to make a change. a) But for public procurement guidelines, is it likely that this RFP would have still been issued at this time? A: Pursuant to City Code, contracts are not eligible to extend past five (5) years. b) What specific improvements or enhancements would the City consider significant enough to outweigh the additional effort associated with making a change in your consulting arrangement? A: Communication, cost and relationship fit are the top priorities the City is seeking in a consulting arrangement. 33. Q: For services that do not occur every year, such as formal RFPs, does the City prefer to have these costs spread over the term of the agreement, or to be billed for these services only in the year in which the service is performed? A: Spread over term of agreement. Addendum 1 – 8283 Benefits Consultant Page 6 of 7 34. Q: What are the three things that employees state they value most about your current programs? A: Employees highly value the employee wellness program, CityCare (on-site health and wellness center), and the high touch services from the Benefits staff. 35. Q: What are the top three concerns, if any, that the City or employees have regarding your current programs? A: Increased cost of medical plan. 36. Q: Is there a central database for all claims and encounter data? In other words, is there a data warehouse that receives medical and pharmacy data? If so, does the warehouse also receive any of the following? a. encounter data from the clinic b. EAP data c. Biometric or health risk assessment data A: All data is available but not housed in a centralized data warehouse. 37. Q: Please provide recent copies or describe the frequency and information provided on each of the following reports: a. Utilization or annual report from the data warehouse b. Annual consultant report (referenced in Item 10 under Objectives and Deliverables on page 4 of the RFP) c. Monthly and quarterly management reports provided by the current consultant (referenced in Item 10 under Objectives and Deliverables on page 4 of the RFP) A: The City currently receives monthly, quarterly and annual reporting on medical and prescription claims, as well as total plan costs associated with all lines of benefits. The City prefers to review the standard or customized offerings of the benefit consultant’s reporting packages, rather than providing copies of current reports. 38. Q: What is the purpose of issuing this RFP? Are you issuing it as part of the normal cycle? A: Pursuant to City Code, all contracts must be bid on the fifth year or prior. The current contract expires this year. 39. Q: Are you currently happy with service provided from your current Benefits Consultant? A: Yes. 40. Q: Is GASB valuation part of this RFP? A: No. 41. Q: How many meetings in a given year are required for the consultant to attend in person? A: See question 5 above. 42. Q: Are there any unions participating in the benefit programs? If so, what role is expected from the consultant to play in negotiations? A: Yes, FOP is the sole union representing sworn police officers. We do not anticipate our benefit consultant playing a role in negotiations with this union. 43. Q: Is there any ability to negotiate the Indemnity and limits of liability language (Section 5 of Exhibit A) A: We can discuss this term with the selected firm; however the insurance requirements are compulsory to contract execution. Addendum 1 – 8283 Benefits Consultant Page 7 of 7 44. Q: Is The City anticipating any strategic planning in the next three years that will incorporate benefit program changes? Does the City require any Board approval for plan design changes? A: Yes, the City is interested in building a strategic plan to support the Total Rewards offerings as it relates to benefits and total compensation. It is likely that will include plan design changes and diversified plan offering. Board approval is not required for plan design changes, however, any changes resulting in budgetary impacts will involve City Council. 45. Q: What is the approval process with the City for choosing a benefits consultant? How many people are involved to vote? A: Proposals will be evaluated by an internal evaluation team using the criteria annotated in Section V of the RFP and the individual scores will be tallied. At the City’s option, top ranked firms will be invited to interview. 2016 BenefitsGuide EXHIBIT 2 - BENEFITS COMMUNICATION MATERIALS Introduction This year’s Open Enrollment will be held October 14 – November 13, 2015. On-line enrollment will be available for two (2) weeks; November 2 – November 13, 2015. The City of Fort Collins (“City”) gives you the opportunity to select the benefits that best meet the needs of you and your family. Health, dental, life, disability, and vision coverage are all part of the City’s extensive benefit package. The City pays the vast majority of your benefit plan costs, including retirement. The City’s cost of your benefits is not taxable to you, except for premiums paid on that portion of your life insurance coverage that exceeds $50,000. Medical and dental are self-insured by the City; vision, life insurance, and long-term disability are fully insured. What’s Inside? • Medical Plan • Prescription Solutions/Optum Rx • Vision Program, VSP • Delta Dental plan • Life Insurance • Long Term Insurance • Voluntary Insurance • Family Care Connection • Employee Assistance Program • Flexible Spending Account • Employee Premiums • Important Notices • Contact Information 2016 Benefits 1 On-Line Open Enrollment During our annual Open Enrollment, you may elect your current group insurance benefit selections or make changes to your coverage. All benefit eligible employees are required to complete the on-line enrollment via CityNet. Please read this guide carefully. The choices you make will be effective for the next Plan Year, January 1 – December 31, 2016. After your elections go into effect, you cannot make changes during the Plan Year except under certain limited circumstances (see page 2). Questions? If you have any questions about your benefits for 2016, you should plan to attend one of the various scheduled Open Enrollment meetings. Spouses are also welcome to attend and ask questions. 2 Change of Family Status As you make your elections for Open Enrollment, you must remember that changing your elections during a Plan Year is quite limited by IRS Rules and Regulations. Again, we ask that you take care in making your elections for the 2016 Plan Year. Once your elections go into effect on January 1, 2016, you cannot make any changes, unless you experience a qualified change of status recognized by Section 125 of the Internal Revenue Code (IRC). These changes of status include changes in your: Eligibility All classified and unclassified management employees who are regularly scheduled to work at least 20 hours per week are eligible to enroll in each of the City’s group insurance plans. In addition, contractual employees whose contracts stipulate benefits, are eligible to enroll for medical, dental, vision and life insurance coverage. Full Time Hourly employees with benefits are eligible to enroll for medical coverage only. You may enroll yourself, your legal spouse (as recognized by Colorado law), your eligible dependent children, or your same-sex spouse and their eligible children. Eligible dependents may be enrolled only if you enroll for coverage yourself. For medical, dental, and vision coverage, dependent children are eligible for coverage until they reach age 26. Dependent children include your natural children, resident step-children, adopted children (from date of placement), children for whom you assume legal guardianship, children for whom you are required by Qualified Medical Child Support Order (QMCSO) to provide coverage, or your same-sex spouse’s eligible children. Make sure your Dependents are truly eligible! Maintaining the lowest possible cost for our health insurance is important to employees and the City. A big part of managing costs is ensuring only eligible dependents are provided coverage under the City’s benefits programs. As such, we will conduct a review of the dependents you add through the on- line enrollment system. Please know that it’s the employee’s responsibility to only include dependents that are eligible for coverage (see definition above). If through this review we find that employees have included ineligible dependents for coverage under the City’s medical, dental, and vision plans, the dependent will be removed. In order for this dependent to be re-enrolled, you will be required to provide proof of eligibility. You May Choose to Enroll • Employee Only • Employee + Child(ren) • Employee + Spouse • Employee + Family (you, your legal spouse and your eligible dependent children) • “Waive” coverage • Legal marital status: an event that changes your legal marital status, including marriage, divorce, annulment or death of a spouse. • Number of dependents: an event that changes the number of your eligible dependents, including birth, death, adoption or placement for adoption, or a child reaching maximum age. • Employment status: termination of employment, commencement of, or return from, unpaid leave of absence, or any other change in the employment status of you, your spouse or dependent that affects an individual’s eligibility for coverage under a plan. • Residence: a change in your residence or the residence of your spouse or dependent that impacts plan eligibility. *Don’t forget! If you get married, have a baby, or one of your family members loses eligibility...notify a Benefits Team Member! The IRS allows only 31 days to make these changes, or you have to wait until the next open enrollment period. 3 Optum Prescription Benefits RETAIL PREMIER Plan (In-network only) Generic/Preferred/Non-preferred $0/$20/$40 MAIL-ORDER (90-day supply) Generic/Preferred/Non-preferred $0/$50/$100 UMR Medical Benefits PREMIER MEDICAL PLAN In-Network Out-of-Network Annual Deductible Individual /Family $300/$600 $900/$1,800 Coinsurance 15% 35% Out-of-Pocket Maximum Individual/Family $5,000/$10,000 $10,000/$20,000 Office Visits PCP Specialist Preventive $20 copay $30 copay Covered at 100% 35% after deductible 35% after deductible 65% after deductible Emergency $200 copay $200 copay Urgent Care $40 copay 35% after deductible Durable Medical Equipment 15% after deductible 35% after deductible Eye Exam $25 copay per exam $25 copay per exam Hearing Aids Deductible/Coinsurance 35% after deductible Maximum benefit is $750/person every 5 years Physical Therapy $30 copay Medical necessity will be reviewed after 25 visits 35% after deductible Speech Therapy $30 copay 35% after deductible Chiropractic $20 copay $1,200 max per benefit year 35% after deductible Inpatient Hospital 15% after deductible 35% after deductible Outpatient Hospital/Surgery 15% after deductible 35% after deductible Maternity Prenatal Postnatal care/Delivery No charge 15% after deductible 35% after deductible Mental Health/ Substance Abuse - Inpatient 15% after deductible 35% after deductible Mental Health/ Substance Abuse - Outpatient $30 copay 15% after deductible on other services 35% after deductible Please see the Summary of Benefits and Coverage document for full plan details. A retail pharmacy will automatically dispense a generic equivalent prescription unless Your provider has indicated “dispense as written” (DAW) on the prescription. If Your provider did not indicate DAW on the prescription, and You elect to have the pharmacy dispense a brand drug, You will be responsible for the applicable co-pay as well as the difference in cost between the generic and brand drug. Automatic generic replacement is applicable in the retail setting only and does not apply to mail order. Claim, Eligibility and Benefit Inquiry You can view your claims (including copies of EOBs) eligibility and benefit information any time of the day or night. In addition, you can view the status of medical deductibles, out-of-pocket and lifetime maximum amounts. You can also access a summary of claim dollars for current year-to-date and prior year claim charges. Other Insurance and Accident Details If you have claims pending for updates to other insurance or accident details information, you can make those updates online. Any claims pending will be automatically reprocessed. ID Card Ordering Order duplicate or replacement ID cards quickly and easily. Member Health Information UMR provides a wealth of information and services to help you live a healthier life. You will have access to health risk assessments, chat rooms and forums, wellness action guides, record keepers and more. Tools, such as Healthcare Advisor, can help you make the best decisions about health conditions and prescription drugs. Within the Disease Management Conditions Centers, you can access surveys, research conditions and interact with our nurse case managers. In addition, we provide links to excellent health information sites, articles and a whole lot more. Provider Network Links For your convenience, we’ve set up a link to your provider network. When you click on the link, the network provider’s home page is displayed. You can click the link on the home page to search for in-network physicians or medical facilities. Forms Our most widely used forms are available online for easy access. 4 UMR Medical Benefits - Accessing Online Services Step1 Visit: www.umr.com Select “Members” For members with health or dental coverage: Enter the member ID located on your ID card in the Online Services Access box. Click “Go to my online services.” Our Web site will redirect you to your online ser- vices home page. If you have previously registered for online services, enter your username and password in the member login box and click “Submit” to login Step2 Step3 Step4 Step5 *If you have not yet registered for online services, click the “Need a Username? Register here.” link and follow the prompts to complete your registration. That’s all you need to do. You now have access to a variety of services, including everything that follows. Well Vision Exam (Every 12 months) $15 copay Prescription Glasses $15 copay Frame (every 24 months) $150 allowance Lenses (every 12 months) Covered up to maximum allowance Contacts (instead of glasses; every 12 months) $150 allowance VSP Vision Benefits The City provides you and your family access to vision insurance at favorable group coverage rates. This plan is funded solely by employee contributions, and is fully insured by Vision Service Plan (VSP). Using your VSP benefit is easy. VSP Provider • Find an eye care provider who’s right for you. • To find a VSP doctor, visit vsp.com or call 800.877.7195 • Review your benefit information • Visit vsp.com to review your plan coverage before your appointment • At your appointment, tell them you have VSP. There’s no ID card necessary That’s it! We’ll handle the rest—there are no claim forms to complete when you see a VSP doctor. 5 NOTE: You may elect Vision coverage when initially eligible with no waiting period on benefits. If you do not elect coverage when initially eligible, or if you drop previously elected Vision coverage, you will be subject to a 2 year waiting period before benefits will begin. Network options through Costco Optical, Walmart and Sam’s Club available. Annual Maximum $1,500/individual $1,500/Individual $1,500/Individual Diagnostic (X-ray/Oral Exams) 100% 80% 80% Preventive (Cleanings/Fluoride) 100% 80% 80% Deductible (every 12 months) $50/individual $100/family $50/individual $100/family $50/individual $100/family Restorative (Fillings, Stainless steel crowns) 80% 60% 60% Endodontics (Root canal therapy) 80% 80% 80% Periodontics (Treatment of the gums) 80% 60% 60% Oral Surgery Extractions 80% 80% 80% Implant, Crown and Bridge 50% 50% 50% Prosthodontics (dentures, partials) 50% 50% 50% Orthodontics: $1,500.00 Lifetime Maximum per eligible dependent child(ren) to 26 50% (Dependents to age 26) 50% (Dependents to age 26) 50% (Dependents to age 26) Delta Dental Benefits The City will continue offering the Comprehensive Plan through Delta Dental. You may enroll for a different level of dental coverage than you enroll for medical; for example, you may enroll for individual medical coverage and family dental coverage. Following are the plan highlights. Delta PPO Provider Delta Premier Provider 6 *Non-Network Provider To locate a Delta Dental In-Network provider please call 1.800.610.0201 or visit the website at www.deltadentalco.com. *May be subject to additional charges over usual/customary fees. Voya Supplemental Life Insurance You – You can select additional life insurance coverage of 1, 2 or 3 times your basic annual earnings, rounded to the next higher $1,000, to a maximum of $500,000. The minimum benefit is $20,000. If Supplemental Life coverage is elected, Supplemental AD&D coverage may be elected in the same amount. Your Spouse and Unmarried, Dependent Children — You may choose from several flat benefit amounts available for your spouse or your children. You may choose coverage for your spouse, or for your children, or for both. Voya Supplemental Accident Insurance You – Accident coverage is available in the amounts of 1, 2 or 3 times your salary, subject to a maximum benefit of $500,000. Your benefit amount can equal the amount of life insurance benefit elected under the Voya’s Supplemental Life plan. Your Spouse – Your Spouse will automatically receive an amount equal to the Spouse’s supplemental life insurance benefit in effect under the Voya Supplemental Life plan. Your Children – Your Child(ren) will automatically receive an amount equal to the Child(ren)’s supplemental life insurance benefit in effect under the Voya Supplemental Life plan. You may need to request changes to your existing coverage if, in the future, you no longer have dependents who qualify for coverage. We will refund premium if you do not notify us of this and it is determined at the time of a claim that premium has been overpaid. NOTE: If you elect Supplemental Coverage for yourself and/or your dependents when you are initially eligible you will be allowed to elect coverage up to the Guaranteed Issue amount with no Evidence of Insurability. If you do not elect the Supplemental coverage when initially eligible you may do so at the next Open Enrollment, however any amount that you elect will be subject to Evidence of Insurability. You may obtain an Evidence of Insurability form at http://citynet.fcgov.com/humanresources/benefithome.php. 7 Voya Basic Life & AD&D The City provides Basic Life and AD&D to all eligible employees in the amount of 1x your annual salary up to $500,000. Benefit Amounts for Spouse $10,000, $25,000, $50,000, $75,000 or $100,000 The guaranteed coverage amount for your spouse is $10,000, offered to new hires only, as guaranteed. Benefit Amounts for Children $5,000 or $10,000 The guaranteed coverage amount for your child(ren) is $10,000, offered to new hires only, as guaranteed. 8 Anthem Voluntary Life Insurance and AD&D At any time during the year, you may enroll for Anthem Voluntary Life Insurance and Voluntary Accidental Death and Dismemberment (AD&D); enrollment is not restricted to the Open Enrollment period. This plan offers a voluntary term life insurance that provides additional term life protection for you, your spouse, and/or your children up to age 25 without the requirement of being a full time student as long as they are financially dependent upon the employee. In addition, you may purchase additional AD&D coverage. This voluntary protection can be purchased on an after-tax basis in addition to the Voya Basic and Supplemental plans. Evidence of Insurability is required for all applications. Coverage is available in $10,000 increments, up to $300,000. Coverage is portable so that after termination of employment, you may continue. NOTE: If you elect Voluntary Coverage for yourself and/or your dependents when you are initially eligible you will be allowed to elect coverage up to the Guaranteed Issue amount with no Evidence of Insurability. If you do not elect the Voluntary coverage when initially eligible you may do so at any time throughout the year, however any amount that you elect will be subject to Evidence of Insurability. Contact HR for an enrollment application. Voya Family Medical Leave Administration & Short Term Disability Family Medical Leave Administration The Family Medical Leave Act (FMLA) may grant an employee an unpaid leave of absence of up to 12 weeks per year for certain events. These events may include, but are not limited to: • your own serious medical condition • caring for a family member with a serious medical condition • birth, adoption or foster care of a child If you need to apply for a Family Medical Leave, please contact Voya Employee Benefits Leave Management Team at 888.464.3652. Short Term Disability The City offers Short Term Disability coverage through Voya. STD provides you with income benefits if you become disabled. An eligible employee may use short term disability leave for up to 90 calendar days per cause, but not to exceed a total of 90 calendar days in a calendar year. If you become disabled and you are approved for STD benefits, the plan will pay you: • 2 week elimination period (14 calendar days) covered by the use of personal leave (sick, vacation, comp time or award time); • 6 weeks of STD pay at 100% of weekly earnings, then; • 4 weeks and 6 days of STD pay at 75% of weekly earnings (remaining 25% of weekly earnings can be supplemented with personal leave (sick, vacation, comp time or award time) Special Provisions Include: • Seat Belt Rider • Common Disaster Benefit Rider • Special Education Benefits Rider • Travel Assistance Benefit Rider • Living Benefits Rider lets you withdraw 50% of the life benefit before death if diagnosed with a terminal illness 9 Family Care Connection Family Care Connection, provides our back-up care services. Employees can call Family Care Connection directly to set up back-up care for their dependents. No registration is necessary. Just call 970.223.9026, 24 hours a day. Please leave a message on the recorder. Someone will call you back as soon as possible. If it’s an urgent day care issue, you will be prompted to leave an urgent message that will be returned as quickly as possible. Voya Long Term Disability The City pays the entire premium cost for this coverage, which is mandatory for classified and unclassified management employees. This plan is not available to firefighters, police officers and emergency dispatchers, under age 55 and less than 25 years of service, since these positions are covered by an alternate benefit (FPPA). Premiums are based on your monthly base salary, and premiums are not taxable to you as income. However, any LTD benefits you receive are taxed as ordinary income. LTD provides you with income replacement if you experience a disabling illness or injury that prevents you from performing the essential functions of your job. This plan is fully insured, and the insurance company, Voya, is solely responsible for the approval of benefits. There is a 90 day waiting period before benefits become payable. If you become disabled and you are approved for LTD benefits, the plan will pay you: • 66 2/3% of your monthly base salary in effect immediately prior to disability. • 60% of your monthly base salary for fire, police, and dispatch. LTD benefits are offset (or reduced) by income you receive from other sources, such as Social Security Disability or Retirement benefits, Workers’ Compensation benefits or other retirement benefits. Please take this fact into account if you need to plan for your income during a period of disability. What is Back-Up Child/Adult Care? You and your spouse both work and provide daycare or adult care for your dependents. Your regular child/adult care provider is sick. Perhaps your child’s school closes unexpectedly, or you need to be at work at an unexpected time. Any time you need to be on the job and your child’s regular care arrangements fall through, you can use Family Care Connection’s Back-up Child/Adult Care Program. When you know that you need care, whether its weeks in advance or at the last minute, simply call the local number 970.223.9026. Arrangements will be made to send a provider to your home. 95% of the requests are filled as needed. The need for care must be work related. This benefit is specifically designed to allow City employees the opportunity to work and minimize absenteeism. Employees pay $7.00 per hour to the daycare provider and are limited to 100 hours of back-up care each year. For more information, please contact: Gwen Feit in Human Resources at 970.221.6843 10 Employee Assistance Program (EAP) ComPsych is our provider for this extremely valuable service that the City provides to unclassified management, classified, and contractual employees and their families. This program offers unlimited telephonic sessions, eight (8) free confidential visits per person per problem per year, along with up to 30 minutes per issue for legal consultation and up to 30 minutes per issue for financial resources. You can reach this confidential assistance with personal or work issues at 1-844- 216-9810, 24 hours a day, seven days a week or log on to guidanceresources. com Web ID: FTCEAP. Brochures are available from your Department Designate or by calling Human Resources at 221-6843 or 416-2785. • Life Balance • Relationships • Problems with your children • Substance Abuse • Stress, Anxiety or Depression • Job Pressures • Marital Conflicts • Grief and Loss • Empty-nesting ...and more! Call us for help with life’s ups and downs. We’ll connect or refer you to a professional who can help with: Flexible Spending Account (FSA) The City offers you the opportunity of opening a health care flexible spending account and/or a dependent care flexible spending account administered by ASI Flex. These accounts allow you to set aside pre-tax dollars from each paycheck to help pay for unreimbursed eligible health care and dependent care expenses for you and your family. Health Care FSA Allows you to set aside up to $2,550 pre-tax dollars per year to pay for out-of-pocket medical expenses. Your full annual election is available to you on your first day of coverage, which means that when you incur eligible expenses, you can submit reimbursement requests immediately. Expenses can be for you, your spouse or any tax dependent, even if your dependents are not enrolled in your employer’s health insurance plan. New in 2016, you can now carryover up to $500 the following year! The Healthcare FSA plan now includes a provision that will allow participants to carryover up to $500 of unused contributions into the following plan year. At the end of 2016, if you have unused money in your healthcare FSA, you can now apply up to $500 of the leftover balance to the 2017 plan year account. Plan your 2016 healthcare FSA election accordingly! Dependent Care FSA Allows you to use pre-tax dollars to pay for out-of-pocket childcare and/or elder dependent care expenses for disabled dependent child over 13 or other disabled adults, such as parents or grandparents. You can set aside up to $5,000 ($2,500 if married and filing separately on your federal income taxes) per year (please note that the $5,000 is a household maximum) in the account. The funds are deducted before federal and state income taxes and FICA are assessed, and reimbursements are completely tax free. Eligible expenses include day care, baby sitting, general purpose day camps and pre-k expenses. Voya Behavioral Health Benefits and More... In addition to ComPsych, our EAP provider, there are additional services available through Voya’s Behavioral Health program. These services are also provided by ComPsych through the Voya Behavioral Health Benefits you can receive: For more information on all of the additional Voya Services – go to http://citynet.fcgov.com/humanresources/benefithome.php or you can 11 2016 Bi-Weekly Employee Premium Costs (Unclassified Management, Classified, Contractual Variable Hour Employees) PREMIER - Medical Full-Time Part-Time Employee Only $35.91 $59.85 Employee + Spouse $173.21 $230.94 Employee + Child(ren) $141.72 $188.96 Employee + Family $220.45 $293.83 Delta Dental Full-Time Part-Time Employee Only $4.98 $6.64 Employee + Spouse $11.96 $14.95 Employee + Child(ren) $14.95 $18.69 Employee + Family $19.93 $24.92 VSP - Vision Full-Time Part-Time Employee Only $3.24 $3.24 Employee + Spouse $6.48 $6.48 Employee + Child(ren) $6.48 $6.48 Employee + Family $10.19 $10.19 Full-Time = 30+ hours/weekly (.75 FTE thru 1.00 FTE) Part-Time = 20-29 hours/weekly (.50 FTE thru .74 FTE) Full-Time Hourly = Full-Time rate - Medical only (average 30+ hours per week, over 12 month measurement period) 12 Notes Plan Documents Shall Govern - While this booklet is intended to provide accurate information, more extensive information is contained in each plan’s specific Summary Plan Description (SPD) and formal plan document. No participant shall accrue any rights because of any statement in or omission from this booklet. In the event of a discrepancy between the information presented here, the respective SPD, and the respective plan document; the respective plan document shall govern. Visit the benefits website at http://citynet.fcgov.com/humanresources/benefithome.php to view the specific Summary Plan Descriptions. Amendment/Termination - The City intends to continue the plans indefinitely but reserves the right to amend or terminate the plans at any time. This right of amendment/termination shall apply to all participants, including retirees. Premiums and plan provisions are subject to change. 13 Important Notices Federal regulations require the City to provide benefit eligible employees with the following important annual notices. For a complete copy if each notice you may go to http://citynet.fcgov.com/humanresources/benefithome.php Private Health Information A portion of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) addresses the protection of confidential health information. It applies to all health benefit plans. In short, the idea is to make sure that confidential health information that identifies (or could be used to identify) you is kept com- pletely confidential. This individually identifiable health information is known as “protected health information” (PHI), and it will not be used or disclosed without your written authorization, except as described in the Plan’s HIPAA Privacy No- tice or as otherwise permitted by federal and state health information privacy laws. A copy of the Plan’s Notice of Privacy Practices that describes the Plan’s policies, practices and your rights with respect to your PHI under HIPAA is avail- able from your medical plan provider. For more information regarding this No- tice, please contact the Human Resources Department. Summary of Benefits and Coverage (SBC) Effective for plan renewals after January 1, 2012, the Patient Protection and Af- fordable Care Act requires employers that offer health coverage to provide a uniform Summary of Benefits and Coverage (SBC) to people who apply for and enroll in the health plan. This document contains the following: • Four-page overview of plan benefits, cost sharing and limitations • Required set of examples of how the plan works • Phone number and internet address for obtaining copies of plan documents • A Standard glossary of medical and insurance terms must also be available The SBC will be updated each plan renewal to reflect applicable plan changes. Women’s Health and Cancer Rights Act The City medical plans, as required by the Women’s Health and Cancer Rights Act of 1998, provides benefits for mastectomy-related services. These services include: • All stages of reconstruction of the breast on which the mastectomy was per- formed • Surgery and reconstruction of the other breast to produce a symmetrical ap- pearance • Prostheses and treatment of physical complications resulting from mastec- tomy (including lymphedema) This coverage will be provided in consultation with the attending physician and the patient, and will be subject to the same annual deductibles and coinsur- ance provisions that apply to the mastectomy. For more information, contact your medical plan provider. Individual Coverage Mandate Effective January 1, 2015, Federal law requires that you have Health Care cov- erage or you may be subject to an income tax penalty. You can enroll in The City health plan, or you may want to consider visiting www.healthcare.gov for information on health plans available through the Healthcare Marketplace in your area. Notice of Prescription Drug Creditable Coverage The City provides a “Notice of Prescription Drug Creditable Coverage” to all Medicare eligible participants on an annual basis. This notice states that under the City medical plan, you have prescription drug coverage that is, on average, as generous as the standard Medicare Prescription Drug Coverage. Continuation Of Coverage If your coverage ends under the Plan, you may be entitled to elect continua- tion coverage (coverage that continues on in some form) in accordance with federal law. If you selected continuation coverage under a prior plan which was then re- placed by coverage under this Plan, continuation coverage will end as sched- uled under the prior plan or in accordance with the terminating events listed 14 Carrier Contacts UMR Medical 76-411027 1.800.826.9781 www.umr.com Delta Dental 1857 1.800.610.0201 www.deltadentalco.com Vision Service Plan (VSP) 12-063997 1.800.877.7195 www.vsp.com Optum Rx 1.877.559.2955 www.OptumRx.com ASI Flexible Spending 1.800.659.3035 www.asiflex.com Voya Supplemental Life AD&D Anthem Voluntary Life/AD&D 674923 006518 1.800.955.7736 www.voya.com 1.866.594.0516 westregion@anthem.com Voya Long Term Disability Voya Family Medical Leave Act Voya Short Term Disability 674923 1.800.955.7736 www.voya.com 1.888.464.3652 www.voya.com ComPsych Employee Assistance Program Web ID: FTCEAP 1.844.216.9810 www.guidanceresources.com City of Fort Collins Benefit Representatives Provider Group # Phone / Website Janie Appleton 970.221.6562 jappleton@fcgov.com Kristi Hess 970.300.1770 khess@fcgov.com Gwen Feit 970.221.6843 gfeit@fcgov.com LeeAnn Vargas 970.416.2785 lvargas@fcgov.com For more information about onsite healthcare go to www.marathon-health.com and click on “Individuals.” This website has information about services, the eHealth Portal, and video success stories from people who use Marathon Health services. www.marathon-health.com The following is a representative list of services available: Bronchitis Common cold Constipation Cough Diarrhea Ear pain Eye infections Headache Hip pain Knee pain Nausea and Vomiting Nosebleed Shoulder pain Sinus infections Skin infections/rashes Strep throat Asthma Coronary artery disease COPD Congestive heart failure Depression Diabetes Gastric esophageal reflux disease Hypertension Low back pain Metabolic syndrome Osteoarthritis Rheumatoid arthritis Sleep apnea Lab Services Blood work and lab tests processed at the Center for A1C, lipid panel, fasting and random glucose, rapid strep, urinalysis, oxygen saturation levels, flu, mono and pregnancy. All other lab tests can be drawn and sent to an external lab for processing. Prevention Health Screenings Blood pressure Body mass index Cholesterol Glucose Health Coaching Nutrition Physical activity WELL Live Well. Wo LEARN MORE ABOUT HOW YOU CAN EARN WELL DAYS! LYNN SANCHEZ, WELLNESS PROGRAM MANAGER 416-2098, lysanchez@fcgov.com ANGIE RHODES, WELLNESS PROGRAM COORDINATOR 221-6349, arhodes@fcgov.com DANNY NELSON, WELLNESS PROGRAM SPECIALIST 224-6194, dnelson@fcgov.com WELLNESS INTERN 416-2475, wintern@fcgov.com WELLNESS Your Health & Wellbeing JANUARY – FEBRUARY 2016 Health Screenings FEBRUARY 1 Well Days Kicks Off MARCH – MAY Marathon Health Risk Assessment SPRING City Safety and Wellness Team Supervisor Breakfast MAY – AUGUST BP Check Clinics JUNE Bike to Work Day SUMMER PICNIC Employee Picnic Fun Run/Walk OCTOBER Health Fair & On-Site Flu Shots TWICE A YEAR On-Site Mammograms Fitness Testing MONTHLY Fitness Room Orientations wellness calendar wellness staff WELLNESS Live Well. Work Well. Be Well. WELL DAYS WELL DAYS incentive program The benefits of the Well Days program go beyond the prizes and are unique for every individual. WHO’S ELIGIBLE? Benefit eligible employees can earn up to three Well Days, or days off. Non-benefit eligible employees and employees eligible for Award Time (Police Services) may participate and are eligible for prize drawings each trimester. Benefit eligible = any employee who is currently eligible to enroll in benefits (medical, dental, vision) from the City of Fort Collins. You do not need to be actively enrolled in benefits to earn Well Days. HOW DO I EARN POINTS? Each trimester you will earn 100 points in each category for a total of 300 points. The categories are Activities, Awareness and Behaviorcation. • Points carry over to the next trimester, but not year-to-year. • There are mandatory points to earn each trimester. • Log into your Well Days page for a complete list of activities you can do to earn points. • Points earned by completing the requirements for a given activity will be added to your account via online forms, signing in at class or entered by Wellness staff. • Click on the title of any activity to get more information about earning those points. EARN PRIZES! At the end of each trimester, all employees who have earned the Well Day will have their name entered in a prize drawing for one of five $100 gift cards. HOW ARE WELL DAYS CALCULATED? Well days are awarded two pay periods after the end of the trimester. CLASSIFIED EMPLOYEES • Based on your FTE and added to your vacation balance HOURLY EMPLOYEES • Based on the number of hours you worked during the trimester • Added to your comp time balance be well REGISTRATION OPENS FEBRUARY 1 To start earning points toward your Well Days, register on CityNet. Registration is required annually for the Well Days Program. FIRST TRIMESTER - SELF CARE FEBRUARY 1 – MAY 13 • Registration & Pre-Program Survey Program 25 Awareness Points • Marathon Health History and Risk Assessment (HHRA) 100 Awareness points get moving SECOND TRIMESTER - PHYSICAL ACTIVITY MAY 14 – AUGUST 26 2016 BenefitsGuide EXHIBIT 2 - BENEFITS COMMUNICATION MATERIALS Introduction This year’s Open Enrollment will be held October 14 – November 13, 2015. On-line enrollment will be available for two (2) weeks; November 2 – November 13, 2015. The City of Fort Collins (“City”) gives you the opportunity to select the benefits that best meet the needs of you and your family. Health, dental, life, disability, and vision coverage are all part of the City’s extensive benefit package. The City pays the vast majority of your benefit plan costs, including retirement. The City’s cost of your benefits is not taxable to you, except for premiums paid on that portion of your life insurance coverage that exceeds $50,000. Medical and dental are self-insured by the City; vision, life insurance, and long-term disability are fully insured. What’s Inside? • Medical Plan • Prescription Solutions/Optum Rx • Vision Program, VSP • Delta Dental plan • Life Insurance • Long Term Insurance • Voluntary Insurance • Family Care Connection • Employee Assistance Program • Flexible Spending Account • Employee Premiums • Important Notices • Contact Information 2016 Benefits 1 On-Line Open Enrollment During our annual Open Enrollment, you may elect your current group insurance benefit selections or make changes to your coverage. All benefit eligible employees are required to complete the on-line enrollment via CityNet. Please read this guide carefully. The choices you make will be effective for the next Plan Year, January 1 – December 31, 2016. After your elections go into effect, you cannot make changes during the Plan Year except under certain limited circumstances (see page 2). Questions? If you have any questions about your benefits for 2016, you should plan to attend one of the various scheduled Open Enrollment meetings. Spouses are also welcome to attend and ask questions. 2 Change of Family Status As you make your elections for Open Enrollment, you must remember that changing your elections during a Plan Year is quite limited by IRS Rules and Regulations. Again, we ask that you take care in making your elections for the 2016 Plan Year. Once your elections go into effect on January 1, 2016, you cannot make any changes, unless you experience a qualified change of status recognized by Section 125 of the Internal Revenue Code (IRC). These changes of status include changes in your: Eligibility All classified and unclassified management employees who are regularly scheduled to work at least 20 hours per week are eligible to enroll in each of the City’s group insurance plans. In addition, contractual employees whose contracts stipulate benefits, are eligible to enroll for medical, dental, vision and life insurance coverage. Full Time Hourly employees with benefits are eligible to enroll for medical coverage only. You may enroll yourself, your legal spouse (as recognized by Colorado law), your eligible dependent children, or your same-sex spouse and their eligible children. Eligible dependents may be enrolled only if you enroll for coverage yourself. For medical, dental, and vision coverage, dependent children are eligible for coverage until they reach age 26. Dependent children include your natural children, resident step-children, adopted children (from date of placement), children for whom you assume legal guardianship, children for whom you are required by Qualified Medical Child Support Order (QMCSO) to provide coverage, or your same-sex spouse’s eligible children. Make sure your Dependents are truly eligible! Maintaining the lowest possible cost for our health insurance is important to employees and the City. A big part of managing costs is ensuring only eligible dependents are provided coverage under the City’s benefits programs. As such, we will conduct a review of the dependents you add through the on- line enrollment system. Please know that it’s the employee’s responsibility to only include dependents that are eligible for coverage (see definition above). If through this review we find that employees have included ineligible dependents for coverage under the City’s medical, dental, and vision plans, the dependent will be removed. In order for this dependent to be re-enrolled, you will be required to provide proof of eligibility. You May Choose to Enroll • Employee Only • Employee + Child(ren) • Employee + Spouse • Employee + Family (you, your legal spouse and your eligible dependent children) • “Waive” coverage • Legal marital status: an event that changes your legal marital status, including marriage, divorce, annulment or death of a spouse. • Number of dependents: an event that changes the number of your eligible dependents, including birth, death, adoption or placement for adoption, or a child reaching maximum age. • Employment status: termination of employment, commencement of, or return from, unpaid leave of absence, or any other change in the employment status of you, your spouse or dependent that affects an individual’s eligibility for coverage under a plan. • Residence: a change in your residence or the residence of your spouse or dependent that impacts plan eligibility. *Don’t forget! If you get married, have a baby, or one of your family members loses eligibility...notify a Benefits Team Member! The IRS allows only 31 days to make these changes, or you have to wait until the next open enrollment period. 3 Optum Prescription Benefits RETAIL PREMIER Plan (In-network only) Generic/Preferred/Non-preferred $0/$20/$40 MAIL-ORDER (90-day supply) Generic/Preferred/Non-preferred $0/$50/$100 UMR Medical Benefits PREMIER MEDICAL PLAN In-Network Out-of-Network Annual Deductible Individual /Family $300/$600 $900/$1,800 Coinsurance 15% 35% Out-of-Pocket Maximum Individual/Family $5,000/$10,000 $10,000/$20,000 Office Visits PCP Specialist Preventive $20 copay $30 copay Covered at 100% 35% after deductible 35% after deductible 65% after deductible Emergency $200 copay $200 copay Urgent Care $40 copay 35% after deductible Durable Medical Equipment 15% after deductible 35% after deductible Eye Exam $25 copay per exam $25 copay per exam Hearing Aids Deductible/Coinsurance 35% after deductible Maximum benefit is $750/person every 5 years Physical Therapy $30 copay Medical necessity will be reviewed after 25 visits 35% after deductible Speech Therapy $30 copay 35% after deductible Chiropractic $20 copay $1,200 max per benefit year 35% after deductible Inpatient Hospital 15% after deductible 35% after deductible Outpatient Hospital/Surgery 15% after deductible 35% after deductible Maternity Prenatal Postnatal care/Delivery No charge 15% after deductible 35% after deductible Mental Health/ Substance Abuse - Inpatient 15% after deductible 35% after deductible Mental Health/ Substance Abuse - Outpatient $30 copay 15% after deductible on other services 35% after deductible Please see the Summary of Benefits and Coverage document for full plan details. A retail pharmacy will automatically dispense a generic equivalent prescription unless Your provider has indicated “dispense as written” (DAW) on the prescription. If Your provider did not indicate DAW on the prescription, and You elect to have the pharmacy dispense a brand drug, You will be responsible for the applicable co-pay as well as the difference in cost between the generic and brand drug. Automatic generic replacement is applicable in the retail setting only and does not apply to mail order. Claim, Eligibility and Benefit Inquiry You can view your claims (including copies of EOBs) eligibility and benefit information any time of the day or night. In addition, you can view the status of medical deductibles, out-of-pocket and lifetime maximum amounts. You can also access a summary of claim dollars for current year-to-date and prior year claim charges. Other Insurance and Accident Details If you have claims pending for updates to other insurance or accident details information, you can make those updates online. Any claims pending will be automatically reprocessed. ID Card Ordering Order duplicate or replacement ID cards quickly and easily. Member Health Information UMR provides a wealth of information and services to help you live a healthier life. You will have access to health risk assessments, chat rooms and forums, wellness action guides, record keepers and more. Tools, such as Healthcare Advisor, can help you make the best decisions about health conditions and prescription drugs. Within the Disease Management Conditions Centers, you can access surveys, research conditions and interact with our nurse case managers. In addition, we provide links to excellent health information sites, articles and a whole lot more. Provider Network Links For your convenience, we’ve set up a link to your provider network. When you click on the link, the network provider’s home page is displayed. You can click the link on the home page to search for in-network physicians or medical facilities. Forms Our most widely used forms are available online for easy access. 4 UMR Medical Benefits - Accessing Online Services Step1 Visit: www.umr.com Select “Members” For members with health or dental coverage: Enter the member ID located on your ID card in the Online Services Access box. Click “Go to my online services.” Our Web site will redirect you to your online ser- vices home page. If you have previously registered for online services, enter your username and password in the member login box and click “Submit” to login Step2 Step3 Step4 Step5 *If you have not yet registered for online services, click the “Need a Username? Register here.” link and follow the prompts to complete your registration. That’s all you need to do. You now have access to a variety of services, including everything that follows. Well Vision Exam (Every 12 months) $15 copay Prescription Glasses $15 copay Frame (every 24 months) $150 allowance Lenses (every 12 months) Covered up to maximum allowance Contacts (instead of glasses; every 12 months) $150 allowance VSP Vision Benefits The City provides you and your family access to vision insurance at favorable group coverage rates. This plan is funded solely by employee contributions, and is fully insured by Vision Service Plan (VSP). Using your VSP benefit is easy. VSP Provider • Find an eye care provider who’s right for you. • To find a VSP doctor, visit vsp.com or call 800.877.7195 • Review your benefit information • Visit vsp.com to review your plan coverage before your appointment • At your appointment, tell them you have VSP. There’s no ID card necessary That’s it! We’ll handle the rest—there are no claim forms to complete when you see a VSP doctor. 5 NOTE: You may elect Vision coverage when initially eligible with no waiting period on benefits. If you do not elect coverage when initially eligible, or if you drop previously elected Vision coverage, you will be subject to a 2 year waiting period before benefits will begin. Network options through Costco Optical, Walmart and Sam’s Club available. Annual Maximum $1,500/individual $1,500/Individual $1,500/Individual Diagnostic (X-ray/Oral Exams) 100% 80% 80% Preventive (Cleanings/Fluoride) 100% 80% 80% Deductible (every 12 months) $50/individual $100/family $50/individual $100/family $50/individual $100/family Restorative (Fillings, Stainless steel crowns) 80% 60% 60% Endodontics (Root canal therapy) 80% 80% 80% Periodontics (Treatment of the gums) 80% 60% 60% Oral Surgery Extractions 80% 80% 80% Implant, Crown and Bridge 50% 50% 50% Prosthodontics (dentures, partials) 50% 50% 50% Orthodontics: $1,500.00 Lifetime Maximum per eligible dependent child(ren) to 26 50% (Dependents to age 26) 50% (Dependents to age 26) 50% (Dependents to age 26) Delta Dental Benefits The City will continue offering the Comprehensive Plan through Delta Dental. You may enroll for a different level of dental coverage than you enroll for medical; for example, you may enroll for individual medical coverage and family dental coverage. Following are the plan highlights. Delta PPO Provider Delta Premier Provider 6 *Non-Network Provider To locate a Delta Dental In-Network provider please call 1.800.610.0201 or visit the website at www.deltadentalco.com. *May be subject to additional charges over usual/customary fees. Voya Supplemental Life Insurance You – You can select additional life insurance coverage of 1, 2 or 3 times your basic annual earnings, rounded to the next higher $1,000, to a maximum of $500,000. The minimum benefit is $20,000. If Supplemental Life coverage is elected, Supplemental AD&D coverage may be elected in the same amount. Your Spouse and Unmarried, Dependent Children — You may choose from several flat benefit amounts available for your spouse or your children. You may choose coverage for your spouse, or for your children, or for both. Voya Supplemental Accident Insurance You – Accident coverage is available in the amounts of 1, 2 or 3 times your salary, subject to a maximum benefit of $500,000. Your benefit amount can equal the amount of life insurance benefit elected under the Voya’s Supplemental Life plan. Your Spouse – Your Spouse will automatically receive an amount equal to the Spouse’s supplemental life insurance benefit in effect under the Voya Supplemental Life plan. Your Children – Your Child(ren) will automatically receive an amount equal to the Child(ren)’s supplemental life insurance benefit in effect under the Voya Supplemental Life plan. You may need to request changes to your existing coverage if, in the future, you no longer have dependents who qualify for coverage. We will refund premium if you do not notify us of this and it is determined at the time of a claim that premium has been overpaid. NOTE: If you elect Supplemental Coverage for yourself and/or your dependents when you are initially eligible you will be allowed to elect coverage up to the Guaranteed Issue amount with no Evidence of Insurability. If you do not elect the Supplemental coverage when initially eligible you may do so at the next Open Enrollment, however any amount that you elect will be subject to Evidence of Insurability. You may obtain an Evidence of Insurability form at http://citynet.fcgov.com/humanresources/benefithome.php. 7 Voya Basic Life & AD&D The City provides Basic Life and AD&D to all eligible employees in the amount of 1x your annual salary up to $500,000. Benefit Amounts for Spouse $10,000, $25,000, $50,000, $75,000 or $100,000 The guaranteed coverage amount for your spouse is $10,000, offered to new hires only, as guaranteed. Benefit Amounts for Children $5,000 or $10,000 The guaranteed coverage amount for your child(ren) is $10,000, offered to new hires only, as guaranteed. 8 Anthem Voluntary Life Insurance and AD&D At any time during the year, you may enroll for Anthem Voluntary Life Insurance and Voluntary Accidental Death and Dismemberment (AD&D); enrollment is not restricted to the Open Enrollment period. This plan offers a voluntary term life insurance that provides additional term life protection for you, your spouse, and/or your children up to age 25 without the requirement of being a full time student as long as they are financially dependent upon the employee. In addition, you may purchase additional AD&D coverage. This voluntary protection can be purchased on an after-tax basis in addition to the Voya Basic and Supplemental plans. Evidence of Insurability is required for all applications. Coverage is available in $10,000 increments, up to $300,000. Coverage is portable so that after termination of employment, you may continue. NOTE: If you elect Voluntary Coverage for yourself and/or your dependents when you are initially eligible you will be allowed to elect coverage up to the Guaranteed Issue amount with no Evidence of Insurability. If you do not elect the Voluntary coverage when initially eligible you may do so at any time throughout the year, however any amount that you elect will be subject to Evidence of Insurability. Contact HR for an enrollment application. Voya Family Medical Leave Administration & Short Term Disability Family Medical Leave Administration The Family Medical Leave Act (FMLA) may grant an employee an unpaid leave of absence of up to 12 weeks per year for certain events. These events may include, but are not limited to: • your own serious medical condition • caring for a family member with a serious medical condition • birth, adoption or foster care of a child If you need to apply for a Family Medical Leave, please contact Voya Employee Benefits Leave Management Team at 888.464.3652. Short Term Disability The City offers Short Term Disability coverage through Voya. STD provides you with income benefits if you become disabled. An eligible employee may use short term disability leave for up to 90 calendar days per cause, but not to exceed a total of 90 calendar days in a calendar year. If you become disabled and you are approved for STD benefits, the plan will pay you: • 2 week elimination period (14 calendar days) covered by the use of personal leave (sick, vacation, comp time or award time); • 6 weeks of STD pay at 100% of weekly earnings, then; • 4 weeks and 6 days of STD pay at 75% of weekly earnings (remaining 25% of weekly earnings can be supplemented with personal leave (sick, vacation, comp time or award time) Special Provisions Include: • Seat Belt Rider • Common Disaster Benefit Rider • Special Education Benefits Rider • Travel Assistance Benefit Rider • Living Benefits Rider lets you withdraw 50% of the life benefit before death if diagnosed with a terminal illness 9 Family Care Connection Family Care Connection, provides our back-up care services. Employees can call Family Care Connection directly to set up back-up care for their dependents. No registration is necessary. Just call 970.223.9026, 24 hours a day. Please leave a message on the recorder. Someone will call you back as soon as possible. If it’s an urgent day care issue, you will be prompted to leave an urgent message that will be returned as quickly as possible. Voya Long Term Disability The City pays the entire premium cost for this coverage, which is mandatory for classified and unclassified management employees. This plan is not available to firefighters, police officers and emergency dispatchers, under age 55 and less than 25 years of service, since these positions are covered by an alternate benefit (FPPA). Premiums are based on your monthly base salary, and premiums are not taxable to you as income. However, any LTD benefits you receive are taxed as ordinary income. LTD provides you with income replacement if you experience a disabling illness or injury that prevents you from performing the essential functions of your job. This plan is fully insured, and the insurance company, Voya, is solely responsible for the approval of benefits. There is a 90 day waiting period before benefits become payable. If you become disabled and you are approved for LTD benefits, the plan will pay you: • 66 2/3% of your monthly base salary in effect immediately prior to disability. • 60% of your monthly base salary for fire, police, and dispatch. LTD benefits are offset (or reduced) by income you receive from other sources, such as Social Security Disability or Retirement benefits, Workers’ Compensation benefits or other retirement benefits. Please take this fact into account if you need to plan for your income during a period of disability. What is Back-Up Child/Adult Care? You and your spouse both work and provide daycare or adult care for your dependents. Your regular child/adult care provider is sick. Perhaps your child’s school closes unexpectedly, or you need to be at work at an unexpected time. Any time you need to be on the job and your child’s regular care arrangements fall through, you can use Family Care Connection’s Back-up Child/Adult Care Program. When you know that you need care, whether its weeks in advance or at the last minute, simply call the local number 970.223.9026. Arrangements will be made to send a provider to your home. 95% of the requests are filled as needed. The need for care must be work related. This benefit is specifically designed to allow City employees the opportunity to work and minimize absenteeism. Employees pay $7.00 per hour to the daycare provider and are limited to 100 hours of back-up care each year. For more information, please contact: Gwen Feit in Human Resources at 970.221.6843 10 Employee Assistance Program (EAP) ComPsych is our provider for this extremely valuable service that the City provides to unclassified management, classified, and contractual employees and their families. This program offers unlimited telephonic sessions, eight (8) free confidential visits per person per problem per year, along with up to 30 minutes per issue for legal consultation and up to 30 minutes per issue for financial resources. You can reach this confidential assistance with personal or work issues at 1-844- 216-9810, 24 hours a day, seven days a week or log on to guidanceresources. com Web ID: FTCEAP. Brochures are available from your Department Designate or by calling Human Resources at 221-6843 or 416-2785. • Life Balance • Relationships • Problems with your children • Substance Abuse • Stress, Anxiety or Depression • Job Pressures • Marital Conflicts • Grief and Loss • Empty-nesting ...and more! Call us for help with life’s ups and downs. We’ll connect or refer you to a professional who can help with: Flexible Spending Account (FSA) The City offers you the opportunity of opening a health care flexible spending account and/or a dependent care flexible spending account administered by ASI Flex. These accounts allow you to set aside pre-tax dollars from each paycheck to help pay for unreimbursed eligible health care and dependent care expenses for you and your family. Health Care FSA Allows you to set aside up to $2,550 pre-tax dollars per year to pay for out-of-pocket medical expenses. Your full annual election is available to you on your first day of coverage, which means that when you incur eligible expenses, you can submit reimbursement requests immediately. Expenses can be for you, your spouse or any tax dependent, even if your dependents are not enrolled in your employer’s health insurance plan. New in 2016, you can now carryover up to $500 the following year! The Healthcare FSA plan now includes a provision that will allow participants to carryover up to $500 of unused contributions into the following plan year. At the end of 2016, if you have unused money in your healthcare FSA, you can now apply up to $500 of the leftover balance to the 2017 plan year account. Plan your 2016 healthcare FSA election accordingly! Dependent Care FSA Allows you to use pre-tax dollars to pay for out-of-pocket childcare and/or elder dependent care expenses for disabled dependent child over 13 or other disabled adults, such as parents or grandparents. You can set aside up to $5,000 ($2,500 if married and filing separately on your federal income taxes) per year (please note that the $5,000 is a household maximum) in the account. The funds are deducted before federal and state income taxes and FICA are assessed, and reimbursements are completely tax free. Eligible expenses include day care, baby sitting, general purpose day camps and pre-k expenses. Voya Behavioral Health Benefits and More... In addition to ComPsych, our EAP provider, there are additional services available through Voya’s Behavioral Health program. These services are also provided by ComPsych through the Voya Behavioral Health Benefits you can receive: For more information on all of the additional Voya Services – go to http://citynet.fcgov.com/humanresources/benefithome.php or you can 11 2016 Bi-Weekly Employee Premium Costs (Unclassified Management, Classified, Contractual Variable Hour Employees) PREMIER - Medical Full-Time Part-Time Employee Only $35.91 $59.85 Employee + Spouse $173.21 $230.94 Employee + Child(ren) $141.72 $188.96 Employee + Family $220.45 $293.83 Delta Dental Full-Time Part-Time Employee Only $4.98 $6.64 Employee + Spouse $11.96 $14.95 Employee + Child(ren) $14.95 $18.69 Employee + Family $19.93 $24.92 VSP - Vision Full-Time Part-Time Employee Only $3.24 $3.24 Employee + Spouse $6.48 $6.48 Employee + Child(ren) $6.48 $6.48 Employee + Family $10.19 $10.19 Full-Time = 30+ hours/weekly (.75 FTE thru 1.00 FTE) Part-Time = 20-29 hours/weekly (.50 FTE thru .74 FTE) Full-Time Hourly = Full-Time rate - Medical only (average 30+ hours per week, over 12 month measurement period) 12 Notes Plan Documents Shall Govern - While this booklet is intended to provide accurate information, more extensive information is contained in each plan’s specific Summary Plan Description (SPD) and formal plan document. No participant shall accrue any rights because of any statement in or omission from this booklet. In the event of a discrepancy between the information presented here, the respective SPD, and the respective plan document; the respective plan document shall govern. Visit the benefits website at http://citynet.fcgov.com/humanresources/benefithome.php to view the specific Summary Plan Descriptions. Amendment/Termination - The City intends to continue the plans indefinitely but reserves the right to amend or terminate the plans at any time. This right of amendment/termination shall apply to all participants, including retirees. Premiums and plan provisions are subject to change. 13 Important Notices Federal regulations require the City to provide benefit eligible employees with the following important annual notices. For a complete copy if each notice you may go to http://citynet.fcgov.com/humanresources/benefithome.php Private Health Information A portion of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) addresses the protection of confidential health information. It applies to all health benefit plans. In short, the idea is to make sure that confidential health information that identifies (or could be used to identify) you is kept com- pletely confidential. This individually identifiable health information is known as “protected health information” (PHI), and it will not be used or disclosed without your written authorization, except as described in the Plan’s HIPAA Privacy No- tice or as otherwise permitted by federal and state health information privacy laws. A copy of the Plan’s Notice of Privacy Practices that describes the Plan’s policies, practices and your rights with respect to your PHI under HIPAA is avail- able from your medical plan provider. For more information regarding this No- tice, please contact the Human Resources Department. Summary of Benefits and Coverage (SBC) Effective for plan renewals after January 1, 2012, the Patient Protection and Af- fordable Care Act requires employers that offer health coverage to provide a uniform Summary of Benefits and Coverage (SBC) to people who apply for and enroll in the health plan. This document contains the following: • Four-page overview of plan benefits, cost sharing and limitations • Required set of examples of how the plan works • Phone number and internet address for obtaining copies of plan documents • A Standard glossary of medical and insurance terms must also be available The SBC will be updated each plan renewal to reflect applicable plan changes. Women’s Health and Cancer Rights Act The City medical plans, as required by the Women’s Health and Cancer Rights Act of 1998, provides benefits for mastectomy-related services. These services include: • All stages of reconstruction of the breast on which the mastectomy was per- formed • Surgery and reconstruction of the other breast to produce a symmetrical ap- pearance • Prostheses and treatment of physical complications resulting from mastec- tomy (including lymphedema) This coverage will be provided in consultation with the attending physician and the patient, and will be subject to the same annual deductibles and coinsur- ance provisions that apply to the mastectomy. For more information, contact your medical plan provider. Individual Coverage Mandate Effective January 1, 2015, Federal law requires that you have Health Care cov- erage or you may be subject to an income tax penalty. You can enroll in The City health plan, or you may want to consider visiting www.healthcare.gov for information on health plans available through the Healthcare Marketplace in your area. Notice of Prescription Drug Creditable Coverage The City provides a “Notice of Prescription Drug Creditable Coverage” to all Medicare eligible participants on an annual basis. This notice states that under the City medical plan, you have prescription drug coverage that is, on average, as generous as the standard Medicare Prescription Drug Coverage. Continuation Of Coverage If your coverage ends under the Plan, you may be entitled to elect continua- tion coverage (coverage that continues on in some form) in accordance with federal law. If you selected continuation coverage under a prior plan which was then re- placed by coverage under this Plan, continuation coverage will end as sched- uled under the prior plan or in accordance with the terminating events listed 14 Carrier Contacts UMR Medical 76-411027 1.800.826.9781 www.umr.com Delta Dental 1857 1.800.610.0201 www.deltadentalco.com Vision Service Plan (VSP) 12-063997 1.800.877.7195 www.vsp.com Optum Rx 1.877.559.2955 www.OptumRx.com ASI Flexible Spending 1.800.659.3035 www.asiflex.com Voya Supplemental Life AD&D Anthem Voluntary Life/AD&D 674923 006518 1.800.955.7736 www.voya.com 1.866.594.0516 westregion@anthem.com Voya Long Term Disability Voya Family Medical Leave Act Voya Short Term Disability 674923 1.800.955.7736 www.voya.com 1.888.464.3652 www.voya.com ComPsych Employee Assistance Program Web ID: FTCEAP 1.844.216.9810 www.guidanceresources.com City of Fort Collins Benefit Representatives Provider Group # Phone / Website Janie Appleton 970.221.6562 jappleton@fcgov.com Kristi Hess 970.300.1770 khess@fcgov.com Gwen Feit 970.221.6843 gfeit@fcgov.com LeeAnn Vargas 970.416.2785 lvargas@fcgov.com For more information about onsite healthcare go to www.marathon-health.com and click on “Individuals.” This website has information about services, the eHealth Portal, and video success stories from people who use Marathon Health services. www.marathon-health.com The following is a representative list of services available: Bronchitis Common cold Constipation Cough Diarrhea Ear pain Eye infections Headache Hip pain Knee pain Nausea and Vomiting Nosebleed Shoulder pain Sinus infections Skin infections/rashes Strep throat Asthma Coronary artery disease COPD Congestive heart failure Depression Diabetes Gastric esophageal reflux disease Hypertension Low back pain Metabolic syndrome Osteoarthritis Rheumatoid arthritis Sleep apnea Lab Services Blood work and lab tests processed at the Center for A1C, lipid panel, fasting and random glucose, rapid strep, urinalysis, oxygen saturation levels, flu, mono and pregnancy. All other lab tests can be drawn and sent to an external lab for processing. Prevention Health Screenings Blood pressure Body mass index Cholesterol Glucose Health Coaching Nutrition Physical activity WELL Live Well. Wo LEARN MORE ABOUT HOW YOU CAN EARN WELL DAYS! LYNN SANCHEZ, WELLNESS PROGRAM MANAGER 416-2098, lysanchez@fcgov.com ANGIE RHODES, WELLNESS PROGRAM COORDINATOR 221-6349, arhodes@fcgov.com DANNY NELSON, WELLNESS PROGRAM SPECIALIST 224-6194, dnelson@fcgov.com WELLNESS INTERN 416-2475, wintern@fcgov.com WELLNESS Your Health & Wellbeing JANUARY – FEBRUARY 2016 Health Screenings FEBRUARY 1 Well Days Kicks Off MARCH – MAY Marathon Health Risk Assessment SPRING City Safety and Wellness Team Supervisor Breakfast MAY – AUGUST BP Check Clinics JUNE Bike to Work Day SUMMER PICNIC Employee Picnic Fun Run/Walk OCTOBER Health Fair & On-Site Flu Shots TWICE A YEAR On-Site Mammograms Fitness Testing MONTHLY Fitness Room Orientations wellness calendar wellness staff WELLNESS Live Well. Work Well. Be Well. WELL DAYS WELL DAYS incentive program The benefits of the Well Days program go beyond the prizes and are unique for every individual. WHO’S ELIGIBLE? Benefit eligible employees can earn up to three Well Days, or days off. Non-benefit eligible employees and employees eligible for Award Time (Police Services) may participate and are eligible for prize drawings each trimester. Benefit eligible = any employee who is currently eligible to enroll in benefits (medical, dental, vision) from the City of Fort Collins. You do not need to be actively enrolled in benefits to earn Well Days. HOW DO I EARN POINTS? Each trimester you will earn 100 points in each category for a total of 300 points. The categories are Activities, Awareness and Behaviorcation. • Points carry over to the next trimester, but not year-to-year. • There are mandatory points to earn each trimester. • Log into your Well Days page for a complete list of activities you can do to earn points. • Points earned by completing the requirements for a given activity will be added to your account via online forms, signing in at class or entered by Wellness staff. • Click on the title of any activity to get more information about earning those points. EARN PRIZES! At the end of each trimester, all employees who have earned the Well Day will have their name entered in a prize drawing for one of five $100 gift cards. HOW ARE WELL DAYS CALCULATED? Well days are awarded two pay periods after the end of the trimester. CLASSIFIED EMPLOYEES • Based on your FTE and added to your vacation balance HOURLY EMPLOYEES • Based on the number of hours you worked during the trimester • Added to your comp time balance be well REGISTRATION OPENS FEBRUARY 1 To start earning points toward your Well Days, register on CityNet. Registration is required annually for the Well Days Program. FIRST TRIMESTER - SELF CARE FEBRUARY 1 – MAY 13 • Registration & Pre-Program Survey Program 25 Awareness Points • Marathon Health History and Risk Assessment (HHRA) 100 Awareness points get moving SECOND TRIMESTER - PHYSICAL ACTIVITY MAY 14 – AUGUST 26 • Blood Pressure (BP) Check – 25 Awareness points (only one mandatory, but you may earn points for up to three). BP checks in the first trimester count toward your mandatory check. Check can be with Wellness staff, CityCare staff or your personal physician’s office. find balance THIRD TRIMESTER - MENTAL HEALTH/ STRESS MANAGEMENT AUGUST 27 – DECEMBER 9 • Post-Program survey – 25 Awareness points WELLNESS Live Well. Work Well. Be Well. TRIMESTER & MANDATORY COMPONENTS Mandatory Points are red on your points page until they are completed. At that time, they will turn green Tobacco cessation Stress management Chronic Condition Coaching Weight loss Primary Care Services What We Treat CityCare, powered by Marathon Health The City of Fort Collins�has partnered with Marathon Health to manage and staff CityCare with licensed clinicians that diagnose, treat, and prescribe for a wide variety of common illnesses and injuries. In addition to sick care,�a full range of health assessments and coaching services�are provided — all from a convenient location. Additionally, services are�offered at no�cost to eligible participants!�CityCare is available�to�City of Fort Collins�employees, spouses and dependents ages 6 years and older who are covered by a City medical insurance plan. Mon., Tue., Wed., Fri. 8am�- 5pm, Thu. 10am - 7pm, 970-672-4331, 214 N. Howes St. below, whichever is earlier. When Coverage Ends We may discontinue these Benefit plans and/or all similar benefit plans at any time. Your entitlement to Benefits automatically ends on the date that coverage ends, even if you are hospitalized or are otherwise receiving medical treatment on that date. When your coverage ends, we will still pay claims for Covered Health Services that you received before your coverage ended. However, once your coverage ends, we do not provide Benefits for health services that you receive after cov- erage ends for medical conditions that occurred before your coverage ended, even if the underlying medical condition occurred before your coverage ended. An Enrolled Dependent’s coverage ends on the date your coverage ends. Premium Assistance Under Medicaid and the Children’s Health In- surance Program (CHIP) If you or your children are eligible for Medicaid or CHIP and you are eligible for health coverage from your employer, your State may have a premium assis- tance program that can help pay for coverage. These States use funds from their Medicaid or CHIP programs to help people who are eligible for these programs, but also have access to health insurance through their employer. If you or your children are not eligible for Medicaid or CHIP, you will not be eli- gible for these premium assistance programs. If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, you can contact your State Medicaid or CHIP office to find out if premium assistance is available. If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, you can contact your State Medicaid or CHIP office at www.insu- rekidsnow.gov to find out how to apply. If you qualify, you can ask the State if it has a program that might help you pay the premiums for an employer- sponsored plan. Once it is determined that you or your dependents are eligible for premium assistance under Medicaid or CHIP, as well as eligible under your employer plan, your employer must permit you to enroll in your employer plan if you are not already enrolled. This is called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium as- sistance. If you have questions about enrolling in your employer plan, you can contact the Department of Labor electronically at www.askebsa.dol.gov. For All States: (877) 267-2323, Ext. 61565 U.S. Department of Labor Employee Benefits Security Administration www.dol.gov/ebsa or 1-866-444-EBSA (3272) U.S. Department of Health and Human Services Centers for Medicare & Medicaid Services www.cms.hhs.gov or 1-877-267-2323, Ext. 61565 Uniformed Services Employment And Reemployment Rights Act (USERRA) If you are called to active duty in the uniformed services, you may elect to con- tinue coverage for you and your eligible dependents under USERRA. This con- tinuation right runs concurrently with your continuation right under COBRA, explained below, and allows you to extend an 18-month continuation period to 24 months. You and your eligible dependents qualify for this extension if you are called into active or reserve duty, whether voluntary or involuntary, in the Armed Forces, the Army National Guard, the Air National Guard, full-time Na- tional Guard duty (under a federal, not a state, call-up), the commissioned corps of the Public Health Services and any other category of persons designated by the President of the United States. contact ComPsych at 1.877.533.2363. • 3 Counselor Visits for you and your family (in addition to the 8 visits offered through EAP) • Family Counseling • Anxiety/Depression Counseling • Most other services offered through the EAP • Blood Pressure (BP) Check – 25 Awareness points (only one mandatory, but you may earn points for up to three). BP checks in the first trimester count toward your mandatory check. Check can be with Wellness staff, CityCare staff or your personal physician’s office. find balance THIRD TRIMESTER - MENTAL HEALTH/ STRESS MANAGEMENT AUGUST 27 – DECEMBER 9 • Post-Program survey – 25 Awareness points WELLNESS Live Well. Work Well. Be Well. TRIMESTER & MANDATORY COMPONENTS Mandatory Points are red on your points page until they are completed. At that time, they will turn green Tobacco cessation Stress management Chronic Condition Coaching Weight loss Primary Care Services What We Treat CityCare, powered by Marathon Health The City of Fort Collins�has partnered with Marathon Health to manage and staff CityCare with licensed clinicians that diagnose, treat, and prescribe for a wide variety of common illnesses and injuries. In addition to sick care,�a full range of health assessments and coaching services�are provided — all from a convenient location. Additionally, services are�offered at no�cost to eligible participants!�CityCare is available�to�City of Fort Collins�employees, spouses and dependents ages 6 years and older who are covered by a City medical insurance plan. Mon., Tue., Wed., Fri. 8am�- 5pm, Thu. 10am - 7pm, 970-672-4331, 214 N. Howes St. below, whichever is earlier. When Coverage Ends We may discontinue these Benefit plans and/or all similar benefit plans at any time. Your entitlement to Benefits automatically ends on the date that coverage ends, even if you are hospitalized or are otherwise receiving medical treatment on that date. When your coverage ends, we will still pay claims for Covered Health Services that you received before your coverage ended. However, once your coverage ends, we do not provide Benefits for health services that you receive after cov- erage ends for medical conditions that occurred before your coverage ended, even if the underlying medical condition occurred before your coverage ended. An Enrolled Dependent’s coverage ends on the date your coverage ends. Premium Assistance Under Medicaid and the Children’s Health In- surance Program (CHIP) If you or your children are eligible for Medicaid or CHIP and you are eligible for health coverage from your employer, your State may have a premium assis- tance program that can help pay for coverage. These States use funds from their Medicaid or CHIP programs to help people who are eligible for these programs, but also have access to health insurance through their employer. If you or your children are not eligible for Medicaid or CHIP, you will not be eli- gible for these premium assistance programs. If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, you can contact your State Medicaid or CHIP office to find out if premium assistance is available. If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, you can contact your State Medicaid or CHIP office at www.insu- rekidsnow.gov to find out how to apply. If you qualify, you can ask the State if it has a program that might help you pay the premiums for an employer- sponsored plan. Once it is determined that you or your dependents are eligible for premium assistance under Medicaid or CHIP, as well as eligible under your employer plan, your employer must permit you to enroll in your employer plan if you are not already enrolled. This is called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium as- sistance. If you have questions about enrolling in your employer plan, you can contact the Department of Labor electronically at www.askebsa.dol.gov. For All States: (877) 267-2323, Ext. 61565 U.S. Department of Labor Employee Benefits Security Administration www.dol.gov/ebsa or 1-866-444-EBSA (3272) U.S. Department of Health and Human Services Centers for Medicare & Medicaid Services www.cms.hhs.gov or 1-877-267-2323, Ext. 61565 Uniformed Services Employment And Reemployment Rights Act (USERRA) If you are called to active duty in the uniformed services, you may elect to con- tinue coverage for you and your eligible dependents under USERRA. This con- tinuation right runs concurrently with your continuation right under COBRA, explained below, and allows you to extend an 18-month continuation period to 24 months. You and your eligible dependents qualify for this extension if you are called into active or reserve duty, whether voluntary or involuntary, in the Armed Forces, the Army National Guard, the Air National Guard, full-time Na- tional Guard duty (under a federal, not a state, call-up), the commissioned corps of the Public Health Services and any other category of persons designated by the President of the United States. contact ComPsych at 1.877.533.2363. • 3 Counselor Visits for you and your family (in addition to the 8 visits offered through EAP) • Family Counseling • Anxiety/Depression Counseling • Most other services offered through the EAP