2021 Benefits Handbook - Pinellas County Employee Benefits Summary
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2021 Benefits Handbook
Pinellas County Employee Benefits Summary
Pinellas County Human Resources Employee Benefits www.pinellascounty.org/hr/benefits
400 South Fort Harrison Avenue, 1st Floor
Clearwater, FL 33756
Phone: (727) 464-3367
eFax: (727) 453-3573
Email: employee.benefits@pinellascounty.org
9/17/21
Welcome to Pinellas County Government!
Benefits choices can have a significant impact on both the health of our employees
and their families and are a critical component of the County’s strategy to be a top-tier
employer. We value our employees and believe in rewarding you for the contributions you
make to the County.
The value of employee benefits is an important part of your total compensation. This
handbook is designed to provide you with general information on benefits programs for
which you may be eligible. Please take time to review the options, and links to tools and
resources, so you can choose the benefits that best fit your needs and lifestyle.
For full plan details, refer to the Human Resources website at www.pinellascounty.org/
hr/benefits which includes links to plan documents or contact the particular vendor for
specific coverage information (see page 21).
Enrollment Tips
Enrollment Tips
Timing
The opportunities you have to enroll or make changes to your benefits are:
When you are newly eligible.
During Annual Enrollment (held each fall).
If you experience a qualifying event or family status change such as marriage,
divorce, birth, dependent gain or loss or other coverage, etc. (see page 3).
Deadlines
New employees have 30 days to enroll.
Employees with a qualifying event have 31 days from the event date to make
changes (supporting documentation is required).
Important Reminders
Before you enroll, please make sure you understand the plans. If you have
questions, contact the vendor or Benefits.
Verify that your beneficiary information in OPUS is up-to-date.
After you enroll, check your paycheck stub to make sure the correct amount is
being deducted and all of the benefits you elected are included.
If corrections are needed, they must be made within the first 30 days of enrollment.
Contact Benefits for information.
For your convenience, this handbook is
interactive. All of the blue underlined
items and the contents page items are
live hyperlinks.
CONTENTS
Enrollment....................................................................................................................................................................................2
Eligibility..................................................................................................................................................................................2
Domestic Partner Coverage.............................................................................................................................................2
Health Plan Opt Out............................................................................................................................................................2
When Can I Enroll in Benefits or Make Changes?.....................................................................................................3
How Do I Enroll?....................................................................................................................................................................3
Health Plan Premiums, Tobacco Premium, Biometric/Health Survey Premium............................................4
Pre-Tax Premium Option...................................................................................................................................................4
Health Plan Options .................................................................................................................................................................5
Consumer Driven Health Plan (CDHP) with Health Savings Account (HSA)...................................................5
Point of Service (POS) Health Plan.................................................................................................................................7
Prescription Coverage..............................................................................................................................................................8
Employee Assistance Program (EAP)...................................................................................................................................9
Vision Coverage .........................................................................................................................................................................9
Pinellas County Health Plan Comparison Chart........................................................................................................... 10
Dental Coverage...................................................................................................................................................................... 11
Wellness Program.................................................................................................................................................................... 12
Life Insurance............................................................................................................................................................................ 13
Flexible Spending Accounts (FSA).................................................................................................................................... 14
Leave Time................................................................................................................................................................................. 16
Other Benefits........................................................................................................................................................................... 17
Glossary...................................................................................................................................................................................... 18
Nurse Liaison............................................................................................................................................................................. 21
Legal Notices............................................................................................................................................................................. 21
Benefits Partners’ Contact Information........................................................................................................................... 21
Important Information
If you have questions about your benefits or eligibility, visit the Benefits webpage at
www.pinellascounty.org/hr/benefits or contact Benefits at (727) 464-3367 or by email
at employee.benefits@pinellascounty.org.
If you have specific claim questions, contact the vendor. See page 21 for contact
information for UnitedHealthcare and our other benefits partners.
Important legal notices including the HIPAA Notice of Privacy are found at
www.pinellascounty.org/hr/notices.
For more information, visit:
ENROLL
www.pinellascounty.org/hr/enrollment.
Eligibility S ubmit a completed Affidavit of Domestic
Permanent and long-term temporary Partnership and Certification for Dependent
classified and exempt employees scheduled Tax Status to Benefits by the end of your
to work 20 hours or more per week are enrollment period each year.
eligible to enroll in certain coverage. You cannot use the Health Savings Account
Dependents eligible for coverage varies (HSA) or the Healthcare Flexible Spending
by plan and may include spouse, domestic Account (FSA) for a domestic partner or
partner, and children. their children’s expenses.
You must pay the cost of domestic partner
Eligibility for Children coverage with after-tax dollars and the
Dependent Children are Eligible for Coverage value of the domestic partner coverage may
Through the End of the Calendar Year be added to your pay as imputed income.
in Which They Reach Age See the Domestic Partner FAQs at www.
Health Plan: Age 26 pinellascounty.org/hr/partner.
Dental Plan: Age 24 (DHMO), 25 (PPO)
Dependent Life: Day prior to 26th birthday
Healthcare FSA: Age 26 Health Plan Opt Out
E mployees who are enrolled in other
I f you and your spouse/partner both work qualified medical benefit coverage may
for Pinellas County, you must each enroll for opt out of Pinellas County’s health plan.
your own coverage (i.e., not as a dependent). Not all plans are considered alternate
When you enroll using Oracle Project coverage for this benefit.
Unified Solution (OPUS), only the plans you By selecting “Opt Out of Health” in OPUS,
are eligible for will be listed. which indicates that you have eligible
alternate health coverage, you may be
eligible to receive $98.00 monthly.
Proof of Eligibility In order to receive opt out payments,
You need to provide documentation of submit a notarized Opt Out Summary and
eligibility (such as a marriage license) for Affidavit at www.pinellascounty.org/hr/
new dependents and qualifying events. optout annually.
Employees who opt out will still be enrolled
in the Employee Assistance Program (EAP),
Domestic Partner Coverage and may choose to enroll in:
Employees who are unmarried and in a • Dental coverage
committed relationship may cover their • Flexible Spending Accounts (FSA)
domestic partner and their child(ren) on • Life insurance
health and dental coverage only. The guidelines Employees who opt out are not eligible for
follow IRS regulations. medical, prescription, vision, or behavioral/
mental health benefits.
| 2 | 2021 BENEFITS HANDBOOK
For more information, visit:
ENROLL
www.pinellascounty.org/hr/enrollment.
When Can I Enroll in Benefits or How Do I Enroll?
Make Changes to My Coverage? 1. Enroll for benefits in OPUS.
The benefits you select during your initial 2. Be prepared with a list of full legal names,
enrollment period or at Annual Enrollment will Social Security numbers, dates of birth,
remain in effect for the calendar year. The IRS and addresses (if different from yours) for
allows you to make changes to your coverage your dependents and beneficiaries. This
during the year only if you experience a information is supplied to the IRS and must
qualifying event and notify Benefits as outlined match their records.
below:
3. Log in to OPUS at home or at work to
Initial Enrollment Period: New hires and complete your benefits enrollment. If you
newly eligible employees have 30 days are new, your department will provide your
from their date of hire or the date they move username and password instructions:
into a benefit-eligible position to make their
benefit elections in OPUS. G o to www.pinellascounty.org and
select Services from the menu at
Annual Enrollment Period: You must enroll the top, and then select OPUS under
each fall during Annual Enrollment for the Employee Access.
upcoming year. You will designate whether
Once logged in, select PIN Employee
you use tobacco, and have the opportunity to
Self Service, Benefits, and Benefits
select benefits; enroll or remove dependents;
Enrollment. Make your selections.
and make selections for a flexible spending
Save or print a Confirmation Statement
account (FSA), life insurance, and annual leave
for your records.
exchange.
4. Payroll deductions will begin in the pay
Qualifying Event: If you have a qualifying
period your elections are effective or as
event during the plan year, you may make
quickly as possible if elections are made
corresponding changes to your elections.
after the effective date. Following Annual
You have 31 days from the date of the
Enrollment, your elections become effective
qualifying event to submit the Qualifying
on January 1st.
Event Status Change Form along with
supporting documentation to Benefits.
Qualifying Event Examples Benefits Start & End
Birth or adoption of a child Start: Your benefits are effective on the first
Dependent becomes ineligible of the month following 30 days of service
Marriage or divorce for eligible individuals.
Domestic partner relationship change End: Benefits end on the last day of the
Transfer between full and part-time pay period in which you no longer meet
eligibility requirements, or you fail to make
Change in other coverage
the required contributions.
Death of spouse/partner or child
2021 BENEFITS HANDBOOK | 3 |
For more information, visit:
ENROLL
www.pinellascounty.org/hr/enrollment.
Health Plan Premiums detect critical changes and identify risks for
disease or medical conditions such as high
Biweekly Premiums blood pressure or diabetes.
Employees and the County share the total Biometric information is 100% confidential
cost of healthcare coverage. and never shared with Pinellas County.
Premiums in both health plans are identical: After completing the Rally online health
survey, you will receive a personalized plan to
Biweekly Health Premiums* help achieve your health and wellness goals.
Coverage Biweekly Cost Employees who opt out of health coverage
or those whose coverage begins on July
Employee Only $ 11.43
1 or later are exempt from the above
Employee and Spouse requirements for the current calendar year.
$131.90
or Domestic Partner See the Biometric Screening and Health
Employee and Child(ren) $105.23 Survey FAQs at www.pinellascounty.org/hr/
biometric for more information.
Family $216.12
Pre-Tax Premium Option
* The same premiums apply to the CDHP and POS plans.
The premium includes medical care, prescription coverage, The County’s Cafeteria Plan/Section 125
behavioral/mental health, and vision care. allows you to make pre-tax payroll
deductions for health and dental coverage.
Tobacco Premium Your payroll deductions can be taken pre-tax
Employees who attest that they used tobacco or post-tax. You make this selection when
products at least once a week in the past completing your OPUS enrollment.
three months will pay an additional $500
annual premium for health coverage.
The premium will be discontinued if the Need Help Enrolling?
employee successfully completes a tobacco
cessation program between August 1, 2020, V
isit the Benefits website at
and March 31, 2021. www.pinellascounty.org/hr/benefits.
Also see www.pinellascounty.org/hr/tobacco. F or questions about your benefits
or eligibility, contact Benefits at
Preferred Premium: Biometric Screening and employee.benefits@pinellascounty.org
Health Survey or (727) 464-3367.
Employees who complete an annual
F or questions about using OPUS to
biometric screening and online health survey
enroll, contact the BTS Operations
earn a preferred health plan premium which
Center Monday to Friday, 7:00 a.m. to
will save $500 in the upcoming year.
6:00 p.m. at (727) 453-HELP (4357) or
A biometric screening includes a physical email btsoc@pinellascounty.org.
examination and lab work. The purpose is to
| 4 | 2021 BENEFITS HANDBOOK
For more information, visit:
HEALTH
www.pinellascounty.org/hr/health.
Health Plan Options CONSUMER DRIVEN HEALTH PLAN
Choose between two health plans, both (CDHP) WITH A HEALTH SAVINGS
administered by UnitedHealthcare: ACCOUNT (HSA)
Consumer Driven Health Plan (CDHP) This plan offers the greatest opportunity to be
with a Health Savings Account (HSA) involved in your healthcare and manage costs.
Point of Service (POS) Health Plan All provider visits and routine and diagnostic
services under this plan are applied to the
Both plans provide 100% coverage for preventive
deductible.
medical care (see www.pinellascounty.org/hr/
preventive) and encourage a commitment to If your deductible is met, you then pay
wellness, a core component of the County’s coinsurance for services and prescriptions.
long-term strategy for the group health plan. Pinellas County contributes to your Health
Savings Account (HSA) to offset a portion of
Both you and the County save money by using the expenses. You may elect to make pre-tax
UnitedHealthcare in-network providers and contributions through payroll deductions to
Premium Care Physicians (look for a rating of two this account.
blue hearts on the myuhc.com website).
CDHP Preventive Care
Higher out-of-pocket costs are associated with Preventive services including your annual
using out-of-network providers and facilities. physical and lab work, are covered at 100%
This includes separate higher deductibles, (see www.pinellascounty.org/hr/preventive).
coinsurance and out-of-pocket maximums. CDHP Deductible and Coinsurance
Both plans provide access to UnitedHealthcare’s Routine and diagnostic services, including
customer service and website at myuhc.com. lab work, X-rays, MRIs and prescription drugs,
Take advantage of the many health management are applied to the deductible and coinsurance
tools and consumer resources available. at a discounted contracted rate.
The Consumer Driven Plan has a pooled
View the Health Plan Comparison Chart on family deductible. This means that routine or
page 10 to compare the two plans including the diagnostic medical, behavioral/mental health,
deductibles, copays and premiums. and prescription drug expenses for all covered
family members are applied to the same
deductible.
The individual deductible for the Consumer
Driven Plan is $1,400 and the family
deductible is $2,800.
Once the deductible is met, you pay 20%
coinsurance when using an in-network
provider and for prescriptions.
2021 BENEFITS HANDBOOK | 5 |
For more information, visit:
HEALTH
www.pinellascounty.org/hr/health.
Your deductible and coinsurance count future healthcare expenses. You may want to
toward your annual out-of-pocket maximum. think of an HSA as a savings plan for future
Once you reach the out-of-pocket maximum, healthcare expenses.
services are covered at 100% by the plan. You may also earn interest on the funds in
This out-of-pocket maximum applies to your HSA account, depending on the balance.
combined health and pharmacy out-of- You may enroll, change or cancel your
pocket expenses. contribution at any time during the plan year
using OPUS.
Health Savings Account (HSA)
An HSA is a pre-tax savings account that An HSA account is an individually owned
can be funded by both the employee and account and belongs to the employee,
even when their employment with the
employer up to the IRS maximum for the year.
County ends.
IRS Maximum Contributions HSA funds may be used on a tax-free
basis for medical expenses at any age,
Coverage Amount but contributions may no longer be made
Employee only coverage $3,600* once an employee no longer has coverage
under the Consumer Driven Health Plan or
All other coverage levels $7,200* has signed up for Medicare Part A or Part B.
Age 55+ catch up Addtl. $1,000 The IRS requires that the HSA account holder
retains receipts for HSA expenses. The receipts
* Includes Pinellas County contribution of $400 or $1,200 will be required if audited by the IRS.
The County contributes $400 for single CDHP Prescription Coverage
coverage, or $1,200 if you have elected to See page 8.
cover your spouse and/or child(ren).
The money in your HSA can be used to help CDHP Behavioral/Mental Health Benefits
pay your health plan deductible and qualified Behavioral/mental health is covered the same
expenses for medical, dental, prescription, as any other medical expense, subject to the
behavioral/mental health and vision. deductible and 20% coinsurance after the
In order to receive or make contributions to deductible is met.
an HSA, you cannot have coverage through
another non high-deductible plan nor Health Savings Account
coverage under Medicare or Tricare.
HSA funds are used first to pay healthcare and
(HSA) with Optum Bank
prescription expenses until the deductible is You must have an open, active HSA account
met. At that time, FSA funds may be used for with Optum Bank in order to receive the
healthcare expenses. Pinellas County contribution to your HSA
Your funds roll over from year to year, so and to make your own pre-tax payroll
you can pay for expenses now, or save for contributions.
| 6 | 2021 BENEFITS HANDBOOK
For more information, visit:
HEALTH
www.pinellascounty.org/hr/health.
POINT OF SERVICE (POS) HEALTH PLAN POS Health Plan Copays (In-Network)
With this plan, you will pay physician and Visit/Treatment Copay
emergency room copays, and coinsurance after
meeting your individual or family deductible. Preventive Medical $0
POS Preventive Care Primary Care Physician $25
Preventive services including an annual Behavioral/Mental Health $25
physical and lab work are covered at 100%
Specialist $35
(see www.pinellascounty.org/hr/preventive).
Virtual Doctor (Amwell, Doctor on
POS Copays, Deductible, Coinsurance $15
Demand and Teladoc only)
For routine or diagnostic office visits, a copay Convenience Care/Urgent Care $25
is required.
Emergency Room $250
Routine or diagnostic services, including
lab work, X-rays and MRIs, are applied POS Prescription Coverage
to the deductible and coinsurance at a
See page 8.
discounted rate.
The individual deductible for the POS plan is POS Behavioral/Mental Health Benefits
$600 and the family deductible is $1,200. Behavioral/mental health is covered the same
• For individuals who have more than two as any other medical expense. For outpatient
people enrolled in coverage, there is a visits, there is a $25 copay, and inpatient care
maximum family deductible equivalent to is handled as a hospitalization, subject to the
two individual deductibles. deductible and 20% coinsurance.
• Once the family deductible is met, the
remaining family member deductibles
are waived.
Once the deductible is met, you pay 20% of
the plan’s discounted rates when using an
in-network provider. Your deductible and
20% coinsurance are applied to your annual
out-of-pocket maximum.
Once you reach the out-of-pocket maximum,
services are covered at 100% by the plan.
This out-of-pocket maximum applies to
combined health and pharmacy out-of-
pocket expenses.
2021 BENEFITS HANDBOOK | 7 |
For more information, visit:
www.pinellascounty.org/hr/prescription.
Rx
Prescription Coverage Point of Service (POS) Prescription Coverage
Prescription medication coverage administered Generic prescriptions have a $15 copayment.
by Express Scripts and their specialty pharmacy Brand drugs are subject to coinsurance
Accredo is included in your health plan premium within a specified minimum and maximum
deduction. The cost for your prescription range as shown:
medications depends on the health plan you
have chosen (CDHP or POS) and the type of POS Prescriptions (up to 30 Days)
medication. Type Your Cost Min Max
Consumer Driven Health Plan with a Health Generic
$15 copay N/A N/A
Savings Account (CDHP) Prescription Coverage
Preventive drugs: The Consumer Driven Preferred Brand 20%
$30 $60
Plan provides 100% coverage for specified coinsurance
preventive drugs on the Preventive Non-Preferred 40%
Medications List including many cholesterol $45 $90
Brand coinsurance
and blood pressure medications. In order to Preferred 20%
be covered at 100%, preventive medications $60 $120
Specialty Brand coinsurance
must be filled in 90-day supplies by Walgreens
or Express Scripts home delivery. Non-Preferred 40%
$90 $180
Specialty Brand coinsurance
Routine or diagnostic drugs: There are no
copays. Instead, all routine or diagnostic
medications are charged at the plan’s
discounted rates until the deductible has
been met, after which 20% coinsurance is Smart90 Walgreens Program
charged until your out-of-pocket maximum
is met. Your pharmacy costs are applied to for a 90-Day Supply
your deductible.
The Smart 90 Walgreens Program
CDHP Prescriptions applies to both health plans.
Type Your Cost Smart 90 requires that prescriptions for
long term maintenance medications,
Preventive drugs No charge* such as blood pressure medicine, be
Routine or diagnostic filled for 90 days at a Walgreens store
The contracted rate up
drugs or through Express Scripts home
to the deductible, then
delivery or you will pay the full retail
20% coinsurance
cost of the medication unless you find
* Medications on the list are free of charge for 30-day supplies a lower cost alternative.
at the pharmacy of your choice, except Walgreens and Express For more information, see the FAQs at
Scripts home delivery which require 90-day supplies per the
www.pinellascounty.org/hr/smart90.
Smart90 Program.
| 8 | 2021 BENEFITS HANDBOOKFor more information, visit: For more information, visit:
www.pinellascounty.org/hr/eap. www.pinellascounty.org/hr/vision.
VISION
EAP
Employee Assistance Program (EAP) Vision Coverage
The Employee Assistance Program is Vision coverage is administered by EyeMed. You
administered by Optum, a subsidiary must be enrolled in a Pinellas County health plan
of UnitedHealthcare. Services include to receive this benefit. To locate a provider, visit
assessment, counseling, and referrals. eyemed.com and select Insight Network. The
EAP benefits are available at no cost for all network includes LensCrafters, Target Optical,
employees and their eligible dependents. and most Pearl Vision locations. It does not
include Visionworks. Coverage includes:
The EAP offers confidential short-term
assistance for you and your eligible family In-Network Basic Exam:
members to help you manage a variety of • $10 basic vision exam copay
life issues. • One exam per calendar year
Support is available for personal and Eyeglass Lenses:
work-life issues, such as stress, relationship • $20 copay per calendar year for clear
conflicts, job pressures, grief, substance plastic lenses (single, bifocal, trifocal or
abuse, problems with children, legal or lenticular prescription)
wellness matters, traumatic events, etc.
Eyeglass Frames:
Counselors offer support by phone,
in-person, and online. • $130 allowance and other options
• 20% discount after the $130 allowance
You are eligible for up to six EAP visits
per issue per year at no cost for initial Contact Lenses in Lieu of Eyeglasses:
assessment counseling and early • Free fitting and follow-up care
intervention treatment. • $100 allowance and 15% off the balance
If you need more than 6 EAP visits, your EAP for conventional lenses (100% of balance
counselor will work with UnitedHealthcare to for disposable lenses)
transition your care to the Behavioral/Mental LASIK or PRK Laser Vision Correction:
Health Program. • 15% off retail or 5% off a promotional
No ID card is provided. price, in addition to a one-time allowance
To find a provider in the Optum network, of up to $1,125 (or $562.50 per eye)
visit provider.liveandworkwell.com. Out-of-Network benefits are also available.
See the EyeMed FAQs and Benefits Summary.
2021 BENEFITS HANDBOOK | 9 |Pinellas County Health Plan Comparison Chart
2021 Pinellas County Health Plans Comparison & Cost
Health Plans Comparison Key ConsumerVirtualDrivenDoctorHealth Visit Cost Point of Service
Item
CDHP = Consumer Driven Health Plan withPlan HSA withCDHPHSA -(CDHP)
$49 then 20% after deductible
Health Plan (POS)
POS = Point of Service Health Plan POS - $15 copay
Biweekly Premiums (same for CDHP and POS) Employee
Employee Convenience Care Clinic/Urgent
Employee Employee Only Care Employee
Employee only - $11.43 Only +1
CDHP + 2 orthen
- $49 More20% after deductible+ 1 or More
Employee and Spouse/Domestic Partner - $131.90 POS - $25 copay
Annual Deductible
Employee and Child(ren) - $105.23 $1,400 $2,800 Room
Emergency $600 $1,200
Family - $216.12 (pooled
CDHPdeductible
- 20% after for deductible (two individual
all family members deductibles of
Annual Deductible POS - $250 copay
on the plan) $600 each)
Employee only Non-Preventive Medical (labs and imaging)
CDHP -$1,400 CDHP - 20% after deductible
County HSA Contribution $400 $1,200 $1,200 N/A N/A
POS - $600
(must have Optum Bank account) POS - 20% after deductible
Employee + 1 or more Preventive Rx
CDHP - $2,800 (pooled
Out-of-Pocket Maximum (includes
deductible for all family
$3,000
CDHP - $0$6,000
$4,000
(view a list of$2,600
preventive medications)
$5,200
members on the plan)
medical and Rx; after you spend this POS - $15 copay for generic or coinsurance for
POS
amount,- $1,200 (two plan
the health individual deductibles of $600
pays 100%) preferred or non-preferred (see below)
each) Rx Generic (up to 30 days)
County HSA Contribution CDHP - 20% after deductible
(must have Optum Bank account) ConsumerPOS - $15Health
Driven copay Point of Service
In-Network Benefit*
Employee only Plan withRx HSAPreferred
(CDHP) Brand (up Health
to 30 days)
Plan (POS)
CDHP - $400 CDHP - 20% after deductible
Preventive
POS Medical
- not applicable POS$0 - 20% coinsurance, minimum$0 $30 (or $60
Employee +1 or
Primary Care Physician more for specialty
20% after deductible medications), $25 copay $60 (or
maximum
CDHP - $1,200 $120 for specialty medications)
Behavioral
POS Health
- not applicable 20% after
Rxdeductible
Non-Preferred Brand (up to $25
30copay
days)
Out-of-Pocket
Specialist
Maximum CDHP - 20% after deductible $35 copay
20% after deductible
(includes medical and RX; after you spend this POS - 40% coinsurance, minimum $45 (or $90
Virtual Doctorthe
amount, Visithealth plan pays 100%) $49 then 20% after fordeductible
specialty medications),$15 copay $90 (or
maximum
Employee only $180 for specialty medications)
Convenience Care Clinics/Urgent Care $49 then 20% after deductible $25 copay
CDHP - $3,000 Rx (up to 90 days)
POS - $2,600Room
Emergency (use
20% after Smart90 Program at Walgreens
deductible or home
$250 copay
Employee +1 delivery)
Non-Preventive Medical (labs and imaging) 20% after deductible 20% after deductible
CDHP - $4,000 CDHP - 20% after deductible
POS - $5,200
Preventive Rx POS$0 - Cost of 30-day supply for specialty
$15 copay for generic or
Employee +2 or more (view the Expressmedication,
Scripts list ofor 2 times the costforofpreferred
coinsurance 30-day or
CDHP - $6,000 preventive medications)
supply for non-specialtynon-preferred (see below)
medication
POS - $5,200
Rx Generic (up to 30 days) 20% after deductible $15 copay
IN-NETWORK BENEFITS
Rx Preferred Brand
(Out-of-network (up to 30
benefits aredays),
also available. 20% after deductible 20% coinsurance
italics indicates specialty
Deductibles, medications
coinsurance and out-of-pocket min: $30 ($60), max: $60 ($120)
maximums are
Rx Non-Preferred higher.)
Brand (up to 30 days) 20% after deductible 40% coinsurance
Preventive
italics indicates Medical Cost
specialty medications min: $45 ($90), max: $90 ($180)
CDHP - $0
Rx (up
POS - $0to 90 days), use Smart90 20% after deductible Cost of 30-day supply (specialty),
Program at Walgreens
Primary Care Physician Cost or home delivery 2x cost of 30-day (non-specialty)
*CDHP
Out-of-network
- 20% after benefits are also available. Deductibles, coinsurance and out-of-pocket maximums are higher.
deductible
POS - $25 copay
Behavioral Biweekly
Health CostPremiums (Same for Consumer Driven and POS Health Plans)
CDHP - 20%
Employee only after deductible $ 11.43
POS - $25 copay
Employee
Specialist and Spouse/Domestic Partner
Cost $131.90
Employee
CDHP - 20% andafterChild(ren)
deductible $105.23
POS -
Family $35 copay $216.12
1/1/21
| 10 | 2021 BENEFITS HANDBOOKFor more information, visit:
DENTAL
www.pinellascounty.org/hr/dental.
Dental Coverage HMO Dental Plan (DHMO)
You have a choice of two plans: a Dental Highlights of this plan include:
Preferred Provider Organization (DPPO) and You do not pay any premiums for yourself or
a Dental Health Maintenance Organization covered dependents.
(DHMO). The same company, Cigna, administers Only in-network benefits are covered. You
both plans, but the networks are different. are required to choose a dentist from the
Please verify your dentist’s network status before Cigna DHMO network. Visit www.cigna.com
selecting a plan or scheduling an appointment. for the most current listing of providers.
PPO Dental Plan (DPPO) Before scheduling an appointment, contact
Highlights of this plan include: Cigna Member Services at (800) 244-6224 to
Coverage provides 100% of the first $150 select your dentist.
of covered expenses, and 50% of the next Preventive services such as annual exam,
$2,700. x-rays, and cleanings are at no cost.
The maximum plan year benefit is $1,500 per There is no maximum annual benefit.
covered member (includes orthodontics). Copays apply based on the procedure and
You can use any dentist or specialist, or the established fee schedule.
choose a Cigna Radius Network provider Specialist services, including pediatric
at www.cigna.com/hcpdirectory to reduce dentists, are discounted at 25%.
your costs. Orthodontics are not included.
There are no deductibles or pre-existing Coverage provides 2 cleanings and up
condition limitations. to 4 exams per year as described in the
Coverage provides 3 cleanings and 2 exams established fee schedule.
per year.
HMO Biweekly Premiums
PPO Biweekly Premiums
Coverage Biweekly Cost
Coverage Biweekly Cost
Employee Only $ 0
Employee Only $ 5.54
Employee + 1 $ 0
Employee + 1 $16.82
Employee + 2 or more $ 0
Employee + 2 or more $22.77
2021 BENEFITS HANDBOOK | 11 |WELLNESS
For more information, visit:
www.pinellascounty.org/hr/wellness.
Wellness Program Wellness Champions
Pinellas County is committed to creating a Wellness Champions volunteer their time
culture of health and well-being in which our to advocate wellness and answer employee
employees and their families can improve and/ questions at their worksite.
or maintain their overall health. Establishing a Champions assist with coordinating wellness
culture of wellness helps us stay healthy, which activities and screenings at their locationby
keeps medical costs down for employees and posting flyers, tracking attendance, and
the County. Wellness staff members manage the collecting evaluations.
program and assist employees as needed. To find your Champion or to volunteer as a
Wellness Incentives Wellness Champion, see www.pinellascounty.
The Wellness Incentive Program offers org/hr/champion.
education and activities that help achieve Other Resources
wellness goals while earning reward points The UnitedHealthcare nurse liaison is
or cash. See www.pinellascounty.org/hr/ available for assistance with topics related to
incentive. UnitedHealthcare (see page 21).
Incentive activities include preventive The To Your Health newsletter provides
screenings, healthy eating and physical informative articles, exercise tips, recipes,
activity tracking, wellness education classes, employee testimonials, class schedules, and
and coaching. more. Look for it each month in your email.
Rally is a UnitedHealthcare online platform
to complete the health survey and track
wellness incentives:
• To access Rally, login to myuhc.com and Four Pillars of Wellness
select the Rally link.
• To learn more, visit www.pinellascounty. Our wellness programs provide
org/hr/rally. support across four pillars of wellness
which represent different areas of
Fitness Centers and Gyms life: physical, emotional, social
The Wellness Center in downtown Clearwater and financial.
is available to all employees at no charge. All four pillars are needed for total
Group fitness classes are offered. well-being, reduced stress, life
There are also two satellite mini-fitness satisfaction and good physical health.
centers. Imbalance in one or two areas, even
Employees benefit from other fitness facility if strong in the other areas, increases
discounts. The County partners with local stress and risk of disease and reduces
municipal recreation centers and Tampa Bay quality of life.
area gyms through YouDecide.
| 12 | 2021 BENEFITS HANDBOOKFor more information, visit:
www.pinellascounty.org/hr/life.
LIFE
Life Insurance times your annual salary requires approval of a
Medical History Statement.
Basic Coverage During Annual Enrollment, you may
The County provides basic Group Term Life purchase up to $20,000 additional coverage
Insurance from Securian Financial at no cost to without underwriting as long as your total
you in an amount based on your annual salary supplemental life coverage does not exceed
rounded up to the next $1,000. three times your base salary. Increases in
This coverage will change based on any coverage in excess of $20,000, or three times
increase or decrease in your annual salary. your current base salary, require approval of
There is a reduction in coverage for members a medical history statement (Policy: 34740,
beginning at age of 65 (see below). Key: Pinellas).
Rates and coverage for life insurance are based
Basic & Supplemental Life Coverage on age groups. The premium and/or age
Reduction reduction is automatically adjusted when you
Age Value of Policy with Age Reduction move to a new age group.For more information, visit:
www.pinellascounty.org/hr/fsa.
FSA
Flexible Spending Accounts (FSA) Healthcare FSA
Flexible Spending Accounts, which are admin- Your full plan year election is available on
istered by TASC, allow you to contribute pre-tax your effective date.
dollars from your paycheck to pay for qualified When you incur a qualified healthcare
expenses that you or your qualified dependents expense (e.g., medical, dental or vision), you
expect to incur, up to the annual Internal Rev- may pay with cash, check or credit card and
enue Service (IRS) limit. There are two types of request reimbursement from TASC, or use
flexible spending accounts: a Healthcare FSA and the TASC card, which acts as a debit card,
a Dependent Care (child or adult care) FSA. to immediately pay the expense at the time
Contributions of service.
The TASC card may be used for both
IRS Limits Healthcare FSA and Dependent Care FSA, and
Type of FSA Minimum Maximum it is smart enough to know the difference!
The card is convenient because it pays your
Healthcare FSA $260 $2,750 expenses up front. However, because of
Dependent Care FSA IRS regulations, TASC may need to request
(combined contribution for $260 $5,000 substantiation of your expenses, so save all
both spouses) itemized receipts.
Your FSA payroll deduction is equal to the full Eligible Healthcare FSA Expenses
election amount divided by the number of Examples*
pay periods remaining in the payroll calendar Health plan deductible, coinsurance,
year. For example, if your benefits begin on copays, and prescriptions
June 1 and you elect to contribute $400, you Vision exams, eye glasses, and contact
will pay $26.67 per pay period ($400 divided lenses
by 15 pay periods). Dental exams, fillings, crowns, and
Your FSA contributions and the expenses you orthodontia
pay from your FSA are never taxed. All over-the-counter drugs and medicines
You do not need to be enrolled in the health (no prescription needed)
or dental plans to participate in either of the Over-the-counter healthcare items such
FSA accounts. as blood pressure monitors, bandages,
contact lenses solutions, and hearing aid
Employees enrolled in the Consumer
batteries
Driven Plan may elect a Limited Purpose
Healthcare FSA account in addition to their Menstrual care products
Health Savings Account. The Limited Purpose * This list is not all-inclusive.
FSA funds may only be used for dental and
vision expenses until the health plan annual View Healthcare Eligible Expenses for more
deductible is met (see page 15). information.
| 14 | 2021 BENEFITS HANDBOOKFor more information, visit:
www.pinellascounty.org/hr/fsa.
FSA
Limited Purpose FSA Eligible dependents are children under age
Employees enrolled in the Consumer Driven 13 who reside with you or for whom you are
Plan may contribute to a Limited Purpose entitled to a personal tax exemption. Other
Healthcare FSA in addition to the Health eligible dependents include spouses and
Savings Account. adult relatives who reside with you, including
adult children, who are physically or mentally
The Limited Purpose FSA may only be
used for eligible dental and vision expenses incapable of self-care.
until you meet your health plan’s annual Funds are not available at the beginning
deductible. of the year. Funds are deducted from your
You must submit documentation to TASC biweekly paycheck and available for use
only after the deduction has been made and
to show that you have met your health plan
credited to your account.
annual deductible. Once you have done so,
then you may use your Limited Purpose FSA Use the TASC website to pay for qualifying
funds for eligible medical expenses. dependent care expenses. Reimbursement
requests must include an itemized statement
FSA Carryover Provisions from the dependent care provider.
Due to the Consolidated Appropriations Act, Funds must be used for eligible expenses
funds remaining in any Flexible Spending within the calendar year they are incurred.
Account in 2020 and/or 2021 will carry over
to the following year, with no restrictions, as
long as you enroll in an FSA for that year.
FSA Savings
Dependent Care FSA
This is a pre-tax benefit account used to pay TASC offers an FSA Savings Calculator
for dependent care services that make it to estimate your potential savings.
possible for the employee to work.
I f your eligible expenses add up to at
Examples are preschool, summer day camp, least $260 per year, you could save
before and after school programs as well as up to 30% by participating in an FSA
child and adult daycare. See Dependent Care through tax-free contributions.
Eligible Expenses.
2021 BENEFITS HANDBOOK | 15 |For more information, visit:
www.pinellascounty.org/hr/leave.
LEAVE
Leave Time Visit www.pinellascounty.org/hr/AFIN to
Pinellas County offers generous paid time off to learn more.
its employees, adding up to over five weeks in FMLA
the first year. The following is a brief summary
The Family and Medical Leave Act (FMLA)
of leave time available. For detailed policies and
provides up to 12 weeks of unpaid leave
procedures, see Personnel Rule 4: Time Off.
time for certain family or medical reasons per
Annual Leave rolling 12 month look-back period.
Annual leave with pay is provided for To be eligible an employee must have
vacations, personal business, emergencies, worked for the County at least 12 months
illness, medical/dental appointments, etc. and at least 1,250 hours in the prior year.
Annual leave is earned throughout the year Funeral Leave
and may be used as accrued. Employees receive up to 3 days with pay in
Employees earn and accrue annual leave the event of the death of any person residing
at increasing rates based on tenure. For in the employee’s household or any member
example, annual leave is accrued at a rate of of the employee’s immediate family.
at least 120 hours per year for new full- time
Holidays / Floating Holidays
employees, while an employee in their fifth
year of service accrues at least 160 hours of Employees receive 9 to 11 paid holidays per
annual leave per year. year, depending on how the holidays fall on
the calendar.
Annual leave may be rolled over from one
year to the next. There is no limitation on the Employees receive up to 2 paid floating
maximum number of hours accrued. holidays per year. Those with 25 years of
continuous service are granted 2 additional
Compensatory Time floating holidays.
Compensatory (comp) time may be granted Unused floating holidays do not carry over to
if a classified employee works more than the next year.
their regularly scheduled hours.
Jury Duty & Witness Duty
Comp time is accumulated at a rate of 1.5.
For example, a classified employee who A leave of absence with pay shall be granted
works 42 hours in one week will accumulate to an employee to perform jury duty or testi-
3 hours of compensatory time. fy as a witness when legally required unless
the employee is the plaintiff or defendant.
Donation of Leave (A Friend in Need)
Personal Day
This voluntary program allows employees to
donate leave time to assist a fellow employee Employees receive up to 2 personal days per
on an approved leave of absence. year to use without prior approval.
� The recipient needs to exhaust all available Unused personal days do not carry over to
leave and be ineligible for disability benefits the next year.
before a donation of leave time may be used.
| 16 | 2021 BENEFITS HANDBOOKFor more information, visit:
www.pinellascounty.org/hr/WhatWeOffer.
OTHER
Other Benefits Deferred Compensation (457)
Employees may choose to contribute pre-tax
Retirement dollars to a deferred compensation plan of
Pinellas County offers group health, dental and their choice to augment retirement savings.
life insurance plans to retirees and participates
in the Florida Retirement System (FRS). See Disability Insurance: Short and Long Term
www.myfrs.com. Disability insurance can replace part of an
employee’s income when unable to work
T he FRS sends information packets to new due to a non work-related illness or injury.
employees within three months of hire date.
Short term disability benefits are provided to
Both the County and employees make permanent employees working at least 20
contributions to fund retirement benefits. hours per week at no cost. New employees
The County contributes to employees’ are eligible for six weeks of benefits, with five
retirement plan savings, and employees weeks added each successive year, up to a
contribute 3% of their pretax pay. maximum benefit of 26 weeks.
Employees have a choice of two FRS retirement Long term disability benefits can replace
plans: up to 60% of income if an employee has
been disabled for at least six months. This
P
ension Plan - The Pension Plan provides coverage is available to classified employees
a guaranteed monthly benefit based on a after one year of employment and available
formula that factors in your eight highest immediately to exempt employees.
years of compensation and your total years
Rewards Program
of creditable service (or your five highest
years if you enrolled in the FRS prior to July The Rewards Program (internal link) offers
1, 2011). An employee is vested in the FRS gifts to employees from an online awards
Pension Plan upon completing eight years of catalog with over 12,000 items. Rewards
creditable service (or six years if you enrolled are given to employees for service awards,
prior to July 1, 2011). wellness incentives, and retirement.
Investment Plan - The retirement benefit is Learning and Development
the value in the employee’s account. There is Employees have access to over 100 in-house
no fixed benefit level. Your future retirement courses and may also apply for tuition
benefit depends on the performance of your reimbursement for classes taken on their
investment options. An employee is vested own time.
in the FRS Investment Plan upon completion
Visit www.pinellascounty.org/hr/learning.
of one year of creditable service.
Credit Union
Discounts
The Pinellas County Credit Union is available
The YouDecide Program offers discounts on
to employees and family members.
items such as theme park tickets, hotels, and
cell phones.
2021 BENEFITS HANDBOOK | 17 |GLOSSARY
Health Plan Terminology CDHP: If two or more people are covered,
The following definitions are for terms used in the pooled family deductible must be met
the Pinellas County health plans. Access links to before any benefits are paid for any covered
the health plan descriptions and summaries at family member.
www.pinellascounty.org/hr/health. Flexible Spending Account (FSA) - An FSA
allows you to set aside pre-tax dollars to pay
Behavioral/Mental Health - Care for for qualified healthcare and/or dependent
concerns including anxiety, depression, day care expenses. You decide how much
substance abuse, anger management, money you want to contribute and the funds
compulsive gambling, and other issues. are deducted from your paycheck. There
Coinsurance - After you meet your plan are no contributions by Pinellas County.
deductible the plan pays a percentage of the The money you set aside can be used to
cost for healthcare services. The coinsurance reimburse yourself for a qualified medical,
is the percentage you are responsible for dental and vision and/or dependent day care
paying. For example, if your plan covers a expenses. You must substantiate all claims
service at 80%, your coinsurance is 20% of with an itemized receipt of the expense.
the contracted rate. Health Savings Account (HSA) - An HSA
Consumer Driven Health Plan (CDHP) is a tax-free savings account available to
- A CDHP is a combination of a high individuals enrolled in an IRS-qualified high
deductible health plan (HDHP) and a health deductible health plan like the County’s
savings account (HSA). The plan is designed Consumer Driven Health Plan. Contributions
to give you greater control over your may be made by you or by the County.
healthcare decisions and your healthcare There is no “use it or lose it” provision, and
dollars. unused funds roll over from one year to the
Copayment (Copay) - A flat dollar amount next. Your deposits earn interest and grow
you are required to pay for visits to your over time. This allows you to save money
primary care, specialist, or behavioral health for future expenses or pay for current ones.
provider and the emergency room. Copays HSA funds may be used to pay for qualified
do not apply toward your deductible, but health, dental and vision expenses for you,
they do apply toward your annual out-of- your spouse, and dependents.
pocket maximum. Copays only apply to the Out-Of-Network - Providers that are not
POS health plan. contracted with any Pinellas County benefit
Deductible - This is the amount you pay out partners’ provider network. When you use an
of your own pocket before the plan begins out-of-network provider, services may not be
to cover a portion your healthcare expenses. covered at all, or at a reduced reimbursement
For example, if your deductible is $600 per level. You are responsible for any differences
person, you will pay the first $600 of the between a provider’s billed charges and the
contracted rate, regardless of whether your plan’s allowed amount. These charges do not
first visit costs that much or it accumulates count towards in-network deductibles or
over the course of several visits. *Note on out-of pocket limits.
| 18 | 2021 BENEFITS HANDBOOKGLOSSARY
Out-Of-Pocket Maximum (OOP) - This is Generic Drugs - Medications marketed
the maximum you will pay out of your own under their active ingredient name instead
pocket for healthcare services. Once you of a patented brand name. When the
reach the OOP maximum, the plan covers brand’s patent expires, the law allows other
your eligible healthcare services at 100%. manufacturers to produce the product –
Point of Service (POS) - Under this plan, you often at lower cost than the original brand.
have the choice to visit any licensed provider. Members pay the lowest cost for generic
If you visit a doctor or facility within the drugs.
plan’s network of providers (in-network), you Legend Drug - A drug or medicine which,
receive greater coverage. If you visit a doctor under federal law, is required to bear
or facility outside of the plan’s network (out- the label, “Caution: federal law prohibits
of-network), your coverage is reduced, which dispensing without prescription” or “Rx only.”
means you pay more out of your pocket. Mail Order Home Delivery - Ongoing
supplies of maintenance medications
Prescription Drug Terminology may be filled through the Express Scripts
Brand Name Drugs with Generic mail order pharmacy under the Smart90
Equivalents - If there is a generic drug program. Home delivery is convenient and
available, and either you or your physician allows up to a three-month supply for many
requests the brand drug (Dispense as medications.
Written), you will pay the brand copay/ Maintenance Medications - Medications
co-insurance plus the difference in price that are taken regularly for the treatment
between the brand and its generic of chronic medical conditions, including
equivalent. asthma, diabetes, heart disease, and high
Cumulative Out-of-Pocket Amounts - blood pressure.
Under the CDHP plan, Rx deductibles and Non-Formulary Drugs (or Non-Preferred
out-of-pocket maximums are combined with Drugs) - Drugs that are not on Express
deductibles and out-of-pocket maximums Scripts’ formulary list. Members pay a higher
under the medical plan. Under the POS out-of-pocket cost for non-formulary drugs.
plan, copays and co-insurance amounts are Participating Retail Pharmacies - Local
included with other claims to meet your pharmacies contracted to dispense
out-of-pocket maximum. prescriptions at a negotiated discounted
Formulary (or Preferred) Drugs - A list of rate. A current list of pharmacies is found at
brand name prescription drugs selected www.express-scripts.com. The Plan covers
by Express Scripts that offer the greatest up to a one-month supply for short-term
overall value. The list is subject to change medications (such as antibiotics) and initial
periodically. A current list is found at prescriptions for maintenance medications
www.express-scripts.com. plus two refills at participating pharmacies.
2021 BENEFITS HANDBOOK | 19 |GLOSSARY Preventive Medications - These medications Smart90 Walgreens Program - Prescription are used to treat many long term, chronic savings plan that offers the choice of Express conditions such as diabetes, high blood Scripts home delivery or a Walgreens retail pressure and high cholesterol. Drugs on the store for a 90-day supply of long-term Express Scripts Preventive Medications List maintenance medications. are available at no cost to Consumer Driven Specialty Drugs - Certain medications that Health Plan members. are prescribed to treat complex conditions, Prior Authorization - Some medications such as certain inflammatory conditions, require a review or pre-authorization to multiple sclerosis and cancer. These high cost determine if they are eligible for coverage. medications require pre-authorization and Your doctor and pharmacist usually know are dispensed by Accredo, Express Script’s which medications require a review, and specialty pharmacy. Members pay the you can also access the information at highest out-of-pocket cost for specialty www.express-scripts.com. drugs. Quantity Management - Certain covered Step Therapy - Some medications require medications, such as pain management you to first try a different medication before drugs, have quantity restrictions based on another (usually more expensive) drug that manufacturer and/or clinically approved your doctor prescribed. The program is guidelines and are subject to periodic review intended to control costs while treating your and change. condition effectively. | 20 | 2021 BENEFITS HANDBOOK
CONTACTS
Nurse Liaison Legal Notices
There is a UnitedHealthcare Nurse Liaison Pinellas County is required to provide information
available to Pinellas County employees and their to eligible plan participants either at the time
family members: of eligibility or on an annual basis. These
notices, including the HIPAA Notice of Privacy,
Amy Hertog, RN, BSN
are posted on the Human Resources website at
Email: Amy_Hertog@uhc.com
www.pinellascounty.org/hr/notices.
(727) 464-5579
400 S. Ft. Harrison Ave., Clearwater
Amy connects employees with UnitedHealthcare
resources, in addition to providing education and
counseling. She works with employees one-on-one
and speaks to groups on a variety of topics.
Benefits Partners
Our benefits partners are your best resource for questions on eligibility, coverage and claims:
Dental Health Savings Account Prescription
Cigna (HSA) Express Scripts
(800) 244-6224 Optum Bank (866) 544-9221
www.mycigna.com (800) 791-9361 www.expressscripts.com
Mobile app: MyCigna www.optumbank.com Mobile app:
Express Scripts
Employee Assistance Life Insurance
Program (EAP) Securian Financial Vision
Optum For life insurance questions, EyeMed
(866) 374-6061 call Benefits staff at 464-3367. (866) 939-3633
www.liveandworkwell.com www.securian.com www.EyeMed.com
Policy: 34740, Key: Pinellas Mobile app: EyeMed
Flexible Spending
Account (FSA) Medical
TASC UnitedHealthcare
(800) 422-4661 (888) 478-4752
www.TASConline.com www.myuhc.com
Mobile app: TASC Mobile app:
UnitedHealthcare
2021 BENEFITS HANDBOOK | 21 |You can also read
