2021 Employee Benefits Summary - Inside you will find information about our: Milton, GA

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2021 Employee Benefits Summary - Inside you will find information about our: Milton, GA
2021 Employee Benefits Summary

                          Inside you will find information about our:
 Benefits Enrollment • Health Benefits • Dental and Vision Benefits • Life and
    Disability Benefits Supplemental Programs • Flexible Spending Accounts

This booklet provides a summary of plan highlights. Please consult the carrier’s contract for complete information on covered charges, limitations,
and exclusions. This is not a binding contract. The carrier’s contract will prevail. If you have further questions please contact the carrier or Relation
Insurance Services.
2021 Employee Benefits Summary - Inside you will find information about our: Milton, GA
welcome
2021                                                     MILTON"'                            ESTABLISHED 2006

                                                                   Dear City of Milton Employees:

                                                                   We are pleased to present your 2021 benefits package. We understand that your health and
                                                                   well-being are very important to you, your family, and the City's success. We are committed to
                                                                   providing our employees and their eligible dependents with a comprehensive benefits package
                                                                   including medical, dental, vision, life, and disability insurance. We strive to ensure that your
                                                                   benefit program is not only high quality, but also affordable in this world of increasing healthcare
                                                                   costs.

                                                                   Our renewal with Cigna went very well this year with the City receiving only minor increases. In
                                                                   2021, we will continue to offer a Base Plan and a High Deductible Health Plan (HDHP) for medical
                                                                   options. The High Deductible option gives you a way, through a Health Savings Account (HSA),
                                                                   to set aside pre-tax dollars to pay for expenses in the HDHP. In addition, the City will contribute
                                                                   an annual amount of $750, $ l,125, or $1,500, based on your level of coverage to your HSA, to
                                                                   help pay for your eligible expenses. If enrolled in the Base Plan, you will receive a $500
                                                                   contribution from the City in the form of a Health Reimbursement Account (HRA) to help pay for
                                                                   expenses. You may also enroll in the Flexible Spending Account (FSA), offered through our
                                                                   provider Basic. The annual contribution limit for the FSA is $2,750 for health related expenses and
                                                                   $5,000 for dependent care. Your plan selections will remain in effect through December 31, 2021.

                                                                   There will continue to be one dental plan offered through Cigna. The deductible and annual
                                                                   maximums have not changed for the dental plan. The vision plan remains with VSP, and there
                                                                   are no changes to the benefit levels or network.

                                                                    We are proud to continue to offer competitive rates for benefits. All rate changes are detailed
                                                                   in this book.

                                                                   This benefits booklet is designed as a resource to help you review your benefit choices, and
                                                                   serves as a summary of the various programs offered to you as an employee of the City of Milton.
                                                                   Additionally, you may contact our insurance broker's office, Relation, for any questions or
                                                                   concerns that you may have. All contact information is listed on the back cover of this booklet.

                                                                   Sincerely,

                                                                   St�ity Manager

                                                           2006 Heritage Walk Milton, GA 30004              P: 678.242.2500 IF: 678.242.2499      info@cityofmiltonga.usIwww.cityofmiltonga.us

                                                           OGOO
Contents
Benefits Focus ���������������������������������������������������������������������������������� 1          Special Health Programs���������������������������������������������������������������� 19
Benefits Eligibility & Changes ������������������������������������������������������� 2-3                   FSA �������������������������������������������������������������������������������������������������� 20
Medical Benefits ������������������������������������������������������������������������� 4-14              AFLAC Programs������������������������������������������������������������������������������ 21
Dental���������������������������������������������������������������������������������������������� 15      Benefits Rates �������������������������������������������������������������������������������� 22
Vision ���������������������������������������������������������������������������������������������� 16     Notices���������������������������������������������������������������������������������������23-25
Life and AD&D�������������������������������������������������������������������������������� 17             Contact Information ��������������������������������������������������������Back Cover
Disability and EAP �������������������������������������������������������������������������� 18

 This booklet provides a summary of plan highlights. Please consult the insurance contract for complete information on covered charges, limitations,
 and exclusions. This is not a binding contract. The carrier’s contract will prevail. If you have further questions, please contact the carrier or Relation
 Insurance Services.
2021 Employee Benefits Summary - Inside you will find information about our: Milton, GA
BENEFITS FOCUS

Our Benefit Goals                                        Reminders for This Year:
We evaluate our benefit programs each year               • Both the POS and the HDHP plan will have an enhanced
to make sure that we accomplish several goals.             benefit when using a Cigna Care Designated (CCD) provider.
We strive to:                                            • The POS members will enjoy a lower primary care or specialist
• Promote health and wellness among The City of Milton     visit copay.
  employees and their dependents.                        • The HDHP members will enjoy a greater coinsurance level
• Provide employees with affordable access to health       when using a CCD provider. The CCD designation C can be
  benefits.                                                found on provider lists located on myCigna.com.
• Provide competitive benefits programs.                 • Due to a merger between Cigna and Express Scripts, all
• Provide resources to support employees and their         members will receive new ID cards for the new plan year
  dependents as they make important decisions about        starting January 1st 2021.
  their health and health care.                          • Effective January 1st 2021, Amwell for Cigna will no longer be
                                                           a Virtual Care option for Cigna members. MD Live will remain
                                                           as the sole telehealth provider.

                                                              Your Benefits are Paid for
                                                                with Pre-Tax Dollars
                                                                 Every penny in your paycheck counts.
                                                             To help you stretch your income, we established a
                                                            Cafeteria Plan or Flexible Benefit Plan that allows you
                                                                to pay for your benefits using pre-tax money.
                                                                  What Does a Cafeteria Plan Mean to Me?
                                                                                     •••••
                                                                       You save at least 15% in Federal Tax
                                                                                     •••••
                                                                              You save 1.45% in FICA Tax
                                                                                     •••••
                                                                          You save 6% in Georgia State Tax
                                                                                     •••••
                                                                More flexibility— you have a menu of benefit
                                                                    alternatives and levels and can choose
                                                                            the right options for you

                                                                2021      |   EMPLOYEE BENEFITS SUMMARY                 1
2021 Employee Benefits Summary - Inside you will find information about our: Milton, GA
BENEFIT ELIGIBILITY AND CHANGES

Benefit Eligibility
The City of Milton provides a comprehensive employee benefit program to all full-time employees. Employees
are eligible for coverage on the first day of the month following date of hire for medical, dental, vision, life,
disability and FSA benefits.

You can enroll the following dependents in our group benefit plans:
• Your legal spouse.
• Children under age 26.
• Unmarried children of any age if totally disabled and claimed as a dependent on your federal income tax return (documentation of
  handicapped status must be provided).
• Dependents for which you have legal guardianship or custody. Legal documentation will be required.

Many employees have other dependents living with them who are not eligible for our benefit plan. Dependents
NOT eligible to be added to your benefit plans include:
•   Grandchildren, nieces, nephews or other children who do not meet specifications listed above.
•   Common law spouses (same or opposite sex).
•   Ex-spouses, unless required via court order (documentation required).
•   Parents, step-parents, grandparents, aunts, uncles, or other relatives who are not qualified legal dependents (even if they live in
    your house).

How to Enroll for Benefits:
Open Enrollment for the 2021 plan year will take place during the month of November. All changes will be
effective January 1, 2021. To review and select your benefits, log in to the payroll system and navigate to My
Benefits>Enrollment.

2          EMPLOYEE BENEFITS SUMMARY              | 2021
2021 Employee Benefits Summary - Inside you will find information about our: Milton, GA
BENEFIT ELIGIBILITY AND CHANGES

Making Changes to Your Benefits
Benefit deductions are withheld from your paycheck on a pre-tax basis and your ability to make changes to these
benefits is restricted by the IRS. Once enrolled, most pre-tax benefit elections cannot be changed until the next
annual Open Enrollment period, unless you have a Qualifying Life Event.

The Most Common Life Status Changes
• Marriage, divorce, legal separation
• Birth or adoption
• Change in your or your spouse’s work status that affects your
  benefits or an eligible dependent’s benefits
• Change in health coverage due to your spouse’s annual Open
  Enrollment period
• Change in eligibility for you or a dependent for Medicaid or
  Medicare
• Receipt of a Qualified Medical Child Support Order or other
  court order
To make benefit changes as a result of your Life Status Change as allowed under Section 125 of the IRS Code,
you must:
• Notify Human Resources within 30 days of the date of the qualifying event
• Provide proof of your life status event, and
• Complete and submit your enrollment form.

Keeping Your Benefits When Eligibility Changes
Sometimes life happens and you need to move, stop working or             In order to select and continue COBRA benefits you
change employers. While the City of Milton hopes that you stay           must:
with us for a long time, circumstances are not always the way we         • Submit an election to continue COBRA within 60 days from
hope. COBRA allows you and/or dependents to continue medical,              the date the notice is received, or 60 days from the date
dental, and vision benefits that are in place at the time eligibility      coverage is terminated, whichever is later.
changes. The cost for health benefits is 100% of the benefit cost        • Submit your COBRA payment within 45 days from the date
plus a 2% administrative fee.                                              that COBRA coverage is elected. Upon receipt of payment,
Medical, dental, and/or vision benefits terminate on the last day of       benefits are retroactive, thus effective on the date your
the month of your last day of work.                                        benefits ended.
                                                                         • Submit future payments on time or benefits will be cancelled.
If you are enrolled in life and/or disability benefits, these benefits     Once cancelled, COBRA benefits cannot be reinstated.
will end on your last day of employment with the City of Milton.
These benefits are convertible and/or portable, and information          COBRA benefits can generally be continued for the
on your conversion rights will be provided to you at that time.          following timeframes:
How does COBRA work?                                                     • 18 months if your employment with the City of Milton ends
Your COBRA notice is mailed to you from Basic once your                  • 36 months if eligibility is lost as a result of a divorce
termination is processed. You should receive it at your home within      • 29 months if you are deemed disabled. You must apply for the
15-20 days after your termination. Basic’s contact information is          additional 11 months when you first enroll in COBRA
listed on the back cover.

                                                                           22021    |   EMPLOYEE BENEFITS SUMMARY Y                   3
2021 Employee Benefits Summary - Inside you will find information about our: Milton, GA
MEDICAL BENEFITS

Medical Benefits
The City of Milton offers two health plan options through Cigna, our Point of Service (POS) and our High-Deductible
Health Plan with a Health Savings Account (HSA).

Point of Service - Open Access Plan (POS)                                  High Deductible Health Plan (HDHP with HSA)
The POS option works like a traditional health plan. Employees             The HDHP option is a high-deductible health insurance plan
pay a $35 copay for in-network visits to their Primary Care                ideal for employees who:
Physician and a $50 copay to see an in-network specialist. If you          • Prefer to pay lower premiums
visit a Cigna CCD doctor, your copay for a primary care visit will         • Want to save money for future health care expenses
be $25 and a specialist visit will be $40. Certain other services are         and post-retirement medical costs
covered at 100% after the $2,500/$7,500 deductible is reached.             • Like to control how their money is spent
Out-of-network services are subject to a higher deductible, cost           • Want all covered medical and prescription expenses to apply
more, and you may have to file your benefit claims yourself or                towards the deductible
pay for services and wait for reimbursement from Cigna.
                                                                           HDHP participants who utilize doctors with the Cigna Care
                                                                           Designation (CCD) will enjoy a coinsurance level of 100% after
                                                                           meeting their deductible of $3,000 / $6,000.

                  Wellness Services for POS and HDHP                       HDHP participants have the added benefit of a HSA contribution
    					                                               Plan Member Cost   from the City. The City contributes between $750 and $1,500 to
     Annual Physical                                               Free    the HSA to be applied to qualifying medical expenses. Employees
     Well Child Care                                               Free    have the option of making additional pre-tax contributions
     Preventative Immunizations                                    Free    to their HSA to use now or as savings towards future medical
     Mammograms/Pap/Prostate                                       Free    expenses. All new enrollees’ contributions will be prorated for
    *Contact Cigna for specific guidelines on preventative care            the plan year.

myCigna.com                                                                myCigna Mobile App
Register today. It’s this easy:                                            myCigna Mobile App gives you a simple way to
1.	 Go to myCigna.com and select “Register.”                               personalize, organize and access your important
2.	 Enter your personal details like name, address and date of birth.      health information – on the go. It puts you in control
3.	 Confirm your identity with secure information like your Cigna          of your health, so you can get more out of life.
    ID, social security number or a security question. This will make
    sure only you can access your information.
                                                                           The myCigna App has big features.
4.	 Create a user ID and password.
5. Review and submit.
                                                                           •   Access the health care professional directory
Now you’re ready to log in to your personal, secure myCigna.               •   View and easily print, email, and scan your ID cards
com site. See how the site has been redesigned with you in mind,           •   View and search recent and past claims
making it easy to navigate and find what you need:                         •   Look up and compare drug costs and find the closest
                                                                               pharmacy
•    Manage and track claims                                               •   Access and view account balances
•    Find doctors and medical services                                     •   Store and organize important contact information
•    Manage and track your health information                              •   Custom health team feature to keep track of your in network
•    See cost estimates for medical procedures                                 doctors, dentists and facilities
•    Compare quality of care ratings for doctors and hospitals             •   Receive proactive messages from Cigna to guide you
•    Access a variety of health and wellness tools and resources           •   Click to chat feature when you need assistance
•    Print ID cards

4              EMPLOYEE BENEFITS SUMMARY                          | 2021
2021 Employee Benefits Summary - Inside you will find information about our: Milton, GA
MEDICAL BENEFITS: HRA

Health Reimbursement Arrangements
Employees are provided a $500 HRA which is funded by the City of Milton and used to provide employees with
reimbursement for qualified medical or prescription expenses incurred by the employee or a covered dependent
under the Cigna Base POS plan. The HRA can be used to offset the cost of your prescription deductible, prescription
copays and medical deductible. Our HRA is administered by Basic. Their contact information is located on the
back page of the booklet.

Using My HRA                                                        Deadline for Filing 2020 Claims
1.	 Rx Copays- you may use your debit card at the pharmacy or       Please file these claims for reimbursement as soon as possible
    submit an EOB manually.                                         in order to avoid a delay in processing. The plan is set up with
2.	 Rx Deductible- you may use your debit card at the pharmacy      a 90 day run out for 2020 claims, which means that they would
    or submit an EOB manually.                                      need to receive the claims by midnight on 3/31/21 to process
                                                                    them for reimbursement. Any 2020 claims received after
3.	 Medical Deductible- you must obtain an EOB from Cigna and
                                                                    midnight on 3/31/21 will be denied. Services can be incurred
    submit these expenses manually.
                                                                    until midnight on 12/31/20, any services after that will apply to
                                                                    the 2021 plan year. Any balance left in the HRA after the grace
If Submitting an HRA Claim Manually                                 period for claims will be forfeited.
1.	 Wait until Cigna processes your claim and you receive your
    Explanation of Benefits (EOB) in the mail or online.
2.	 Use the EOB to determine what portion of the claim was          Sample Eligible Expenses
    applied to your deductible.                                     • Hospital Inpatient Services: room and board, hospital services
3. Complete the claim form from Basic HRA.                              and supplies (x-ray, lab, anesthesia, etc.), physician services
4.	 Send the EOB and Claim Form to Basic for processing.                (surgeon, anesthesiologist, radiologist, pathologist, etc.)
5.	 Reimbursements will be made directly to you.                    •   Inpatient Mental Health Care
                                                                    •   Inpatient Substance Abuse Treatment
If your provider requests payment at the time of service, pay the   •   In-Office Surgery
bill and save your receipt. Once you receive your EOB from Cigna,   •   Outpatient lab & radiology
send it to Basic for processing and they will reimburse you.
                                                                    •   Outpatient Hospital: outpatient facility (lab, x-ray, anesthesia
                                                                        etc.), outpatient physician services (surgeon, radiologist,
                                                                        anesthesiologist, pathologist, etc.)
                                                                    •   Advanced radiology/imaging services (MRI, MRA, PET, CT-
                                                                        Scan, and Nuclear Medicine)
                                                                    •   Radiation Therapy
                                                                    •   Prescription Drug Copay
                                                                    •   Skilled Nursing Facility
                                                                    •   Prescription Drug Deductible

                                                                          2021   |   EMPLOYEE BENEFITS SUMMARY                        5
2021 Employee Benefits Summary - Inside you will find information about our: Milton, GA
MEDICAL BENEFITS: HDHP WITH HSA

HSA: A Health-Wise Investment for Your Future
Money in your HSA is YOURS
                                                                           The City of Milton Contribution to Your HSA
Money left in your HSA rolls over each year and may accumulate
                                                                           Employee Only                                          $750
interest once a certain account balance is reached to help you             Employee + Spouse or Child(ren)                       $1,125
save for future medical expenses. Your HSA fund is portable                Family                                                $1,500
should you terminate employment with the City of Milton or
choose to move to a traditional plan in the future.

The City of Milton Contributions to
Employee Health Savings Accounts
The City of Milton makes contributions to employees’ Health
Savings Accounts at the beginning of each calendar year to help
pay for qualified medical expenses that apply towards the plan
deductible.

HSA Qualified Medical Expenses
Examples of qualified medical expenses.
Listed below are the most common examples of qualified medical expenses. You can find a complete listing at www.irs.gov. Search
under Internal Revenue Service (IRS) Publication 502, Medical and Dental Expenses.

•   Acupuncture                                                        • Hospital services
•   Alcoholism treatment                                               • Laboratory fees
•   Ambulance                                                          • Long-term care (for medical expenses and premiums)
•   Artificial limb                                                    • Nursing home
•   Artificial teeth                                                   • Nursing services
•   Breast reconstruction surgery (mastectomy-related)                 • Operations/surgery (excluding unnecessary cosmetic surgery)
•   Chiropractor                                                       • Physical therapy
•   Contact lenses                                                     • Prescription medicines or drugs
•   Cosmetic surgery (if due to trauma or disease)                     • Psychiatric care
•   Dental treatment (X-rays, fillings, braces, extractions, etc.)     • Psychologist
•   Diagnostic devices (such as blood sugar test kits for diabetics)   • Speech therapy
•   Doctor’s office (including physicians, surgeons, specialists or    • Stop-smoking programs
    other medical practitioners) visits and procedures                 • Vasectomy
•   Drug addiction treatment                                           • Weight-loss programs (to treat a specific disease diagnosed by
•   Drugs, prescription                                                  a physician)
•   Eyeglasses and exams                                               • Wheelchair
•   Eye surgery (such as laser eye surgery or radial keratotomy)       • Wig
•   Fertility enhancements                                             • X-rays
•   Hearing aids (and batteries for use)

6           EMPLOYEE BENEFITS SUMMARY                | 2021
2021 Employee Benefits Summary - Inside you will find information about our: Milton, GA
MEDICAL BENEFITS - HDHP WITH HSA
                                                              HDHP WITH HSA
   			                  					                                               In-Network				Out-of-Network
   Lifetime Maximum						                                                   Unlimited					                                    Unlimited
   Calendar Year Deductible 					                                           $3,000 Individual 				                            $6,000 Individual
   								                                                                 $6,000 Family 				                                $12,000 Family
   Out-of-Pocket Maximum					                                               $4,000 Individual 				                            $12,000 Individual
       (includes deductible, coinsurance, and copays and RX copays)         $8,000 Family 				                                $24,000 Family
   								                                                                 Amount Plan Pays				                              Amount Plan Pays
   Office Visits						                                                      90% after deductible non-CCD provider /
   								                                                                 100% after deductible with CCD provider
                                                                                                                      C       70% after deductible

   Preventive Care						                                                    100%; deductible waived			                        70% after deductible
   Coinsurance (amount plan pays after you meet the deductible)		           90% non-CCD provider /
   								                                                                 100% with CCD provider
                                                                                                                      C       70% after deductible

   Prescription Drug – The full plan deductible must be met before prescription copays apply. Once you meet your out-of-pocket maximum, prescription
   drugs will be covered at 100%.
   •
   Retail - up to a 30-day supply			                            Tier 1 			                      $15 copay after plan deductible
   (same for in- and out-of-network)			                         Tier 2			                       $35 copay after plan deductible
   							                                                      Tier 3			                       $60 copay after plan deductible
   •
   Mail Order/Rx90 Now - per 90-day supply		                    Tier 1 			                      $45 copay after plan deductible
   (same for in- and out-of-network)			                         Tier 2			                       $105 copay after plan deductible
   							                                                      Tier 3			                       $180 copay after plan deductible

This summary should not be considered a full explanation of benefits, see certificate for exact coverage and exclusions.

Frequently Asked Questions About HSAs:
What will I receive once I have made my election?                               Do doctors require payment at the time of service?
Your debit card and your Cigna ID card will each be mailed to                   Most network physicians will bill Cigna first and then bill you for
your home separately. In addition, you will receive a Certificate of            your adjusted costs.
Coverage detailing your plan benefits. If you are new to the HSA,
                                                                                What happens to my HSA if I never withdraw funds,
Health Equity will send a welcome kit to your home 7-10 business
                                                                                change jobs, or retire?
days after notification of your enrollment.
                                                                                Funds in your HSA are yours, even if you change employers or
How do I make deposits to my account?                                           retire. The less that you spend on current medical expenses,
Deposits to your HSA can be made through pre-tax payroll                        the more money stays in your account accumulating interest.
deductions. Unlike an FSA, you can change your payroll deductions               Under IRS guidelines, HSAs are treated like IRAs. HSA funds are
for the HSA during the year. Combined employee/employer                         never taxed or penalized if they are used for qualified medical
contributions for 2021 cannot exceed $3,600 for individuals                     expenses. Funds can be withdrawn for any reason, without
or $7,200 for families. Anyone over age 55 can contribute an                    penalty once you reach age 65.
additional $1,000 for catch-up contributions.
                                                                                What expenses are counted towards my deductible?
Who verifies that my HSA was used for qualified                                 Only medical expenses covered by your medical plan apply
expenses?                                                                       towards your deductible. However, HSA funds used for qualified
Save your receipts — in the event of an IRS audit, you are                      medical expenses not covered under your medical plan (for
responsible for providing documentation to the IRS.                             example, orthodontia), will not count towards your health plan
                                                                                deductible.
 2021 Annual Max: $3,600 Individual & $7,200 Family                             Can I pay for services that cost more than my HSA
                                                                                balance?
          If you enroll in the HDHP you must visit                              No, your HSA balance must be sufficient to cover the expense
          www.healthequity.com to authorize a Health                            before funds are withdrawn, or you must wait until you have
          Savings Account after you receive a welcome packet                    enough money in the account and then submit the expense for
          in the mail detailing the process.                                    reimbursement.

                                                                                   2021     |   EMPLOYEE BENEFITS SUMMARY Y                            7
2021 Employee Benefits Summary - Inside you will find information about our: Milton, GA
MEDICAL BENEFITS - POS PLAN
                                                                                                In-Network Benefits                                  Out-of-Network Benefits
 Lifetime Maximum                                                                   Unlimited                                                      Unlimited
 Calendar Year Deductible (separate, do not combine in- and out-of-network)         $2,500 individual                                              $5,000 individual
                                                                                    $7,500 family                                                  $15,000 family
 Out-of-Pocket Maximum (includes deductible, coinsurance, medical copays            $6,600 individual                                              $19,800 individual
 and pharmacy costs) Non-covered items do not apply.                                $13,200 family                                                 $39,600 family
 Office Visits: Preventive Care
    Well Child and Immunizations                                                    Plan pays 100% (not subject to deductible)                     Plan pays 70% after deductible
                                                                                                                                                   (ded. waived through age 5)
    Periodic Health Examinations                                                    Plan pays 100% (not subject to deductible)                     Plan pays 70% after deductible
    Prostate Screening or Annual Gynecology Examination                             Plan pays 100% (not subject to deductible)                     Plan pays 70% after deductible
 Office Visits: Illness or Injury
    Primary Care Physician                                                          $35 copay non- CCD provider /                                  Plan pays 70% after deductible
                                                                                    $25 copay with CCD provider                              C
    Specialty Care Visit                                                            $50 copay non-CCD provider /                                   Plan pays 70% after deductible
                                                                                    $40 copay with CCD provider                              C
    Urgent Care Visit                                                                                                                $60 copay
    Surgery In Office Setting                                                       Plan pays 100% after deductible                                Plan pays 70% after deductible
    Cigna Virtual Care Services - Online Physician Visit                            $35 copay                                                      Not Covered
 Inpatient Services
    Daily Room, Board, Nurse Care (at semi-private room rate), ICU, Physician       Plan pays 100% after deductible                                Plan pays 70% after deductible
    Services
 Outpatient Services
    Surgery Facility, Hospital Charges, Physician Services, Diagnostic X-ray, Lab   Plan pays 100% after deductible                                Plan pays 70% after deductible
 Emergency Room (Not Covered for Non-Emergency)                                                                          $200 copay (waived if admitted)
 Therapy Services
    Chiropractic Care (35-visit calendar year max.)                                 $35 copay                                                      Plan pays 70% after deductible
    Occupational and Speech Therapy (35-visit calendar year max.)                   $35 copay                                                      Plan pays 70% after deductible
    Physical Therapy (35-visit calendar year max.)                                  $35 copay                                                      Plan pays 70% after deductible
 Mental Health/Substance Abuse - No referral required. Services must be authorized.
    Inpatient / Intensive Outpatient Program / Partial Hospitalization              Plan pays 100% after deductible                                Plan pays 70% after deductible
    Office Services (physician fee)                                                 $35 copay                                                      Plan pays 70% after deductible
    Outpatient Facility Services (physician fee)                                    Plan pays 100% after deductible                                Plan pays 70% after deductible
 Other Services
    Skilled Nursing Facility (30 day benefit period max.)                           Plan pays 100% after deductible                                Plan pays 70% after deductible
    Home Health Care (120-visit calendar year max.)                                 Plan pays 100% after deductible                                Plan pays 70% after deductible
    Hospice Care                                                                    Plan pays 100% after deductible                                Plan pays 70% after deductible
    Ambulance (when medically necessary)                                                                                 Plan pays 100% after deductible
    Durable Medical Equipment                                                       Plan pays 100% after deductible                                Plan pays 70% after deductible
 Prescription Drug - To receive coverage your prescription must be filled at a network pharmacy. Each retail prescription has a 30-day or 90-day limit, mail order maintenance prescriptions
 have a 90-day limit. All member cost shares (copays, coinsurance, and deductible) for pharmacy benefits will apply to the plan Out-of-Pocket Maximum. Members must file a claim form for
 reimbursement when using an out-of-network pharmacy.
 *If a member receives a brand name drug that falls on Tier 2 or Tier 3 that has a generic equivalent available, the member pays 100% the difference between the Brand Name price and the
 generic price, plus the appropriate Brand Name copay, unless the physician indicates DAW (dispense as written).
    Rx Plan Deductible                                                                                                    $150 individual / $300 Family
                                                                                                            (does not apply to Tier 1 retail or mail order prescriptions)
    Retail Tier 1 / Mail Order Tier 1                                                                                         $10 copay / $30 copay
    Retail Tier 2 / Mail Order Tier 2                                                                                         $40 copay / $120 copay
    Retail Tier 3 / Mail Order Tier 3                                                                                         $75 copay / $225 copay

This summary should not be considered a full explanation of benefits, see certificate for exact coverage and exclusions.

8               EMPLOYEE BENEFITS SUMMARY                                 | 2021
MEDICAL BENEFITS

Cigna Member Benefits
Look for the Cigna Care Designation
Choosing the right doctor is a big decision – one where you might
want a doctor you can trust with your health – and you can afford.
The Cigna Care Designation (CCD) is one decision-making tool you
can use to choose a doctor. Cigna checks education and board
certifications, and they also check to see if the quality of care has
earned recognition from within the medical industry.

What does the Cigna Care Designation mean?
                                                            C
The Cigna Care Designation identifies those doctors in the Cigna
network who have achieved top results on Cigna’s quality and
cost-efficiency measures. Cigna evaluates network doctors, using
nationally recognized industry standards for quality and cost-
efficiency. To earn the Cigna Care Designation, a doctor must qualify
for both quality and cost efficiency ratings for an eligible specialty.
There are 18 common medical specialties and 3 primary care
categories represented within the CCD network.

Get help choosing a hospital, too.
Just look for the Centers of Excellence Designation. Choose an in-
network hospital that’s right for you. Cigna reviews how successful
a hospital is in treating 27 common conditions. Cigna’s ratings
are based on actual patient outcomes, average lengths of stay,
and average costs gathered from outside sources. Hospitals that
demonstrate better health outcomes at lower costs for one of the
reviewed conditions earn Cigna’s top rating – the Cigna Centers of
Excellence designation. See Cigna’s hospital ratings on myCigna.com.

Cigna Virtual Care
How Cigna Virtual Care Works:
Register for virtual care visits using MDlive on myCigna.com - Advanced registration allows services to be available when you need them.

Virtual Care By Phone:                                                    Virtual Care By Video Conference:
Step 1: Call Toll-Free                                                    Step 1: Visit the Website
Patients call a toll-free hotline available 24/7/365 including            Patients visit the MDlive website or can download the mobile
holidays. MDlive at 1-888-726-3171.                                       app and then log in with user name and password.

Step 2: Speak with a Coordinator                                          Step 2: Find a Doctor
A consultation coordinator locates the next available doctor and          The system helps the patients search for a doctor by criteria,
prepares patients for the consultation.                                   such as specialty, language, gender, location, or simply finds the
                                                                          next available doctor.
Step 3: Speak with a Doctor
Once an available doctor is located, the system automatically             Step 3: See the Doctor Online
calls and connects the doctor to the patient.                             Once an available doctor is located, the system automatically
                                                                          calls and connects the doctor to the patient.
                                                                               2021   |   EMPLOYEE BENEFITS SUMMARY                       9
MEDICAL BENEFITS

Cigna Care Management
What is Care Management Preferred? Care Management Preferred offers a comprehensive care management
solution. Our model is:
Inpatient and outpatient precertification                                One team, one goal: Outstanding customer support
Precertification helps the members know in advance whether               Our care management approach is delivered through a multi-
a procedure, treatment or service will be covered under their            disciplinary team including a nurse, social worker, medical
health care plan. It also helps make sure they get the right             director, pharmacist and behavioral professional. We connect
care in the right setting. This could save them from costly or           the dots, bring together the right people and resources to help
unnecessary care.                                                        improve the health of the members.
Dedicated care managers connect the dots                                 Specialty care management for whole health support
Our care managers work with the members, their families and              Cigna’s Specialty Care Management programs are designed to
their doctors. Our approach integrates medical, behavioral,              help members with complex health issues. These programs
pharmacy, disability, and disease management. All while                  feature care managers who are nurses with expertise and
helping customers maximize their benefits.                               training in condition management.

Omada- Diabetes Prevention Program
Omada is a digital lifestyle program that inspires healthy habits        Omada features:
though technology and support programs. The goal is to help you          •   Interactive program to guide your journey
accomplish the changes that matter most in the areas of eating,          •   Wireless smart scale to monitor your progress
activity, stress, and sleep. The program is available at no additional   •   Weekly online lessons to empower you
cost if you or your covered adult dependents are enrolled in the         •   Professional Omada health coach for added support
company medical plan offered through Cigna, are at risk for              •   Small online peer group to keep you engaged
diabetes or heart disease, and are accepted into the program.
To see if you are eligible for the program log in to-
myCigna/Wellness/health topics & resources/ Chronic Conditions: Prevention & Management/Diabetes

Healthy Rewards
Cigna’s Healthy Rewards® provides discounts of up to 60% on various wellness programs and services, ranging from Weight Management
and Nutrition, to Vision and Hearing Care, and Tobacco Cessation. To learn more about these and other Healthy Rewards® programs,
visit Cigna.com/rewards (password: savings) or call 1-800-258-3312.

         For a complete list of Healthy Rewards vendors and programs, visit Cigna.com/rewards.com or call 1-800-258-3312.

Active&Fit Direct Program
As a Cigna Customer, you have access to discounts on health
programs through Cigna Healthy Rewards program. Cigna
members and any dependents over the age of 18 are eligible to
join the Active & Fit gym membership network. Start by logging
in to myCigna.com> Wellness> Healthy Rewards-Discount
Programs> Fitness & Mind/Body> Fitness Discounts> Low-cost
Fitness Center Memberships> Learn More. Memberships are $25
per month (plus a $25 enrollment fee) which allows you access to
multiple local gyms in the Active & Fit network.
10           EMPLOYEE BENEFITS SUMMARY                 | 2021
MEDICAL BENEFITS

Prescriptions
Preventive Medications
You may not have to pay a copay, a coinsurance (the percentage
you pay after you meet your deductible) and/or a deductible
(the amount you pay before your plan starts to pay) for some
preventive medications. Please check your plan materials to
understand how preventive medications are covered for you.

Preventive medications are used for the prevention of conditions
such as high blood pressure, high cholesterol, diabetes, asthma,
osteoporosis, heart attack, stroke and prenatal nutrient deficiency.

As with all covered medications, you would need a prescription
from your doctor to process the claim under your pharmacy plan
(including over the counter medications).

Remember, you can use the Prescription Drug Price Quote Tool
on myCigna.com for real-time drug pricing specific to your plan.
You can also call the number on the back of your ID card 24 hours
a day, 365 days a year, for help.

Cigna 90Now Program
Retail drugs for a 30 day supply may be obtained In-Network at a wide range of pharmacies across the nation.
Prescriptions for a 90 day supply will be available at select network pharmacies or Cigna Home Delivery.

Cigna 90Now:                                                            30-Day Specialty Medication Supply Limit:
You may fill your medications in a 30 or 90 day supply. If you          Specialty medications are used to treat rare and chronic
choose to fill a 30 day prescription, it can be filled at any network   conditions. These medications are costly and are one of the
retail pharmacy or Cigna Home Delivery. If you choose to fill a         fastest growing components of health care costs. On average,
90 day prescription, it must be filled at a 90 day network retail       members fill specialty medications twice a year costing around
pharmacy or Cigna Home Delivery to be covered by the plan.              $6300 per script. As a member continues through therapy, the
                                                                        need often arises to change the prescription due to side effects or
You will enjoy:                                                         a new medication may come to market that can more effectively
• Easy refills – up to a 90-day supply means fewer refills              treat the condition. Many of these medications are then wasted
• Reminder service to refill or take your medication available at       because the member has to discontinue the old medication for
  Cigna.com/CoachRx                                                     the new.
• Cigna's free QuickFill service will call or email you when its        Specialty medications are limited to a 30-day supply at retail and
  time to refill your prescriptions                                     Cigna Home Delivery Pharmacy.
• Fast answers from Cigna pharmacists 24/7 at 1-800-285-4812

                                                                             2021    |   EMPLOYEE BENEFITS SUMMARY                      11
MEDICAL BENEFITS

How to Save Money with Cigna!
With healthcare costs continuing to rise, it’s more important than ever to be conscious of how much you are paying for the care you
receive. Becoming an educated healthcare consumer is a great way to help you manage your out-of-pocket healthcare expenses. You
don’t have to go it alone. Cigna is on your side. Cigna has the tools and support you need to help you find a quality in-network doctor
near you, including 24/7 live customer service, plus a host of valuable resources to help you manage and track claims, and compare
cost and quality information. Cigna tools are accessible online or on the go, through myCigna.com or with the free myCigna mobile App.

Top Seven Tips to Save Money with Cigna
1. Schedule your annual checkup.
Preventive care is key to good health and is covered at 100%. Getting your annual checkup can help keep you in shape. Covered services
include:

•    Routine physical examinations
•    Well baby and child care
•    Screening mammography
•    Screening colonoscopy or sigmoidoscopy
•    Cervical cancer screenings
•    Prostate cancer screening
•    Diabetes screenings
•    Bone and mineral density tests

The best way to treat a serious illness is by catching it early or stopping it from happening. During your checkup, your doctor can often
detect the early signs of more serious issues. Remember, in order to receive the 100% preventive care benefit, services must be received
in accordance with USPTF guidelines under Health Care Reform and your physician must code the claims as preventive.

Call Cigna 24/7/365 at 1-866-494-2111 to help find a primary care provider within your area!

2. Find the best providers.
The Cigna Care Designation (CCD) is one decision-making tool you can use to choose a doctor. Cigna checks education and board
certifications, and they also check to see if the quality of care has earned recognition from within the medical industry. Providers who meet
Cigna’s specific quality and cost-efficiency criteria will have the Cigna Care Designation symbol next to their name in the online provider
directory tools. Quality recognition ratings are assigned to providers and provider groups indicating the quality criteria met, and stars are
used to communicate cost-efficiency performance as compared with their peers of the same specialty type and geographic market. Results
in the top category for cost-efficiency assessment will be displayed with three stars.

          Sample: Online Health Care Professional Directory display (myCigna.com)

                                   Quality, cost efficiency and
                                   Cigna Care Designation displays
                                                                                        Cigna Care Designation Symbol

                                                                                            Cost Efficiency Rating

12            EMPLOYEE BENEFITS SUMMARY                              | 2021
MEDICAL BENEFITS
3. Find the most cost effective Rx.
There are three ways to spend less on medicine:

• Buy generic. When it comes to generic vs. brand name drugs, the main difference is name and appearance. Generic drugs are
  manufactured to be just as effective as brand name drugs and they are less expensive. Always check with your doctor or pharmacist
  to understand your options.
• Ask your doctor about getting a three-month supply of your prescription. 90-day prescriptions may be filled using Cigna Home
  Delivery Pharmacy or your preferred retail pharmacy. You may be able to save money when you switch from a retail pharmacy to
  Cigna’s Home Delivery Pharmacy. Call Cigna Home Delivery Pharmacy at 1-800-285-4812.
• Compare drug costs at different pharmacies. Login to myCigna.com> Select Prescriptions Tab> Select “Price a Medication”> Enter or
  Select a Drug Name> Enter Form/Dosage, Quantity, Frequency and Duration> Get cost estimates.

4. Stay In-Network.
Costs will be lower if you choose to see doctors, hospitals and facilities in Cigna’s network. If you use an out-of-network provider,
your costs can add up quickly. You’re going to pay full price and not the discounted price an in-network doctor would charge. Out-of-
Network doctors / facilities may balance bill you for the amount that Cigna does not cover. When you are scheduled for surgery, ensure
that the surgeon, anesthetist, and facility are all In-Network.

How to search for an In-Network Provider:

• The provider directory on myCigna.com shows you results based on your health plan network and your location. Log in to myCigna.
  com> Select Find Care & Costs Tab> Find care and cost estimates in your area by “Primary Care, Doctor by Type, Doctor by Name,
  Reason for Visit or Locations”> Select “Doctor by Type” and Enter a specialty or type of doctor> For example, type “Primary Care
  Provider”> Results for In-Network primary care providers near your area will be displayed.
• Know before you go. Before you visit any provider or facility, we recommend you call ahead to be sure they are in your plan’s
  network, as well as confirm their address, office hours, and that they are accepting new patients. Cigna is available 24/7/365! Call
  anytime day or night for live customer service at 1-866-494-2111.

5. Shop with Cigna for the best outpatient facilities for diagnostic tests.
Costs can vary significantly depending on where you receive care. MRIs, CTs and PET scans can cost much less at some facilities. You
can save by making a more informed choice about where you get your services. You could save money without giving up quality care.
Local facilities offer the same services at a lower cost.

• The provider directory on myCigna.com shows you cost of service within your location. Login to myCigna.com> Select Find Care
  & Costs Tab> Find care and cost estimates in your area by “Primary Care, Doctor by Type, Doctor by Name, Reason for Visit or
  Locations”> For example, Select “Reason for Visit” and Enter procedure “Shoulder MRI Scan with Dye”> Select Facilities> Results for
  facility costs near your area will be displayed.
• Connect directly with the Cigna Customer Service team. Cigna’s team can find the most cost-effective facility for a service. Cigna will
  help you compare costs for hundreds of procedures. Call anytime day or night for live customer service at 1-866-494-2111.

       Freestanding Facility vs Outpatient Hospital
 Radiology Center Cost        Outpatient Hospital Cost
 MRI: $706                    MRI: $1,676
 CT Scan: $457                CT Scan: $1,376
              Potential Savings: Over $900
National averages of participating facilities; actual costs will vary. The information provid-
ed here is intended to be general information on how you can get the most out of your plan
and your health care dollars. It is not intended as medical advice. You should consider all
relevant factors and consult with your treating doctor when selecting a provider for care.

                                                                                                 2021   |   EMPLOYEE BENEFITS SUMMARY   13
MEDICAL BENEFITS
6. The value of In-Network labs.
One of the biggest contributors to your health care costs may be laboratory expenses. You can save money if you use an In-Network lab
instead of an Out-of-Network lab. Cigna’s network includes national labs like LabCorp or Quest as well as regional and local labs. It’s easy
to find In-Network labs in your area by using the Cigna directory. These In-Network labs can provide general and specialty laboratory and
pathology testing in locations that are convenient and cost-effective. You have a choice when it’s time for lab tests, like blood work. Labs
in Cigna’s network give you quality service at a lower cost. When your doctor says you need lab tests, tell your doctor you want to stay
In-Network. Even if samples are taken in the doctor’s office, you can ask for them to be sent to an In-Network lab.

7. Access care in the right settings.
Deciding whether to see a doctor, go to urgent care, or use another option can be difficult. When you need treatment for common
ailments and injuries, you have more choices. Now you can get high-quality, affordable services for a wide variety of routine medical
conditions through different types of settings.

Cigna Health Information Line: A telephone service staffed by nurses that helps you understand and make informed decisions about
health issues you are experiencing, at no extra cost. It can help you choose the right care in the right setting at the right time, whether
it’s reviewing home treatment options, following up on a doctor’s appointment, or finding the nearest urgent care center. Just call
Cigna at 1-866-494-2111.

                 Lower                                               Cost and Time                                                           Greater

                                           Your Guide For Where To Go When You Need Medical Care
 Cigna Virtual Care                Convenience Care Clinic             Doctor’s Office                   Urgent Care Center               Emergency Room
 Treat minor medical               Treat minor medical                 The best place to go for          For conditions that              For immediate
 conditions. Connect               concerns. Staffed by                routine or preventive             aren't life threatening.         treatment of critical
 with board-certified              nurse practitioners and             care, to keep track of            Staffed by nurses and            injuries or illness. Open
 doctor via video or               physician assistants.               medications.                      doctors and usually              24/7. If a situation
 phone.                            Located in retail stores                                              have extended hours.             seems life-threatening,
                                   and pharmacies.                                                                                        call 911 or go to
                                                                                                                                          nearest ER.
 Colds and flu                     Colds and flu                       General health issues             Fever and flu                    Sudden numbness,
 Rashes                            Rashes or skin conditions           Preventative care                 symptoms                         weakness
 Sore throats                      Sore throats, earaches,             Routine checkups                  Minor cuts, sprains,             Uncontrolled bleeding
 Headaches                         and sinus pain                      Immunizations and                 burns, rashes                    Seizure or loss of
 Stomachaches                      Minor cuts or burns                 screenings                        Headaches                        consciousness
 Fever                             Pregnancy testing                                                     Lower back pain                  Shortness of breath
 Allergies                         Vaccines                                                              Joint pain                       Chest pain
 Acne                                                                                                    Minor respiratory                Head injury/ major
 UTIs and more                                                                                           symptoms                         trauma
                                                                                                         Urinary tract infections         Blurry or loss of vision
 Costs same or less than Costs same or lower                           May charge copay/                 Costs lower than                 Costs highest. No
 a visit with primary care than doctor's office. No                    coinsurance and/or                ER. No appointment               appointments needed.
 provider. Appointments appointment needed.                            deductible. Usually               needed. Wait times will          Wait times may be
 typically in an hour or                                               need appointment.                 vary.                            long.
 less.

The information provided here is intended to be general information on how you can get the most out of your plan and your health care dollars. It is not intended as
medical advice. You should consider all relevant factors and consult with your treating doctor when selecting a provider for care.

14            EMPLOYEE BENEFITS SUMMARY                        | 2021
DENTAL

Cigna Dental Plan
Good oral hygiene is part of a healthy lifestyle.

     D E N TA L S E R V I C E S 							                                                   IN-NETWORK BENEFITS

  Calendar year Deductible								                                                    $50 individual
  											                                                                         $150 family
  Out-of Network Reimbursement 							                                                Members billed for charges above the
  (In-network reimbursement is always paid at the contracted rate)				                90% UCR amount
  Preventive Services
  • Oral exams, dental cleanings, fluoride and sealants					                          100% no deductible
  Basic Services
  • Fillings, oral surgery - simple extractions, periodontics, root canal therapy,			 80% after deductible
  endodontics, brush biopsy
  Major Services
  • Oral surgery, inlays, onlays, crowns, dentures, bridges and implants				          50% after deductible
  Orthodontia
  • Adults and Dependent Children 							                                             50% to $1,500 lifetime maximum
  Implants										50% after deductible
  											                                                                         $1,500 lifetime maximum
  Maximum Annual Benefit (per individual per calendar year)					                      $1,500

                                                        It’s About More Than a Pretty Smile
                                                        Our oral health affects our ability to speak, smell, taste, chew, and swallow.
                                                        However, oral diseases, which can range from cavities to oral cancer, cause
                                                        pain and disability for millions of people each year.

                                                        Visit Your Dentist Regularly
                                                        Regular preventive visits to your dentist can help protect your health, and
                                                        we are talking about more than just your mouth. Recent studies have linked
                                                        gum disease to damage elsewhere in the body. According to the Centers
                                                        for Disease Control and Prevention, there may be associations between
                                                        oral infections and diabetes, heart disease, stroke, and preterm, low-
                                                        weight births. Research is underway to further examine these connections.

                                                        Plan members can visit a network provider two times a year for a cleaning
                                                        and the plan pays for 100% of preventive services. You can visit any dentist;
                                                        however, STAY IN-NETWORK if you want the best value.

                                                                 To find out if your dentist is in-network, visit
                                                                 www.mycigna.com or call 866-494-2111

                                                                      2021    |   EMPLOYEE BENEFITS SUMMARY                       15
VISION

  Vision Plan
  Taking care of your vision is important to your overall health.
  VSP members can take care of their vision and have routine eye exams, while saving
  money on all of their eye care needs. To start using your benefit, visit www.vsp.com or
  call 1-800-877-7195 to locate a participating provider.

  Did You Know?
  Taking care of your vision can also                    A qualified vision care professional
  mean early detection for symptoms of:                  can help treat and manage:
  •    Diabetes                                          •    Cataracts
  •    Hypertension                                      •    Corneal diseases
  •    High cholesterol                                  •    Diabetic retinopathy
  •    Tumors                                            •    Eye infections
  •    Thyroid disorders                                 •    Glaucoma
  •    Neurological disorders                            •    Macular degeneration

                                                       Your Coverage with a VSP Provider
Benefit                Description                                                                           Copay          Frequency
WellVision Exam        • Focuses on your eyes and overall wellness                                           $10            Every calendar year
Prescription Glasses                                                                                         $30            See frame and lenses
                       •   $130 allowance for a wide selection of frames
                                                                                                             Included in
                       •   $150 allowance for featured frame brands
Frame                                                                                                        Prescription   Every calendar year
                       •   20% savings on the amount over your allowance
                                                                                                             Glasses
                       •   $70 Walmart®/Costco® frame allowance
                                                                                                             Included in
                       • Single vision, lined bifocal, and lined trifocal lenses
Lenses                                                                                                       Prescription   Every calendar year
                       • Polycarbonate lenses for dependent children
                                                                                                             Glasses
                     •   Standard progressive lenses                                                          $0
                     •   Tints/Photochromic adaptive lenses                                                   $0
Lens Enhancements •      Premium progressive lenses                                                           $80 - $90       Every calendar year
                     •   Custom progressive lenses                                                            $120 - $160
                     •   Average savings of 35-40% on other lens enhancements
Contacts (instead of •   $130 allowance for contacts; copay does not apply
                                                                                                                    Up to $60 Every calendar year
glasses)             •   Contact lens exam (fitting and evaluation)
                     •   As a VSP member, you can visit your VSP doctor for medical and urgent eyecare. Your VSP
                         doctor can diagnose, treat, and monitor common eye conditions like pink eye, and more
Primary Eyecare                                                                                                     $20       As needed
                         serious conditions like sudden vision loss, glaucoma, diabetic eye disease, and cataracts.
                         Ask your VSP doctor for details.
                       Glasses and Sunglasses
                       • Extra $20 to spend on featured frame brands. Go to vsp.com/offers for details.
                       • 30% savings on additional glasses and sunglasses, including lens enhancements, from the same VSP provider on the same
                         day as your WellVision Exam. Or get 20% from any VSP provider within 12 months of your last WellVision Exam.
Extra Savings          Retinal Screening
                       • No more than a $39 copay on routine retinal screening as an enhancement to a WellVision Exam
                       Laser Vision Correction
                       • Average 15% off the regular price or 5% off the promotional price; discounts only available from contracted facilities
                       • After surgery, use your frame allowance (if eligible) for sunglasses from any VSP doctor
Your Coverage with Out-of-Network Providers: Get the most out of your benefits and greater savings with a VSP network doctor. Call Member
Services for out-of-network plan details.

  16           EMPLOYEE BENEFITS SUMMARY                     | 2021
LIFE AND AD&D

Unum Life Insurance and
Accidental Death & Dismemberment
Employees are automatically enrolled at NO COST in our base group life and AD&D insurance with Unum. Full-
time employees are covered for up to three times annual earnings up to a maximum of $550,000. The AD&D
benefits are three times your annual salary plus $50,000.

Voluntary Life Insurance
The Voluntary Life and AD&D Insurance program provides
coverage above the amount paid for by the City of Milton.
Employees can purchase $10,000 increments up to a maximum
of $500,000 (not to exceed 5x annual salary), with a guarantee
issue* amount of $100,000. In addition, you can purchase
coverage for a spouse in $5,000 increments to a maximum of
100% of the employee amount. Not to exceed $500,000 with a
guarantee issue* amount of $25,000. Children are eligible for
coverage in $2,000 increments to a maximum of $10,000.
*Guarantee Issue is the amount of coverage new hires are guaranteed
without answering any medical questions.

Why buy Voluntary Life and AD&D coverage?
Voluntary Life provides a lump sum cash benefit to surviving
dependents to cover immediate costs such as funeral expenses
or ongoing living expenses. Life insurance benefits often help
survivors adjust to the loss of income related to the death of a
wage earner, or provide funds for college or retirement for the
survivors.

    Voluntary Life       		            Employee Coverage			                     Spouse Coverage			                       Child(ren) Coverage
    Maximum:			                        Voluntary Life 			                       Voluntary Life Increments		              Voluntary Life
    					                              Increments of $10,000 up to a		          of $5,000 up to a maximum		              Increments of $2,000
    					                              maximum of $500,000. Not to 		           of 100% of employee amount.		            up to a maximum of
    					                              exceed 5x salary.			                     Not to exceed $500,000.		                $10,000
    Increments of:			                  $10,000				                              $5,000				                               $2,000
    Evidence of Insurability Required		          Electing an amount over the GI Amount or it you have previously declined coverage
    Guaranteed Issue Amount		          $100,000				                             $25,000				                              $10,000

Waiver of Premium
If it is determined that you are totally disabled, your life insurance benefit will continue without payment of premium, subject to
certain conditions.

What is Evidence of Insurability?
Unum requires EOI in order for new employees to purchase insurance above the guaranteed issue amount, or for any employee who
has previously declined coverage. If you or your dependents have medical conditions that make it difficult to purchase life insurance
on your own, you should consider applying for life insurance when you are hired. EOI involves completing a medical questionnaire
and receiving carrier approval before your insurance takes effect. Dependents are covered up to age 19 or to age 26 if they are full
time student.
                                                                                2021    |   EMPLOYEE BENEFITS SUMMARY                           17
DISABILITY AND EAP

Disability
One third of all Americans between the ages of 35 and 65 will become disabled for more than 90 days, according
to the American Council of Life Insurers. Short-Term Disability (STD) insurance provides income continuation if
you are ever unable to work due to a non-work related accident or illness. Long Term Disability (LTD) insurance
provides income continuation for both non-work and work-related accidents or illnesses. The City of Milton pays
the full cost of both STD and LTD for full-time employees through Unum.

                                                                      STD
                                                                      STD begins on the 8th day after a qualifying
                                                                      accident or illness. STD lasts for up to 16
                                                                      weeks and pays a weekly benefit equal
                                                                      to 66.67% of your weekly earnings to a
                                                                      maximum of $1,500 per week. The maximum
                                                                      period of payment is 16 weeks.

                                                                      LTD
                                                                      LTD begins on the 121st day after a qualifying
                                                                      accident or illness and pays a monthly benefit
                                                                      equal to 60% of your monthly income up to
                                                                      $7,500 per month. The maximum benefit
                                                                      period is to age 65 or the Social Security
                                                                      Normal Retirement Age.

Employee Assistance Program (EAP)
Our EAP is a company-paid benefit that provides confidential
counseling services for you and your family members at no
cost. The EAP can help you when problems in your life start to
interfere with your family, your job, and your peace of mind.
Our EAP provider, Families First / fei Behavioral Health, also
provides referrals for child and elder care, as well as legal
services and financial counseling. Your calls and counseling
services are completely confidential.

For more information contact Families First/fei Behavioral
Health at 1-800-824-4372 or on the web at www.feieap.com.
Username: milton

18         EMPLOYEE BENEFITS SUMMARY              | 2021
SPECIAL HEALTH PROGRAMS

Non-Tobacco User Discount
Our non-tobacco user discount remains in effect for this plan year. All employees and your covered dependents
MUST complete an affidavit indicating whether or not you use tobacco products. If you and or a covered
dependent use tobacco, you will pay the full medical premium contribution. If you DO NOT use tobacco, you will
receive a $25 discount per paycheck on your medical plan premiums.

Ready to End Your Tobacco Addiction?
If you don’t already live tobacco free, we encourage you to do so. If you currently use tobacco, we have included
some tobacco cessation resources in this booklet to help you quit. Employees who are tobacco free or becomes
tobacco free are rewarded with a discount off the cost of life and medical insurance.
In order to support our employees in their goals to end tobacco usage, the City will continue to offer a tobacco cessation reimbursement
program. The program reimburses employees tobacco cessation products only. The individual reimbursement limit is $260 per year.
Please contact human resources for more information about the program.

Health Benefits of Quitting

Within 20 minutes:
• Your blood pressure and pulse rate drop to normal.
Within 24 hours:
• Your risk of a sudden heart attack goes down.
Within 2 weeks to 3 months:
• Your circulation improves. Walking becomes easier. Your lungs work better. Wounds heal
  more quickly.
                                                                                                          Resource List
Within 1 to 9 months:
• You have more energy. Your coughing, nasal congestion, fatigue, and shortness of breath                 Your Physician
  improve.
Within 1 year:                                                                                            Georgia Tobacco Quitline
• Your risk of coronary heart disease is half that of someone still using tobacco.                        1-877-270-7867
Within 5 years:                                                                                           www.smokefree.gov
• Your chances of developing lung cancer drop by nearly 50% compared to people who smoke
  one pack a day. Your risk of mouth cancer is half that of a tobacco user.                               American Lung Association Atlanta
Within 10 years:                                                                                          770-434-5864
• Your risks of cancer goes down. Your risk of stroke and lung cancer are now similar to that of          www.lungusa.org
  someone who never smoked.
                                                                                                          CDC-Tobacco Information
                                                                                                          and Prevention Source (TIPS)
Finding the Right Tobacco                                                                                 www.cdc.gov/tobacco

Cessation Program                                                                                         Kill the Can
                                                                                                          www.killthecan.org
The program that works best for you may be very different from the program that works best for
someone else. Talk to your primary care physician. That person is one of your best resources for          E-Cigarettes
                                                                                                          https://e-cigarettes.
finding cessation programs designed to meet your total health needs. Your physician can discuss
                                                                                                          surgeongeneral.gov
over-the-counter and prescription medications, and provide a reference as well.

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