2022 Benefits Handbook - Pinellas County Employee Benefits Summary
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2022 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, option 1
Fax: (727) 453-3573
Email: employee.benefits@pinellascounty.org
11/16/21
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 benefits partner
for specific coverage information (see page 22).
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).
When 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 benefits partner 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
Medical Plan Opt Out................................................................................................................................................................2
When Can I Enroll in Benefits or Make Changes to My Coverage?...........................................................................3
How Do I Enroll?..........................................................................................................................................................................3
Plan Premiums, Tobacco Premium, Biometric/Health Survey Premium................................................................4
Pre-Tax Premium Option..........................................................................................................................................................4
Medical Plan Options ...............................................................................................................................................................5
Prescription Coverage..............................................................................................................................................................8
Employee Assistance Program (EAP)...................................................................................................................................9
Vision Coverage .........................................................................................................................................................................9
Pinellas County Plan Comparison Chart......................................................................................................................... 10
Dental Coverage...................................................................................................................................................................... 11
Voluntary Benefits................................................................................................................................................................... 12
Wellness Program.................................................................................................................................................................... 13
Life Insurance............................................................................................................................................................................ 14
Flexible Spending Accounts (FSA).................................................................................................................................... 15
Leave Time................................................................................................................................................................................. 17
Other Benefits........................................................................................................................................................................... 18
Glossary...................................................................................................................................................................................... 19
Onsite Resources..................................................................................................................................................................... 22
Legal Notices............................................................................................................................................................................. 22
Benefits Partner’s Contact Information........................................................................................................................... 22
Important Information
If you have questions about your benefits or eligibility, visit the Benefits web page at
www.pinellascounty.org/hr/benefits or contact Benefits at (727) 464-3367, option 1 or
by email at employee.benefits@pinellascounty.org.
If you have specific claim questions, see our benefits partners’ contact information
on page 22.
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 D omestic partners and their children are
Permanent and long-term temporary not eligible for a Health Savings Account
classified and exempt employees scheduled (HSA) or Healthcare Flexible Spending
to work 20 hours or more per week are Account (FSA).
eligible to enroll in certain coverage. Submit a completed Affidavit of Domestic
Dependents eligible for coverage varies Partnership and Certification for Dependent
by plan and may include spouse, domestic Tax Status to Benefits by the end of your
partner, and children. enrollment period each year.
You 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.
Medical and Vision 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 Medical Plan Opt Out
E mployees who are enrolled in other
If
you and your spouse/domestic partner qualified medical benefit coverage may
both work for Pinellas County, you must opt out of Pinellas County’s medical plan.
each enroll for your own coverage (i.e., not Not all plans are considered alternate
as a dependent). Dependent children may coverage for this benefit.
covered by one parent only, not both.
By selecting “Opt Out” in OPUS, which
When you enroll using OPUS, only the plans indicates that you have eligible alternate
you are eligible for will be listed. medical coverage, you may be eligible to
receive $98.00 monthly.
Proof of Eligibility To receive payments, submit a notarized
Opt Out Summary and Affidavit annually.
You need to provide documentation of Employees who opt out will still be enrolled
eligibility (such as a marriage license) for in the Employee Assistance Program (EAP),
new dependents and qualifying events. and may choose to enroll in:
• Dental coverage
Domestic Partner Coverage • Flexible Spending Accounts (FSA)
Employees who are unmarried and in a • Life insurance
committed relationship may cover their • Voluntary benefits
domestic partner and their child(ren) on Employees who opt out are not eligible for
medical, vision, dental and voluntary benefits medical, prescription, vision, or behavioral/
plans (through Aflac) only. They are not eligible mental health benefits.
for other benefits coverage.
| 2 | 2022 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.
Initial Enrollment Period: New hires and 3. Log in to OPUS at home or at work to
newly eligible employees have 30 days complete your benefits enrollment. If you
from their date of hire or the date they move are new, your department will provide your
into a benefit-eligible position to make their username and password instructions.
benefit elections in OPUS.
G o to www.pinellascounty.org and
Annual Enrollment Period: You must enroll select Services from the menu at
each fall during Annual Enrollment for the the top, and then select OPUS under
upcoming year. You will designate whether Employee Access.
you use tobacco, and have the opportunity to
Once logged in, select PIN Employee
select benefits; enroll or remove dependents;
Self Service, Benefits, and Benefits
and make selections for a flexible spending
Enrollment. Make your selections.
account (FSA), life insurance, and annual leave
Save or print a Confirmation Statement
exchange.
for your records.
Qualifying Event: If you have a qualifying
4. Payroll deductions will begin in the pay
event during the plan year, you may make
period your elections are effective or as
corresponding changes to your elections.
quickly as possible if elections are made
You have 31 days from the date of the
after the effective date. Following Annual
qualifying event to submit the Qualifying
Enrollment, your elections become effective
Event Status Change Form along with
on January 1st.
supporting documentation to Benefits. If you
are unsure if something is a qualifying event,
please contact Benefits.
Benefits Start & End
Qualifying Event Examples
Start: Your benefits are effective on the first
Birth or adoption of a child of the month following 30 days of service
Dependent becomes ineligible for eligible individuals.
Marriage or divorce End: Benefits end on the last day of the
Domestic partner relationship change pay period in which you no longer meet
Transfer between full and part-time eligibility requirements, or you fail to make
Change in other coverage the required contributions.
Death of spouse/partner or child
2022 BENEFITS HANDBOOK | 3 |
For more information, visit:
ENROLL
www.pinellascounty.org/hr/enrollment.
Medical Plan Premiums HDL cholesterol, LDL cholesterol,
triglycerides, and fasting glucose.
Biweekly Premiums Biometric information is 100% confidential
Employees and the County share the total and never shared with Pinellas County.
cost of healthcare coverage. After completing the online health survey,
Premiums in both medical plans are identical: you will receive a personalized plan to help
achieve your health and wellness goals.
Biweekly Premiums*
Employees who opt out of medical coverage
Coverage Biweekly Cost or those whose coverage begins on July 1
or later are exempt from completing the
Employee Only $ 11.43
biometric screening and health survey for the
Employee and Spouse 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 medical 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 medical coverage.
The premium will be discontinued if the Need Help Enrolling?
employee successfully completes a tobacco
cessation program between August 1, 2021, V
isit the Benefits website at
and March 31, 2022. 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, option 1.
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 plan premium which will
Center Monday to Friday, 7:00 a.m. to
save $500 in the upcoming year.
6:00 p.m. at (727) 453-HELP (4357) or
A biometric screening measures blood email btsoc@pinellascounty.org.
pressure, height, weight, total cholesterol,
| 4 | 2022 BENEFITS HANDBOOK
MEDICAL
For more information, visit:
www.pinellascounty.org/hr/health.
Medical Plan Options CONSUMER DRIVEN HEALTH PLAN
Choose between two medical plans, both (CDHP) WITH A HEALTH SAVINGS
administered by Cigna: 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) 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 medical plan. Pinellas County contributes to your Health
Savings Account (HSA) to offset a portion of
Using Cigna in-network providers may save the expenses. You may elect to make pre-tax
you money. contributions through payroll deductions to
Higher out-of-pocket costs are associated with this account.
using out-of-network providers and facilities. CDHP Preventive Care
This includes separate higher deductibles, Preventive services including your annual
coinsurance and out-of-pocket maximums. physical and lab work, are covered at 100%
Both plans provide access to Cigna’s customer (see www.pinellascounty.org/hr/preventive).
service and website at mycigna.com. Take
CDHP Deductible and Coinsurance
advantage of the many health management tools
and consumer resources available. Routine and diagnostic services, including
lab work, X-rays, MRIs and prescription drugs,
View the Plan Comparison Chart on page 10 to apply to the deductible.
compare the two plans including the deductibles, The Consumer Driven Plan has a pooled
copays and premiums. family deductible. This means that routine or
diagnostic medical, behavioral/mental health,
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, undergoing lab procedures, and
purchasing prescriptions.
2022 BENEFITS HANDBOOK | 5 |
MEDICAL
For more information, visit:
www.pinellascounty.org/hr/health.
Your deductible and coinsurance count healthcare expenses. Think of an HSA as a
toward your annual out-of-pocket maximum. savings plan for future healthcare expenses.
Once you reach the out-of-pocket maximum, You may also earn interest on the funds in
services are covered at 100% by the plan. your HSA account, depending on the balance.
This out-of-pocket maximum applies to You may enroll, change or cancel your
combined medical and pharmacy out-of- contribution at any time during the plan year
pocket expenses. using OPUS.
Health Savings Account (HSA) An HSA account is an individually owned
HSA is a pre-tax savings account that can account and belongs to the employee,
be funded by both the employee and even when their employment with the
employer up to the IRS maximum for the year. County ends.
HSA funds may be used on a tax-free
IRS Maximum Contributions basis for medical expenses at any age,
Coverage Amount but contributions may no longer be made
once an employee no longer has coverage
Employee only coverage $3,650* under the Consumer Driven Health Plan or
has signed up for Medicare Part A or Part B.
All other coverage levels $7,300*
The IRS requires that the HSA account holder
Age 55+ catch up Addtl. $1,000 retains receipts for HSA expenses. The receipts
will be required if audited by the IRS.
* Includes Pinellas County contribution of $400 or $1,200
The County contributes $400 for single CDHP Prescription Coverage
coverage, or $1,200 if you have elected to See page 8.
cover your spouse/domestic partner and/or
CDHP Behavioral/Mental Health Benefits
child(ren).
Behavioral/mental health is covered the same
The money in your HSA can be used to
as any other medical expense, subject to the
help pay your medical plan deductible
deductible and 20% coinsurance after the
and qualified expenses for medical, dental,
deductible is met.
prescription, behavioral/mental health and
vision.
In order to receive or make contributions to Health Savings Account
an HSA, you cannot have coverage through
another non high-deductible plan nor
(HSA) with HSA Bank
coverage under Medicare or Tricare.
You need an open, active HSA account with
HSA funds are used first to pay healthcare and HSA Bank to receive the Pinellas County
prescription expenses until the deductible is contribution to your HSA and to make
met. At that time, FSA funds may be used for your own pre-tax payroll contributions. An
qualified healthcare expenses. account will be automatically opened for
Your funds roll over from year to year, so you first-time enrollees.
can pay for expenses now, or save for future
| 6 | 2022 BENEFITS HANDBOOK
MEDICAL
For more information, visit:
www.pinellascounty.org/hr/health.
POINT OF SERVICE (POS) PLAN POS 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 (MDLIVE for Cigna only) $15
POS Copays, Deductible, Coinsurance
Convenience Care/Urgent Care $25
For routine or diagnostic office visits, a copay
is required. Emergency Room $250
Routine or diagnostic services, including
POS Prescription Coverage
lab work, X-rays and MRIs, are applied
to the deductible and coinsurance at a See page 8.
discounted rate. POS Behavioral/Mental Health Benefits
The individual deductible for the POS plan is Behavioral/mental health is covered the same
$600 and the family deductible is $1,200. as any other medical expense. For outpatient
• For individuals who have more than two visits, there is a $25 copay, and inpatient care
people enrolled in coverage, there is a is handled as a hospitalization, subject to the
maximum family deductible equivalent to deductible and 20% coinsurance.
two individual deductibles.
• 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 medical and pharmacy out-of-
pocket expenses.
2022 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 plan premium within a specified minimum and maximum
deduction. The cost for your prescription range as shown:
medications depends on the 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 Program for a
charged until your out-of-pocket maximum
is met. Your pharmacy costs are applied to 90-Day Supply
your deductible.
The Smart 90 Program applies to both
CDHP Prescriptions medical 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 | 2022 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 Cigna. Services include must be enrolled in a Pinellas County medical
assessment, counseling, and referrals. plan to receive this benefit. To locate a provider,
EAP benefits are available at no cost for all visit eyemed.com and select Insight Network. The
employees and their eligible dependents. network includes LensCrafters, Target Optical,
and most Pearl Vision locations. It does not
The EAP offers confidential short-term include Visionworks. Coverage includes:
assistance for you and your eligible family
members to help you manage a variety of In-Network Basic Exam:
life issues. • $10 basic vision exam copay
Support is available for personal and • One exam per calendar year
work-life issues, such as stress, relationship Eyeglass Lenses:
conflicts, job pressures, grief, substance use
disorder, problems with children, legal or • $20 copay per calendar year for clear
wellness matters, traumatic events, etc. plastic lenses (single, bifocal, trifocal or
lenticular prescription)
Counselors offer support by phone,
in-person, and online. Eyeglass Frames:
You are eligible for up to six EAP visits • $130 allowance and other options
per issue per year at no cost for initial • 20% discount after the $130 allowance
assessment counseling and early Contact Lenses in Lieu of Eyeglasses:
intervention treatment. • Free fitting and follow-up care
If you need more than 6 EAP visits, your EAP • $100 allowance and 15% off the balance
counselor will work with Cigna to transition for conventional lenses (100% of balance
your care to the Behavioral/Mental Health for disposable lenses)
Program.
LASIK or PRK Laser Vision Correction:
No ID card is provided. • 15% off retail or 5% off a promotional
To find a provider in the Cigna network, visit price, in addition to a one-time allowance
mycigna.com. of up to $1,125 (or $562.50 per eye)
Out-of-Network benefits are also available.
See the EyeMed FAQs and Benefits Summary.
2022 BENEFITS HANDBOOK | 9 |Pinellas County Plan Comparison Chart
2022 Pinellas County Medical Plans Comparison & Cost
Medical Plans Comparison Key Virtual Doctor Visit Cost
CDHP = Consumer Driven Health Plan Consumer
with HSA Driven
CDHP Health
- $49 then 20% after Point of Service
deductible
Item
POS = Point of Service Plan Plan with HSA (CDHP)
POS - $15 copay Plan (POS)
Biweekly Premiums (same for CDHP and POS) Convenience Care Clinic/Urgent Care
Employee Employee Employee Employee Only
Employee only - $11.43 Only
CDHP
+1
- +$49 then 20%
2 or More
after deductible+Employee
1 or More
Employee and Spouse/Domestic Partner - $131.90 POS - $25 copay
Employee and Child(ren) - $105.23
Annual Deductible $1,400
Emergency
$2,800
Room $600 $1,200
Family - $216.12 CDHP - 20%
(pooled deductible after
for deductible (two individual
Annual Deductible allPOS - $250
family copay
members deductibles of
Employee only Non-Preventive
on the plan) Medical (labs and imaging)
$600 each)
CDHP -$1,400 CDHP - 20% after deductible
POS - $600
County HSA Contribution $400 POS - 20%
$1,200 after deductible
$1,200 N/A N/A
(must
Employeehave +Optum Bank account)
1 or more Preventive Rx
CDHP - $2,800 (pooled deductible for all family CDHP - $0 (view a list of preventive medications)
Out-of-Pocket
membersMaximum (includes
on the plan) $3,000 $4,000
POS - $15$6,000
copay for generic$2,600 $5,200
or coinsurance for
medical and Rx; after you spend this
POS - $1,200 (two individual deductibles of $600 preferred or non-preferred (see below)
amount,each)the health plan pays 100%) Rx Generic (up to 30 days)
County HSA Contribution CDHP - 20% after deductible
(must have Optum Bank account) Consumer POS Driven- $15Health
copay Point of Service
In-Network Benefit*
Employee only Plan with HSA (CDHP)
Rx Preferred Brand (up to Plan
30 days)(POS)
CDHP - $400 CDHP - 20% after deductible
Preventive Medical
POS - not applicable $0 - 20% coinsurance, minimum$0$30 (or $60
POS
Employee
Primary +1Physician
Care or more for specialty medications),$25
20% after deductible maximum
copay $60 (or
CDHP - $1,200 $120 for specialty medications)
Behavioral Health
POS - not applicable 20% after Rxdeductible
Non-Preferred Brand (up to $2530copay
days)
Out-of-Pocket
Specialist Maximum CDHP -
20% after deductible 20% after deductible $35 copay
(includes medical and RX; after you spend this POS - 40% coinsurance, minimum $45 (or $90
Virtual Doctor the
amount, Visithealth plan pays 100%) $49 then 20% after fordeductible
specialty medications),$15 copay $90 (or
maximum
Employee only
Convenience Care Clinics/Urgent Care $180 for
$49 then 20% after deductible specialty medications)
$25 copay
CDHP - $3,000 Rx (up to 90 days)
Emergency
POS - $2,600 Room 20% after deductible
(use Smart90 Program at Walgreens $250 copay
or home
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 (see preventive medications
medication, list)or 2 times
coinsurance
the costforof
preferred
30-day or
CDHP - $6,000 supply for non-specialty non-preferred (see below)
medication
POS
Rx - $5,200
Generic (up to 30 days) 20% after deductible $15 copay
IN-NETWORK BENEFITS
Rx Preferred Brandbenefits
(Out-of-network (up to 30are
days),
also available. 20% after deductible 20% coinsurance
italicsDeductibles,
indicates specialty 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 Medical
indicates Cost
specialty medications min: $45 ($90), max: $90 ($180)
CDHP - $0
Rx
POS (up to 90 days), use Smart90
- $0 20% after deductible Cost of 30-day supply (specialty),
Program at Walgreens or home delivery 2x cost of 30-day (non-specialty)
Primary Care Physician Cost
*CDHP
Out-of-network
- 20% afterbenefits are also available. Deductibles, coinsurance and out-of-pocket maximums are higher.
deductible
POS - $25 copay
Biweekly Premiums (Same for Consumer Driven and POS Plans)
Behavioral Health Cost
Employee
CDHP - 20%only
after deductible $ 11.43
Employee
POS and Spouse/Domestic Partner
- $25 copay $131.90
Specialist Cost
Employee and Child(ren) $105.23
CDHP - 20% after deductible
Family $216.12
POS - $35 copay
View accessible version. 10/19/21
| 10 | 2022 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 mycigna.com for
selecting a plan or scheduling an appointment. 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 to Orthodontics are not included.
reduce your costs. Coverage provides 2 cleanings and up
There are no deductibles or pre-existing to 4 exams per year as described in the
condition limitations. established fee schedule.
Coverage provides 3 cleanings and 2 exams
per year.
PPO Biweekly Premiums HMO Biweekly Premiums
Coverage Biweekly Cost Coverage Biweekly Cost
Employee Only $ 5.54 Employee Only $ 0
Employee + 1 $16.82 Employee + 1 $0
Employee + 2 or more $22.77 Employee + 2 or more $0
2022 BENEFITS HANDBOOK | 11 |VOLUNTARY
For more information, visit:
www.pinellascounty.org/hr/voluntary
NEW
Voluntary Benefits Benefits include stays in the hospital and
You have a choice of three voluntary benefit intensive care unit related to physical,
plans from Aflac: Accident, Hospital and Critical mental/nervous or substance use issues.
Illness. If you experience a covered issue under Example: John selects the Hospital Plan
one or more of these plans, you file a claim and with employee only, high payout coverage
receive a lump sum payout, to use however you for $7.06/per paycheck. He goes to the
wish. The benefits are 100% employee-paid. emergency room with a high fever and is
admitted to the hospital. He’s released from
There is a low and high plan option for each the hospital after 2 days. The Aflac plan pays
benefit as well as individual and family coverage John $1,400 for the hospital admission and
tiers. Children age out the last day of the month 2-day stay.
after their 26th birthday. Example: Child turns
26 on October 20; they would be terminated on Critical Illness Plan
October 31. The benefits are payable for covered
conditions such as heart attack, stroke,
Accident Plan cancer, coronary bypass and kidney failure.
The benefits are payable in case of an COVID-19 is covered if the individual is
accident which occurs on or off the job. hospitalized for 4 or more days.
The plan includes treatment for both This is a lump sum benefit paid directly to
inpatient and outpatient services along with the insured for a covered illness. It is paid
a hospital benefit if the admittance is due to based on a schedule of conditions and
an injury or accident. percent of benefit paid.
The plan covers a wide range of events from This benefit can be used to cover out-of-
broken teeth or bones, burns, concussions, pocket or unexpected expenses such as
lacerations, eye injuries and more. copays, lost wages, transportation, childcare
Example: Sue selects the Accident Plan with or even groceries.
employee only, high payout coverage for You can select a $10,000 or $20,000 benefit.
$3.36/per paycheck. She injures her leg in an The employee or spouse/domestic partner
accident, goes to the hospital by ambulance, would receive the full amount while a child
and is treated by the ER doctor for a leg receives 50% (i.e., $5,000 or $10,000).
fracture. The Aflac plan pays Sue $3,310 Example: Martin selects the Critical Illness
which includes ambulance, emergency Plan. He is a 35 year old non-smoker so his
room, x-ray, fracture diagnosis, crutches and rate is $2.76/per paycheck for employee
3 follow-up doctor visits. only $10,000 benefit coverage. He goes to
the emergency room with chest pains and is
Hospital Plan
diagnosed with a heart attack. The Aflac plan
The benefits are payable for hospitalizations pays Martin $10,000.
due to accident, sickness or maternity
coverage. For more information, payout amounts and
rates, visit www.pinellascounty.org/hr/voluntary.
2022 BENEFITS HANDBOOK | 12 |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 location
keeps medical costs down for employees and by 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 Cigna provides on-site help with resources
or cash. See www.pinellascounty.org/hr/ including a customer service claims
incentive. representative and a registered nurse (RN)
Incentive activities include preventive health coach (see page 22).
screenings, healthy eating and physical The To Your Health newsletter provides
activity tracking, wellness education classes, informative articles, exercise tips, recipes,
and coaching. employee testimonials, and more. Look for it
MotivateMe is a Cigna online platform each month in your email.
to complete the health survey and track
wellness incentives. To access MotivateMe,
login to mycigna.com. Four Pillars of Wellness
Fitness Centers and Gyms
Our wellness programs provide
The Wellness Center in downtown Clearwater support across four pillars of wellness
is available to all employees at no charge. which represent different areas of
There are also two satellite mini-fitness life: physical, emotional, social
centers. and financial.
Employees benefit from other fitness facility All four pillars are needed for total
discounts. The County partners with local well-being, reduced stress, life
municipal recreation centers and Tampa Bay satisfaction and good physical health.
area gyms through YouDecide. Imbalance in one or two areas, even
if strong in the other areas, increases
stress and risk of disease and reduces
quality of life.
2022 BENEFITS HANDBOOK | 13 |For 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 $2,850 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 Medical 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 medical (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 Driven
batteries
Plan may elect a Limited Purpose Healthcare
FSA account in addition to their Health Menstrual care products
Savings Account (HSA). The Limited Purpose * This list is not all-inclusive.
FSA funds may only be used for dental
and vision expenses until the medical plan View Healthcare Eligible Expenses for more
annual deductible is met (see page 16). information.
| 15 | 2022 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 (HSA). adult relatives who reside with you, including
adult children, who are physically or mentally
The Limited Purpose FSA may only be used
incapable of self-care.
for eligible dental and vision expenses
until you meet your medical plan’s annual Funds are not available at the beginning
deductible. of the year. Funds are deducted from your
biweekly paycheck and available for use
You must submit documentation to TASC to
only after the deduction has been made and
show that you have met your medical 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 2021 will carry over to 2022, with
no restrictions, as long as you enroll in an
FSA for 2022.
The carryover of unused FSA funds from FSA Savings
2022 to 2023 is limited to $570, per the IRS.
TASC offers an FSA Savings Calculator
Dependent Care FSA to estimate your potential savings.
This is a pre-tax benefit account used to pay I f your eligible expenses add up to at
for dependent care services that make it least $260 per year, you could save
possible for the employee to work. up to 30% by participating in an FSA
Examples are preschool, summer day camp, through tax-free contributions.
before and after school programs as well as
child and adult daycare. See Dependent Care
Eligible Expenses.
2022 BENEFITS HANDBOOK | 16 |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 rolling
Annual leave is earned throughout the year 12 month look-back period.
and may be used as accrued. Funeral Leave
Employees earn and accrue annual leave Employees receive up to 3 days with pay in
at increasing rates based on tenure. For the event of the death of any person residing
example, annual leave is accrued at a rate of in the employee’s household or any member
at least 120 hours per year for new full- time of the employee’s immediate family.
employees, while an employee in their fifth
Holidays / Floating Holidays
year of service accrues at least 160 hours of
annual leave per year. Employees receive 9 to 11 paid holidays per
year, depending on how the holidays fall on
Annual leave may be rolled over from one
the calendar.
year to the next. There is no limitation on the
maximum number of hours accrued. Employees receive up to 2 paid floating
holidays per year. Those with 25 years of
Compensatory Time continuous service are granted 2 additional
Compensatory (comp) time may be granted floating holidays.
if a classified employee works more than Unused floating holidays do not carry over to
their regularly scheduled hours. the next year.
Comp time is accumulated at a rate of 1.5.
Jury Duty & Witness Duty
For example, a classified employee who
works 42 hours in one week will accumulate A leave of absence with pay shall be granted
3 hours of compensatory time. to an employee to perform jury duty or testi-
fy as a witness when legally required unless
Donation of Leave (A Friend in Need) the employee is the plaintiff or defendant.
This voluntary program allows employees to
Personal Day
donate leave time to assist a fellow employee
on an approved leave of absence. Employees receive up to 2 personal days per
year to use without prior approval.
� The recipient needs to exhaust all available
leave and be ineligible for disability benefits Unused personal days do not carry over to
before a donation of leave time may be used. the next year.
| 17 | 2022 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 medical, 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 (default) - The retirement Learning and Development
benefit is the value in the employee’s Employees have access to over 100 in-house
account. There is no fixed benefit level. Your courses and may also apply for tuition
future retirement benefit depends on the reimbursement for courses taken on their
performance of your investment options. An own time.
employee is vested in the FRS Investment
Visit www.pinellascounty.org/hr/learning.
Plan upon completion of one year of
creditable service. Credit Union
Discounts The Pinellas County Credit Union is available
to employees and family members.
The YouDecide Program offers discounts on
items such as theme park tickets, hotels, and
cell phones.
2022 BENEFITS HANDBOOK | 18 |GLOSSARY
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 medical plans. Access links before any benefits are paid for any covered
to the medical plan descriptions and summaries family member.
at 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 use disorder, 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 medical, 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 medical 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.
| 19 | 2022 BENEFITS HANDBOOKGLOSSARY
Out-Of-Pocket Maximum (OOP) - This is plan, copays and co-insurance amounts are
the maximum you will pay out of your own included with other claims to meet your
pocket for healthcare services. Once you out-of-pocket maximum.
reach the OOP maximum, the plan covers Formulary (or Preferred) Drugs - A list of
your eligible healthcare services at 100%. brand name prescription drugs selected
Point of Service (POS) - Under this plan, you by Express Scripts that offer the greatest
have the choice to visit any licensed provider. overall value. The list is subject to change
If you visit a doctor or facility within the periodically. A current list is found at
plan’s network of providers (in-network), you www.express-scripts.com.
receive greater coverage. If you visit a doctor Generic Drugs - Medications marketed
or facility outside of the plan’s network (out- under their active ingredient name instead
of-network), your coverage is reduced, which of a patented brand name. When the
means you pay more out of your pocket. brand’s patent expires, the law allows other
Voluntary Benefits - Also known as manufacturers to produce the product –
supplemental insurance or employee-paid often at lower cost than the original brand.
benefits, these are products, benefits, or Members pay the lowest cost for generic
services offered by employers at a group drugs.
rate, but are fully paid by employees. They Legend Drug - A drug or medicine which,
include medical supplement plans like under federal law, is required to bear
Accident or Hospital Indemnity. Employees the label, “Caution: federal law prohibits
file a claim for a covered issue and receive dispensing without prescription” or “Rx only.”
payment directly to use however they wish. 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.
2022 BENEFITS HANDBOOK | 20 |GLOSSARY Participating Retail Pharmacies - Local drugs, have quantity restrictions based on pharmacies contracted to dispense manufacturer and/or clinically approved prescriptions at a negotiated discounted guidelines and are subject to periodic review rate. A current list of pharmacies is found at and change. www.express-scripts.com. The Plan covers Smart90 Program - Prescription savings up to a one-month supply for short-term plan that offers the choice of Express Scripts medications (such as antibiotics) and initial home delivery or a Walgreens retail store for prescriptions for maintenance medications a 90-day supply of long-term maintenance plus two refills at participating pharmacies. medications. Preventive Medications - These medications Specialty Drugs - Certain medications that are used to treat many long term, chronic are prescribed to treat complex conditions, conditions such as diabetes, high blood such as certain inflammatory conditions, pressure and high cholesterol. Drugs on the multiple sclerosis and cancer. These high cost Express Scripts Preventive Medications List medications require pre-authorization and are available at no cost to Consumer Driven are dispensed by Accredo, Express Script’s Health Plan members. specialty pharmacy. Members pay the Prior Authorization - Some medications highest out-of-pocket cost for specialty require a review or pre-authorization to drugs. determine if they are eligible for coverage. Step Therapy - Some medications require Your doctor and pharmacist usually know you to first try a different medication before which medications require a review, and another (usually more expensive) drug that you can also access the information at your doctor prescribed. The program is www.express-scripts.com. intended to control costs while treating your Quantity Management - Certain covered condition effectively. medications, such as pain management | 21 | 2022 BENEFITS HANDBOOK
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