2022 Retiree Benefits Book - DEPARTMENT OF HUMAN RESOURCES refresh restart renew - Gwinnett County
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DEPARTMENT OF HUMAN RESOURCES 2022 Retiree Benefits Book refresh · restart · renew
Receive benefits information right on your phone! • Text the word Gwinnett to 833.437.0978 OR scan the QR code to the left. • Then reply GC Retiree
TABLE OF CONTENTS
6 2022 Benefit Changes
7 Health Plan Eligibility Information
10 2022 Benefit Changes Plans
12 Kaiser HMO
15 Aetna Traditional PPO
19 Aetna Bronze, Silver, and Gold Max Choice HSA
23 Humana Medicare Advantage
25 Dental Plan
27 Vision Plan
28 GC Retiree Website
29 My GCHub (Formerly ESS) Instructions
34 Important Information for Gwinnett County Retirees
35 Gwinnett County Human Resources Contact Information
36 Vendor Contact Information
2022 Retiree Benefit Plans | 3
Gwinnett County
Board of Commissioners
2022 Retiree Benefits Plans
Welcome to the Retiree Benefits program. Gwinnett County provides a broad range of benefits designed to support all aspects of retiree
health and wellbeing and to provide financial protection. This book provides details about the benefits options available to you and your
eligible dependents. Also find important eligibility and enrollment information. Both the retiree and the County contribute to the cost of
benefits. Premiums are included in each section.
Find additional resources on GC Retiree, including the Annual Enrollment video and presentation and the Annual Enrollment guide.
The GC Retiree website also has Summary Plan Descriptions (SPDs) and details, as defined by the Funding and Eligibility Policy for Other
Post-Employment Benefits (OPEB) Policy.
2022 Retiree Benefit Plans | 4
Benefits Plans
The Gwinnett County Board of Commissioners reserves the right to revise benefits offered at
any time and the right to charge appropriate premiums for these benefits.
The benefits and premiums listed in this book are effective as of January 1, 2022, and are not
guaranteed to remain the same in future years.
Please note: Fraudulent statements on benefits application forms or website (My GCHub, formerly known as ESS)
enrollment will invalidate any payment of claims for services and will be grounds for canceling the retiree’s benefit coverage.
2022 Retiree Benefit Plans | 5
2022 Updates
Pre-Medicare Medical Plans
• There are no changes to deductibles, coinsurance, or out-of-pocket maximums.
• Medical plan costs are trending higher, and many retiree plans have reached the County’s maximum contribution
amount as outlined in the Other Post Employment Benefits (OPEB) policy. While the County will continue to
contribute toward the cost of retiree health care, premiums will increase for 2022. Please review the many plan
options available to determine the right plan and costs for you.
Two new, free programs are coming for Aetna members in 2022:
• Aetna Back and Joint, powered by Hinge Health, is an app-based, digital physical therapy program to help manage
back, knee, shoulder, neck, and hip pain.
• Aetna Second Opinion, partnered with 2nd.MD, provides access to elite specialists for questions about new or
existing conditions, surgery or procedures, medications, and treatment plans.
New Humana Medicare Advantage Plan – Same Benefits, Lower Premiums
Humana will replace Aetna as the Medicare Advantage Plan’s insurance carrier with no changes to the benefits, lower
premiums, and minimal prescription formulary changes. If you are currently enrolled in the Aetna Medicare Advantage
Plan and make no changes during Annual Enrollment, your enrollment will automatically transfer to the new Humana
Medicare Advantage Plan. If you have questions, call 866.396.8810 to speak to a Humana representative.
Cigna
There are no changes to plan designs and premiums decreased.
VSP
There are no changes to plan designs or premiums.
2022 Retiree Benefit Plans | 6
HEALTH PLAN
ELIGIBILITY INFORMATION
Medical Levels of Coverage
• Retiree only: No dependent coverage
• Retiree + spouse: No dependent children
• Retiree + child(ren): Employee + one or more children, no spouse
• Family: Retiree, spouse, and child(ren)
Coverage for the retiree
This document describes the benefits an eligible retiree may receive through health plans (medical, dental, vision, and EAP) offered by Gwinnett County.
Employees approved for a medical disability while employed by Gwinnett County are eligible to continue health, dental, and/or vision benefits at retiree
rates for a maximum of two years. Benefits can continue past two years if the disability is total and permanent, as defined by the Social Security
Administration, and if the employee is receiving approved disability benefits provided by Gwinnett County. Refer to CA OPEB Policy for additional details
concerning continued benefit eligibility.
Coverage for the retiree’s dependents
If the retiree is covered by Gwinnett County health plans, eligible dependents of the retiree may also enroll. Only dependents who were eligible for benefits
on the participant’s retirement date can be covered by any of the Gwinnett County benefits plans.
If the retiree is covered, eligible dependents can enroll in any plan that offers dependent coverage. Eligible dependents are:
• Legal spouse
• Eligible children, who include:
• Natural children
• Stepchildren
• Legally adopted children (or children proposed for adoption)
• Foster children
• Appointed legal guardianship of a child
Retirees adding dependents during Annual Enrollment, or adding dependents as a result of a qualified life status change, will be required to prove the
eligibility of all dependents being enrolled in Gwinnett County medical, dental, and/or vision benefits. Gwinnett County’s eligibility requirements are
included in this book. If documentation for a dependent(s) is not received and validated by the date specified, the level of coverage for elected benefits
will be “retiree only” as of their0 effective date.
The Gwinnett County Department of Human Resources will verify all retiree and dependent eligibility. For a list of documentation required for each
potentially benefit-eligible dependent (spouse, child, or stepchild) please refer to the Gwinnett County Summary Plan Document located on the GC
2022 Retiree Benefit Plans | 7
Retiree website.
Important information about eligibility for Medicare: Consider this
retirees and covered dependents
If there is a non-Medicare participant and a Medicare eli-
Important Notice: Retirees are required to contact the Gwinnett
County Benefits Division 60 days prior to the date they or their
gible participant on the same coverage, the non-Medicare
covered dependent(s) become Medicare-eligible. As soon as the participant will be linked to a non-Medicare plan of choice
retiree becomes Medicare-eligible they must immediately enroll in as provided by Gwinnett County. If there is a non-Medicare
Medicare Part A and Part B to continue participation in Gwinnett eligible retiree/dependent, coverage for the dependent will
County health plans. be linked to a non-Medicare plan of your choice as provid-
The Gwinnett County health plan option for retirees and eligible ed by Gwinnett County.
dependent(s) who are Medicare-eligible is the Humana Medicare
Advantage Plan.
Retiree procedures for submission of documentation
Upon final completion of the website enrollment process, print and review a confirmation statement to ensure accuracy of the enrollment. Supporting
documentation must be received by the Department of Human Resources, Benefits Division, by the date specified. Clear photocopies of the documents
will be adequate. The documents submitted will not be returned.
Enrollment must be completed within 30 days of retirement. Documents must be received in the Department of Human Resources within 30 calendar
days of retirement or life status change for the benefits to become effective for the retiree and any eligible dependents.
Document review procedures
Documents will be reviewed by the Department of Human Resources staff. If the documentation is found to be adequate, no further action will be necessary.
If documentation is deemed inadequate, a Department of Human Resources staff member will request additional documentation or clarification from
the retiree. If the documentation does not support dependent eligibility for benefits, enrollment of the dependent will be denied. Medical, dental, and/or
vision coverage for dependents ruled ineligible will be rescinded unless an appeal of this decision
is processed and approved.
Immediately upon denial of a dependent’s eligibility, the employee
will be contacted by Human Resources.
2020 Retiree Benefit Plans | 8
Life status change At any time other than the annual enrollment period, retirees are unable to add or delete coverage for themselves or their dependents unless the retiree experiences a life status change, as defined by the IRS. For details of life status change, refer to the Gwinnett County Summary Plan Document located on the GC Retiree website. Important information: If a retiree experiences a qualified life status change that results in a request to add a dependent to any of his/her benefits plans, the request will be considered only if the dependent was eligible for benefits at the time of retirement. Only dependents who were eligible for benefits on the retiree’s retirement date can be covered by any of the Gwinnett County benefits plans at that time or in the future. (See CA OPEB policy) The Department of Human Resources must be notified – in writing, with required documentation – within 30 calendar days of a qualified life status change if the retiree wants to apply for a change in coverage as a result of the change in status. If approved, the requested change will be effective on the date of the qualifying event.
Qualified Event Required Documentation of Proof
• Marriage Certificate
Marriage • Qualified financial document (ie. tax filing, bank statement, rental agreement etc.)
• Completed Life Status Change Form
• Divorce Decree or Legal Separation Agreement
• Completed Life Status Change Form
Divorce or legal separation • Failure to notify Human Resources in writing within 30 days of a divorce or legal
separation can result in reimbursement to Gwinnett County for any employer-paid
premiums for any ineligible dependents left on the plan
• Birth Certificate
Birth and/or adoption • Completed Life Status Change Form
• Death Certificate
Death of a spouse
• Completed Life Status Change Form
• Proof of coverage lost
You, your spouse, or your eligible dependent • Marriage Certificate and financial documentation if covering spouse
has a loss of qualified coverage • Birth Certificate for eligible dependents
• Completed Life Status Change Form
• This is not an exclusive list. Please contact Human Resources if you think you may have a
Other
qualified life status change
Opting out of benefits offered by Gwinnett County
Retirees are given the opportunity to elect to continue receiving group health benefits at the time of retirement. If the option
to continue group health benefits is not elected within 30 days of retirement, and the retiree does not have comparable2022 Benefits Plans
• Kaiser Permanente Gold and Silver HMO Plans • Cigna Dental Plans
• Aetna Traditional PPO Plan • VSP Vision Plans
• Aetna Maximum Choice HSA • Employee Assistance
Gold, Silver, and Bronze Plans Program (EAP)
• Aetna Medicare Advantage Plan
2022 Retiree Benefit Plans | 11Pre-Medicare Medical Plans
You can choose between Aetna and Kaiser.
Kaiser
Choose from two Health Maintenance Organizations (HMOs). You must use an in-network provider—there
is no out-of-network coverage except in an emergency.
Aetna
Choose from three high deductible health plans. After you meet your deductible, the plan will pay a portion
of covered services. You also have a traditional PPO option. Aetna is an open network, which means you
can pick and choose your medical providers.
2022 Retiree Benefit Plans | 12Kaiser HMO
Cost to You
What’s Covered
Silver HMO Gold HMO
In-Network In-Network
$2,150 per person $1,200 per person
Annual Deductible
$4,300 per family $2,400 per family
Out-of-Pocket Maximum
Deductible, coinsurance, and copay accumulate toward the Out-of- $6,100 per person $3,700 per person
Pocket Maximum $12,200 per family $7,400 per family
Primary Care Office Visit $65 copay $35 copay
Preventive Care No cost No cost
Affordable Care Act Guidelines Varies, based on type Varies, based on type
Non-ACA Services and place of service and place of service
Specialty Care Office Visit $85 copay $55 copay
Emergency Care
Urgent Care Facility $70 copay $50 copay
Ambulance $100 copay per trip $100 copay per trip
Hospital Emergency Room 30% coinsurance after deductible 20% coinsurance after deductible
Inpatient Hospital
30% coinsurance after deductible 20% coinsurance after deductible
Including Mental Health and Chemical Dependency
Inpatient/Outpatient Surgery 30% coinsurance after deductible 20% coinsurance after deductible
Lab and Imaging
Inpatient and Outpatient No cost with office visit; No cost with office visit;
Lab, Diagnostic Clinic, or Facility 30% coinsurance outpatient 20% coinsurance outpatient
Outpatient Visit
$65 copay $30 copay
Mental Health and Chemical Dependency
2022 Retiree Benefit Plans | 13Kaiser HMO
Cost to You
What’s Covered Silver HMO Gold HMO
In-Network In-Network
Rehabilitation
Physical Therapy
Occupational Therapy
30% coinsurance after deductible 20% coinsurance after deductible
(PT and OT: combined 20 visit limit per calendar year)
Speech Therapy
(20 visit limit per calendar year)
Chiropractic Visit
$85 copay $50 copay
(30 visit limit per calendar year)
Maternity Services
Specialty Office Visit $85 copay $50 copay
Pre and Post Maternity Care 30% coinsurance after deductible 20% coinsurance after deductible
Delivery and Hospital Care
Family Planning
Specialty Office Visit $85 copay $85 copay
Diagnostic Infertility Services (to diagnose condition) 30% coinsurance after deductible 20% coinsurance after deductible
(Artificial Insemination and In-Vitro Fertilization are not covered)
Skilled Nursing Facility
30% coinsurance after deductible 20% coinsurance after deductible
(60-day limit per calendar year)
Home Health Care
30% coinsurance after deductible 20% coinsurance after deductible
(120-day limit per calendar year)
Hospice Care 0% coinsurance, no deductible 0% coinsurance, no deductible
Vision Exam
(no optical hardware benefit) $85 copay $55 copay
Hearing Aids $1,000 maximum benefit $1,000 maximum benefit
(every 3 years)
2022 Retiree Benefit Plans | 14Kaiser HMO
Cost to You
What’s Covered
Silver HMO Gold HMO
In-Network In-Network
Durable Medical Equipment 30% coinsurance after deductible 20% coinsurance after deductible
Prescription Drugs – Kaiser Network
Pharmacy Deductible None None
Retail (up to 30 days)
Generic $30 copay $10 copay
Brand $70 copay $40 copay
Mail Order (up to 90 days)
Generic $60 copay $20 copay
Brand $140 copay $80 copay
Drug must be on Kaiser formulary to be covered unless medical
exception is approved. View Kaiser formulary at www.kp.org.
Kaiser Silver Kaiser Gold
Monthly Pre-Medicare Retiree Premium
HMO Plan HMO Plan
Retiree $233.03 $409.09
Ret + Spouse $519.06 $902.14
Ret + Child(ren) $486.98 $865.52
Ret + Family $697.47 $1,111.39
Monthly Blended Retiree Premium Kaiser Silver Kaiser Gold
(Pre-Medicare and Medicare Retiree) HMO Plan HMO Plan
Retiree + Spouse (1 Medicare) $381.77 $575.94
Ret + Child(ren) (1 Medicare) $301.37 $468.23
Ret + Family (2 Medicare) $273.56 $283.29
Ret + Family (1 Medicare) $409.89 $609.72
2022 Retiree Benefit Plans | 15Aetna Traditional PPO
Traditional PPO
Aetna Network: (Aetna Choice POS II)
What’s Covered (Open Access)
In-Network Out-of-Network
$1,600 per person $3,200 per person
Annual Deductible
$3,200 per family $6,400 per family
Out-of-Pocket Maximum
$4,200 per person $8,400 per person
Deductible, coinsurance, and copay accumulate toward the Out-of-
$8,400 per family $16,800 per family
Pocket Maximum
Primary Care Office Visit $50 copay 50% coinsurance after deductible
Preventive Care
Affordable Care Act Guidelines No cost 50% coinsurance after deductible
Non-ACA Services Varies based on type/place of service
Specialty Care Office Visit $75 copay 50% coinsurance after deductible
Emergency Care
Urgent Care Facility $75 copay 50% coinsurance after deductible
Ambulance 30% coinsurance after deductible 50% coinsurance after deductible
Hospital Emergency Room 30% coinsurance after deductible 30% coinsurance after deductible
Inpatient Hospital
30% coinsurance after deductible 50% coinsurance after deductible
Including Mental Health and Chemical Dependency
Inpatient/Outpatient Surgery 30% coinsurance after deductible 50% coinsurance after deductible
Lab and Imaging
Inpatient and Outpatient 30% coinsurance after deductible 50% coinsurance after deductible
Lab, Diagnostic Clinic, or Facility
Outpatient Visit
$75 copay 50% coinsurance after deductible
Mental Health and Chemical Dependency
2022 Retiree Benefit Plans | 16Aetna Traditional PPO
Traditional PPO
Aetna Network: (Aetna Choice POS II)
What’s Covered (Open Access)
In-Network Out-of-Network
Therapy Services
(Calendar year maximums are combined between in-network and out-of-network)
$75 co-pay 50% after deductible; 60-visit
Speech Therapy, Physical Therapy,
60-visit combined maximum combined per year maximum for
Occupational Therapy
per year for speech, physical, speech, physical, occupational, and
Chiropractic Services
occupational, and chiropractic visits chiropractic visits
Behavioral Health Services
(Services must be authorized by calling 1.800.292.2879)
Inpatient (Facility fee) 30% coinsurance after deductible 50% coinsurance after deductible
Inpatient (Physician fee) 30% coinsurance after deductible 50% coinsurance after deductible
Inpatient Substance Abuse Detoxification (Facility fee) 30% coinsurance after deductible 50% coinsurance after deductible
Inpatient Substance Abuse Detoxification (Physician fee) 30% coinsurance after deductible 50% coinsurance after deductible
Other Services
(Calendar year maximums are combined between in-network and out-of-network)
Urgent Care Center $75 copayment 50% coinsurance after deductible
Skilled Nursing Facility
Annual Maximum: 30 days 30% coinsurance after deductible 50% coinsurance after deductible
(Maximum = combined in-network and out-of-network days) 60-day calendar year maximum 60-day calendar year maximum
Home Health Care
Annual Maximum: 120 days (combined in-network and out-of- 30% coinsurance after deductible 50% coinsurance after deductible
network) 60-visits per calendar year 60-visit calendar year
Hospice Care 30% coinsurance 50% coinsurance
(not subject to deductible) (not subject to deductible)
Ambulance (Covered only when medically necessary) 30% coinsurance 50% coinsurance
2022 Retiree Benefit Plans | 17Aetna Traditional PPO
Traditional PPO
Aetna Network: (Aetna Choice POS II)
What’s Covered (Open Access)
In-Network Out-of-Network
Durable Medical Equipment (DME) 30% coinsurance after deductible 50% coinsurance after deductible
Prescription drug coverage is provided by CVS/Caremark. See the CVS/
Prescription Drug Coverage
Caremark summary on page 12 for details.
Rehabilitation
Physical Therapy
Occupational Therapy
$75 copay 50% coinsurance after deductible
Speech Therapy
(PT, OT, and ST - includes Autism and Cerebral Palsy: combined 60
visit limit per calendar year)
Chiropractic Visit/Spinal Manipulation $75 copay 50% coinsurance after deductible
Maternity Services
Specialty Office Visit $75 copay 50% coinsurance after deductible
Pre and Post Maternity Care 30% coinsurance after deductible
Delivery and Hospital Care
Family Planning
Specialty Office Visit $75 copay 50% coinsurance after deductible
Diagnostic Infertility Services (to diagnose condition) 30% coinsurance after deductible
(Artificial Insemination and In-Vitro Fertilization are not covered)
Skilled Nursing Facility
30% coinsurance after deductible 50% coinsurance after deductible
(Annual Maximum: 60 days combined in or out-of-network)
Home Health Care
30% coinsurance after deductible 50% coinsurance after deductible
(Annual Maximum: 60 days combined in or out-of-network)
Hospice Care 30% coinsurance after deductible 50% coinsurance after deductible
Vision Exam
$75 copay 50% coinsurance after deductible
(no optical hardware benefit)
Hearing Aids
30% coinsurance after deductible 50% coinsurance after deductible
(one per ear, every 3 years)
2022 Retiree Benefit Plans | 18Aetna Traditional PPO
Traditional PPO
Aetna Network: (Aetna Choice POS II)
What’s Covered (Open Access)
In-Network Out-of-Network
Durable Medical Equipment 30% coinsurance after deductible 50% coinsurance after deductible
Pharmacy Deductible None
Retail (up to 30 days)
Generic $20 copay
Preferred Brand $50 copay
Non-Preferred Brand $75 copay
Mail Order (up to 90 days)
Generic $40 copay
Preferred Brand $100 copay
Non-Preferred Brand $150 copay
Drug must be on Aetna formulary to be covered unless medical exception is approved. View Aetna formulary at www.aetna.com.
Aetna
Monthly Pre-Medicare Retiree Premium
Traditional PPO Plan
Retiree $585.13
Ret + Spouse $1,403.87
Ret + Child(ren) $1,368.21
Ret + Family $1,423.08
Monthly Blended Retiree Premium Aetna
(Pre-Medicare and Medicare Retiree) Traditional PPO Plan
Retiree + Spouse (1 Medicare) $897.10
Ret + Child(ren) (1 Medicare) $593.25
Ret + Family (2 Medicare) $281.26
Ret + Family (1 Medicare) $939.62
2022 Retiree Benefit Plans | 19Aetna Maximum Choice HSA Gold, Silver, and Bronze Plans
Aetna Bronze Max Choice HSA Aetna Silver Max Choice HSA Aetna Gold Max Choice HSA
Aetna Network: Aetna Choice POS II Aetna Network: Aetna Choice POS II Aetna Network: Aetna Choice POS II
What’s Covered (Open Access) (Open Access) (Open Access)
In-Network Out-of-Network In-Network Out-of-Network In-Network Out-of-Network
$3,900/individual $7,800/individual $2,350/individual $4,700/individual $1,550/individual $3,100/individual
Annual Deductible
$7,800/family $15,600/family $4,700/family $9,400/family $3,100/family $6,200/family
Out-of-Pocket Maximum
Deductible, coinsurance $6,900/ $13,800/ $4,900/individual $9,800/individual $2,800/individual $5,600/individual
and copay accumulate individual individual $9,800/family $19,600/family $5,600/family $11,200/family
toward the Out-of-Pocket $13,800/family $27,600/family
Maximum
30%
50% coinsurance 30% coinsurance 50% coinsurance 15% coinsurance 50% coinsurance
Primary Care Office Visit coinsurance
after deductible after deductible after deductible after deductible after deductible
after deductible
Preventive Care
50% coinsurance 50% coinsurance 50% coinsurance
Affordable Care Act Guidelines No cost No cost No cost
after deductible after deductible after deductible
Non-ACA Services
30%
50% coinsurance 30% coinsurance 50% coinsurance 15% coinsurance 50% coinsurance
Specialty Care Office Visit coinsurance
after deductible after deductible after deductible after deductible after deductible
after deductible
Emergency Care
30%
50% coinsurance 30% coinsurance 50% coinsurance 15% coinsurance 50% coinsurance
Primary Care Office Visit coinsurance
after deductible after deductible after deductible after deductible after deductible
after deductible
Hospital Emergency 30%
Room 50% coinsurance 30% coinsurance 30% coinsurance 15% coinsurance 15% coinsurance
coinsurance
Urgent Care Facility after deductible after deductible after deductible after deductible after deductible
after deductible
Ambulance
Inpatient Hospital
30%
Including Mental 50% coinsurance 30% coinsurance 50% coinsurance 15% coinsurance 50% coinsurance
coinsurance
Health and Chemical after deductible after deductible after deductible after deductible after deductible
after deductible
Dependency
2022 Retiree Benefit Plans | 20Aetna Maximum Choice HSA Gold, Silver, and Bronze Plans
Aetna Bronze Max Choice HSA Aetna Silver Max Choice HSA Aetna Gold Max Choice HSA
Aetna Network: Aetna Choice POS II Aetna Network: Aetna Choice POS II Aetna Network: Aetna Choice POS II
What’s Covered (Open Access) (Open Access) (Open Access)
In-Network Out-of-Network In-Network Out-of-Network In-Network Out-of-Network
30%
Inpatient/Outpatient 50% coinsurance 30% coinsurance 50% coinsurance 15% coinsurance 50% coinsurance
coinsurance
Surgery after deductible after deductible after deductible after deductible after deductible
after deductible
Lab and Imaging
30%
Inpatient and Outpatient 50% coinsurance 30% coinsurance 50% coinsurance 15% coinsurance 50% coinsurance
coinsurance
Lab, Diagnostic Clinic, or after deductible after deductible after deductible after deductible after deductible
after deductible
Facility
Outpatient Visit 30%
50% coinsurance 30% coinsurance 50% coinsurance 15% coinsurance 50% coinsurance
Mental Health and coinsurance
after deductible after deductible after deductible after deductible after deductible
Chemical Dependency after deductible
Rehabilitation
Physical Therapy
Occupational Therapy
Speech Therapy 30%
50% coinsurance 30% coinsurance 50% coinsurance 15% coinsurance 50% coinsurance
(PT, OT, and ST – coinsurance
after deductible after deductible after deductible after deductible after deductible
includes Autism and after deductible
Cerebral Palsy: combined
60 visit limit per calendar
year)
Chiropractic Visit/Spinal 30%
50% coinsurance 30% coinsurance 50% coinsurance 15% coinsurance 50% coinsurance
Manipulation coinsurance
after deductible after deductible after deductible after deductible after deductible
(30 per calendar year) after deductible
Maternity Services
Specialty Office Visit 30% 50% coinsurance 30% coinsurance 50% coinsurance 15% coinsurance 50% coinsurance
Pre and Post Maternity coinsurance after deductible after deductible after deductible after deductible after deductible
Care after deductible
Delivery and Hospital Care
2022 Retiree Benefit Plans | 21Aetna Maximum Choice HSA Gold, Silver, and Bronze Plans
Aetna Bronze Max Choice HSA Aetna Silver Max Choice HSA Aetna Gold Max Choice HSA
Aetna Network: Aetna Choice POS II Aetna Network: Aetna Choice POS II Aetna Network: Aetna Choice POS II
What’s Covered (Open Access) (Open Access) (Open Access)
In-Network Out-of-Network In-Network Out-of-Network In-Network Out-of-Network
Family Planning
Specialty Office Visit
Diagnostic Infertility 30%
Services (to diagnose 50% coinsurance 30% coinsurance 50% coinsurance 15% coinsurance 50% coinsurance
coinsurance
condition) (Artificial after deductible after deductible after deductible after deductible after deductible
after deductible
Insemination and In-
Vitro Fertilization are not
covered)
Skilled Nursing Facility
30%
(Annual Maximum: 60 days 50% coinsurance 30% coinsurance 50% coinsurance 15% coinsurance 50% coinsurance
coinsurance
combined in or out-of- after deductible after deductible after deductible after deductible after deductible
after deductible
network)
Home Health Care
30%
(Annual Maximum: 60 days 50% coinsurance 30% coinsurance 50% coinsurance 15% coinsurance 50% coinsurance
coinsurance
combined in or out-of- after deductible after deductible after deductible after deductible after deductible
after deductible
network)
30%
50% coinsurance 30% coinsurance 50% coinsurance 15% coinsurance 50% coinsurance
Hospice Care coinsurance
after deductible after deductible after deductible after deductible after deductible
after deductible
Vision Exam 30%
50% coinsurance 30% coinsurance 50% coinsurance 15% coinsurance 50% coinsurance
(no optical hardware coinsurance
after deductible after deductible after deductible after deductible after deductible
benefit) after deductible
30%
Hearing Aids 50% coinsurance 30% coinsurance 50% coinsurance 15% coinsurance 50% coinsurance
coinsurance
(one per ear, every 3 years) after deductible after deductible after deductible after deductible after deductible
after deductible
30%
50% coinsurance 30% coinsurance 50% coinsurance 15% coinsurance 50% coinsurance
Durable Medical Equipment coinsurance
after deductible after deductible after deductible after deductible after deductible
after deductible
2022 Retiree Benefit Plans | 22Aetna Maximum Choice HSA Gold, Silver, and Bronze Plans
Aetna Bronze Max Choice HSA Aetna Silver Max Choice HSA Aetna Gold Max Choice HSA
Aetna Network: Aetna Choice POS II Aetna Network: Aetna Choice POS II Aetna Network: Aetna Choice POS II
What’s Covered (Open Access) (Open Access) (Open Access)
In-Network Out-of-Network In-Network Out-of-Network In-Network Out-of-Network
Prescription Drugs
Pharmacy Deductible None
Retail (up to 30 days)
Generic 30%
30% coinsurance 15% coinsurance
Preferred Brand coinsurance
after deductible after deductible
Non-Preferred Brand after deductible
Mail Order (up to 90 days)
Generic 30%
30% coinsurance 15% coinsurance
Preferred Brand coinsurance
after deductible after deductible
Non-Preferred Brand after deductible
Drug must be on Aetna formulary to be covered unless medical exception is approved. View Aetna formulary at www.aetna.com.
Aetna Bronze Aetna Silver Aetna Gold
Monthly Pre-Medicare Retiree Premium
HSA Plan HSA Plan HSA Plan
Retiree $166.50 $279.70 $462.52
Ret + Spouse $315.25 $559.42 $925.06
Ret + Child(ren) $301.26 $527.62 $853.12
Ret + Family $413.28 $807.32 $1236.94
Monthly Blended Retiree Premium Aetna Bronze Aetna Silver Aetna Gold
(Pre-Medicare and Medicare Retiree) HSA Plan HSA Plan HSA Plan
Retiree + Spouse (1 Medicare) $246.46 $350.14 $755.63
Ret + Child(ren) (1 Medicare) $175.22 $274.27 $623.82
Ret + Family (2 Medicare) $168.89 $276.23 $286.08
Ret + Family (1 Medicare) $278.43 $410.29 $794.44
2022 Retiree Benefit Plans | 23Humana Medicare Advantage Plan
There is one Medicare Advantage Plan available for Medicare-eligible retirees and their Medicare-eligible dependents.
Humana Medicare Advantage Plan
Cost To You
What’s Covered
In-Network Out-of-Network
$150
Annual Deductible This is the amount you have to pay out of pocket before the plan will pay its share for your covered
Medicare Part A and B services.
$3,400
Out-of-Pocket Maximum per year The maximum out-of-pocket limit applies to all covered Medicare Part A and B
benefits including deductible.
Optional
Primary Care Physician Selection
There is no requirement for member pre-certification. Your provider will do this on your behalf.
Referral Requirement None.
$15 Copay
Primary Care Office Visit Includes services of an internist, general physician, family practitioner for routine care as well as
diagnosis and treatment of an illness or injury and in-office surgery.
Specialty Care Office Visit $30 Copay
Ambulance Services $75 Copay
Emergency Room $50 Copay
Urgent Care $30 Copay
Preventive Care $0
Screenings/Immunizations $0
Inpatient Hospital $500 copay per stay
$20 copay per day, day(s) 1 – 5; $0 copay per day, day(s) 6 –100.
Skilled Nursing
Limited to 100 days per Medicare Benefit Period
2022 Retiree Benefit Plans | 24Humana Medicare Advantage Plan
Retail Prescription Drugs
Generic $10 copay
Preferred Brand $30 copay
Non-Preferred Brand $60 copay
$100 Copay
Specialty
Limited to One-Month Supply
Cost To You
What’s Covered
In-Network Out-of-Network
Mail Order Prescription Drugs (up to 90 days)
Generic $15 copay
Preferred Brand $75 copay
Non-Preferred Brand $150 copay
$100 copay
Specialty
Limited to One-Month Supply
Medicare Eligible Monthly Retiree Premium
Retiree Only $54.82
Retiree + Spouse $166.76
Important Notice: You are required to contact the Gwinnett County Benefits Division 60 days prior to the date you or your covered dependent becomes Medicare eligible due to
a disability. As soon as you become Medicare eligible, you must immediately enroll in Medicare Part A and Part B in order to continue participating in Gwinnett County health
plans.
2022 Retiree Benefit Plans | 25DENTAL AND VISION PLANS
Dental Plans
You have a choice of three Cigna dental plans. Please note, Cigna dental plans do not cover boney-impacted wisdom teeth, which are
covered under the medical plans.
Dental Plans
For a complete list of DHMO copays, see Schedule of Benefits on GCRetiree.
What’s Covered PPO Mid-Option PPO High-Option
$100 per person $50 per person
Annual Deductible(s)
$300 per family $150 per family
Annual Benefit Maximum $1,000 per person $1,500 per person
Diagnostic and Preventive
Oral Exams
Teeth Cleaning No out-of-pocket costs. No out-of-pocket costs.
X-rays Expense applied to benefit maximum. Expense applied to benefit maximum.
Maximum of two visits per calendar year
Basic Benefits PPO Dentist: 20% PPO Dentist: 20%
Fillings Non-PPO Dentist: Non-PPO Dentist:
Oral Surgery – Extractions 20% of UCR * 20% of UCR *
PPO Dentist: 50% PPO Dentist: 50%
Periodontics and Endodontics
Non-PPO Dentist: Non-PPO Dentist:
Root Canals, etc.
50% of UCR * 50% of UCR *
Major Benefits PPO Dentist: 50% PPO Dentist: 50%
Crowns and Bridges Non-PPO Dentist: Non-PPO Dentist:
Prosthetics – Dentures 50% of UCR * 50% of UCR *
2022 Retiree Benefit Plans | 26PPO Dentist: 50%
Orthodontic Benefits
Not Covered Non-PPO Dentist:
Children and Adults
50% of UCR
Orthodontic Lifetime Benefit Maximum Not Applicable $2,500 per person
What’s Covered PPO Mid-Option PPO High-Option
Implants PO Dentist: 50%
Crowns and Bridges Not Covered Non-PPO Dentist:
Prosthetics – Dentures 50% of UCR *
Implant Lifetime Benefit Maximum Not Applicable $1,500 per person
*Payable after Annual Deductible is met
*See Cigna Dental Care Patient Charge Schedule posted on the GC Retiree website.
Usual, Customary, and Reasonable allowances apply to charges from non-PPO, or out-of-network dentists. Out-of-network providers are not required
to write off charges that exceed the allowable amount. The patient is responsible for those amounts. PPO High-Option Plan: Lifetime maximums
for orthodontic treatment and implants are separate from annual benefit maximums. Benefits paid for these expenses do not apply to the patient’s
annual maximum.
Removal of boney-impacted wisdom teeth is a medical expense and is not covered by the dental plans.
Monthly Premium DHMO PPO Mid-Option PPO High-Option
Retiree $12.52 $31.97 $49.62
Ret + Spouse $25.03 $63.89 $99.25
Ret + Child(ren) $31.29 $79.86 $124.05
Ret + Family $37.54 $95.76 $148.59
2022 Retiree Benefit Plans | 27Vision Plans
VSP offers two vision plans as well as several Exclusive Member Extras.
Vision Plans
Basic Vision Plan Premium Vision Plan
What’s Covered Out-of-Network
(In-Network) (In-Network)
Any licensed Optometrist,
Contracted Optometrists and Ophthalmologists
Provider Ophthalmologist, or
Provider list is available at www.vsp.com
dispensing Optician of your choice
Pay Provider at time of Service Submit Claim for Reimbursement
Routine Eye Exam* $10 copay $15 copay $45
Frequency Once per calendar year Once per calendar year Once per calendar year
Lenses**
Single Vision $32
Bifocal $10 copay $15 copay $50
Trifocal $65
Lenticular $100
Frequency Once per calendar year Once per calendar year
Frames $10 copay up to $120 frame allow- $15 copay up to $150 frame allow-
ance, 20% discount on cost above ance, 20% discount on cost above
$70
frame allowance frame allowance
Frequency Once every other calendar year Once per calendar year
Contact Lenses $60 contact fitting copay plus any $60 contact fitting copay plus any
cost above $120 materials limit cost above $150 materials limit $105
Frequency Once per calendar year Once per calendar year
Laser Vision Correction 15% – 20% discount 15% – 20% discount NA
*Routine eye care only. Medical conditions of the eye (i.e., eye infections, foreign body in the eye, cataracts, etc.) are covered under your medical plan.
**Calendar year lens limitation includes contact lenses. ***Basic and premium plans will only cover the purchase of frames OR contacts in one calendar year.
Monthly Premium Basic Vision Plan Premium Vision Plan
Retiree $5.38 $11.34
Ret + Spouse $10.98 $23.14
Ret + Child(ren) $11.35 $23.91
Ret + Family $18.13 $38.24
2022 Retiree Benefit Plans | 282022 EAP and
Work-Life Services
Employee Assistance Program
Active employees, and any members of the employee's household, have access to the Gwinnett Employee Assistance
Program and Work-Life Services program administered by Humana at no cost. EAP offers short-term counseling up to
four visits per issue, per person, per year to help manage everyday life issues.
As an added benefit, the Gwinnett Employee Wellness Center has an onsite Humana EAP counselor who can provide
help or guidance with your particular situation. Contact Humana EAP at 1.855.330.2962 for an appointment with our
onsite EAP counselor or speak with a telephonic counselor.
EAP professionals are available to assist you with:
• Everyday needs and life events • Sleeping difficulties
• Emotional issues • Loss of a loved one
• Relationship concerns • Eating disorders
• Coping with a serious illness • Workplace concerns
• Family relationships • Smoking cessation
Work-Life Services
Work-Life offers extensive assistance, information, and support to help you achieve a better balance between work, life,
and family to help make your life easier. You can access information and self-search locators to find resources and pro-
viders that can help you with the following:
• Housing options • Caregiving from a distance
• Child care • Finding colleges and universities
• Financing college • Adjusting to retirement
• Adoption, pregnancy, and infertility • Services and education for children
• Moving and relocation • Many other life situations
Legal and Financial Assistance
As part of the EAP, you also have access to a free 30-minute consultation with a local attorney or financial professional
on issues such as real estate, retirement planning, divorce and separation, budgeting/debt reconstruction, and trusts and
estates. Further legal and tax preparation services can then be accessed at a discount.
2022 Retiree Benefit Plans | 29Gwinnett Employee Wellness Center
The Gwinnett Employee Wellness Center is an affordable, convenient option for many medical needs. The wellness
center sees:
• Active, full-time employees enrolled in a Gwinnett County Government medical plan
• Pre-Medicare retirees enrolled in a Gwinnett County Government medical plan
• Age 18 and over dependents who are Pre-Medicare and enrolled in a Gwinnett County Government medical plan
The Wellness Center features five exam rooms, a laboratory, a dispensary (a type of pharmacy that dispenses pre-pack-
aged medications), office space for medical and wellness staff, and a multipurpose room for training and wellness
activities. The following services are provided:
Preventive Care • Asthma
• Annual physicals • Sinus Infections
• Immunizations • Headaches
• Biometric Screening • Muscle and Joint Pain
• Wellness Coaching • URI, UTI
• Sprains and Strains
• Tobacco Cessation
Disease Management • Weight Management
• Diabetes • Referral to Specialists
• Cholesterol • Order and interpret lab work
• Blood Pressure • Prescription Medication
(after thorough assessment)
*This list is not all-inclusive.
To see a list of available medications in the Gwinnett Employee Wellness CEnter dispensary, see GC Retiree.
GWINNETT COUNTY
EMPLOYEE WELLNESS CENTER OPERATING HOURS
Monday, Wednesday, and Friday
7:00am to 4:00pm
closed for lunch: 11:00am to noon
Tuesday and Thursday
10:00am to 7:00pm
closed for lunch: 2:00pm to 3:00pm
2022 Retiree Benefit Plans | 30GC RETIREE WEBSITE
Human Resources’ goal is to deliver information to retirees in an effective manner and thus provide a website
designed exclusively for retirees called GC Retiree. This website contains information about issues and events
that impact retirees, details about benefit options for 2022, and a direct link to log in to My GCHub for benefits
enrollment.
To access GC Retiree, go to GwinnettCounty.com, select Login in the upper right corner, and click on the GC
Retiree logo shown below.
Be sure to save GC Retiree as a browser “favorites.” Human Resources will continue to post information for retir-
ees on this website year-round.
Receive emails from
Human Resources
Share your personal email
address with Human Resources
to get benefits information more
quickly. If you choose to stop
receiving emails from Gwinnett
County, your email address will
be removed. Please send your
email address to Benefits@
GwinnettCounty.com
2022 Retiree Benefit Plans | 31MY GCHUB
Any updates/changes made on the My GCHub To print Benefits confirmation (benefits, de- 3. Click on one of the addresses to create a
system are immediate. pendents, and cost): new entry
1. Click Benefits
Accessing My GCHub from a Gwinnett County 4. Once created, click on Save and Back or Save
network computer or from your home computer: 2. Click Benefits Confirmation Statement
5. To edit an address, click on the pencil to the
1. Go to GwinnettCounty.com; click on Login 3. Change date in Key Date to display Benefits right of the address listed
in the top right corner of the page coverage as of effective date
2. Select the GC Retiree icon 6. Once edited, click on Save and Back or Save
4. Click Print Form and an Adobe window will
To access ESS: display the Confirmation Statement
Note: Retirees must contact Voya or Transamer-
1. Click on My GCHub login 5. Click Print Icon on Adobe window to print ica Retirement directly to update their address
2. The My GCHub log on screen will appear the Confirmation Statement related to retirement benefits, 401(a) and 457(b)
plan information.
3. Enter usual login information
Links to benefits forms, summary of docu-
4. Click Log On ments, and vendor website: To display/update dependents:
1. Click General Information and New Hire On- 1. Click Benefits
boarding 2. Select Family Members/Dependents
Important information
• Disable the pop-up blocker under Tools on 2. Click Forms and Helpful Links 3. Click on one of the family members or de-
the computer’s Internet menu bar 3. Click on the vendor name and open the pendent types to create a new entry
• The Adobe Reader® software is required in vendor link 4. Once created, click on Save and Back or Save
order to display/print forms
To display/change (or manage) 5. To edit someone listed, click on the pencil
to the right of the entry
My GCHub procedures for personal information:
retired employees 1. Click Personal Information 6. Once edited, click on Save and Back or Save
2. Click Personal Data
To enroll in benefits: 3. Update personal email and other types of Services to enroll in benefits or add
1. Click Benefits information under Data Maintenance head- eligible dependents are available only
2. Click Benefits Enrollment er during Annual Enrollment or as a result
3. Click Enrollment and then the Enrollment of a Life Status Change.
Reason – Annual Enrollment (R) To display/update an address and emergency
4. Detailed instructions with screen prints contacts: Note: Refer to the Summary Plan Description lo-
are listed under the Guide tab on the next 1. Click Personal Information cated on the GC Retiree website for details on life
screen within My GCHub 2. Click Address/Emergency Contacts status changes and the required documentation.
2022 Retiree Benefit Plans | 32IMPORTANT INFORMATION
FOR ALL GWINNETT COUNTY RETIREES
Please read the following documents carefully:
• Children’s Health Insurance Program (CHIP)
• Medicare Prescription Drug Comparable Coverage Notice
• Medicare Part D Creditable Coverage Notice
2020 Retiree Benefit Plans | 33Medicaid and the Children’s Health Insurance Program
If you or your children are eligible for Medicaid or CHIP and you’re eligible for health coverage from your employer, your state may have a premium
assistance program that can help pay for coverage, using funds from their Medicaid or CHIP programs. If you or your children aren’t eligible for Medic-
aid or CHIP, you won’t be eligible for these premium assistance programs but you may be able to buy individual insurance coverage through the Health
Insurance Marketplace. For more information, visit HealthCare.gov.
If you or your dependents are already enrolled in Medicaid or CHIP and you live in a state listed below, contact your State Medicaid or CHIP office to
find out if premium assistance is available.
If you or your dependents are not currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of
these programs, contact your State Medicaid or CHIP office or dial 1.877.KIDS NOW or InsureKidsNow.gov to find out how to apply. If you qualify, ask
your state if it has a program that might help you pay the premiums for an employer-sponsored plan.
If you or your dependents are eligible for premium assistance under Medicaid or CHIP, as well as eligible under your employer plan, your employer
must allow you to enroll in your employer plan if you aren’t already enrolled. This is called a “special enrollment” opportunity, and you must request
coverage within 60 days of being determined eligible for premium assistance. If you have questions about enrolling in your employer plan, contact the
Department of Labor at AskEBSA.dol.gov or call 1.866.444.EBSA (3272).
If you live in one of the following states, you may be eligible for assistance with paying your employer health plan premiums. The following list of states
is current as of July 31, 2015. Contact your state for more information on eligibility:
Alabama Medicaid Arkansas Medicaid Georgia Medicaid
Medicaid.Alabama.gov MyARHIPP.com DCH.Georgia.gov
1.855.692.5447 1.855.MyARHIPP (855.692.7447) Click on Health Insurance Premium Payment
404.656.4507
Alaska Medicaid Colorado Medicaid
The AK Health Insurance Colorado.gov/hcpf Indiana Medicaid
Premium Payment Program 1.800.221.3943 Healthy Indiana Plan for low-income adults 19-64
MyAKHIPP.com HIP.IN.gov
1.866.251.4861 Florida Medicaid 1.877.438.4479
Email: CustomerService@MyAKHIPP.com FLMedicaidTPLRecovery.com All other Medicaid
Medicaid Eligibility: DHSS.Alaska.gov/DPA/ 1.877.357.3268 IndianaMedicaid.com
Pages/Medicaid/Default.aspx 1.800.403.0864
2022 Retiree Benefit Plans | 34Iowa Medicaid Nebraska Medicaid Oregon Medicaid
DHS.State.IA.US/HIPP DHHS.NE.gov/Children_Family_Services/Ac- OregonHealthyKids.gov
1.888.346.9562 cessNebraska/Pages/AccessNebraska_index. hijossaludablesOregon.gov
aspx 1.855.632.7633 1.800.699.9075
Kansas Medicaid
KDHEKS.gov/HCF Nevada Medicaid Pennsylvania Medicaid
1.785.296.3512 DWSS.NV.gov DHS.State.PA.US/hipp
1.800.992.0900 1.800.692.7462
Kentucky Medicaid
CHFS.KY.gov/DMS/default.htm New Hampshire Medicaid Rhode Island Medicaid
1.800.635.2570 DHHS.NH.gov/OII/Documents/HippApp.pdf EOHHS.RI.gov
1.603.271.5218 401.462.5300
Louisiana Medicaid
DHH.Louisiana.gov/index.cfm/sub- New Jersey Medicaid South Carolina Medicaid
home/1/n/331 State.NJ.US/HumanServices/DMAHS/Clients/ SCDHHS.gov
1.888.695.2447 Medicaid 1.888.549.0820
1.609.631.2392
Maine Medicaid South Dakota Medicaid
Maine.gov/DHHS/OFI/Public-Assistance New Jersey CHIP DSS.SD.gov
1.800.442.6003 NJFamilyCare.org/Index.html 1.888.828.0059
TTY: Maine relay 711 1.800.701.0710
Texas Medicaid
Massachusetts Medicaid and CHIP New York Medicaid GetHippTexas.com
Mass.gov/MassHealth NYHealth.gov/Health_Care/Medicaid 1.800.440.0493
1.800.462.1120 1.800.541.2831
Utah Medicaid and CHIP
Minnesota Medicaid North Carolina Medicaid Health.Utah.gov/Medicaid
MN.gov/DHS/ NCDHHS.Gov/DMA Health.Utah.gov/CHIP
1.800.657.3739 1.919.855.4100 1.877.543.8427
Missouri Medicaid North Dakota Medicaid Vermont Medicaid
DSS.MO.gov/MHD/Participants/Pages/ ND.gov/DHS/Services/MedicalServ/Medicaid GreenMountainCare.org
HIPP.htm 1.844.854.4825 1.800.250.8427
1.573.751.2005
Oklahoma Medicaid
Montana Medicaid InsureOklahoma.org
DPHHS.MT.gov/MontanaHealthcarePrograms/ 1.888.365.3742
HIPP
1.800.694.3084 2022 Retiree Benefit Plans | 35Virginia Medicaid and CHIP To see if any other states have added a
Medicaid: CoverVA.org/Programs_ premium assistance program since
Premium_Assistance.cfm July 31, 2015,
1.800.432.5924 or for more information on special enrollment
CHIP: CoverVA.org/Programs_Premium_ rights, contact:
Assistance.cfm
U.S. Department of Labor
1.855.242.8282
Employee Benefits Security Administration
DOL.gov/EBSA • 1.866.444.EBSA (3272)
Washington Medicaid
HCA.WA.gov/Medicaid/PremiumPymt/ or
Pages/index.aspx
1.800.562.3022 ext. 15473 U.S. Department of
Health and Human Services
West Virginia Medicaid Centers for Medicare and Medicaid Services
DHHR.WV.gov/BMS/Medicaid%20 CMS.HHS.gov • 1.877.267.2323,
Expansion/Pages/default.aspx Menu Option 4, Ext. 61565
1.877.598.5820
Wisconsin Medicaid and CHIP
DHS.Wisconsin.gov/Medicaid/
Publications/p-10095.htm
1.800.362.3002
Wyoming Medicaid
WYEqualityCare.ACS-Inc.com
307.777.7531
Call 1.877.KIDS NOW (1.877.543.7669) or visit
InsureKidsNow.gov for more information.
Note: You must request coverage within 60 days of
being determined eligible for premium assistance.Medicare Part D Creditable Coverage Notice
Important notice from Gwinnett County Board of Commissioners about your prescription drug coverage and Medicare.
This notice has information about prescription drug coverage under the Aetna Medicare Advantage Plan.
Note: Read this notice carefully. It explains the options you have under Medicare prescription drug coverage.
Beginning January I, 2006, Medicare prescription drug coverage was made available to everyone with Medicare. Health
plans administering claim services on behalf of the Gwinnett County Board of Commissioners have determined that the
prescription drug coverage offered by Aetna, the prescription drug vendor for the Aetna plans is on average, for all plan
participants, expected to cover/pay as much as standard Medicare prescription drug coverage.
Because the Gwinnett County prescription drug coverage for the Aetna medical program is, on average, as good as stan-
dard Medicare prescription drug coverage, you may keep Gwinnett County health plan coverage and not pay extra if you
later decide to enroll in Medicare prescription drug coverage.
If you decide to enroll in a Medicare prescription drug plan, you will not be eligible for Gwinnett County prescription drug
coverage through the Gwinnett County Board of Commissioners health plans.
If you drop your Gwinnett County coverage and enroll in a Medicare prescription drug plan, you may not be able to
re-enroll in Gwinnett County coverage later. Compare your current coverage, including the specific drugs covered, with
the coverage and cost of plans offering Medicare prescription drug benefits.
If you drop or lose your coverage with Gwinnett County and fail to enroll in Medicare prescription drug coverage when
your current coverage ends, you may pay more to enroll in a Medicare prescription drug coverage at a later date.
Note: You may receive this notice at other times in the future. You may also request a copy from the Gwinnett County De-
partment of Human Resources.
Please refer to the Gwinnett County Summary Plan Document located on the GC Retiree website for:
• Privacy Notice
• Genetic Information Nondiscrimination
• Mental Health Parity and Addition Equity Act
• Women’s Health and Cancer Rights Act
• Patient Protection Provider Choice Notice
• EEOC Wellness notice
2022 Retiree Benefit Plans | 37DEPARTMENT OF HUMAN RESOURCES
Benefits Division
Human Resources
Department of Human Resources 770.822.7915
770.822.7932 Office
Department of Human Resources 770.822.7775 Fax
– Benefits Division benefits@gwinnettcounty.com
Retirement and Health Plans
Raechell Dickinson Deputy Director
Karissa Askew HR Program Coordinator
Misty Kyle HR Benefits Manager
Nancy Purves Health and Wellness Coordinator
Cassie Shorter Wellness Coordinator
JoLynn Mills Resources and Marketing Coordinator
Carol Vermilya HR Benefits Manager
Kelly Ellison HR Associate III
LaTosha Smiley-Peoples HR Associate III
Connie Meyer HR Specialist
Jody Currie Administrative Support Associate III
Robert Queen HR Tech
Other Contacts
Angel Mario 770.822.7874
Voya Financial Angel.Mario@Voya.com
Wendy Moy 770.822.7782 Gwinnett Justice and
Voya Financial Wendy.Moy@Voya.com Administration Center
Yinessia Miller 770.822.7973 75 Langley Drive
Wellness Advocate Yinessia.Miller@PremiseHealth.com Lawrenceville, GA 30046
Laura Beck 855.330.2962 Monday – Friday • 8:00am – 5:00pm
EAP Consultant Humana.com/EAP
2022 Retiree Benefit Plans | 38VENDOR CONTACT INFORMATION
Customer
Group
Plan Name Company Address Service Website
Number
Number
Aetna
Aetna Aetna 737528 P.O. Box 14079 866.307.6077 Aetna.com
Lexington, KY 40512-4079
Nine Piedmont Center
404.760.3549
Kaiser Permanente Kaiser Building 10, 3rd floor
9284 or KP.org
HMO Permanente 3495 Piedmont Road NE
888.865.5813
Atlanta, GA 30305-1736
Humana
Humana Medicare
Humana 101 East Main Street 866.396.8810 Humana, com
Advantage
Louisville, KY 40202
PPO –
Cigna
Cigna HMO 3212404
Cigna P.O. Box 188037 800.244.6224 Cigna.com
& PPO Plans HMO –
Chattanooga, TN 37422-8037
10141213
WEX
Wex WEX Inc. 4321 20th Ave S 866.451.3399 WexInc.com
Fargo, ND 58103
Vision Plans Out-of-Network Claims Only
VISION Service
VSP Basic & VSP 12-320640 P.O. Box 385018 800.877.7195 VSP.com
Plan (VSP)
Premier Birmingham, AL 35238-5018
Employee Humana.com/EAP
N/A – No claims filed for EAP/Work-
Assistance Program Humana N/A Life services 855.330.2962 username = gwinnett
(EAP) password = gwinnett
Premise Health 678.377.4080
2022 Retiree Benefit Plans | 39Gwinnett County
Department of Human Resources
75 Langley Drive • Lawrenceville, GA 30046
GwinnettCounty.com
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