BLOUNT COUNTY GOVERNMENT EMPLOYEE - 2021 GUIDE

Page created by Bruce Brewer
 
CONTINUE READING
BLOUNT COUNTY GOVERNMENT EMPLOYEE - 2021 GUIDE
2021
BLOUNT COUNTY
GOVERNMENT
EMPLOYEE

GUIDE

                2021 Employee Benefits Guide I 1
BLOUNT COUNTY GOVERNMENT EMPLOYEE - 2021 GUIDE
Welcome to the 2021 Employee Benefits Guide
       Blount County Government recognizes the importance of benefits within the overall
       compensation package provided to all of our eligible employees. This year when we
       reviewed our employee benefits options, we focused not only on providing quality medical
plans but also on controlling the cost and financial risk for our employees. Please review the following
pages for a summary of our benefit offerings.

                     TABLE OF CONTENTS
                       Welcome & Table of Contents ............................................... 2

                       Contact Information ................................................................. 3

                       2021 At A Glance and Key Terms ........................................... 4

                       Care Coordinators .................................................................... 5

                       2nd MD ........................................................................................ 7

                       Understanding Your Medical Plan Options .......................... 8

                       Prescription Benefits ................................................................ 12

                       Care Options and When to Use Them ................................ 14

                       Convenient Care Plus ............................................................. 15

                       Flexible Spending Accounts (FSAs) ...................................... 17

                       Understanding Health Savings Account (HSAs) ................ 18

                       Dental Insurance ..................................................................... 20

                       Voluntary Vision Insurance..................................................... 21

                       Life Insurance and AD&D ...................................................... 22

                       Voluntary Coverages.............................................................. 23

                       Retirement ................................................................................ 27

                       Additional Services .................................................................. 29

                       Glossary of Terms and Video Links ....................................... 31

                       Important Notices .................................................................... 32

            Throughout this booklet you will find video icons that will take you to resources that provide
            additional information on the benefits available to you.

Blount County Government I 2
BLOUNT COUNTY GOVERNMENT EMPLOYEE - 2021 GUIDE
CONTACT INFORMATION
If you have any questions regarding your benefits, please contact your Care
Coordinators at Quantum Health, your Human Resources Department, or the CBIZ
Service Center.

 Your Human Resources Department                CBIZ Service Center
    865.273.5780                                   865.251.5140
    www.blounttn.org                               9648 Kingston Pike, Ste 8
                                                   Knoxville, TN 37922
 Care Coordinators
    Quantum Health                              Telemedicine
    www.blountcountybenefits.com                    Convenient Care Plus
    1.866.952.0340                                  www.convenientcareplus.com
                                                    1.877.900.8701
 Medical
   Allegiance                                   BARInet
   www.askallegiance.com/blount                    www.barinet.com
   1.855.999.1051                                  1.800.720.5831
   Group Number: 2003090
   Hours: Monday -- Friday 6 am -- 6 pm MST     LTC Solutions—Long-Term Care
                                                    Email: LTCiBenefitsTeam@ltc-solutions.com
 2nd Opinion Medical Consultation                   1.877.286.2852
    2nd.MD
    www.2nd.MD/blountcounty                     Flexible Spending Account (FSA)
    1.866.841.2575                                  Allegiance
                                                    www.askallegiance.com/blount
 Prescription                                       1.855.999.1051
     Magellan
     www.magellanrx.com                         Health Savings Account
     1.888.202.1654                                Health Equity
     Group Number: 2003090                         www.healthequity.com
                                                   1.866.346.5800
    Pay’d Health
    www.paydhealth.com                          Retirement Plan - 401(k) and 457(b)
    1.877.869.7772                                  www.retirereadytn.gov
                                                    1.800-922-7772
    Blount Discount Pharmacy                        8:00 am—7:00 pm CST
    865.681.0520
                                                Retirement Plan - Defined Benefit Plan
 Dental                                             Tennessee Consolidated Retirement System
    Delta Dental of Tennessee                       www.treasury.tn.gov/tcrs/
    www.deltadentaltn.com                           1.800.922.7772
    1.800.223.3104
    Group Number: 4207                          Employee Assistance Program
                                                   SupportLinc
 Vision                                            www.supportlinc.com
     Superior Vision                               Username: blountcounty
     www.superiorvision.com                        1.888.881.LINC (5462)
     1.800.507.3800
     Group Number: 29382                        Employee Clinic
                                                   Blount Memorial Physicians Group-Care Today Clinic
 Life, AD&D, and Supplemental Plans                266 Joule St. Alcoa, TN 37701
      USAble Life                                  865.983.0093
      https://group.usablelife.com/tn/blount-      Operating Hours:
      county-government/                           Monday - Friday: 7AM - 9PM
      1.800.370.5856                               Saturday, Sunday & Holidays: 8am - 6pm
      Group Number: 50032939                       Closed Thanksgiving and Christmas Day

                                                                         2021 Employee Benefits Guide I 3
BLOUNT COUNTY GOVERNMENT EMPLOYEE - 2021 GUIDE
2021 AT A GLANCE
                    The plan year runs                                                This year we will continue to offer three
                                                                                       medical plans through Allegiance to
January 1, 2021 - December 31, 2021                                                    better provide for the needs of each of
                                                                                       our employees and their families.

                                                                                      There will be NO CHANGE to current plan
                                                                                       benefits

                               KEY TERMS                                              Magellan RX will be the new vendor for
                                                                                       our prescription coverage.
Full-Time Employee: Defined as an employee working 30 or
more hours per week. Full benefits include all benefits in
accordance with Blount County Government policy.                                   HOW TO MAKE CHANGES
                                                                                   ● You are only allowed to make mid-year
Part-Time Employee: Defined as an employee working 20 to 29                          changes if one of the following Qualified
hours per week. Partial benefits are provided in accordance                          Events occur: marriage, divorce, legal
                                                                                     separation, birth or adoption of a child,
with Blount County Government policy.                                                change in child’s dependent status,
                                                                                     death of spouse, child or other qualified
                                                                                     dependent, change in residence due to
                                                                                     an employment transfer for you or your
                                                                                     spouse, commencement or termination
  Eligible Employees may enroll themselves in benefits as well as their eligible     of adoption proceedings, or change in
                                                                                     spouse’s benefits or employment status.
   dependents. Employees may select any of the tiers below when adding
                                                                                     Your election changes must be submitted
      dependent coverage. See key terms below for coverage selection:
                                                                                     to HR within 30 days of the qualifying
 Employee only: Employees may select this tier if they wish only to enroll           event.
 themselves on the plan.

 Employee + Spouse: Employees may select this tier if they wish to enroll          WAIVING COVERAGE
 themselves and their legal spouse on the plan.                                    ● If you are declining enrollment for yourself
                                                                                     or your dependents (including your
 Employee + Child(ren): Employees may select this tier if they wish to enroll        spouse) because of other insurance
 themselves and one or more children on the plan.                                    coverage, you may in the future be able
                                                                                     to enroll yourself or your dependents in
 Family: Employees may select this tier if they wish to enroll themselves, their
                                                                                     this plan, providing that you request
 legal spouse, and one or more children on the plan.                                 enrollment within 30 days after your other
                                                                                     creditable group or government
                                                                                     sponsored coverage ends.

                                                                                   COBRA
New employees who are benefits eligible must enroll within 30 days of              ● COBRA continuation is offered to
                                                                                     covered employees, their spouses, their
their date of hire. New employee benefits are effective the first of the             former spouses, and their dependent
month following 31 days of employment.                                               children when group health coverage
                                                                                     would otherwise be lost due to certain
Children up to age 26 may be covered on your insurance plan,                         specific events. COBRA continuation
regardless of dependent status. At the end of the month that the                     applies to Medical, Pharmacy, Dental,
dependent turns 26, they will automatically be dropped from the                      Vision, and FSA. Qualified individuals may
                                                                                     be required to pay for the entire premium
insurance plan and offered COBRA coverage. A COBRA notice will be
                                                                                     for coverage up to 102 percent of the
mailed from the Medical carrier.                                                     cost of the plans selected and may
                                                                                     continue for up to 18 months or 36
Retiree Coverage: You may be able to continue your coverage upon
                                                                                     months (if applicable).
retirement (medical, dental, vision, and a basic life benefit of $10,000).
Please contact Human Resources for more information or guidelines.

Blount County Government I 4
BLOUNT COUNTY GOVERNMENT EMPLOYEE - 2021 GUIDE
HEALTH CARE COORDINATORS

    Historically, you contacted your insurance company and physicians’ offices directly for questions
    related to your healthcare benefits and services - that is changing!

    As of January 1, 2021, your MyQHealth Care Coordinators are now your primary contact.

              DEDICATED SUPPORT

Healthcare can be a difficult and costly journey that no one should have to navigate alone. We're with you
every step of the way. Think of MyQHealth as your personal healthcare guide. They are nurses, clinicians and
benefit specialists who take the time to get to know you and your family's unique health and wellness needs and
then they work with your providers to ensure you get the best possible care. They fight for your care so you don’t
have to.

             PERSONALIZED GUIDANCE

From medical claims to check-ups to treatment plans, your Care Coordinators are here to help. MyQHealth’s
mission is to provide you with a simpler, more affordable healthcare experience for all of your medical, dental,
vision and prescription needs.

             BENEFITS EXPERTISE

Figuring out what is or isn't covered by your plan can be confusing. Your Care Coordinators know your benefits
from top to bottom. When you have questions, call them. You may have benefits you're not even aware of.

             CLAIMS SOLUTIONS

There isn't a billing issue their claims specialists can't solve. They break down even the most complex claim so
you always know exactly what has been paid and what is due. If you believe a claim has been unfairly denied,
MyQHealth will do the research and either resolve it on your behalf or explain why it was denied.

             MOST COMMON ISSUES WE SOLVE

    Receiving ID cards                   Saving money on out of pocket          Learning simple steps to
                                           costs                                   improving your health
    Answering claims, billing and
     benefit questions                    Understanding how to get the           Helping with medical needs -
                                           most out of your benefits               anything that can make the
    Finding in-network providers
                                                                                   healthcare process easier for
    Managing a health condition                                                   you

              EARLY INTRO

Between December 1st and the plan effective date, January 1st, your Care Coordinators will be available by
phone to answer general procedural or benefits questions. Please keep in mind they will not have access to
your personal information, such as insurance claims or medical history, during this time.

                                                                                 2021 Employee Benefits Guide I 5
BLOUNT COUNTY GOVERNMENT EMPLOYEE - 2021 GUIDE
WHEN YOU DON’T KNOW
                                                   WHERE TO BEGIN,
                                                   START WITH US.
                                                   IF THERE’S A BETTER WAY FOR YOU
                                                   TO EXPERIENCE HEALTHCARE,

                                                   WE’LL FIND IT.
                                                     Think of us as your personal team of nurses,
From replacing ID cards to more                      benefit experts and claims specialists who will
complicated matters like claim                       do all we can to support your unique
resolutions, no request is too big                   healthcare needs. Each time you contact us,
or small for your MyQHealth                          you’ll talk to a real person who knows you,
                                                     your benefits and your health history.
Care Coordinators. We’re your
one resource to contact
whenever you need help with
your medical, dental, wellness
or pharmacy benefits.

Empowered and resourceful, MyQHealth                 We also help confirm precertification for
Care Coordinators do things like:                    services to make sure you’re always covered.
   Verify coverage        Answer claims,
                                                        Home Health and          Oncology therapy
   Provide health-         billing and benefits
                                                         Hospice                  Dialysis
    education               questions
                                                        Skilled Nursing          Mental Health/
    resources              Create health-
                                                         Facility admissions       Substance Abuse:
   Advocate for your       improvement
                            plans                       Transplants               Partial
    care
                                                                                   Hospitalization
                           Help reduce                 MRI, MRA and PET
   Help manage
                            unnecessary, out-            scans                    Genetic Testing
    chronic conditions
                            of-pocket costs             Durable Medical
   Find in-network
                                                         Equipment over
    providers
                                                         $1500
   Contact providers
    to discuss
    treatment

Blount County Government I 6
BLOUNT COUNTY GOVERNMENT EMPLOYEE - 2021 GUIDE
2021 Employee Benefits Guide I 7
BLOUNT COUNTY GOVERNMENT EMPLOYEE - 2021 GUIDE
MEDICAL INSURANCE

      HOW TO GET STARTED
      SELECT YOUR MEDICAL PLAN
     □   OPTION 1: Gold Plan

     □   OPTION 2: Silver Plan

     □   OPTION 3: Bronze Plan

                                               As a full-time employee of Blount County Government you have
      TIP: Get the most out of
           your insurance by using             the choice between three medical plan options: two PPO plans
           in-network providers.               and a Qualified High Deductible Health Plan (QHDHP).

                                               Regardless of the plan you select, your deductible will run from
                                               January 1−December 31.
FREQUENTLY ASKED QUESTIONS
                                               To locate an in-network provider, go to
     How many hours do I need to work          www.askallegiance.com/blount and click Find A Provider.
     to be eligible for medical insurance?
                                               Through the site, you will be able to access Blount County
     You must be a full-time employee
                                               Government’s PPO network.
     working a minimum of 30 hours per
     week on a regular basis.

     Will I receive a new Medical
     ID card?                                  Healthcare BlueBook:
     Yes, all employees will receive a
                                               You may also visit Healthcare Bluebook to take advantage of
     new medical ID card for the 2021
     plan year.                                significant savings on the most common medical procedures.

     Does the deductible run on                All employees enrolling onto the health plan will have access to
     a calendar year or policy                 this price transparency tool. Prices of healthcare procedures
     year basis?                               often vary from 300% - 500%, within the same provider network
     A calendar year basis.                    and same region.
     How long can I cover my dependent         Healthcare Bluebook provides detailed cost information on
     children?
                                               procedures at different facilities to give you the information you
     Dependent children are eligible           need to be an informed consumer. Healthcare Bluebook also
     until the end of the month in
     which they turn age 26.                   provides a tool that measures the quality of healthcare provided
                                               by both hospitals and doctors.
     I just got hired. When will my benefits
     become effective?                         Color-coded results are displayed for members to see, so you
     Your medical insurance will begin         can compare price and quality ranking:
     on the 1st of the month following
     thirty-one (31) days of
     employment for full-time
     employees.

Blount County Government I 8
BLOUNT COUNTY GOVERNMENT EMPLOYEE - 2021 GUIDE
MONTHLY PREMIUMS

Gold Plan                 Full Monthly Premium Employer Contribution                      Employee Monthly Cost

Employee Only                       $731.00                         $573.00                           $158.00

Employee + Spouse                  $1,677.00                       $1,315.00                          $362.00

Employee + Child(ren)              $1,649.00                       $1,294.00                          $355.00

Family                             $1,704.00                       $1,337.00                          $367.00

Silver Plan               Full Monthly Premium Employer Contribution                      Employee Monthly Cost

Employee Only                       $674.00                         $573.00                           $101.00

Employee + Spouse                  $1,547.00                       $1,315.00                          $232.00

Employee + Child(ren)              $1,522.00                       $1,294.00                          $228.00

Family                             $1,572.00                       $1,337.00                          $235.00

Bronze Plan               Full Monthly Premium Employer Contribution                      Employee Monthly Cost

Employee Only                       $637.00                         $573.00                            $64.00

Employee + Spouse                   $1,463.00                      $1,315.00                          $148.00

Employee + Child(ren)               $1,439.00                      $1,294.00                          $145.00

Family                              $1,488.00                      $1,337.00                          $151.00

         SPOUSAL SURCHARGE

   A spousal surcharge of $50 will be applied in addition to the above Employee + Spouse and Family rates if the
    employee’s spouse works full time equivalent hours and has other coverage available through his or her own
    employer (with a deductible of $2,000 or less), and chooses to enroll in the Blount County Government Plan instead
    of their own coverage available. The spousal surcharge does not apply to spouses who are not employed or
    whose employers do not offer health insurance. The spousal surcharge is not applicable to coverage for children.
    The surcharge is designed to encourage spouses to use their own available health coverage and to contribute to
    the added cost of covering spouses who choose not to do so.

   A spousal surcharge of $250 will be applied in addition to the above Employee + Spouse and Family rates if the
    employee’s spouse works full time equivalent hours and has other coverage available through his or her own
    employer that offers monetary incentives if he or she waives their health plan and chooses to enroll in the Blount
    County Government Plan instead of their own coverage available. The spousal surcharge does not apply to
    spouses who are not employed or whose employers do not offer health insurance. The spousal surcharge is not
    applicable to coverage for children. The surcharge is designed to encourage spouses to use their own available
    health coverage and to contribute to the added cost of covering spouses who choose not to do so.

                                                                                     2021 Employee Benefits Guide I 9
BLOUNT COUNTY GOVERNMENT EMPLOYEE - 2021 GUIDE
MEDICAL PLAN OPTIONS

                                                                        IN-NETWORK BENEFITS
                                                    Gold Plan                       Silver Plan              Bronze Plan
Calendar Year Deductible
                                                     $750 / $1,500                  $1,500 / $3,000           $3,000 / $6,000
  Individual / Family

                                             Deductibles incurred in the last quarter of the calendar
                                             year (October 1 thru December 31) will carry over to
                                             next year’s calendar year deductible
Supplemental Accident                                           First $300 paid at 100%

Percentage Payable
                                                 85% after deductible            85% after deductible      100% after deductible
  (unless otherwise stated)
Out-of-Pocket Maximum
                                               $3,000 per covered person            $4,500 / $9,000           $3,000 / $6,000
  Individual / Family

The out-of-pocket maximum includes deductibles and medical copayments, but excludes cost containment penalties, amounts paid for
non-covered services, or reductions in allowed amounts as a result of seeking service from an out-of-network provider.
PERVENTIVE CARE
Preventive Care                                  100%, no deductible             100%, no deductible       100%, no deductible
Preventive/Routine Lab and X-Ray                 100%, no deductible             100%, no deductible       100%, no deductible

Pap Smear and Mammogram                          100%, no deductible             100%, no deductible       100%, no deductible

Prostate Screening                               100%, no deductible             100%, no deductible       100%, no deductible

Child Immunizations                              100%, no deductible             100%, no deductible       100%, no deductible

Adult Immunizations                              100%, no deductible             100%, no deductible       100%, no deductible

Colonoscopies                                    100%, no deductible             100%, no deductible       100%, no deductible

PHYSICIAN SERVICES
                                                                               $25 copay - Primary Care
Office Visits                                    85% after deductible                                      100% after deductible
                                                                                 $45 copay - Specialist

                                                                                  100% covered after
Diagnostic X-ray and Lab                         85% after deductible                                      100% after deductible
                                                                                   Office Visit Copay

Allergy Injections                               85% after deductible                100% covered          100% after deductible

Inpatient Services                               85% after deductible            85% after deductible      100% after deductible

Outpatient Services                              85% after deductible            85% after deductible      100% after deductible

                                                                                  100% covered after
Outpatient and Office Surgery                     85%, no deductible               Office Visit Copay      100% after deductible

FACILITY SERVICES

Inpatient Services                               85% after deductible            85% after deductible      100% after deductible

Outpatient Services                              85% after deductible            85% after deductible      100% after deductible

Outpatient Surgery                                85%, no deductible             85% after deductible      100% after deductible

Outpatient Advanced Imaging
(PET, MRI, MRA, CAT, SPECT) In a hospital,       85% after deductible            85% after deductible      100% after deductible
freestanding facility or clinic

                                              85% after deductible, then      85% after deductible, then
Emergency Room/Services                      $150 copay (copay waived if     $150 copay (copay waived if   100% after deductible
                                                      admitted)                       admitted)
Blount County Government I 10
MEDICAL PLAN OPTIONS

                                                                           IN-NETWORK BENEFITS
                                                         Gold Plan                Silver Plan             Bronze Plan
OTHER SERVICES

Skilled Nursing Facility
                                                    85% after deductible        85% after deductible    100% after deductible
  (limited to 100 days per calendar year)

Hospice Care                                        85% after deductible        85% after deductible    100% after deductible
Home Health Care
                                                    85% after deductible        85% after deductible    100% after deductible
(limited to 80 visits per calendar year)
Chiropractic Care*
(limited to 25 visits per calendar year)
                                                    85% after deductible        $45 Specialist copay    100% after deductible
*Only the in-network deductible applies.
X-rays are covered for the initial visit only.

Physical, Occupational, Speech,
Audiology, and Cognitive Therapy
  (visits in excess of 20 per type of therapy       85% after deductible        $45 Specialist copay    100% after deductible
  per calendar year require prior
  authorization)

Urgent Care                                         85% after deductible        $45 Specialist copay    100% after deductible

Durable Medical Equipment                           85% after deductible        85% after deductible    100% after deductible
Prosthesis
                                                    85% after deductible        85% after deductible    100% after deductible
(requires prior authorization)

Ambulance                                           85% after deductible        85% after deductible    100% after deductible

Maternity                                           85% after deductible        85% after deductible    100% after deductible

Non-Surgical TMJ
                                                    85% after deductible        85% after deductible    100% after deductible
(limited to $1,500 per calendar year)
Transplant Services
                                                    85% after deductible        85% after deductible    100% after deductible
(requires prior authorization)

MENTAL HEALTH, CHEMICAL, AND ALCOHOL DEPENDENCY SERVICES
Inpatient services require pre-admission certification

Inpatient Facility                                  85% after deductible        85% after deductible    100% after deductible

Inpatient Physician                                 85% after deductible        85% after deductible    100% after deductible

Outpatient Facility                                 85% after deductible        85% after deductible    100% after deductible

Outpatient Physician                                85% after deductible        85% after deductible    100% after deductible

Office Visit                                        85% after deductible          $25 PCP copay         100% after deductible

 Please Note: While all three plans give you the option of using out-of-network providers, you can save
 money by using in-network providers because Allegiance has negotiated significant discounts with them.
 The benefit percentage will be the same for in-network providers both inside and outside of Blount County.
 If you choose to go out-of-network, you’ll be responsible for the difference between the actual charge
 and the Allegiance UCR (Usual, Customary and Reasonable) charge, plus your out-of-network deductible
 and coinsurance.

                Medical Plan Sum-
                                                                Deductible / Copay / Coinsurance / Out-of-Pocket
                HDHP vs. PPO
                                                                                          2021 Employee Benefits Guide I 11
PRESCRIPTION BENEFITS
   (INCLUDED WITH MEDICAL)

  Employees enrolled in the Blount County Government health plan have prescription drug
  coverage included as part of the health plan benefits. Prescription benefits are administered
  by the health plan’s prescription benefit manager (PBM), which is Magellan. Benefit
  information for your prescription drug coverage is included on your medical ID card from
  Allegiance - a separate ID card is not needed. Magellan has thousands of participating
  pharmacies in their network.

  As a way to save time and money, members can choose to fill a 90-day supply of medications for chronic
  conditions either through Magellan’s mail order service or at any in-network pharmacy location. Regardless of
  your choice, you will experience a lower out of pocket cost!

  You can visit the Magellan RX website to obtain more information about both of these convenient options.

                              Medical - Gold and Silver Plans
                 Prescription Drugs            Retail - 30 day supply       Mail Order - 90-day supply
           Out-of-Pocket Maximum                 $2,000 per person (separate from medical plan)

           Generic                                   $10 copay                      $20 copay

                                             30% coinsurance, up to a       30% coinsurance, up to a
           Preferred Brand
                                              maximum copay of $60          maximum copay of $120
                                             40% coinsurance, up to a       40% coinsurance, up to a
           Non-Preferred Brand
                                             maximum copay of $100          maximum copay of $200
                                             50% coinsurance, up to a
           Specialty                                                               Not available
                                             maximum copay of $200

                                       Medical - Bronze Plan
                 Prescription Drugs            Retail - 30 day supply       Mail Order - 90-day supply

            Out-of-Pocket Maximum            Included with the Medical Plan Out-of-Pocket Maximum

                                               Covered at 100% after          Covered at 100% after
            Generic
                                                   deductible                     deductible

                                               Covered at 100% after          Covered at 100% after
            Preferred Brand
                                                   deductible                     deductible

                                               Covered at 100% after          Covered at 100% after
            Non-Preferred Brand
                                                   deductible                     deductible

                                               Covered at 100% after
            Specialty                                                              Not available
                                                   deductible

Blount County Government I 12
PRESCRIPTION BENEFITS
            (CONTINUED)

Additional Prescription Drug Benefit (paydhealth Program)

Your prescription drug plan has been enhanced to offer you the
opportunity to substantially reduce your out-of-pocket cost for specialty
drugs.

Effective January 1, 2021, Blount County Government will be adding to it’s prescription drug
plan a program through paydhealth called the Select Drugs and Products Program. This
enhancement will provide additional support to plan participants who are prescribed
specialty drugs and products.

Select Drugs and Products Program

Participation is required of those plan participants seeking coverage for products included
on the Select Drugs and Products List. All products included in the program require prior
authorization. A Reimbursement Case Coordinator from the program will assist you with
accessing and making these high cost specialty drugs affordable.

If you are taking a specialty medication, you will be contacted by paydhealth. They will
provide you with the necessary forms to complete and return. Once the paperwork has
been completed an advocate will contact you to finalize the process. This process must be
completed prior to any prescriptions being filled.

The Specialty Contact Center may be reached toll-free at (877) 869-7772 from 8 a.m. to 8
p.m. CT, Monday through Friday.

                                                               2021 Employee Benefits Guide I 13
QUICK TIPS ON CARE
          BLUECROSS      OPTIONS
                     BLUESHIELD                                                    Primary Care vs Urgent Care vs ER

         CARE OPTIONS AND TIPS
  While we recommend that you seek routine medical care from your primary care physician whenever possible, there are
  alternatives available to you. Services may vary, so it’s a good idea to visit the healthcare provider’s website. Be sure to
  check that the facility is in-network by calling the toll-free number on the back of your medical ID card, or by visiting
  www.blountcountybenefits.com.

                                                                   PRIMARY CARE
                                                                   For routine, primary/ preventive care or non-urgent
                      ● Routine, primary/
                                                                   treatment, we recommend going to your doctor’s office.
                        preventive care
     PRIMARY                                                       Your doctor knows you and your health history and has
                      ● Non-urgent treatment
      CARE                                                         access to your medical records. You may also pay the least
                      ● Vaccinations                               amount out of pocket.
                      ● Screenings
                                                                   TELEMEDICINE (CONVENIENT CARE PLUS)
                                                                   Telemedicine lets you see and talk to a doctor from
                       ● Cold/flu         ● Rash                   your mobile device or computer without an appointment,
                       ● Diarrhea         ● Sinus                  anytime and anywhere! Convenient Care Plus brings you
  TELEMEDICINE                              Problems               care from the comfort and convenience of your home or
                       ● Fever
                                                                   wherever you are. Download the app once your benefits
                                                                   become active!

                                                                   CONVENIENCE CARE
                      ● Common infections (ear                     These providers are a good alternative when you are not
                        infections, pink eye, strep                able to get to your doctor’s office and your condition is not
                        throat)                                    urgent or an emergency.
 CONVENIENCE
    CARE              ● Flu shots                                  They are often located in malls or retail stores (such as CVS
                      ● Pregnancy tests                            Caremark, Walgreens, Wal-Mart and Target), and generally
                                                                   serve patients 18 months of age or older without an
                                                                   appointment. Services may be provided at a lower out-of-
                                                                   pocket cost than an urgent care center.

                      ● Sprains          ● Minor                   URGENT CARE
     URGENT           ● Small cuts         infections              Sometimes you need medical care fast, but a trip to the
      CARE                                                         emergency room may not be necessary.
                      ● Strains
                      ● Sore throats                               During office hours, you may be able to go to your doctor’s
                                                                   office. Outside regular office hours—or if you can’t be seen
                                                                   by your doctor immediately—you may consider going to
                                                                   an Urgent Care Center, where you can generally be
                                          ● Spinal injuries        treated for many minor medical problems faster than at an
                       ● Heavy
                         bleeding         ● Difficulty             emergency room.
   EMERGENCY
     ROOM              ● Large open         breathing
                         wounds           ● Major burns            EMERGENCY ROOM
                       ● Chest pain                                An emergency medical condition is any condition
                                                                   (including severe pain) which you believe that without
                                                                   immediate medical care may result in serious injury or is life
                                                                   threatening.
   If you believe you are experiencing a
                                                                   Emergency services are always considered
   medical emergency, go to the nearest
                                                                   in-network. If you receive treatment for an emergency in a
   emergency room or call 911, even if your
   symptoms are not described here.
                                                 CALL 9-1-1        non-network facility, you may be transferred to an in-
                                                                   network facility once your condition has been stabilized.
Blount County Government I 14
CONVENIENT CARE PLUS
A Convenient Care Plus membership allows 24/7 unlimited access to a healthcare
provider for basic illnesses such as cold and flu, infections, pink eye, sore throat, allergies, and more. You are eligible for
this benefit the first of the month following 31 days of employment.

Depending on the membership level that you select, your plan will include some or all of the following features:
 Telemedicine– 24/7/365 telephone access to a licensed physician
 Generic RX Prescription Plan– Several medications are covered at no charge                                   CCP
 Patient Advocate– Helps navigate healthcare and insurance issues
 Medical Bill Saver– Negotiates medical bills or balances over $400
 Clinic Visits - See a healthcare provider in person for minor illnesses and injuries at one of the network clinics for a $30
  copay (level 2 only; see the app for a list of network providers).
      Services                                                                 Level 2                  Level 3
      Unlimited Telemedicine
      Unlimited Clinic Visits

      Generic Prescriptions
      Member Plans & Fees
      Blount County Premium Contribution - Full Time Employees Only                  $5 / month              $5 / month
      Employee Cost - Individual & Individual + 1                                 $11.50 / month             $6 / month
      Employee Cost - Family                                                      $26.50 / month             $6 / month
      Clinic Visit Fee                                                               $30 / visit                  N/A

GENERIC RX PROGRAM
    Members can obtain the following generic medications at no charge using the CCP formulary.

                                                                                         2021 Employee Benefits Guide I 15
TELEHEALTH
  Access to a nurse or doctor 24/7. Call 877-900-8701
    No travel, no waiting and no missed work! Speak to a nurse/doctor from home or work by phone or video.
    Get treatment for common conditions such as allergies, sore throat, infections and more.
    Prescriptions sent electronically to your local pharmacy.

ON-SITE VISITS

  $30 visit fee - Level 2 only
    Call 877-900-8701 to see a healthcare provider in person at one of our approved local clinics.
    Most of our clinics offer extended evening and weekend hours for your convenience.
    Same-day visits are available at most of our provider locations.
    $150 CCP maximum cap coverage per visit. The member is responsible for charges above $150.

GENERIC RX PROGRAM

    Visit www.convenientcareplus.com for the most updated list of episodic medications available to
     our members.

PATIENT ADVOCACY
    Your membership gives you additional health and wellness resources.
    Core Advocacy: Personal Health Advocates help you and your family navigate healthcare and
     insurance-related issues, 24/7 / 365
    Medical Bill Saver: Negotiates medical bill son balances over $400

INTERNET IDENTITY GUARD

 Level 2 only
    To register and activate, log onto www.convenientcareplus.com and click on the Internet Identity
     Guard button/icon.
    Your membership gives you access to secure email accounts, digital vault, safe browsing (VPN) and
     Identity monitoring.
    Identity monitoring $1 million insurance benefit & unlimited restoration and recovery from identity
     theft.

 ID CARD

  Member ID # on card below to be handwritten by member in this format– FML+10 digit phone
  number (Initials from First, Middle and Last name– ex: JQP5556667788

 Blount County Government I 16
FLEXIBLE SPENDING
           ACCOUNT (FSA)                                                   What is a Flexible Spending Account?

                                                                2020 Maximum Contributions
                                                                *2021 Maximum has not yet been released
FLEXIBLE SPENDING ACCOUNT                             Health Care Flexible Spending Account   $2,750 max
This account enables you to pay medical, dental,
                                                      Dependent Care Expense Account          $5,000 max
vision, and prescription drug expenses that may or
may not be covered under your insurance program Medical FSA Carryover                         $550 max

(or your spouse’s) with pre-tax dollars. You can also      DEPENDENT CARE EXPENSE ACCOUNT
pay for dependent health care, even if you choose          This account gives you the opportunity to
single (vs. family) coverage.                              redirect a portion of your annual pay on a
                                                           pre-tax basis to pay for dependent care
The total amount of your annual election is available
                                                           expenses. An eligible dependent is any
to you up front, reducing the chance of having a
                                                           member of your household for whom you
large out-of-pocket expense early in the plan year.
                                                           can claim expenses on your Federal
Note: You can rollover up to $550 of unused funds to
                                                           Income Tax Form 2441, “Credit for Child
the next year. Any remaining amounts over $550 will
                                                           and Dependent Care Expenses.” Children
be forfeited.
                                                           must be under age 13.

 Eligible Expenses Examples                                          Care centers which qualify include
                                                                     dependent care centers, preschool
 ● Alcoholism treatment         ● Laboratory fees
                                                                     educational institutions, and qualified
 ● Artificial limbs             ● Licensed osteopaths
                                                                     individuals (as long as the caregiver is not a
 ● Ambulance                    ● Licensed practical nurses          family member and reports income for tax
 ● Braces                       ● Orthodontia                        purposes).
 ● Chiropractors                ● Orthopedic shoes
                                                                     Before deciding to use the Dependent
 ● Coinsurance and
   copayments                   ● Obstetrical expenses               Care Expense Account, it would be wise to
 ● Contact lens solution        ● Oxygen                             compare its tax benefit to that of claiming
 ● Contraceptives               ● Prescription drugs
                                                                     a child care tax credit when filing your tax
                                                                     return. You may want to check with your
 ● Crutches                     ● Podiatrists
                                                                     tax advisor to determine which method is
 ● Dental expenses              ● Psychiatric care
                                                                     best for you and your family. Any unused
 ● Dentures                     ● Psychologist expenses
                                                                     portion of your account balance at the
 ● Dermatologists               ● Routine physical                   end of the plan year is forfeited.
 ● Diagnostic expenses          ● Seeing-eye dog expenses
                                                                     How the Health Care Flexible Spending
 ● Eyeglasses, including exam   ● Smoking cessation
   fee                            programs                           Account Works
                                                                     When you have out-of-pocket expenses
 ● Handicapped care and         ● Sterilization and reversals
   support                                                           (such as copayments and deductibles),
 ● Nutrition counseling         ● Substance abuse treatment          you can use your FSA debit card to pay
 ● Hearing devices and                                               for these expenses at qualified providers.
   batteries                    ● Surgical expenses
                                                                     Reimbursement is issued to you through
 ● Hospital bills               ● Prescribed vitamin
                                  supplements (medically
                                                                     direct deposit into your bank account, or
 ● Deductible Amounts             necessary)                         if you prefer, a check can be issued to
                                                                     you.        2021 Employee Benefits Guide I 17
HEALTH SAVINGS ACCOUNT
          (HSA)                                        WHAT ARE THE RULES?
                                                       ● You must be covered under a Qualified
  Two ways you can put money into your HSA:              High Deductible Health plan (QHDHP) in order
  (1) Regular payroll deductions on a pre-tax            to establish an HSA (Bronze plan).
  basis and (2) lump-sum contributions of any          ● You cannot establish an HSA if you or your
  amount, anytime, up to the maximum limit.              spouse also have a medical FSA, unless it is a
                                                         Limited Purpose FSA.
                                                       ● You cannot be enrolled in Medicare
UNDERSTANDING A HEALTH SAVINGS
                                                         or Tricare due to age or disability.
ACCOUNT (HSA)
                                                       ● You cannot set up an HSA if you have
                                                         insurance coverage under another plan, for
WHAT IS AN HSA?
                                                         example your spouse’s employer, unless that
A savings account where you can either direct pre-       secondary coverage is also a qualified high
tax payroll deductions or deposit money to be used       deductible health plan.
to pay for current or future qualified medical         ● You cannot be claimed as a dependent under
expenses for you and/or your dependents. Once            someone else’s tax return.
money goes into the account, it’s yours to keep—
the HSA is owned by you, just like a personal          WHAT ELSE SHOULD I KNOW?
checking or savings account.
                                                       ● SAVE: You can invest up to the IRS’s annual
                                                         contribution limit. Contributions are based on a
THE HSA CAN ALSO BE AN                                   calendar year. The contribution limits for 2021
INVESTMENT OPPORTUNITY.                                  are $3,600 for Single and $7,200 for Family
Depending upon your HSA
                                      Contribute         coverage. If you’re age 55 or older, you are
                                         up to           allowed to make extra contributions each
account balance, your
account can grow tax-free
                                      $3,600             year ($1,000).
                                       Single, or      ● GROW: The contributions grow tax-free and
in an investment of your
choice (like an interest-             $7,200             come out tax-free as long as you utilize the
                                                         funds for approved services based on the IRS
                                         Family          Publication 502, (medical, dental, vision
bearing savings account, a
                                                         expenses and over-the-counter medications
money market account, a
                                                         with a physician’s prescription).
wide variety of mutual
                                                       ● OWN: Your unused contributions roll over from
funds—or all three). Of course, your funds are           year to year and can be taken with you if you
always available if you need them for qualified          leave your current job.
health care expenses.                                  ● CHOOSE: If you use the money for non-qualified
                                                         expenses, then the money becomes taxable
                                                         and subject to a 20% excise tax penalty (like in
YOUR FUNDS CAN CARRY OVER
                                                         an IRA account).
AND EVEN GROW OVER TIME.
The money always belongs to you, even if you           ● There is no penalty for distributions following
                                                         death, disability (as defined in IRC 72), or
cease employment with Blount County, and                 attainment of Medicare eligibility age, but
unused funds carry over from year to year. You           taxes would apply for non-qualified
never have to worry about losing your money. That        distributions.
means if you don’t use a lot of health care services   ● If your healthcare expenses are more than your
now, your HSA funds will be there if you need them       HSA balance, you need to pay the remaining
                                                         cost another way, such as a credit card or
in the future - even after retirement.
                                                         personal check. You can request
                                                         reimbursement later, after you have
HSA FUNDS CAN BE USED FOR YOUR FAMILY.                   accumulated more money in your account.
You can use your HSA for your spouse and tax             But save your receipts in case you are ever
                                                         audited!
dependents for their eligible expenses - even if
they’re not covered by your medical plan.

Blount County Government I 18
YOU CAN USE HSA FUNDS FOR
IRS-APPROVED ITEMS SUCH AS:
                                                FREQUENTLY ASKED QUESTIONS:
● Doctor's office visits
● Dental services
● Eye exams, eyeglasses, laser surgery,                   What will I pay at
  contact lenses and solution                        the pharmacy with the HSA
● Hearing aids                                         qualified plan options?
● Orthodontia, dental cleanings, and fillings
                                                       You will pay the actual
                                                    discounted cost of the drug
● Prescription drugs and some over-the-
  counter medications (with a physician’s               until you satisfy your
  prescription)                                     calendar year deductible in
● Physical therapy, speech therapy, and                          full.
  chiropractic expenses
More information about approved items,
plus additional details about the HSA, is
available at irs.gov.                                              What will I pay at the
                                                                 physician’s office with the
Every time you use your HSA, save your                             HSA qualified plan?
receipt in case the IRS asks you to prove                 You’ll provide your ID card at the time
your claim was for a qualified expense. If               of the visit and the physician’s office will
you use HSA funds for a non-qualified                    submit the claim to Allegiance. You will
expense, you will pay tax and a penalty on               not owe anything at the time of the visit.
those funds.                                              Later you’ll receive an Explanation of
The HSA is your personal account and                        Benefits (EOB) from Allegiance that
contains your personal funds. It can be                   shows the charges discounted based
considered an asset by a creditor and                      on their contract with the physician.
garnished as applicable.                                     When you receive a bill from the
                                                          physician’s office, you pay the portion
As an HSA account holder, you will be                         of the discounted cost you are
required to file a Form 8889 with the IRS                                 responsible
each year. This form identifies any
                                                                  for as shown on the EOB.
contributions, distributions, or earned
interest associated with your account.                            Where can I get
                                                                 a copy of an EOB?
                                                           You can access all of your
                                                           EOB information, as well as
                                                             obtain other important
                                                           information, by logging on
                                                                       to
                                                           www.blountcountybenefits
                                                                     .com

                                                            What is a Health Savings Account?

                                                                     2021 Employee Benefits Guide I 19
HOW TO FIND A DENTIST
                                                             To find a Delta Dental provider in your area, visit
      DENTAL INSURANCE                                       www.deltadentaltn.com

                                                             ● Scroll down to “Find a Dentist”
                                                             ● Select a specialty and “Delta Dental PPO”
                                                             ● Enter your zip code and click “Find a Dentist”
Dental benefits are effective the first of the month
following 31 days of full time employment. As an           ● You can apply additional filters to narrow your search or
                                                              leave them blank for a complete directory
employee at Blount County Government, your dental
benefits are provided through Delta Dental of Tennessee under a PPO Plan. The benefit levels are the same in-
network and out-of-network. If services are provided by an in-network provider, your provider agrees to a negotiated
charge and you will not be responsible for balance billing. Additionally, the provider’s office will file a claim for you so
there is no paperwork for you to complete.

Dental services are divided into four coverages. Preventive procedures include exams, x-rays and preventive care
and is paid entirely by the plan. Basic procedures include basic restorative treatment, endodontics, oral surgery, and
periodontics. Major procedures include complex restorative surgeries and prosthodontics. Orthodontia refers to
orthodontic procedures.

As a member of Delta Dental of TN, you have access to the nation’s largest dental networks: Delta Dental PPO and
Delta Dental Premier. With 3 out of 4 dentists participating, these two networks provide great access to care as well
as the privilege of reduced rates through Delta Dental’s agreed upon fees with dentists. When seeing a dentist in
either the PPO or Premier networks, you cannot be balance billed - giving you added savings. You are also free to
visit non-network dentists, but you may be balance billed. If services are provided by a non-network provider,
charges in excess of the 80th percentile of usual and customary charges will be your responsibility.

Please be sure to consult either the online directory or call Delta Dental Customer Service (800.223.3104) to confirm
that your dentist is in the network.

                    Dental Plan Summary                                                  What is Dental Insurance?

    Delta Dental                               Full Monthly Premium        Employer Monthly          Employee Monthly
                                                                             Contributions              Deduction

    Employee Only                                      $26.57                     $21.57                     $5.00
    Family (Employee + Dependents)                     $83.31                     $21.57                    $61.74

                                                                             In-Network

    Plan Year Annual Deductible
    Individual / Family
                                                                              $50 / $150

    Plan Year Annual Maximum Benefit                                $1,200 per covered person

    Orthodontia Lifetime Maximum                                                $1,000
    (12 month waiting period)

    Preventive Services                                          100% , deductible does not apply
    Basic Services                                                      80% after deductible
    Major Services                                                      50% after deductible
    Orthodontia Services
    (children only, to age 19)                                    50%, deductible does not apply

Blount County Government I 20
HOW TO FIND A PROVIDER
            VOLUNTARY VISION                                                       To find a provider in your area, visit superiorvision.com

                     INSURANCE                                                     ● Click on “Find an eye care professional” at the top of the
                                                                                     page
                                                                                   ● Enter your location, coverage type, Superior National
The Blount County vision plan covers routine eye care,                               Network, and click search.

including eye exams and eyeglasses (lenses and frames)
or contacts. When you choose an in-network provider for your eye exam and materials, you are responsible for
the copay only. If you choose a provider that is not in network, Superior Vision will reimburse you according to
the plan’s non-network benefit schedule (listed below under “Out-of-Network Provider”).

Superior Vision has contracted with providers who specialize in the highly publicized elective procedures of
Radial Keratotomy (RK), Photo Refractive Keratotomy (PRK), and LASIK to provide a 20% discount off their usual
customary surgical fee for members.

Go to www.superiorvision.com to find an in-network provider near you, and to order and print I.D. cards.

                Vision Plan Summary                                                                              What is Vision Insurance?

                                                                         Full Monthly            Employer Monthly                  Employee Monthly
                                                                           Premium                 Contribution                       Deduction

  Employee                                                                   $8.88                        N/A                              $8.88
  Employee & Spouse                                                         $17.53                        N/A                             $17.53
  Employee & Child(ren)                                                     $17.18                        N/A                             $17.18
  Employee & Family                                                         $26.15                        N/A                             $26.15

                                                                                       In-Network                                  Out-of-Network
  Vision Exam
      Covered every 12 months
      Ophthalmologist (M.D.)                                            Covered in full after $10 copay                         Plan pays up to $34
      Optometrist (O.D.)                                                                                                        Plan pays up to $26

  Frames
                                                                    Plan pays up to $125 after $10 copay                        Plan pays up to $65
      Covered every 24 months

  Lenses
      Covered every 12 months
      Single                                                                                                                    Plan pays up to $32
      Bifocal                                                                                                                   Plan pays up to $46
                                                                        Covered in full after $10 copay
      Trifocal                                                                                                                  Plan pays up to $57
      Lenticular                                                                                                                Plan pays up to $90
      Progressive                                                                                                               Plan pays up to $46
  Contact Lenses
Covered every 12 months - in lieu of glasses
Medically necessary                                                                Covered in full                              Plan pays up to $210
Cosmetic (Elective)                                                             Plan pays up to $120                            Plan pays up to $100
Standard Contact Lens Fitting Exam Fee*                                              $25 copay                                      Not covered
Specialty Contact Lens Fitting Exam Fee                                            $50 allowance                                    Not covered
*Standard contact lens fitting fee applied to an existing contact lens user who wears disposable, daily wear, or extended lenses only. The specialty contact lens
   fitting fee applies to new contact lens wearers and/or a member who wears toric, gas permeable, or multi-focal lenses. For the specialty fit, the member is
                                                              responsible for any charges over $50.
                                                                                                               2021 Employee Benefits Guide I 21
LIFE INSURANCE AND AD&D
                                                                         Beyond providing financial security for your loved
                                                                         ones, life insurance can also offer you: financial
        REVIEW YOUR                                                      protection for your loved ones or business,
        LIFE INSURANCE POLICY                                            supplemental retirement income, protection from
                                                                         long-term care expenses, and many more.
       □    Basic Life / AD&D

       □    Supplemental Life / AD&D                                     Consider your options with your loved ones in mind.

                   BASIC LIFE / AD&D                                                        What is Term Life Insurance?

             Basic Life/AD&D Insurance is a County provided benefit offered at no cost to you through USAble
             Life Insurance Company. The coverage amount is one times your annual salary up to a maximum
             of $50,000. The definition of earnings is based on your prior year’s W-2. AD&D Insurance pays an
             additional percentage of the amount of your life insurance benefit based on a specific list of
             losses such as loss of life, limb, or sight due to an accident.

 You are eligible for this benefit the first of the month following 31 days of full-time employment.

 If you have questions or need to update your beneficiaries, please contact the Human Resources
 Department.

 *Benefits reduce by 50% of the original amount at age 70, and further reduce by 70% of the original amount
 at age 75, and 80% of the original amount at age 80.

 *some exclusions apply
 Upon becoming ineligible for group insurance (ex: leaving employment), you may be eligible to convert your Basic Life
 benefit to an Individual Whole Life policy. This must be done within 31 days after the date your insurance ends. The rate
 for the converted policy is based on the age of the individual at the time of conversion. Contact Human Resources or
 USAble Life for more information.

            VOLUNTARY TERM LIFE

 Voluntary Term Life can be purchased for you and your spouse in increments of $10,000 up to
 $300,000 (not to exceed 7x annual earnings). Coverage is also available for children up to $10,000.

 The guaranteed issue amount for employees is $200,000; spouse is $30,000; and child(ren) is $10,000.

 *All life insurance amounts are subject to age reductions, and terminates at retirement - see plan
 documents for details.
 *Voluntary spouse and child coverage can only be purchased if the employee has elected coverage and
 cannot exceed employee’s elected amount.
 *Amounts in excess of the guaranteed issue amounts require medical underwriting (EOI).
 *Children can be covered until they reach age 26.

 If you do not enroll in voluntary life insurance coverage upon initial eligibility (within 31 days of your date of hire), you may be asked to
 complete an Evidence of insurability form if you wish to enroll (or increase your coverage) at a later date.

 Upon becoming ineligible for group insurance (ex: termination of employment), you may be eligible to port or convert your current
 coverage. This must be done within 31 days after the date your insurance ends. Contact Human Resources or USAble Life for more
 information.

Blount County Government I 22
VOLUNTARY COVERAGES
                                                                          Hospital Procedure/Service                         Select
                                                                          First-Day Hospital
                                                                                                                               $750
                                                                          Confinement (10 per year)
               □    Hospital Care

               □    Cancer Care                                           Daily Hospital Confinement
                                                                          (per day, up to 180 days)
                                                                                                                               $150

                                                                          Intensive Care Confinement
                      HOSPITAL CARE                                                                                            $225
                                                                          (per day, up to 15 days)
  This plan provides a reassuring layer of financial                      Ground Ambulance (3 per
                                                                                                                               $120
  protection for you and your family by paying you cash to                year)
  cover the unexpected expenses in the event of
                                                                          Air Ambulance (3 per year)                           $750
  hospitalization. Benefits are paid directly to you, with no
  coordination of benefits with the medical plan. The plan                Surgical Benefit (based on surgical schedule) - examples:
  provides coverage for hospitalization, intensive care,
                                                                             Coronary Bypass                                  $1,000
  ambulance, and wellness. It is portable; you can take it
  with you even if you leave employment. Coverage is                         Appendix Removal                                  $220
  available for you, your spouse, and eligible dependents.
                                                                             Gallbladder Removal                               $284

                         What is Hospital Care?                           Anesthesia                                5% of surgical benefit
                                                                          Preoperative Visit                       1.5% of surgical benefit
                                                                          Second Surgical Opinion                  1.5% of surgical benefit
                       CANCER CARE
                                                                          Diagnostic Procedure (per
                                                                                                                               $50
                                                                          procedure, up to 3 per year)
                         What is Cancer Care?                             Emergency Treatment (3 per
                                                                                                                               N/A
                                                                          year)
USAble Life’s Cancer Care Plan can help offset the out-of-                Physician Office Visit (5 per
pocket medical and non-medical expenses related to                                                                             N/A
                                                                          year)
cancer that most medical plans don’t cover. This coverage
provides benefits that you can use to help with the loss of               Wellness Benefit                                   Select
income, child care, lodging and meals, deductibles and                    Annual Benefit Amount                                $45
copays, and much more. A lump sum benefit is paid to the
                                                                          To promote healthier routines, insureds can receive an annual payment for
member upon first diagnosis of a covered cancer. You can
                                                                          having covered health screenings and tests, such as a mammogram, Pap
choose policy amounts in $5,000 increments up to $50,000.
                                                                          test, PSA (prostate-Specific Antigen) test, and colonoscopy.
This plan is portable; you can take if with you even if you
leave Blount County. The plan pays YOU directly in the event
                                                                                                                 Percentage of Policy
of a covered cancer diagnosis or treatment. Coverage is                        Cancer Care Coverage
                                                                                                                       Amount
available for you, your spouse, and eligible dependents and
premiums are payroll deducted. Spouse and dependent                            Cancer Diagnosis                            100%
coverage cannot exceed the amount of employee
                                                                               Bone Marrow Transplant                      100%
coverage elected. It includes recurrent benefit which
extends coverage to a second covered diagnosis, enabling                       Prostate Cancer and/or
                                                                                                                           30%
insured employees to receive benefits up to 200% of the                        Carcinoma In Situ
plan’s value. To promote healthier routines, insureds can
                                                                               Skin Cancer Diagnosis                       10%
receive an annual payment of $100 for having covered
health screenings and tests, such as mammogram, Pap test,                                                        $75 lifetime, one-time
                                                                               Cancer Vaccine
PSA test, and colonoscopy.                                                                                              payment
   If enrolled in cancer care, you cannot enroll in the critical care &        Cancer Treatment &                $50/month, up to 12
   cancer policy.                                                              Care                                   months
                                                                                                  2021 Employee Benefits Guide I 23
VOLUNTARY COVERAGES

           □    Critical Care & Cancer

           □    Accident Recovery

Premiums are payroll deducted and paid entirely by you.
Please contact the Human resources Department or USAble
Life for more information or to enroll in one of these coverages.

         CRITICAL CARE & CANCER                                     Coverage                          Percent of Policy Amount
                                                                    Cancer Diagnosis                                 100%
          USAble Life’s Group Critical Care                         Heart Attack/Stroke                              100%
          insurance helps you to maintain financial
                                                                    Major Organ Transplant                           100%
          security during the lengthy, expensive
recovery period of a serious medical event such                     Bone Marrow Transplant                           100%
as cancer, heart attack, or stroke. It provides a                   End-Stage Renal Failure                          100%
lump sum benefit to help with the out-of-pocket
medical and/or non-medical expenses of critical                     Burns (3rd degree, over at                       100%
                                                                      least 50% of body)
illness and/or cancer. You can choose policy
amounts in $5,000 increments up to $50,000. This                    Specified Diseases*                              100%
plan is portable; you can take it with you even if                  Prostate Cancer and/or                            30%
you leave employment. Coverage is available for                       Carcinoma In Situ
you, your spouse, and eligible dependents.                          Coronary Artery Bypass
                                                                     Surgery                                          30%
Premiums are payroll deducted for your
convenience. It includes recurrent benefit which                    Alzheimer’s Disease                               30%
extends coverage to a second covered diagnosis,
                                                                    Angioplasty/Stent                                 10%
enabling insured employees to receive benefits up
to 200% of the plan’s value. To promote healthier                   Skin Cancer Diagnosis                             10%
routines, insureds can receive an annual payment
                                                                    Cancer Vaccine                     $75 lifetime, one-time payment
of $100 for having covered health screenings and
tests, such as mammogram, Pap test, PSA test,                       Cancer Treatment & Care             $50/month, up to 12 months
and colonoscopy.
*Specified diseases include ALS (Lou Gehrig’s Disease), Anthrax, Cholera, Encephalitis, Meningitis, Rocky Mountain Spotted and Typhoid
Fevers, Tuberculosis, Primary Sclerosing Cholangitis (Walter Payton’s Disease)

If enrolled in critical care & cancer coverage, you cannot enroll in the cancer care policy.
                                                                                                 What is Critical Care?
          ACCIDENT RECOVERY                                                                    What is Accident Recovery?

 This plan provides lump sum benefits for covered accidents, such as benefits for fractures, concussions, emergency
 treatment, hospital confinement, and accidental death and dismemberment. These benefits can help with the out
 of pocket medical and non-medical expense associated with an accident. Coverage is provided 24 hours a day -
 no matter where the accident occurs. Coverage is guaranteed; no health questions or underwriting required. The
 plan is portable; you can take it with you even if you leave employment. Coverage is available for you, your spouse,
 and eligible dependents and premiums are payroll deducted. Benefits are provided for hospitalization, surgery, and
 follow-up with a physician. To promote healthier routines, insureds can receive an annual payment of $60, $75 or
 $105 (based on the plan you select) for having covered health screenings and tests, such as mammogram, Pap test,
 PSA test, and colonoscopy.

Blount County Government I 24
VOLUNTARY COVERAGES

            □    Short-Term Disability

            □    Long–Term Disability

             What is Disability Insurance?

Premiums are payroll deducted and paid entirely by you. Please contact the Human Resources
Department or USAble Life for more information or to enroll in one of these coverages.

       SHORT-TERM DISABILITY

        A Short-Term Disability (STD) plan can give you financial protection and help replace a
        portion of your income if you become unable to work as a result of a covered illness, injury, or
        pregnancy. You can select the STD benefit that’s right for you, not to exceed 60% of your pre-
        disability earnings or a weekly amount of $750. Benefit amounts can be purchased in
        increments of $10. The minimum weekly benefit is $50.

        STD benefits begin the 15th day of an injury or illness and terminate after 13 weeks (90 days) of
        continuous disability due to covered accident or illness.

        LONG-TERM DISABILITY

      Because some disabilities continue for a significant amount of time, Long-Term Disability (LTD)
      coverage can help provide partial income replacement when you’re unable to work during
      a serious disability or extended illness. Your LTD benefit cannot exceed 60% of your pre-
      disability earnings (up to a monthly amount of $6,000), and can be purchased in increments
      of $100,

      LTD benefits start after you have been disabled for 90 days and can continue until you return
      to work, retire (up to age 65 or Social Security normal retirement age depending on the date
      of disability), or death.
If you do not enroll in short term disability, long term disability, or voluntary life insurance coverage upon initial eligibility
(within 31 days of your date of hire), you may be asked to complete an Evidence of Insurability form if you wish to enroll
(or increase your coverage) at a later date.

                                                                                           2021 Employee Benefits Guide I 25
VOLUNTARY COVERAGES

       □ Long-Term Care

   New Voluntary Benefit!
   We are excited to announce that Blount County will be introducing Long-Term care
   insurance as a new voluntary benefit! Enrollment will run Monday, October 12th
   through Friday, October 30th.

   What is Long-Term Care?

   Long-term care assists you with your everyday activities. It can be received in an as-
   sisted living facility, nursing home or in your own home. This type of care is needed
   due to a cognitive or physical impairment which requires assistance with two out of
   the six Activities of Daily Living: eating, bathing, dressing, transferring, toileting, and
   continence.

   Some common reasons you may need this type of care are due to an accident
   (such as a car accident or injury), illness (such as cancer), aging, or a cognitive im-
   pairment (such as Alzheimer’s, dementia, or effects of a stroke).

   The costs for this type of care can approach $90,5201 per year. These expenses are
   not paid for by either group health insurance or disability plans while working and are
   only minimally covered by government programs such as Medicare upon retirement.

   Long-Term Care insurance (LTCi) is a way to help pay for the cost of your care so you
   will not have to rely solely on your savings, assets, family, or other means to pay for
   your care.

   Keep an eye out for additional information to come soon!

   To learn more contact LTC Solutions, Inc.
   LTCiBenefitsTeam@ltc-solutions.com
   (877) 286-2852
   3Metlife Mature Market Institute, The 2012 MetLife Market Survey of Nursing Home, Assisted Living, Adult
   Day Service and Home Care Costs.

Blount County Government I 26
You can also read