Livingston County 2020 Enrollment - 2020 Annual Enrollment begins Thursday, October 17th and continues through Friday, November 1st

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Livingston County 2020 Enrollment - 2020 Annual Enrollment begins Thursday, October 17th and continues through Friday, November 1st
Livingston County 2020 Enrollment
2020 Annual Enrollment begins Thursday, October 17th and continues through Friday, November 1st

Livingston County | 2020 Open Enrollment
Livingston County 2020 Enrollment - 2020 Annual Enrollment begins Thursday, October 17th and continues through Friday, November 1st
Agenda

   1.      Annual Enrollment
   2.      2020 Updates
   3.      Medical Plans
            a.    Health Savings Accounts
            b.    Blue Cross Online Visits (telehealth)
   4.      Dental Plans
   5.      Vision Plans
   6.      Health Care Blue Book
   7.      Flexible Spending Accounts
   8.      CIGNA Life, Disability, and Voluntary Benefits
   9.      Health Advocate
   10.     Pet Insurance
   11.     Ulliance Employee Assistance Program
   12.     What You Need To Do!
   13.     Wrap Up

Livingston County | 2020 Open Enrollment                    2
Livingston County 2020 Enrollment - 2020 Annual Enrollment begins Thursday, October 17th and continues through Friday, November 1st
Annual Open Enrollment

This year we will be having a Passive enrollment. This means you do not need to re-enroll
and your 2019 benefit elections will carry-over into 2020.
You Must Enroll If…
 …you wish to participate in the Healthcare or Dependent Care FSA (you must make a new election
  every year as these do not carry-over)
 …add or delete dependent(s)
 …elect a new plan or make changes to your benefits

Changes are effective January 1, 2020 and remain in effect through December 31, 2020
unless you experience one of the following mid-year changes:
 Birth or adoption of a child

 Marriage or divorce                                   You must notify
                                                           Human
 Dependent gains or loses eligibility                 Resources within
                                                        30 days of the
 Change in spouse’s employment status                 event to make a
                                                        change in your
                                                          elections!

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Livingston County 2020 Enrollment - 2020 Annual Enrollment begins Thursday, October 17th and continues through Friday, November 1st
2020 Updates

 Livingston County will continue to offer a full suite benefit package, including maintaining current
  coverage levels with Blue Cross Blue Shield of Michigan for medical and prescription drug coverage
     – CIGNA claims advocacy services are provided via CIGNA Health Advocate
     – Employee Assistance Program (EAP) services will continue being provided via Ulliance
     – Life and Disability coverage remains with CIGNA
 Per a Livingston County Board vote, elective abortions are no longer covered for non-union
  employees under The County’s Blue Cross Blue Shield of Michigan health insurance

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Livingston County 2020 Enrollment - 2020 Annual Enrollment begins Thursday, October 17th and continues through Friday, November 1st
Medical Insurance

 All Medical Plans are administered by Blue Cross Blue Shield of Michigan
  (BCBSM)
 Livingston County offers various medical plan options (varies based on
  bargaining units)
 We will be offering the same coverage as we did in 2019:
          – PPO 4
          – PPO 6
          – PPO 1 (only available to some union groups)
          – High Deductible Health Plan (only available to non-union employees)

Livingston County | 2020 Open Enrollment                               5
Livingston County 2020 Enrollment - 2020 Annual Enrollment begins Thursday, October 17th and continues through Friday, November 1st
When Choosing A Plan…Consider the ABC’s

A. Ask yourself: would you rather pay for coverage up front (via premiums paid through payroll
   deduction) or at the point of service when seeing a physician or paying for a medical service

B. Budget accordingly. Can you afford to pay your deductible if you incur a large expense early in the
   year?

C. Consider your previous years’ medical expenses and your known 2020 medical events (planned
   surgeries, pregnancies, etc.) when choosing a plan

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Livingston County 2020 Enrollment - 2020 Annual Enrollment begins Thursday, October 17th and continues through Friday, November 1st
Medical Plans

                                                                                                       High Deductible*
                                                                                Union Only:
                                              PPO4              PPO6                                  Health Plan – HDHP
                                                                                   PPO1
                                                                                                         (Non-Union)
                                                                                                           $2,000 Single
                                           $500 Single        $250 Single
  Deductible                                                                         N/A                   $4,000 Family
                                           $1000 Family       $500 Family
                                                                                                      (**Aggregate deductible)

                                     You Pay 20% after     You Pay 10% after                             You Pay 20% after
  Coinsurance                                                                        N/A
                                      deductible is met     deductible is met                               deductible

  Coinsurance Max –                        $2,000 single     $1,250 single
  Includes deductible and                                                            N/A                        N/A
                                           $4,000 family     $2,500 family
  coinsurance

  Total Out-of-Pocket
  Max –
  Includes, deductibles,               $6,350 Single        $6,350 Single       $6,350 Single              $3,000 Single
  coinsurance, fixed dollar            $12,700 Family       $12,700 Family      $12,700 Family             $6,000 Family
  copays and RX Copays

  Office Visits                             $10 copay          $10 copay        Varies by B/U           20% after deductible

                                                                                                         $49 copay/visit until
                                                                                                     deductible is met; $0 copay
  Online Visits                              No copay          No copay           No copay
                                                                                                      after deductible plus 20%
                                                                                                           coinsurance/visit

                                                                                                       ***$500 Rx preventive
  Prescription Drugs                       Varies by B/U     Varies by B/U      Varies by B/U            $10/$40/$80 (after
                                                                                                         deductible is met)

Livingston County | 2020 Open Enrollment                                                         7
Livingston County 2020 Enrollment - 2020 Annual Enrollment begins Thursday, October 17th and continues through Friday, November 1st
Health Savings Account (HSA) – Non-Union Only

 Administered by HealthEquity in partnership with BCBSM

 What is an HSA?
     – A tax-advantaged medical savings account; contributions are made pre-tax
       and funds can be used to pay for qualified medical expenses
     – Must be in a qualified high-deductible health plan (HDHP) in order to
       contribute to an HSA

 Questions About Your HSA?
     – Call HealthEquity member services (877-284-9840)
     – If you have questions about your medical coverage, call the Customer
       Service number on the back of your Blue Cross ID card

Livingston County | 2020 Open Enrollment                        8
Livingston County 2020 Enrollment - 2020 Annual Enrollment begins Thursday, October 17th and continues through Friday, November 1st
Health Savings Accounts – Key Rules
Rules of Participating in an HSA:
 Must be enrolled in Livingston County’s HDHP (a qualified HDHP/HSA plan)
 Cannot be enrolled in another health plan that is not qualified (i.e. Medicare, secondary on spouse’s
  plan, etc.) and cannot be claimed as a dependent on someone else’s tax return (dependent children
  can draw from your account, but cannot open their own accounts)
 Money in your account must only be used for “qualified medical expenses”
 Cannot have a Flexible Spending Account (FSA) – any FSA balances must be liquidated/spent.
 You have the option of enrolling in a Limited-Purpose FSA (for qualified dental and vision expenses
  ONLY)

Advantages of an HSA:
 Portability and flexibility
      –      You own the account
      –      Funds rollover – NOT a “use it or lose it” account
      –      Both annual employer contributions and employee contributions (up to IRS limit)
 Tax savings and growth
      –      Lowers your taxable income; Tax free interest growth; Tax free investment growth; Tax free
             withdrawals for Qualified Medical Expenses

Livingston County | 2020 Open Enrollment                                           9
Livingston County 2020 Enrollment - 2020 Annual Enrollment begins Thursday, October 17th and continues through Friday, November 1st
Health Savings Account 2020 Contribution Limits

                                                                                           Maximum
                                                         Funding                           Individual
                                    IRS Maximum                        Match Provided
                                                         Provided By                       Contribution
                                    Total Contribution                 By Employer
                                                         Employer                          Allowed After
                                    Amount Allowed                     (Livingston
                                                         (Livingston                       Livingston
                                                                       County)
                                                         County)                           County
  Tier                                                                                     Contribution

  Single                            $3,550               $500          $500                $2,550*
  2 Person                          $7,100               $1,000        $1,000              $5,100*
  Family                            $7,100               $1,000        $1,000              $5,100*
 *Please note an additional $1,000 in catch-up contributions can be made if you are age 55 or older

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Health Savings Accounts – Using Your Funds

How to Access HSA Funds:
    Online
         –     Use your member portal to pay providers electronically
         –     Mobile App
         –     Use a linked personal bank account to pay, then reimburse online from your HSA

    HSA Debit Card
         –     Swipe HSA debit card at time of service
         –     When you receive your bill from your provider you may write in your card number

Unused Funds:                                                             Remember to
    Unused funds stay with you; save for retirement                       keep your
                                                                            receipts!
    Interest accrues tax free
    Invest any balance in excess of $2,000
         –     HealthEquity offers a selection of mutual funds and bonds; Investments are tax free

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Blue Cross ONLINE VISITS

Livingston County’s Telehealth Solution:

      No fees or copays when seeing a doctor (except those in the HDHP plan - $49 copay
       until you’ve hit your deductible)
      Utilize for you or your covered dependents                   Online care is useful for
                                                                               nonemergency
                                                                               illnesses, such as:

                                                                                       Sinus and respiratory
                                   1. Take out your
                                                                                        infections
                                     smart phone
                                                                                       Colds, flu and
                                                                                        seasonal allergies
                                                                                       Urinary tract
                                                               4. Use BCBS              infections
                 2. Go to the App           3. Download the   ONLINE VISITS            Vomiting
                 Store or Google             BCBSM Online      next time you           Headache
                    Play store                  Visits app     need to see a           Strains and sprains
                                                                   doctor              Pinkeye
                                                                                       Rashes

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Dental Plans – Blue Cross Blue Shield of Michigan

  Service                                       Union Benefit         Non-Union Benefit
  Preventive                                        100%                     100%

  Basic                                              50%                      80%

  Major                                              50%                      50%

  Orthodontia (to age 19)                        Not covered               Not covered

  Maximum                                       $800 Annually
                                              $1,200 Annually for
                                                                       $1,200 Annually
                                           DEPS, 911, SGTS, LTS and
                                                     EMS

Livingston County | 2020 Open Enrollment                              13
Vision Plan – EyeMed

  Service                                        EyeMed Provider Benefits via the
                                                        Access Network
  Eye Exams
                                                               No copay
  Once every 12 Months
  Lenses
                                                              $10 copay
  Once every 12 Months
                                            $130 allowance is applied towards contact lens
  Elective Contacts                        exam and contact lenses (member is responsible
                                                  for cost exceeding the allowance)
  Frames                                          $130 allowance, 20% off balance
  One pair every 12 Months                                   over $130
  Lasik or PRK                              15% off retail price or 5% off promotional price
                                           40% off hearing exams and a low price guarantee
  Hearing Care
                                                     on discounted hearing aids

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Healthcare Bluebook
Shop For Your Healthcare

                                           Healthcare Bluebook is your healthcare
                                           transparency solution to…

                                              …help you shop for care, compare facilities,
                                               save money on healthcare services, and
                                               earn rewards.
                                              …save money on your large out-of-pocket
                                               healthcare expenses

                                           The HCBB web and mobile applications make it
                                           EASY TO SAVE MONEY ON HUNDREDS OF
                                           THE MOST COMMON MEDICAL SERVICES
                                           AND PROCEDURES by showing you the cost
                                           ranges in your area, and providing you with a
                                           selection of fair price facilities.

                                                           Healthcare
                                                         Bluebook is a
                                                        FREE service for
                                                         members and
                                                         their covered
                                                          dependents.

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Flexible Spending Accounts

Administered by Navia
 Two accounts offered:
     – General-purpose Health FSA (if you or your spouse are not contributing to a Health
       Savings Account)
     – Dependent Care FSA
 Your contributions are taken pre-tax out of your paycheck in equal amounts
  throughout the year and not included on your W-2 form as taxable income.

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Healthcare FSA
Save money on your out-of-pocket medical expenses, including office visit
copays, deductibles, and other medical, dental, and vision expenses!

                                                                                 By contributing
                                                                                 money to an FSA…

                                                        Use It Or Lose It! All
                                                          claims must be         …you are lowering
                           Helps you pay for
                         out-of-pocket medical
                                                        submitted by March       your adjusted gross
                                                          31st for claims
                               expenses
                                                         incurred through        income through the
                                                            12/31/2019           pre-tax contributions
                                                                                 you make. Through
                                                                                 this tax savings, you
     Full election is                      Eligible to roll over                 will save, on average,
  available to you on a                    up to $500 of your                    30% on eligible
   Benefits debit card                     remaining balance
    on January 1st                              into 2020
                                                                                 healthcare expenses
                                                                                 by using an FSA!

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Dependent Care FSA
A Dependent Care FSA (DCFSA) is a pre-tax benefit account used to pay for
eligible dependent care services, including, but not limited to: preschool,
summer day camp, before or after school programs, and child daycare.

                             Helps you pay              If you’re married,
                          expenses for care of          your spouse must
                          a dependent so that         also work or be a full-
                             you can work.                 time student.

                                           You must contribute
  You can contribute a
                                           the money into your
   maximum of $5,000
                                            account via payroll
  into your Dependent
                                           deduction before the
   Care FSA. This is a
                                             money becomes
    family maximum.
                                             available to you.

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Limited Purpose FSA

For those enrolled in the HDHP with HSA, you have the opportunity to enroll in the Limited-Purpose FSA
through Health Equity.
 LFSA allows you to contribute additional pre-tax dollars to use for Dental and Vision expenses only

     – The LFSA lets you spend pre-tax money on dental and vision expenses while keeping your HSA
       funds for medical and pharmacy expenses.
     – Should you elect the LPFSA, you will have two debit cards: one for your FSA and one for your
       Limited Purpose account

                                           Before you enroll in an HSA or LPFSA,
                                           you cannot have any money in your FSA.
                              NOTE         Per IRS guidelines, you must liquidate
                                           your account prior to 1/1 if electing the
                                           HDHP/HSA plan.

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CIGNA Basic Life Insurance + AD&D

 Your Basic Life and Accidental Death & Dismemberment benefit is paid for by Livingston County.
  Coverage is insured by Cigna.
 Your benefit varies depending on bargaining unit – please refer to your benefit guide for your specific
  benefit amount.
 Benefit reductions apply for employees age 70 and older. Please see Human Resources with any
  questions.
                                                                                    CIGNA
 Benefit Level
 Eligibility               Class 1 Paramedics
                           Class 2 MAPE Court Members
                           Class 3 MAP Sergeants
                           Class 4 MAPE 911 Dispatch Members
                           Class 5 LCDSA Deputies, Corrections Officers and Detectives
                           Class 6 MAP lieutenants
                           Class 7 Non-Union Members, Elected Officials and Judges
 Employee                  Base Life:
                           Class 1 - $40,000
 Life/AD&D                 Class 2 - 2 times your Annual Earnings rounded to the next higher multiple of $1,000, if not already a multiple of $1,000.
 Benefit                   Maximum: $200,000
                           Class 3 - $40,000
 Amount                    Class 4 - 1 times Annual Earnings rounded to the next higher multiple of $1,000. Maximum: $500,000.
                           Class 5 - $45,000
                           Class 6 - $50,000
                           Class 7 - 1 times your Annual Earnings, rounded to the next higher multiple of $1,000, if not already a multiple of $1,000.
                           Maximum: $500,000

                           Base AD&D:
                           All Classes Amount equal to Base life amount

Livingston County | 2020 Open Enrollment                                                                             20
CIGNA Voluntary Term Life Insurance + AD&D

You may elect to purchase additional insurance through Cigna:

 Your benefit varies depending on bargaining unit - please refer to your benefit guide for you specific
  benefit amount.
 Benefit reductions apply for employees age 70 and older. Please see Human Resources with any
  questions.

Additional financial resources if you pass away from a covered circumstance:

     Valuable- help your family cover expected and unexpected costs and living expenses
     Easy- if you apply during your enrollment period, you may not have to answer medical questions
     Portable- you can take your coverage with you if you retire or leave your company prior to age 70
     Waiver of Premium- if you become disabled prior to age 60, premium payments are waived
     Accelerated life insurance benefits- you can receive the lesser of 75% up to $500,000 if you’re
      diagnosed with a terminal condition

    Notes:
    1. Coverage elections above the guaranteed issue amount require medical underwriting.
    2. Higher rates may apply.
    3. No premium payments are required if you become continuously totally disabled for the time period specified in your Policy Certificate. Refer to the
       plan materials for more specific information, including your plan’s definition of disability.
    4. Accelerated death benefits reduce the life insurance death benefit and are payable up to the maximum specified by your plan. See your plan
       materials for details and diagnosis requirements.

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CIGNA Disability Insurance (STD and LTD)

Disability insurance replaces part of your paycheck when you can’t work for a period of time due to a
covered illness or injury. It gives you and your family additional financial protection

 If you become disabled, you use it like a paycheck to help pay for:
  – Day-to-day living expenses like groceries, mortgage or utilities
  – Unplanned costs like medical bills
 Your benefit varies depending on your bargaining unit – please refer to your benefit guide for your
  specific benefit amount.

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CIGNA Voluntary Benefits (Accident, Critical Illness, Hospital Indemnity)

Voluntary benefits can provide supplemental coverage in case of an accident, illness, or hospital stay.
 Group rates
 Payroll deducted
 Choices – you select the coverage that suits the needs of you and your family

Accidental Injury (Accident) Insurance:
  – Additional coverage when accidents happen (broken bones, burns, torn ligaments, ruptured
     discs, stiches, concussions, etc.)
  – Benefits may be payable for initial treatment, ER visit, hospitalization, follow-up care
  – Off the job accidents only
  – Pays a scheduled amount to you based on the injury/accident
     • Via check
  – Portable

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CIGNA Voluntary Benefits (cont.)

 Critical Illness:
  – Pays a lump-sum benefit directly to you upon diagnosis of a covered illness (i.e. Heart
     Attack, Stroke, Cancer, Paralysis, Coma, ALS, Parkinson’s, etc.)
     • Via check
  – What you do with your payment is up to you. Pay-outs can be used to cover anything. Some
     examples of typical expenditures include: child care, everyday household bills, treatment not
     covered by traditional insurance, travel for medical treatment, etc.
  – Benefit Election Amounts (no waiting period):
     • Employee: $5,000, $10,000, or $20,000
     • Spouse: 50% of employee election amount
     • Child: 25% of employee lection amount
  – Health Screening Benefit ($75 per calendar year)
     • Mammography, chest x-ray, cholesterol screening, etc.
  – Reoccurrence benefit
     • Additional coverage for reoccurring illness

Livingston County | 2020 Open Enrollment                                    24
CIGNA Voluntary Benefits (cont.)

 Hospital Care (Hospital Indemnity) Insurance
  – Pays a benefit for covered hospital stays resulting from injury or illness. Coverage continues
    after your first hospital stay so you have additional protection for future hospital stays.
  – You can use your money however you’d like
    • For Example: medical bills not covered by your health plan, child care, travel, other out of
       pocket expenses
  – There are no copays, deductibles, coinsurance, or network requirements
  – Additional features include:
    • Health Screen Benefit

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CIGNA Value-Added Programs and Services

 The following are services available to all Livingston County employees:
  – My Secure Advantage
    • 30-days’ pre-paid expert money-coaching for all types of financial planning and challenges,
        Identity theft prevention and fraud resolution services, online tools for state-specific wills and
        other important legal documents
  – CIGNA Health Rewards
    • Discounts on health and wellness services, including vision and hearing care, diet programs,
        fitness centers, massage, chiropractic care and acupuncture.
  – Health Advocacy Services (more on this later!)
    • Personalized assistance to help employees and their family members (including parents and
        parents-in-law) navigate a wide range of health care and health insurance challenges.
  – CIGNAassurance
    • Free, interest-bearing account for claim payments of $5,000 or more, and access to Life
        Assistance, My Secure Advantage and Healthy Rewards for beneficiaries
  – CIGNA Secure Travel
    • A comprehensive worldwide travel assistance program that includes pre-trip planning and
        emergency assistance to covered persons while traveling 100+ miles from home

  *These programs are NOT insurance and do not provide reimbursement for financial losses. Some restrictions may apply. Customers are required to pay the entire discounted
    charge for any discounted products or services available through these programs. Programs are provided through third party vendors who are solely responsible for their products
    and services. Full terms, conditions and exclusions are contained in the applicable client program description, and are subject to change. Program availability may vary by plan
    type and location, and are not available where prohibited by law.
  **Services available at the option of employer for an additional cost and not available to Health Advocates, Inc. existing clients.

Livingston County | 2020 Open Enrollment                                                                                                          26
CIGNA Advocacy – Health Advocate

CIGNA Advocacy is there to get you the answers you need when you need them as you
navigate the complex world of healthcare.

Help for you and your family is just a phone call away…get 24/7 support from Health
Advocate by calling 866-799-2725

Services Include:
    Find a doctor based on your needs
    Locate specialists, schedule appointments
    Answer questions about diagnoses, test results, treatment medications
    Address questions and concerns related to your medical bills
    Find options for non-covered and alternative health services
    Clarify and get help applying for Medicare, Medicare Supplement insurance, and Medicaid
    Coordinate care among multiple providers
    Get assistance with special needs services
    Find in-home care, adult day care, group homes, and assisted living + long term care

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Pet Insurance – Nationwide

Livingston County | 2020 Open Enrollment   28
Employee Assistance Program

                                           Available services include:

                                           •   Counseling (telephonic and
                                               face-to-face)
                                           •   Support for your family
                                           •   Legal & Financial Services
                                           •   Work-Life Resources

                                           Call 800-488-8326 for assistance!

                                                     Don’t forget to
                                                      mention you
                                                        work for
                                                       Livingston
                                                        County!

Livingston County | 2020 Open Enrollment               29
Ulliance EAP Services Available To Employees + Dependents

Livingston County | 2020 Open Enrollment          30
Open Enrollment Next Steps!

 This year’s enrollment will be passive – you do not need to complete the online enrollment unless you
  are electing the Healthcare or Dependent Care Reimbursement Account or electing new or changing
  current coverage (i.e. adding pet Insurance, switching medical plans, adding critical illness, etc.)

 Login to your employee Portal to make changes to your benefits no later than 11/1/19 (this is the last
  day of Open Enrollment).

 If you are enrolling for Life or Disability coverage for the first time, or you are increasing your voluntary
  coverage amounts, Evidence of Insurability may be required. Your coverage will not be effective until
  you have been approved.

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Employee Portal

1.     Go to www.livgov.com and click on Employees in the upper right ribbon

2.     Next you will need to login with your employee information.

3.     Once in your employee portal click on Employee Self Service

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Employee Portal (cont.)

4.     Next click on Benefits

5.     Then you will need to click on the Open Enrollment link

6.     You will now be ready to select your 2020 Benefits

7.     Once completed, click Continue

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Wrap Up + Questions
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