1. RISK MANAGEMENT & INSURANCE

2. WHEN ARE MY BENEFITS EFFECTIVE ? Benefits are effective the first day of the month following 60 days of employment. Example: Hire Date Benefits Effective 8/13 11/1 4/22 7/1 You must turn in your Enrollment and Change form in person or by pony (interoffice envelope) to Risk Management and Insurance Department within 31 days of your hire date or full time position date.

3. PAYROLL DEDUCTIONS 20 Payroll Deductions per year. You pay for 12 months of coverage during the 10 month school year. You pay one month in advance. Deductions include a portion for summer coverage. Summer premium may be owed upon your initial enrollment or if you change benefits during the year. If your deductions change during the year, you may owe premium or you may be due a refund.

4. Dependent Eligibility For Medical, Dental & Vision coverages: Legally married spouse Dependent children may be covered through end of calendar year in which they reach age 26 Family OTL and Dependent Child(ren) Life Insurance coverages: Legally married spouse Dependent children may be covered up to age 26: – A.) if they are dependent upon you for support: OR – B.) they are a full-time student For Medical: Dependent children up to age 30, please contact Risk Management at 588-6197 for further details and documentation. DOCUMENTATION IS REQUIRED FOR DEPENDENTS enrolled in health, dental or vision coverage: marriage certificate for a spouse, birth certificates for children. Photocopies are acceptable. DOCUMENTATION IS REQUIRED FOR DEPENDENTS enrolled in health, dental or vision coverage: marriage certificate for a spouse, birth certificates for children. Photocopies are acceptable.

7. Rates are per pay period, 20 pay periods per year. Use your $75 per pay period “No Health” Board credit on coverages marked with a diamond. Board credits may not be used for Optional Term Life Insurance.

8. Rates are per pay period, 20 pay periods per year. Use your $75 per pay period “No Health” Board credit on coverages marked with a diamond. Short term disability must be elected in order to elect long term disability. Monthly benefit is determined by your annual salary.

9. Terms and Definitions  Co-payment - the specified dollar amount that the member must pay for a covered service. You will pay co-payments for services under the HMO Staff plan.  Co-insurance - the % amount of a covered service that the member must pay. Example: An 80%/20% coinsurance means that Humana will pay 80% of the allowable charge and the member will pay 20%. 9

10. Terms and Definitions  Deductible - the amount of covered services that the member must pay per year before Humana pays benefits for covered services.  Medical Out-of-pocket limit - the most a member would have to pay per calendar year before Humana pays 100% of the in network cost. Excludes Rx costs. 10

11. Terms and Definitions DEDUCTIBLE You pay 100% of the cost up to the amount of the deductible* CO-INSURANCE You pay 20% of the cost up to the out of pocket limit OUT OF POCKET LIMIT Humana pays 100% of the costs after the costs reach $4000 for an individual, $8000 for a family 11 *All individual deductible amounts will count toward the family deductible, but an individual will not have to pay more than the individual deductible amount.

12. Three health plans to choose from: 1.Staff HMO 2.National Point Of Service (NPOS) 3.Consumer Directed Health Plan (CDHP) Preventative physicals, GYN care, mammography and colonoscopy exams covered at no charge Maximum out-of-pocket (excluding prescriptions) EE only$4,000 EE+1, EE + Children$8,000 EE + Family

13. HMO Staff  No Out-of-Network Benefit except for emergencies  Referrals to Specialists limited by PCP Choice  Co-pays for all services; preventive services covered at 100%  Hospital co-pay: $500 per day, 5 day maximum  Very Narrow Physician Network Service areas Pinellas, Pasco, Hillsborough, Manatee, Polk, Sarasota, Hernando & Citrus

14. NPOS (National Point of Service)  Broad National NPOS Network – open access  No Specialist referrals needed  In-Network and Out-of- Network benefits  80/20% co-insurance for physician visits, outpatient services, lab and x-rays.  Hospital co-pay: $500 per day, 5 day maximum.  Deductible: $400/individual $800/family ++ Good option For Out of Area Family Members

15. CDHP Benefit Plan (Consumer Directed Health Plan)  No Specialists referrals needed.  NO Out-of-Network benefits.  Network – HMO Premier:  Service areas: Pinellas, Pasco, Hillsborough and several other Florida counties as well as a limited number of states outside of Florida.  $1,500 (individual) and $3,000 (family) deductible with a $500 (individual) and $1,000 (family) allowance.  80%/20% In–Network Co-insurance once deductible has been met.

16. Which Health Plan is Right for You? HMO CDHP NPOS Must stay in Network Must Select a PCP No deductible - set co-pays for all services Limited coverage area Must get a referral to see a specialist Must stay in Network Not required to select a PCP No referrals necessary Must meet a deductible Healthcare allowance provided Not required to stay in Network Not required to select a PCP No referrals necessary Must meet a deductible

17. Pinellas County Schools health insurance coverage meets the standard for minimum essential coverage and is considered affordable under the Affordable Care Act. Benefit eligible employees who enroll in the Marketplace plans would not be eligible for Advanced Premium Tax Credits (tax subsidy) and would not receive premium assistance. PCS COVERAGE VS. THE HEALTHCARE MARKETPLACE

18. Tier/PlanConsumer Directed Health Plan Staff HMONational Point of Service (NPOS) Employee$53$71$80 Employee + Spouse $159$195$213 Employee + Child/Children $146$182$200 Family$215$266$302 2 Board Family$120$171$207 18 2016 Health Plan Deductions Payroll deductions are PER PAY -- 20 pays. These are after the Board contribution has been applied. This applies to all employees no matter what pay options is selected (pages 6 & 7 in BeneFlex Guide) To be eligible for Two Board Family, you and your spouse are employees of the School Board, both qualify for benefits and have at least one child who meets the eligibility guidelines

19. Pharmacy Benefits Rx4 Traditional replaces Rx3 Deductible on Tier 3 & Tier 4 medications must be met before copays will apply. Pay two co-pays for a 90 day supply at a participating pharmacy or mail order through Humana Pharmacy (after deductible on Tier 3 & Tier 4 medications). Check our website for manufacturer programs that help with Rx costs!

20. “No Health” Board Contribution Use your $75 per pay period Board Credit for: Dental Met Life or Comp Benefits Vision EyeMed Vision Care Accidental Death & Dismemberment Insurance Short Term/Long Term Disability MetLife HOSPITAL INDEMNITY (HIP) Flexible Spending Account Apply up to $25 to a Health Care Reimbursement Account.

21. Flexible Spending Accounts (FSA) 21 A Health Care FSA could save you money if you or your dependents:  Have out of pocket health expenses like co-pays or deductibles  Take Tier 3 or Tier 4 prescription medications and have an Rx deductible  Wear glasses or contact lenses  Need orthodontia care, such as braces or other eligible dental expense A Dependent Care FSA provides pre-tax reimbursement of out of pocket expenses related to dependent care, if you and your spouse are working or in school and:  Your dependent children under age 13 attend daycare, after-school care or summer day camp

22. Flexible Spending Accounts ( FSA ) 22 You decide how much to contribute: Health Care FSA: $200 - $2500 Dependent Day Care FSA: $200 - $5000 Use it or lose it – the amount deposited into FSA may be used for services incurred for the plan year ending 12/31. Receive a debit card – for Health Care Expenses. Not for Dependent Day Care. Funds available for Health Care expenses on January 1, 2016 Look for Humana Access Visa cards last week in December (plain envelope)

23. Dental Plans 23 1. Humana/ CompBenefits Copayments, in-network providers only 2. Met Life PDP (reimbursement plan) Co-insurance, chose any dentist, save on preferred providers *Board Contribution (Flex Credits) may be used

24. Dental Plans Comparison Chart

27. Eye Med Vision Plan 27 KEY FEATURES Free coverage for employee only. May purchase coverage for dependents Routine eye exam once every calendar year - $10 co-pay Single vision lenses OR contact lenses once every calendar year Frames once every two years National retail and private practice optometrists & ophthalmologists Standard plastic lens co-pay $15 Contact lens allowance $110 plus 20% off balance over $110 Frame allowance $110 RATES Employee Only Free Employee + 1 $2.83 Employee + Family $5.92

28. Employees must complete the beneficiary section for Board Life. Primary and Secondary beneficiaries must equal 100%:

30. Short Term/Long Term Disability 30

31. MetLife HOSPITAL INDEMNITY (HIP) Box #4 Covered Benefits: Hospital Admission - $500 Hospital Confinement - $250 per day, 30 day maximum Inpatient Rehabilitation Unit - $100 per day, 15 day maximum – Accident only Pre-existing conditions limitations apply. *Board Contribution (Flex Credits) may be used Rates are listed on page 7 in the Beneflex Guide. The MetLife HIP pays a cash benefit when you or a covered dependent is hospitalized due to an accident or illness.

32. Humana Vitality is a wellness and rewards program for employees enrolled in a Humana health plan that gives its members an opportunity to: Set goals – create a personalized plan! Earn Vitality Points™ and shop at the Vitality Mall with Vitality Bucks! Learn the value of making healthy choices to experience personal results! Employees reaching Silver Status or above by June 30, 2016, will be eligible for a premium credit during 2016 AND 2017! Employee Only $10 credit per pay period Employee + Spouse $15 credit per pay period Employee + Child/ren $15 credit per pay period Employee + Family $20 credit per pay period Better health, great rewards- it's all part of Humana Vitality!

33. How does it work?

34. Employee Assistance Program Covers all eligible employees and family members Up to 8 free counseling sessions per incident.(no co-pays) Strictly confidential Stress (on & off the job) Family & Marital problems Divorce Substance or Alcohol Abuse Depression Elder Care Referral Legal Assistance Referrals Corporate Care Works 1-800-327-9757

35. Voluntary Products Convenient payroll deductions Enroll anytime throughout the year after your eligibility begins - Group Legal Services may only enroll as a new hire or during annual enrollment Met Life: Great rates for cars, recreational vehicles and motorcycles MetLife – Auto/Motorcycle/Recreation Vehicle, and Veterinary Pet Insurance Enrollment any time during the year through: 1-800-Get Met 8 (438-6388)

36. Retirement Florida Retirement System (FRS) – You will contribute 3% of your gross pay – You must decide after receiving your packet from FRS in 60 days which plan to select FRS Pension Plan FRS Investment Plan Tax Deferred Annuity Program – Defer up to 25% of pay, not to exceed $15,500 per year. (If you turn age 50 or older this year, you can contribute and additional $5,000.) – NO contributions /matching funds from PCS

37. Please do not ask questions of coworkers, school secretaries, department heads, principals. They may not have the answers that best meet your needs. Instead, contact the RISK MANAGEMENT BENEFITS TEAM for the most accurate answer at 727-588-6197 Or visit our website at www.pcsb.org/risk-benefits QUESTIONS

38. Risk Management & Insurance Department We offer a comprehensive and flexible benefit program that meets your needs today & tomorrow. We are here to serve you, our customer. Please call us anytime 588-6197 Good luck & Welcome to Pinellas County Schools