2018 - 2019 Annual Enrollment Guide - Explain My Benefits€¦ · Allstate Universal Life, these plans will no longer be payroll deducted as of 10/1/2018. You may keep these plans

2018 - 2019

Annual

Enrollment

Guide

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Who is Eligible?

Full time regular employees and their eligible dependents. Please make your benefit elections carefully. NO CHANGES are allowed during the plan year, unless the member experiences a qualifying life event.

WELCOME TO OPEN ENROLLMENT

FOR YOUR 2018-2019 BENEFITS!

We know that quality benefits and the opportunity to choose are important to you and your family. With that in mind, The City of Apopka maintains a high quality benefits program. On the following pages you will find information on the benefits that are in effect for the plan year October 1, 2018 through September 30, 2019.

What’s in the Guide?

Enrollment Process……………………….………..…….3

Login Instructions………………………………………4-6

Mobile App...…………...…………………….……..……..7

Medical………………………………………..……...….8-13

Dental………………………………………………….…..…14

Vision………………………………...………..………..……15

Life Insurance………………………………….…….……16

Voluntary Long Term Disability…………...………17

Identity Theft Protection……..…………………..…18

Additional Benefits.…………...……………………....19

Trustmark Voluntary Benefits………………..20-21

Allstate Voluntary Benefits…………………….22-25

Important Contacts……………….…………………….26

IMPORTANT NOTICE If you currently have Allstate Short Term Disability or Allstate Universal Life, these plans will no longer be payroll deducted as of 10/1/2018. You may keep these plans via direct bill with Allstate.

The following plans have been discontinued by Allstate and will no longer be payroll deducted as of 10/1/2018: • Allstate SHOP • Allstate Heart/Stroke • Allstate CP10 Cancer

These plans have been replaced by the following: • Allstate Group SHOP • Allstate Critical Illness • Allstate CP12 Cancer

If you currently have any of the discontinued plans, you have a couple of options available to you: 1. If you wish to keep the discontinued plan, you will be

able to do so via direct bill with Allstate. Please note: The only changes that will be allowed on these discontinued plans will be to drop dependents from coverage, no other changes will be allowed.

2. You can move to one of the new replacement plans listed above. Additional information regarding the new plans and how to enroll in them can be found later in this guide.

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We are honored to present your 2018-2019 Benefit Options! The elections you make during open enrollment will become effective October 1, 2018 and run through September 30, 2019.

Enrollment Process

Open Enrollment

August 14th through August 17th

STEP 1 - Review Your Benefits

• Review this Benefit Guide which provides an overview of all benefits being offered for the upcoming plan year. You will also be able to review a copy at : www.explainmybenefits.com/apopka

• The website above will give you the opportunity to schedule a benefit enrollment meeting with Explain My Benefits at the Fran Carlton Center from 8:30am - 4:00pm.

STEP 2 - Options to Enroll

Self-Service

• Visit www.explainmybenefits.com/apopka and move through the enrollment system at your own pace.

• If choosing this option, be sure to click “submit” at the end of the process and make note of your confirmation numbers. If you do not receive a confirmation number, you have not completed your enrollment and you will not be enrolled for the 2018-2019 plan year.

• Return to the system anytime and click your confirmation number to view your confirmation statement.

On-Site Benefit Counselor

• Meet one-on-one with a benefit counselor to discuss and help you enroll in your benefits for the upcoming plan year.

• We highly recommend you schedule an appointment with an EMB Benefit Counselor this year especially if you currently have Allstate benefits.

Kiosk Enrollment

• There will be multiple computers available for you to use at the Fran Carlton Center to complete your enrollment.

Reminders

Be sure to review this 2018-2019 Benefit Guide and plan summaries prior to going through any enrollment process.

Confirm all demographic information in the enrollment system is accurate. Be prepared by gathering dependent and beneficiary information (i.e. Social Security Numbers and Dates of Birth).

http://www.explainmybenefits.com/apopka

http://www.explainmybenefits.com/apopka

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Mobile App

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DEPENDENTS You may also elect coverage for your dependents. Eligible dependents may include the following:

• Your Legal Spouse

• Dependent of you or your spouse; legally adopted children; children for which legal guardianship has been awarded

• Disabled dependent children who are supported primarily by you, and who are incapable of self-sustaining employment by reasons of mental or physical handicap (proof of their condition and dependence must be submitted)

Medical - Dependent children up to age 26 regardless of financial dependency, residency, student sta-tus, employment or martial status or up to age 30 if they meet ALL of the following requirements:

- Unmarried and does not have a dependent of his or her own

- A resident of this state or a full-time or part-time student; and

- Is not provided coverage as a named subscriber, insured, enrollee, or covered person under any other group, blanket, or franchise health insurance policy or individual health benefits plan, or is not entitled to benefits under title XVIII of the Social Security Act. Dental - Dependent children are covered until the end of the year in which they reach age 30 (unless disabled). Vision - Dependent children are covered until the end of the year in which they reach age 25 (unless disabled).

We continue to offer a Florida Blue PPO plan and have added a “buy-up” plan with increased benefits. The new plan is an HMO with no deductible and no coinsurance. With coverage under the PPO plan, your care is self-directed. With coverage under the HMO plan, your care is managed by your primary care physician (PCP) and has a more narrow network. Emergency services while traveling domestically or internationally are covered under the broader BCBS network for both plans.

Medical

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BlueOptions 03559 Plan At-A-Glance - NEW for 2018-2019 BlueOptions 03559 Plan

In Network Out of Network

Deductible

Single $750 Combined w/ In-Network

Family $2,250 Combined w/ In-Network

Coinsurance

Member Responsibility 20% 40%

Out-of-Pocket Maximum

Single $3,000 Combined w/ In-Network


What Applies to the Out-of-Pocket Maximum? Co-pays, Deductible and Coinsurance (excludes Rx)

Physician Services

Physician Office Visit $20 Deductible + 40%

Specialist Office Visit $35

Preventive Care $0 40%

Diagnostic Services (Freestanding Facility)

Clinical Lab (Blood Work) at Independent Facility $100

Deductible + 40% X-rays at Independent Facility $100

Advanced Imaging (MRI, PET, CT) $100

Hospital Services

Inpatient $750 per admission $2,000 per admission

Outpatient Surgery (Ambulatory Surgical Center) $100 Deductible + 40%

Physician Services at Hospital Deductible + 20% In Network Deductible + 20%

Emergency Room $100 + 20% $100 + 20%

Urgent Care Center $35 $35

Mental Health / Alcohol & Substance Abuse

Inpatient (30 days max) Deductible + 20% In Network Deductible + 20%

Outpatient $35 Deductible + 40%

Prescription Drugs (Rx)

Generic $10

50% Coinsurance Preferred Brand Name $25

Non-Preferred Brand Name $60

Mail Order Drug (90 Day Supply) $20 / $50 / $120

Medical

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BlueChoice 0727 (PPO) Plan At-A-Glance BlueChoice 0727 (PPO) Plan


Deductible

Single $500 Combined w/ In-Network


Coinsurance

Member Responsibility 20% 40%


Single $1,500 Combined w/ In-Network


What Applies to the Out-of-Pocket Maximum? Co-pays, Deductible and Coinsurance (excludes Rx)

Physician Services

Physician Office Visit $15 Deductible + 40%

Specialist Office Visit $15

Preventive Care $0 30% (no deductible)


Clinical Lab (Blood Work) at Independent Facility Deductible + 20%

Deductible + 40% X-rays at Independent Facility $15


Hospital Services

Inpatient Deductible + 20% $300 PAD + Deductible + 40%

Outpatient Surgery Deductible + 20% Deductible + 40%

Physician Services at Hospital Deductible + 20% Deductible + 20%

Emergency Room Deductible + 20% Deductible + 20%



Inpatient (30 days max) Deductible + 20% $300 PAD + Deductible + 40%

Outpatient Deductible + 20% Deductible + 40%


Generic $5

50% of allowance Preferred Brand Name $35


Mail Order Drug (90 Day Supply) $10/$70/$70

Medical

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BlueCare 59 (HMO) Plan At-A-Glance

BlueCare 59 (HMO) Plan


Deductible

Single N/A N/A

Family N/A N/A

Coinsurance

Member Responsibility N/A N/A


Single $1,500 N/A

Family $3,000 N/A

What Applies to the Out-of-Pocket Maximum? Co-pays, including Rx N/A

Physician Services

Physician Office Visit $15 (PCP)

Not Covered Specialist Office Visit $35

Preventive Care $0


Clinical Lab (Blood Work) at Independent Facility $0

Not Covered X-rays at Independent Facility $0


Hospital Services

Inpatient $150 per day up to $750 Not Covered

Outpatient Surgery $200 Not Covered

Physician Services at Hospital $0 Not Covered

Emergency Room $50 $50



Inpatient (30 days max) $150 per day up to $750 Not Covered

Outpatient $35 Not Covered


Generic $10

N/A Preferred Brand Name $25


Mail Order Drug (90 Day Supply) $20/$50/$120

Medical

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Health Insurance - Per Pay Period Payroll Deduction

Employee Health and Wellness Center—CareHere! (paid by City)

Employees have access to no cost general medical care at the medical facility provided by the City. There are no charges for examinations, no charge for prescriptions dispensed, no charge for lab work, and any other service available on-site. The facility also offers access to wellness programs, including weight-loss programs, tobacco cessation programs and other wellness initiatives. CareHere should not be considered a replacement for your primary care physician should you enroll in the HMO.

Coverage Tier

Plan Employee w/ Spouse Only w/ Child(ren) Family

BlueOptions 03559 $0.00* $101.67 $64.42 $140.01

BlueChoice 0727 (PPO) $10.84 $126.29 $86.08 $176.45

BlueCare 59 (HMO) $16.14 $136.91 $95.42 $192.09

Medical

*100% of the employee premium is paid by the City.

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Medical

MEET OUR DOCTORS Teladoc is simply a new way to access qualified doctors. All Teladoc doctors:

• Are practicing PCPs, pediatricians, and family medicine physicians

• Average 20 years experience

• Are U.S. board-certified and li-censed in your state

• Are credentialed every three years, meeting NCQA standards

GET THE CARE YOU NEED Teladoc doctors can treat many medical conditions, including:

• Cold & flu symptoms

• Allergies

• Sinus problems

• Urinary tract infection

• Respiratory infection

• Skin problems

• And more!

WHY TELADOC? It is a convenient and affordable option for quality care.

• When you need care now

• If you’re considering the ER or urgent care for a non-emergency issue

• On vacation, on a business trip, or away from home

• For short term prescription re-fills

Your Teladoc visit copay is the same as your PCP visit copay.

A welcome kit is being mailed to your home with instructions for setting up your Teladoc® account, completing your medical history and requesting a consult. Once you’re set up, a Teladoc doctor is always just a call or click away.

Teladoc gives you access 24 hours, 7 days a week to a U.S. board certified doctor through the convenience of phone, video or mobile app visits. Set up your account so when you need care now, a Teladoc doctor is just a call or click away.

SET UP YOUR ACCOUNT Set up your account by phone (toll free), web, mobile app or by texting “Get Started” to 469-844-5637

Online: Go to Teladoc.com and click “set up account”.

Mobile App: Download the app and click “Activate account”. Visit teladoc.com/mobile to download the app.

Call Teladoc: Teladoc can help you register your account over the pone.

PROVIDE MEDICAL HISTORY Your medical history provides Teladoc doctors with the information they need to make an accurate diagnosis.

REQUEST A CONSULT Once your account is set up, request a consult anytime you need care. An talk to a doctor by pone, web or mobile app.

Teladoc can treat Cold & flu symptoms Respiratory infection Sinus proglems And more!

Use Teladoc when You need care now. You’re considering the ER or urgent care for a non-emergency issue Traveling out of town

Teladoc’s wait time

Talk to a doctor In less than 10 minutes

Talk to a doctor now

Teladoc.com | 1-800 –Teladoc (835-2362)

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BlueDental Choice Plus High Plan BlueDental Choice Standard Plan Plan

In Network Out of Network In Network Out of Network

Deductible Individual / Family

$50 / $150 $50 / $150 $50 / $150 $50 / $150

Annual Maximum $1,500 $1,000

Preventive Services Exams, Cleanings, X-Rays, etc.

Plan pays 100% Deductible is

waived.


waived.


waived.


waived.

Basic Services Fillings, Simple extractions, Periodontics, Root Canals, etc.

90% covered 80% covered 80% covered 50% covered

Major Services Crowns, Dentures, Fillings, etc.

60% covered 50% covered 50% covered 25% covered

Orthodontics Lifetime Max BlueDental Pays

$1,500 50%

$1,000 50%

Employees have a choice between two plans. Both plans are PPOs and have “open access” within the network, plus you have the option to go outside the network. The low option, BlueDental Choice Plan, is a good basic plan. The high option plan, BlueDental Choice Plus, might be a better choice if you expect to have heavier utilization of the dental plan.

Locate a Dentist within the BCBS/Florida Combined network at

www.bcbsfl.com

Tier of Coverage Payroll Deduction Per

Pay Period High Plan Payroll Deduction Per

Pay Period Standard Plan

Employee $8.16 $5.31

w/ Spouse Only $17.88 $11.52

w/ Child(ren) $23.02 $15.86

Family $30.68 $20.75

Dependent children are covered until the end of the year in which they reach age 30 (unless disabled).

Dental

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You may use any provider you wish, but your benefits are higher when you use a participating provider. You may locate a provider at www.vsp.com.

Benefit Participating Provider Non-Participating Provider

(Reimbursement) Frequency

WellVision Exam $10 Co-pay Up to $45.00 Every Plan Year

Frames & Lenses (single/lined bifocal/ lined trifocal)

(Polycarbonate lenses for dependent children)

$30 Co-pay

Frames - up to $70.00 Single - up to $30.00

Lined bifocal - up to $50.00 Lined trifocal—up to $65.00

Frames - Every Other Plan Year

Lenses - Every

Plan Year

Lens Enhancements

Scratch Resistant - $0 Standard Progressive - $55

Premium Progressive - $95-$105 Custom Progressive - $150-$175

Progressive - up to $50.00 Every Plan Year

Contacts (in lieu of glass-es)

$130 Allowance (contacts and contact lens

exam) Up to $105.00 Every Plan Year

Dependent children are covered until the end of the year in which they reach age 25 (unless disabled).


Pay Period

Employee $1.58

w/ Spouse Only $2.53

w/ Child(ren) $2.58

Family $4.16

Vision

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Voluntary Supplemental Life Employees have the opportunity at the time of hire or open enrollment to purchase extra life insurance for themselves and their dependents.

Employee - You may elect life insurance, on yourself, up to a maximum of $350,000, not to exceed 5 times annual pay.

One Time Guaranteed Issue Amount at Initial Eligibility Only Up to $200,000 (Not to exceed 3x annual salary)

If coverage is applied for at a later date ( or if an increase in coverage is requested at a later date) “Evidence of Insurability” must be provided, including health questions.

Spouse - You may elect coverage for your spouse in the amount of $15,000 (up to age 70)

Child(ren) - You may elect coverage for your dependent children* in the amount of $5,000 per child

Coverage Tier Rate Available Coverage

Employee $.56 / mo. per each $1,000 (must be

purchased in $10,000 increments) Up to $350,000, not to exceed 5x annual salary

Spouse $4.50 / mo. $15,000

Dependent Child(ren) $1.15 / mo. $5,000 each child

COSTS FOR VOLUNTARY SUPPLEMENTAL LIFE INSURANCE

Basic Term Life and AD&D The City of Apopka provides Basic Life and AD&D Insurance through Cigna for all eligible employees at no cost

to the employee. The Basic Life and AD&D insurance benefit is $30,000.

You must elect supplemental term life on yourself in order to elect coverage for your spouse and/or

dependents.

Term Life Insurance

*Dependent Child Your unmarried child if he or she meets the following requirements: 1. A child 14 days of age but less than 19 years old; 2. A child who is 19 or more years old but less than 26 years old, enrolled in a school as a full-time student

and primarily supported by you; 3. A child who is 19 or more years old, primarily supported by you and incapable of self-sustaining

employment by reason of mental or physical handicap.

The term “child” means a child born to or legally adopted by you. It includes a child during any waiting period prior to finalization of the child’s adoption. It also means a stepchild living with and financially dependent upon you.

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All eligible employees have the opportunity to enroll in Long Term Disability Insurance. Benefits begin after a person is disabled for 180 days (six months). The benefit is 60% of your monthly salary (up to a maximum of $5,000 per month). The plan has a Two-Year “Own Occupation” benefit. This important provision means that for the first two years of disability, the policy will pay you benefits as long as you can’t work at the position for which you’ve been educated or trained and will continue to pay benefits after the first two years if you are still unable to work at any occupation due to disability. (Some LTD policies don’t pay any benefits unless you are completely disabled and unable to perform any gainful employment.) Benefits are payable to age 65. For those over 65, the benefit period will vary based on the age at which you first purchased coverage. Cost for Long Term Disability Insurance: $.37/mo. per $100 of monthly salary, not to exceed $8,333

Voluntary Long Term Disability

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Identity theft in the United States is a major problem that continues to be on the rise. Professional pro-tection and assistance have become important tools in fighting the identity theft epidemic.

Thieves today can get a hold of your personal information from trash cans, dumpsters, stolen mail, and even shoulder surfing. Once thieves have your information, it’s a simple matter to open new fraudulent accounts and make purchases in your name.

When you enroll in LifeLock, you can be confident knowing that they are available 24 hours a day, 7 days a week, and committed 100% to helping protect your information as if it were their own.

LifeLock offers Proactive Protection in both of the plans offered:

Benefit Elite Plan

• LifeLock Identity Alert System

• Lost Wallet Protection

• Address Change Verification

• Black Market Website Surveillance

• Live Member Service Support

• LifeLock Privacy Monitor

• Reduce Pre-Approved Credit Card Offers

• Identity Restoration Support

• Stolen Funds Replacement - up to $100,000

• Fictitious Identity Monitoring

• Court Records Scanning

• Data Breach Notifications

• Investment Account Activity Alerts

Ultimate Plan

Provides all of the benefits of the Benefit Elite Plan plus:

• Stolen Funds Replacement - up to $1,000,000

• Credit Card, Checking & Savings with Account Activity Alerts

• Online Annual Credit Report

• Online Annual Credit Score

• Checking & Savings Account Application Alerts

• Bank Account Takeover Alerts

• Credit Inquiry Alerts

• Online Annual Tri-Bureau Credit Reports & Scores

• Monthly Credit Score Tracking

• File Sharing Network Searches

• Sex Offender Registry Reports

• Priority Live Member Service Support

$1 Million Total Service Guarantee LifeLock’s proactive approach works to help stop identity theft before it happens. As a LifeLock member, if you become a victim of identity theft because of a failure in their service, they will help fix it at their expense, up to $1,000,000.


Pay Period

Payroll Deduction Per

Pay Period

Plan Benefit Elite Plan Ultimate Plan

Employee $1.96 $5.88

w/ Spouse Only $3.92 $11.76

w/ Child(ren)* $3.43 $8.33

Family* $5.39 $14.22

*Employee & Children and Family Tiers: You may enroll up to 8 children with 4 of those children between the ages of 18 and 26.

Identity Theft Protection

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Flexible Spending Account Each employee is allowed to make tax-sheltered contributions to a Flexible Spending Account which may be used to pay for qualified Medical Expenses. “Over the counter” medications and supplies no longer qualify as eligible expenses. Your contribution is made on a Pre-Tax basis. The employee contribution maximum is $2,000/plan year ($38.46 per week). Medical Expense Reimbursement Account Carryover “Left-over” balances from the current plan year (10/1/16 - 9/30/17) between $100 and $500 will be carried over to the new plan year; balances of less than $100 revert to the employer, as will balances over $500 - i.e.: a $96 balance will not carry over, a $695 balance will carry over only to the $500 limit. Carryover funds will be used first to satisfy expenses incurred in the previous plan year which are claimed in the new plan year after 10/1, but before 12/31. Current year funds will be depleted before carryover funds are used for current plan year expenses, however, at the end of the plan year the roll-over provision will apply, regardless of which plan year the funds came from.

Employee Assistance Program (provided by the City) EAP benefit providing multiple types of counseling, including work-life, legal, financial, etc. Available to all

employees and their households. Coverage provided at the City’s expense - counseling services are at the

employee’s expense, if charges apply.

Additional Benefits

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What are Voluntary Benefits? Voluntary Benefits are being offered to strengthen your overall benefits package. You customize the benefit based on need and affordability.

• Ownership – Policies are fully portable and belong to you if you leave your employer, same price and same plan

• Benefits are payroll deducted

• Cash benefits are paid directly to you, not to a hospital or doctor

• Benefits are paid regardless of any other coverage you may have

• Level premiums—Rates do not increase with age

• Guaranteed Renewable

• Designed to provide additional cash flow to assist with out of pocket medical costs and other bills

Short Term Disability

Trustmark’s Short Term Disability is designed to provide income to you and your family when you cannot work due to an illness or injury.

• Pays 60% of salary up to $6,000 per month

• Option of 7 day or 14 day elimination (waiting) period with a 6 month benefit period

• Pregnancy covered as any other illness

• Premium stays the same as long as you own the policy. The premium does not increase with age.

PLEASE NOTE: These benefits are ONLY offered once a year at Annual Open Enrollment, they are not available at new hire enrollment. In order to maintain your initial eligibility for guaranteed issue products, you must meet with a representative at the first available meeting following your date of hire. At that time the representative will be able to provide rates based on you and your family’s needs.

Voluntary Benefits

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Universal Life with Long Term Care

Universal Life with Long Term Care includes both a death benefit and a living benefit.

• Trustmark Universal Life with Long Term Care is a permanent life insurance that is designed to match your needs throughout your lifetime. It pays a higher death benefit during your working years when expenses are high and you need maximum protection.

• The Universal Life with Long Term Care is priced to remain the same cost to you until age 100.

• The death benefit reduces at age 70 when the need for life insurance typically decreases.

• The Living Benefit, Long Term Care never reduces and is 4% of the original death benefit per month for up to 25 months.

• If you use the Long Term Care benefit, your death benefit amount does not reduce due to the Benefit Restoration feature included.

• Coverage available for spouse and children as well.

Life with Long Term Care example: $100,000 Death Benefit

Long Term Care Benefit (LTC):

Pays a monthly benefit equal to 4% of your death benefit for up to 25 months.

Before Age 70

$100,000

After Age 70

$100,000

Benefit Restoration:

Restores the death benefit that is reduced to pay for LTC.

$100,000 $33,333

Total Maximum Benefit:

Long Term Care Benefits may double the value of your insurance

$200,000 $133,333

Voluntary Benefits

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Voluntary Benefits

New Allstate Cancer CP12 (Replaces the current Allstate Cancer CP10)

Receiving a cancer diagnosis can be one of life's most frightening events. Unfortunately, statistics show you probably know someone who has bee in this situation.

With Cancer insurance from Allstate Benefits, you can rest a little easier. Our coverage pays you a cash benefit to help with the costs associated with treatments, to pay for daily living expenses - and more importantly - to empower you to seek the care you need.

Just a few examples of benefits included in the plans:

• Initial Diagnosis • Hospital Confinement • Surgery

• Radiation & Chemotherapy • Bone Marrow & Stem Cell • Non-Local Transportation

• New or Experimental Treatment • Prosthesis • Ambulance

Weekly Payroll Deductions

Plan 1 18-64 65-69 70-74 75-80

Employee Only $5.39 $12.19 $14.18 $15.66

Family $10.73 $24.68 $28.49 $31.55

Plan 2 18-64 65-69 70-74 75-80

Employee Only $9.07 $21.06 $25.30 $28.78

Family $17.67 $40.77 $47.90 $53.97

Plan 3 18-64 65-69 70-74 75-80

Employee Only $11.47 $25.63 $31.78 $35.95

Family $22.46 $52.07 $60.94 $68.42

A Wellness Benefit is included and pays either $50 or $100 (depending on which plan you have) for each insured. Each covered person will get one routine test, providing support for early detection and prevention.

Examples of Wellness Screenings

• Mammography • EKG/ECG • HPV Vaccination • CA 125 Blood Test

• Pap Smear • Colonoscopy • PSA Test • Lipid Panel

Schedule an appointment to meet with an EMB Benefits Counselor if you currently have the discontinued Allstate Cancer Plan and would like to find out more information about this new plan.

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Voluntary Benefits

New Allstate Critical Illness (Replaces the current Allstate Heart/Stroke Plan)

The Critical Illness Plan is a benefit that will pay you a lump sum of money if you are diagnosed with a critical illness, heart attack or stroke. The cash benefit is provided upon the first diagnosis of a covered condition to help you with associated costs and beyond. Employees have the option to elect either $20,000 or $25,000 of coverage.

Regardless of other coverage in force, the benefit is paid out in a full lump sum.

Examples of Covered Conditions:

100% Benefit: Heart Attack, Stroke, Heart Transplant, Major Organ Transplant, End Stage Renal Failure, Paralysis (4 limbs)

50% Benefit: Paralysis (2 limbs)

25% Benefit: Bypass Surgery, Angioplasty, Atherectomy, Stent Placement, Multiple Sclerosis, Alzheimer’s Disease

A Cancer Screening Benefit is included and pays either $50 for each insured. Each covered person will get one screening test, providing support for early detection and prevention.

Examples of Wellness Screenings

• Mammography • Chest X-ray • Biopsy for skin cancer • CA 125 Blood Test

• Pap Smear • Colonoscopy • PSA Test • CA 15-3 Blood Test

Rates This benefit is customized by each employee so rates vary, but can start as little as a few dollars a week. Please schedule an appointment to meet with an EMB Benefits Counselor if you currently have the discontinued Allstate Heart/Stroke Plan and would like to find out more information about this new plan.

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Voluntary Benefits

New Allstate Group SHOP (Replaces the current Allstate Individual SHOP)

This plan helps cover the extra costs that come with hospitalization. It also helps with expenses such as medical insurance deductible and copayment amounts. With the Group SHOP play you can keep your family financially secure, in illness and in health.

Benefits increase 5% each year for the first 6 years the plan is in force at no increase in premium. There are 2 plan options to choose from and both include coverage for the following benefits.

Benefits include: Initial Hospitalization Confinement, Daily Hospital Confinement, Hospital Intensive Care, Surgery and Anesthesia, Inpatient Physician’s Treatment, Outpatient Emergency Accident Benefit, Outpatient Physician’s Treatment Benefit, At Home Nursing Benefit, Ambulance and Non-Local Transportation Benefit.

Schedule an appointment to meet with an EMB Benefits Counselor if you currently have the discontinued Allstate Individual SHOP Plan and would like to find out more information about this new plan.

Weekly Payroll Deductions

Plan 1 18-35 36-49 50-59 60-64 65+

Employee $4.93 $5.74 $7.02 $9.18 $12.09

Employee & Spouse $9.43 $11.10 $13.82 $18.36 $24.18

Employee & Child(ren) $8.28 $9.50 $10.90 $13.17 $16.45

Family $12.53 $14.51 $17.40 $22.00 $28.13

Plan 2 18-35 36-49 50-59 60-64 65+

Employee $7.38 $8.64 $10.76 $14.38 $19.26

Employee & Spouse $13.92 $16.37 $21.06 $28.75 $38.51

Employee & Child(ren) $11.92 $13.76 $15.76 $19.03 $23.93

Family $18.20 $21.22 $25.77 $33.05 $42.77

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Term Life Insurance (20 Year Term)

Provides protection for the individual who wants higher amounts of coverage for a set period of time

Premiums remain level during the entire 20 year term

Contains a “Living” benefit that pays partial benefits if diagnosed with a terminal condition

Coverage available for your spouse, children and grandchildren

Accident insurance

24 hours a day, 7 days a week coverage to help pay for unexpected expenses that result from an Accident.

Guaranteed Issue, No health questions

On and off the job coverage (24 hours per day, 7 day per week)

Benefits are paid directly to you

Guaranteed Renewable

Benefits are paid regardless of other coverage

Voluntary Benefits

Schedule an appointment to meet with an EMB Benefits Counselor if you would like to enroll in either of these benefits or if you need to make changes to your current Allstate benefits.

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Vendor Phone Number Website

Medical

Florida Blue 800-352-2583 www.floridablue.com

Teladoc 800-835-2362 www.teladoc.com

Dental

Florida Combined Life 888-223-4892 www.floridabluedental.com

Vision

VSP 800-877-7195 www.vsp.com

Voluntary Benefits

Trustmark

Allstate

800-918-8877

800-521-3535

www.trustmarksolutions.com

www.allstatebenefits.com/mybenefits

Basic Life & Supplemental Life & Long Term Disability

Cigna

800-732-1603 www.cigna.com

Identity Theft Protection

LifeLock 800-543-3562 www.lifelock.com

Trustmark & Allstate Benefits Claims Help

Explain My Benefits

888-734-6937, Option 3

[email protected]

Important Contacts

Benefit Guide Description

Please Note: This guide is designed to provide an overview of the

coverages available. It is not a Summary Plan Description (SPD).

Official plan and insurance documents from the carriers govern

your rights and benefits, including covered benefits, exclusions and

limitations. If any discrepancy exists between this guide and the

official documents, the official documents will prevail.

Documents

2018 - 2019 Annual Enrollment Guide - Explain My Benefits€¦ · Allstate Universal Life, these plans will no longer be payroll deducted as of 10/1/2018. You may keep these plans