2019 | 2020 TEAMMATE

2019 | 2020

TEAMMATEBENEFIT HIGHLIGHTS

The Office of Nikki Alvarez-Sowles, Esq., Pasco County Clerk & Comptroller | Teammate Benefit Highlights | 2019-2020

© 2016, Gehring Group, Inc., All Rights Reserved

This booklet is merely a summary of teammate benefits. For a full description, refer to the plan document. Where conflict exists between this summary and the plan document, the plan document controls. Pasco County Clerk & Comptroller reserves the right to amend, modify or terminate the plan at any time. This booklet should not be construed as a guarantee of employment.

Table of ContentsContact Information 1

Introduction 2

Online Benefit Enrollment 2

Group Insurance Eligibility 3

Qualifying Events and Section 125 4

Medical Insurance 5

Other Available Plan Resources 6

Summary of Benefits and Coverage 6

Medical Insurance: Side-By-Side Plans At-A-Glance 7-8

Pasco County Health Savings Account 9

Wellness Centers 10

Dental Insurance 11

UnitedHealthcare Incentive PPO Plan At-A-Glance 12

Vision Insurance 13

EyeMed Vision Plan At-A-Glance 14

Flexible Spending Accounts 15-16

Basic Life and AD&D Insurance 17

Voluntary Life and AD&D Insurance 18

Voluntary Long Term Disability 19

Voluntary Short Term Disability 19

Supplemental Insurance 19

Pet Insurance 20

Employee Assistance Program 20

Retiree Insurance Notice 21

Retiree Medical Insurance 22

Retiree Dental and Vision Insurance 22

Retirement Benefits 23

Claims, Billing & Benefit Assistance 23

Notes 24

1



Contact InformationPasco County Clerk & Comptroller Human Resources Phone: (727) 847-8916

Email: [email protected]

Claims, Billing & Benefit Assistance Gehring Group Phone: (800) 244-3696Email: [email protected]

Online Benefit Website Bentek Support (888) 5-Bentek (523-6835)www.mybentek.com/pascoclerk

Medical Insurance Florida Blue Customer Service: (800) 664-5295www.floridablue.com

Prescription Drug Coverage & Mail-Order Program

Prime Therapeutics Customer Service: (877) 794-3574www.myprime.com

Alliance Rx Walgreens Prime Customer Service: (888) 849-7865www.floridablue.com

HSA HealthEquity Customer Service: (866) 346-5800www.healthequity.com

Dental Insurance UnitedHealthcare Customer Service: (877) 816-3596www.myuhcdental.com

Vision Insurance EyeMed Customer Service: (866) 723-0513www.eyemedvisioncare.com

Flexible Spending Accounts P&A Customer Service: (800) 688-2611www.padmin.com

Basic Life and AD&D Insurance Sun Life Customer Service: (800) 247-6875www.sunlife.com/us

Voluntary Life and AD&D Insurance Sun Life Customer Service: (800) 247-6875www.sunlife.com/us

Voluntary Long Term Disability Insurance Sun Life Customer Service: (800) 247-6875

www.sunlife.com/us

Supplemental Insurance AflacAgent: Jeff Nelson | Phone: (813) 929-9846 Customer Service: (800) 992-3522www.aflac.com

Pet Insurance Nationwide Customer Service: (877) 738-7874www.petinsurance.com/pascoclerk

Employee Assistance Program Guidance Resource Customer Service: (877) 595-5284www.guidanceresources.com

FRS Agency Plan# 61001 Customer Service: (866) 446-9377www.myfrs.com

Nationwide Retirement Solutions Plan# 0044560001Agent: Steve DuganieriOffice: (877) 677-3678 | Cell: (631) 767-2308www.nrsforu.com

ICMA Plan# 305701Agent: Meghan Doherty Phone: 866-620- 6070 ext. 4938www.icmarc.org

VALIC Plan# 71440 Agent: Randy Ramos | Phone: (813) 269-3357www.valic.com

FMLA FMLA Source Customer Service: (877) 365-2666www.fmlasource.com

2© 2016, Gehring Group, Inc., All Rights Reserved


IntroductionThe Office of Nikki Alvarez-Sowles, Esq., Pasco County Clerk & Comptroller, provides group insurance benefits to eligible teammates. The Teammate Benefit Highlights booklet provides a general summary of the benefit options as a convenient reference. Please refer to the Clerk & Comptroller’s guidelines and applicable contracts and/or Certificates of Coverage for detailed descriptions of all available teammate benefit programs and stipulations therein. If a teammate requires further explanation or needs assistance regarding claims processing, please refer to the customer service phone numbers under each benefit description heading or contact Human Resources for further information.

Online Benefit EnrollmentPasco County Clerk & Comptroller provides teammates with an online benefits enrollment platform through Bentek’s Employee Benefits Center (EBC). The EBC provides benefit-eligible teammates the ability to select or change insurance benefits online during the annual Open Enrollment period, New Hire Orientation, or Qualifying Events.

Accessible 24 hours a day, throughout the year, teammate may log in and review comprehensive information regarding benefit plans and view and print an outline of benefit elections for teammate and dependent(s). Teammate has access to important forms and carrier links, can report qualifying life events and review and make changes to life insurance beneficiary designations.

To Access the Employee Benefits Center:

99 Log on to www.mybentek.com/pascoclerk

99 Sign in using a previously created username and password or click "Create an Account" to set up a username and password.

99 If teammate has forgotten username and/or password, click on the link “Forgot Username/Password” and follow the instructions.

99 Once logged on, navigate to the menu in order to review current elections, learn about benefit options, and make elections, changes or beneficiary designations.

For technical issues directly related to using the EBC please call (888) 5-Bentek (523-6835) or email Bentek Support at [email protected], Monday through Friday, during regular business hours, 8:30am - 5:00pm.

To access group insurance benefits online, log on to: www.mybentek.com/pascoclerk

Please Note: Link must be addressed exactly as written. Due to security reasons, the website cannot be accessed by Google or other search engines.

3



OCTOBER

01

Group Insurance EligibilityPasco County Clerk & Comptroller's group insurance plan year is October 1 through September 30.

Teammate EligibilityTeammates are eligible to participate in Pasco County Clerk & Comptroller’s insurance plans if they work a minimum of 24 hours per week. Coverage will be effective the first of the month following 60 days of employment. For example, if a teammate is hired on April 11, then the effective date of coverage will be July 1.

Separation of EmploymentIf a teammate separates employment from Pasco County Clerk & Comptroller, insurance will continue through the end of month in which separation occurred. COBRA continuation of coverage may be available as applicable by law.

Dependent EligibilityA dependent is defined as the legal spouse and/or dependent child(ren) of the participant or spouse. The term “child” includes any of the following:

• A natural child • A stepchild • A legally adopted child• A newborn child (up to the age of 18 months) of a covered

dependent (Florida)• A child for whom legal guardianship has been awarded to the

participant or the participant’s spouse

Dependent Age RequirementsMedical Coverage: A dependent child may be covered through the end of the calendar year in which the child turns age 26. An over-age dependent may continue to be covered on the medical plan to the end of the calendar year in which the child reaches age 30, if the dependent meets the following requirements:

• Unmarried with no dependents; and• A Florida resident, or full-time or part-time student; and• Otherwise uninsured; and• Not entitled to Medicare benefits under Title XVIII of the

Social Security Act, unless the child is handicapped.

Dental and Vision Coverage: Dependent children may be covered through the end of the calendar year in which child turns age 26.

Disabled DependentsCoverage for an unmarried dependent child may be continued beyond age 26 if:

• The dependent is physically or mentally disabled and incapable of self-sustaining employment (prior to age 26); and

• Primarily dependent upon the teammate for support; and• The dependent is otherwise eligible for coverage under the group

medical plan; and• The dependent has been continuously insured; and• Coverage with the Pasco County Clerk & Comptroller began prior to

age 19.

Proof of disability will be required upon request. Please contact Human Resources if further clarification is required.

Taxable DependentsCurrent IRS rules do not permit a teammate to receive a tax advantage on any portion of premiums paid related to the coverage of a dependent who is not a qualified tax dependent. Teammates covering adult child(ren) under teammate's medical insurance plan may continue to have the related coverage premiums payroll deducted on a pre-tax basis through the end of the calendar year in which the dependent child reaches age 26. Beginning January 1 of the calendar year in which the dependent child reaches age 27 through the end of the calendar year in which the dependent child reaches age 30, teammate will be charged the value of the premium coverage as Imputed Income for tax purposes only for such dependents. Contact Human Resources for further details if covering an adult dependent child who will turn age 27 any time during the upcoming calendar year or for more information.

4



Qualifying Events and Section 125Section 125 of the Internal Revenue CodePremiums for medical, dental, vision insurance, contributions to Flexible Spending Accounts (FSA) and/or certain supplemental policies are deducted through a Cafeteria Plan established under Section 125 of the Internal Revenue Code and are pre-taxed to the extent permitted. Under Section 125, changes to a teammate's pre-tax benefits can be made ONLY during the Open Enrollment period unless the teammate or qualified dependent(s) experience(s) a Qualifying Event and the request to make a change is made within 30 days of the Qualifying Event.

Under certain circumstances, a teammate may be allowed to make changes to benefit elections during the plan year, if the event affects the teammate, spouse, or dependent’s coverage eligibility. An “eligible” Qualifying Event is determined by Section 125 of the Internal Revenue Code. Any requested changes must be consistent with and due to the Qualifying Event.

Examples of Qualifying Events:

• Teammate gets married or divorced• Birth of a child• Teammate gains legal custody or adopts a child• Teammate's spouse and/or other dependent(s) die(s)• Teammate, teammate's spouse and/or dependent(s) terminate or

start employment• An increase or decrease in teammate's work hours causes eligibility

or ineligibility• A covered dependent no longer meets eligibility criteria for coverage• A child gains or loses coverage with other parent or legal guardian• Change of coverage under an employer’s plan• Gain or loss of Medicare coverage• Losing eligibility or becoming eligible for coverage under a State

Medicaid or CHIP (including Florida Kid Care) program (60 day notification period)

IMPORTANT NOTES

If a teammate experiences a qualifying event, Human Resources must be contacted within 30 days of the qualifying event to make the appropriate changes to a teammate's coverage. Beyond 30 days, requests will be denied and the teammate may be responsible, both legally and financially, for any claim and/or expense incurred as a result of the teammate or dependent who continues to be enrolled but no longer meets eligibility requirements. If approved, changes will be effective on the first of the month following the latter, date of the Qualifying Event or date written request for change in coverage is received by Human Resources. Newborns are effective on the date of birth. Marriage is effective on the date of occurrence. Cancellations will be processed at the end of the month. In the event of death, coverage terminates the date following the death. Teammate may be required to furnish valid documentation supporting a change in status or “Qualifying Event.”

5



Medical Insurance Pasco County Clerk & Comptroller offers medical insurance through Florida Blue to benefit-eligible teammates. The costs per pay period for coverage are listed in the premium tables below. For more detailed information about the medical plans, please refer to the carrier’s Summary of Benefits and Coverage document or contact Florida Blue's customer service.

Medical Insurance – Florida Blue BlueOptions 3900 (PPO) Plan

24 Payroll Deductions - Per Pay Period Cost

Tier of Coverage Teammate CostNon-Tobacco

Discount Cost*

Teammate $10.00 $0

Teammate + Spouse $40.00 $30.00

Teammate + Children $15.00 $5.00

Teammate + Family $110.00 $100.00

*$20 per month Non-Tobacco Discount

Medical Insurance – Florida Blue BlueCare 52 (HMO) Plan



Discount Cost*

Teammate $25.00 $15.00





Medical Insurance – Florida Blue BlueOptions 5781 (PPO) Plan



Discount Cost*

Teammate $25.00 $15.00





Medical Insurance – Florida Blue BlueCare 56 (HMO) Plan



Discount Cost*

Teammate $30.00 $20.00





Medical Insurance – Florida Blue BlueCare 122/123 (HMO) HSA Compatible Plan



Discount Cost*

Teammate $10.00 $0





Florida Blue | Customer Service: (800) 664-5295 | www.floridablue.com

6



Other Available Plan ResourcesFlorida Blue offers all enrolled members and dependents additional services and discounts through value added programs. For more details regarding other available plan resources, please refer to the Summary of Benefits and Coverage (SBC) document, contact Florida Blue's customer service at (800) 664-5295 or visit www.floridablue.com.

Blue365Blue365 is a free discount program on products and services available to all members such as:

99 Vision Care, Glasses, and Contact Lenses

99 Hearing Care and Aids

99 Fitness Club Memberships, Exercise Footwear and Apparel

99 Weight Loss Management

99 Alternative Medicine

99 Elder Care Advisory Services

99 Hotel Rooms and Travel Information

For more information, please contact Florida Blue at (800) 664-5295 or visit www.floridablue.com and select “Members” then “Members Tips & Tools.” Click “Discounts & Rewards” and then click “I Agree” on the “Explore Healthy Choices with Blue 365” website.

The Florida Blue Mobile App Florida Blue’s mobile website can be accessed from any smartphone or download the app from iPhone® or Android™ with just a tap! Visit the smartphone’s app store and search for Florida Blue or visit http://apps.floridablue.com.

Florida Blue CentersFlorida Blue Centers connect neighbors to services, support, and advice that help members achieve better health. Florida Blue Centers offer a variety of services, such as:

99 Care Consulting

99 Fitness Activities

99 Nutrition Advice

99 Health Education

99 Wellness Programs

99 Health Tech Demos

To find the nearest Florida Blue Center, please visit: https://www.floridablue.com/find-a-floridablue-center

Florida Blue | Customer Service: (800) 352-2583 | www.floridablue.com

Summary of Benefits and CoverageA Summary of Benefits & Coverage (SBC) for the medical plans is provided as a supplement to this booklet. The summary is an important item in understanding the benefit options. A free paper copy of the SBC document may be requested or is available as follows:

From: Human Resources

Address: 7530 Little Road New Port Richey, FL 34654

Phone: (727) 847-8916

Email: [email protected]

Website URL: www.mybentek.com/pascoclerk

The SBC is only a summary of the plan’s coverage. A copy of the plan document, policy, or certificate of coverage should be consulted to determine the governing contractual provisions of the coverage. A copy of the group certificate of coverage can be reviewed and obtained by contacting Human Resources.

If there are questions about the plan offerings, please contact Human Resources.

7



Medical Insurance: Side-By-Side Plans At-A-Glance

PlanBlueOptions 3900

(PPO)BlueOptions 5781

(PPO)Network BlueOptions BlueOptions

Plan Year Deductible (PYD) In-Network Out-of-Network* In-Network Out-of-Network*Single 1,500 $4,500 $1,500 $4,500

Family N/A $4,500 $13,500

CoinsuranceMember Responsibility 50% 50% 30% 50%

Plan Year Out-of-Pocket LimitSingle $6,350 $20,000 $5,500 $11,000

Family $12,700 $20,000 $11,000 $22,000

What Applies to the Out-of-Pocket Limit? Deductible, Coinsurance, Copays and Rx Deductible, Coinsurance, Copays and Rx

Physician ServicesPrimary Care Physician (PCP) Office Visit $35 Copay 50% After PYD $30 Copay 50% After PYD

Specialist Office Visit $50 Copay 50% After PYD $55 Copay 50% After PYD

Non-Hospital Services; Freestanding Facility Clinical Lab (Blood Work)** No Charge 50% After PYD No Charge 50% After PYD

X-rays 50% After PYD 50% After PYD $50 Copay 50% After PYD

Advanced Imaging (MRI, MRA, CT) $200 Copay 50% After PYD $250 Copay 50% After PYD

Outpatient Surgery in Surgical Center 50% After PYD 50% After PYD $200 Copay 50% After PYD

Physician Services at Surgical Center 50% After PYD 50% After PYD $55 Copay 50% After PYD

Urgent Care Center 50% After PYD 50% After PYD $60 Copay $60 Copay After PYD

Hospital Services

Inpatient Hospital (Per Admission)Option 1 - $1,500 CopayOption 2 - $2,500 Copay

50% After PYD 30% After PYD$500 PAD*** + 50% After PYD

Outpatient Hospital (Per Visit)Option 1 - $300 CopayOption 2 - $400 Copay

50% After PYD 30% After PYD 50% After PYD

Physician Services at Hospital 50% After PYD 50% After In-Network PYD 30% After PYD 30% After In-Network PYD

Emergency Room (Per Visit) 50% After PYD 50% After PYD $250 Copay $250 Copay

Mental Health/Alcohol & Substance AbuseInpatient Hospital Services (Per Admission) No Charge 50% Coinsurance No Charge 50% Coinsurance

Outpatient Services (Per Visit) No Charge 50% Coinsurance No Charge 50% Coinsurance

Prescription Drugs (Rx) Generic – Tier 1 $10 Copay 20% Coinsurance $10 Copay 50% Coinsurance

Preferred Brand Name – Tier 2 Not Covered Not Covered $60 Copay 50% Coinsurance

Non-Preferred Brand Name – Tier 3 Not Covered Not Covered $100 Copay 50% Coinsurance

Mail Order Drug (90-Day Supply) $25 Copay (Generic Only) Not Covered 2.5x Retail Copay Not Covered

Locate a ProviderTo search for a participating provider,

contact Florida Blue's customer service or visit www.floridablue.com.

When completing the necessary search criteria, select the BlueOptions

network.

Plan References*Out-Of-Network Balance Billing:

For information regarding out-of-network balance billing that may be

charged by out-of-network providers, please refer to the Summary of Benefits

and Coverage (SBC) document.

**Quest Diagnostics is the preferred lab for bloodwork through Florida Blue.

When using a lab other than Quest, please confirm they are contracted with Florida Blue's BlueOption network prior

to receiving services.

***PAD: Per Admission Deductible

8



Medical Insurance: Side-By-Side Plans At-A-Glance

PlanBlueCare 52

(HMO)BlueCare 56

(HMO)BlueCare 122

Individual (HMO)BlueCare 123Family (HMO)

Network BlueCare (HMO) BlueCare (HMO) BlueCare (HMO)

Plan Year Deductible (PYD) In-Network In-Network In-Network In-NetworkSingle $1,500 $0 $5,000 $5,000

Family N/A $0 N/A $10,000

CoinsuranceMember Responsibility 30% 0% 10% 10%

Plan Year Out-of-Pocket LimitSingle $6,350 $2,000 $6,550 $6,850

Family $12,700 $4,000 N/A $10,000

What Applies to the Out-of-Pocket Limit?Deductible, Coinsurance,

Copays and RxDeductible, Coinsurance,

Copays and RxDeductible, Coinsurance, Copays and Rx

Physician ServicesPrimary Care Physician (PCP) Office Visit $40 Copay $25 Copay 10% After PYD 10% After PYD

Specialist Office Visit $65 Copay $35 Copay 10% After PYD 10% After PYD

Non-Hospital Services; Freestanding Facility Clinical Lab (Blood Work)* No Charge No Charge 10% After PYD 10% After PYD

X-rays $65 Copay No Charge 10% After PYD 10% After PYD

Advanced Imaging (MRI, MRA, CT) $200 Copay $200 Copay 10% After PYD 10% After PYD

Outpatient Surgery in Surgical Center 30% After PYD $100 Copay 10% After PYD 10% After PYD

Physician Services at Surgical Center 30% After PYD $35 Copay 10% After PYD 10% After PYD

Urgent Care (Per Visit) $85 Copay $35 Copay 10% After PYD 10% After PYD

Hospital Services

Inpatient Hospital (Per Admission) 30% After PYD$300 Copay Per Day,

Up To $1,50010% After PYD 10% After PYD

Outpatient Hospital (Per Visit) 30% After PYD $100 Copay 10% After PYD 10% After PYD

Physician Services at Hospital 30% After PYD No Charge 10% After PYD 10% After PYD

Emergency Room (Per Visit) $300 Copay $250 Copay 10% After PYD 10% After PYD

Mental Health/Alcohol & Substance AbuseInpatient Hospital Services (Per Admission) No Charge No Charge 10% After PYD 10% After PYD

Outpatient Services (Per Visit) No Charge No Charge 10% After PYD 10% After PYD

Prescription Drugs (Rx) Generic – Tier 1 $10 Copay $10 Copay $10 Copay After PYD $10 Copay After PYD

Preferred Brand Name – Tier 2 $30 Copay $25 Copay $50 Copay After PYD $50 Copay After PYD

Non-Preferred Brand Name – Tier 3 $50 Copay $40 Copay $80 Copay After PYD $80 Copay After PYD

Mail Order Drug (90-Day Supply) 2.5x Retail Copay 2x Retail Copay 2.5x Retail Copay After PYD 2.5x Retail Copay After PYD

Locate a ProviderTo search for a participating provider, contact Florida Blue's customer service or visit www.floridablue.com. When completing the necessary search criteria, select the BlueCare (HMO) network.

Plan References*Quest Diagnostics is the preferred lab for bloodwork through Florida Blue. When using a lab other than Quest, please confirm they are contracted with Florida Blue's BlueCare (HMO) network prior to receiving services.

Important NotesServices received by providers or facilities not in the BlueCare (HMO) network, will not be covered.

9



Pasco County Health Savings AccountThe Florida Blue BlueCare 122/123 (HMO) HSA Compatible High Deductible Health Plan (HDHP) complies with the Internal Revenue Service (IRS) requirements and qualifies enrollee to open a Health Savings Account (HSA). An HSA is an interest-bearing account where funds may be used to help pay teammate and dependent(s) deductible, coinsurance and any qualified medical expenses not covered by the plan.

What to know about an HSA• Teammate owns the HSA funds from day one and decides how and

when to spend the money. • No use-it or lose-it rules; funds are in the account when needed,

now or in the future. Participant cannot fund a traditional Health Care FSA, however, participant may fund a Limited Purpose FSA for dental and vision expenses only.

• HSA funds may earn interest. • The HSA will be funded with employer contributions. If teammate

desires to fund the remaining IRS HSA Combined Contribution Limit balance they may do so with pre-tax payroll deductions.

• HSA dollars may be used tax-free for all eligible medical expenses.• HSA funds are portable from one employer to another. Accumulated

funds can help teammate plan for retirement.• An account holder may write a check or withdraw funds with a

Health Savings Account Debit Card.• Some account service fees, determined by the bank, may apply.• Account holder can access HSA statement at any time to track

account balance and activity online at www.HealthEquity.com. • To be eligible to open an HSA, teammate must be covered by a

high deductible health plan. Teammate may not be covered under another medical plan that is not a high deductible health plan including a plan the teammate's spouse may have selected where he/she has family coverage. Please Note: Eligibility status to qualify for an HSA is specifically driven by teammate and NOT dependents.

• HSA funds can be used for dependent(s) even if dependent is not enrolled in the teammate’s group insurance benefits as long as the dependent is a qualified tax dependent.

• Over-age dependent is not able to use HSA funds for qualified expenses, even if dependent is covered under the medical plan as Federal law does not recognize them as a qualified dependent.

• If teammate is enrolled in Medicare, TRICARE or TRICARE for Life, teammate is not eligible to contribute funds into an HSA. In addition, the IRS prohibits Pasco County from contributing HSA funds into the account. If teammate is not enrolled in Medicare, TRICARE or TRICARE for Life, then teammate is eligible to enroll and contribute into the HSA up to the maximum contribution amounts.

• Active teammate NOT on Medicare but with a spouse enrolled in Medicare: Any active teammate who is covering a spouse that is enrolled in Medicare is eligible to enroll and contribute into the HSA up to the maximum contribution amounts. These funds can be utilized for the active teammate and spouse expenses.

• Active teammate ON Medicare and with a spouse NOT enrolled in Medicare: Any active teammate who is enrolled in Medicare and covering a spouse may not contribute or receive HSA funding. Any remaining balance in the HSA can be utilized until there are no funds remaining.

*Please contact Human Resources for further information regarding funding variations towards employer HSA contributions.

2019-2020 Plan Year Funding:• Teammate will receive: $100 Monthly Contribution

Teammate may opt to fund an HSA via pre-tax evenly dispersed payroll deductions or in a lump sum payroll deduction. Teammate contributions to an HSA may also be made on an after-tax basis and taken as an above-the-line deduction on teammate's tax return (making such contributions tax-free).

• 2019 IRS Contribution Limitations: $3,500 (individual coverage) $7,000 (family coverage)

• 2020 IRS Contribution Limitations: $3,550 (individual coverage) $7,100 (family coverage)

• Individuals ages 55 and older can also make additional "catch-up" contributions up to $1,000 annually

Guidelines regarding the HSAs are established by the IRS.

HealthEquity | Customer Service: (866) 346-5800 | www.HealthEquity.com

10



Wellness CentersWellness Centers have come to Pasco County Clerk & Comptroller!

Teammates will be able to use the Wellness Centers established by the Board of County Commissioners. The best news is that services are provided to all Clerk & Comptroller Office teammates, spouses, dependents, and retirees enrolled in Pasco County Clerk & Comptroller's medical plans at a $0 Copay for the non-HSA plans and $20 for HSA plans. Common prescriptions are also available at no cost to those insured!

Wellness Centers are staffed by physicians and a nurse practitioner, and offer a variety of services, including treatments for the following:

99 Cold/flu

99 Allergies

99 Minor injuries

99 Rashes

99 Sinus infections

99 Vaccinations

99 Physicals

99 NOT for major illnesses including chest pain, head injuries, or broken bones

99 NOT for children under 10 years of age

Port Richey 7421 Ridge Road, Unit 110

Port Richey, FL 34668

Hours of Operation

Monday 7:00am - 6:00pm

Tuesday 7:00am - 6:00pm

Wednesday 7:00am - 6:00pm

Thursday 7:00am - 6:00pm

Friday 7:00am - 6:00pm

Saturday Closed

Sunday Closed

Dade City 36739 State Road 52, Suite 104

Dade City, FL 33525

Hours of Operation

Monday Closed

Tuesday 7:00am - 6:00pm

Wednesday Closed

Thursday 7:00am - 6:00pm

Friday Closed

Saturday Closed

Sunday Closed

Land O Lakes 4111 Land O’ Lakes Blvd., Suite 301

Land O’ Lakes, FL 34638

Hours of Operation

Monday 7:00am - 6:00pm

Tuesday Closed

Wednesday 7:00am - 6:00pm

Thursday Closed

Friday 7:00am - 6:00pm

Saturday 7:00am - 12:00pm

Sunday Closed

Paid time off is available for teammates to visit these centers (limited to one hour per visit) during the workday. Once an appointment is confirmed, code the time as “CLINIC” on teammate timecard, with supervisor approval. PTO is required for any time missed over 1 hour.

Appointments can be made by calling: (866) 959-9355 (for either location). After first visit, online scheduling will be available.

Please be considerate of others. If teammate will miss a scheduled appointment, cancel as soon as possible to ensure availability for others.

Contact Human Resources with any questions.

11



Dental InsuranceUnitedHealthcare Incentive PPO PlanPasco County Clerk & Comptroller offers dental insurance through UnitedHealthcare to benefit-eligible teammates. The costs per pay period for coverage are listed in the premium table below and a brief summary of benefits is provided on the following page. For more detailed information about the dental plan, please refer to the carrier's summary plan document or contact UnitedHealthcare's customer service.

Dental Insurance UnitedHealthcare Incentive PPO Plan


Tier of Coverage Teammate Cost

Teammate Only $4.03

Teammate + 1 Dependent $7.66

Teammate + Family $11.29

In-Network BenefitsIncentive PPO plan provides benefits for services received from in-network and out-of-network providers. It is also an open-access plan which allows for services to be received from any dental provider without having to select a Primary Dental Provider (PDP) or obtain a referral to a specialist. The network of participating dental providers the plan utilizes is the UnitedHealthcare National Options PPO 30 network. These participating dental providers have contractually agreed to accept UnitedHealthcare's contracted fee or "allowed amount." This fee is the maximum amount a UnitedHealthcare dental provider can charge a member for a service. The member is responsible for a Plan Year Deductible (PYD) and then coinsurance based on the plan's charge limitations.

Out-of-Network Benefits Out-of-network benefits are used when member receives services by a non-participating UnitedHealthcare provider. UnitedHealthcare reimburses out-of-network services based on what it determines is the allowable expense. The allowable expense is defined as the most common charge for a particular dental procedure performed in a specific geographic area. If services are received from an out-of-network dentist, the member may be responsible for balance billing. Balance billing is the difference between UnitedHealthcare's allowable expense and the amount charge by the out-of-network dental provider. Balance billing is in addition to any applicable plan deductible or coinsurance responsibility.

Plan Year DeductibleThe Incentive PPO plan requires a $50 individual or a $150 family deductible to be met for in-network or out-of-network services before most benefits will begin. The deductible is waived for preventive services.

Plan Year Benefit MaximumThe maximum benefit (coinsurance) the Incentive PPO plan will pay for each covered member is $2,000 for in-network and out-of-network services combined. All services, including preventive services accumulate towards the benefit maximum. Once the plan's benefit maximum is met, the member will be responsible for future charges until next plan year.

IMPORTANT NOTES

• Each covered member may receive one (1) routine cleaning every six (6) months under the preventive benefit.

• For any dental work expected to cost $500 or more, the plan will provide a "Pre-Treatment Estimate" upon the request of the dental provider. This will assist with determining approximate out-of-pocket costs should teammate have the dental work performed.

• Waiting periods and age limitations may apply.

• Benefit frequency limitations may apply to certain services.

UnitedHealthcare | Customer Service: (877) 816-3596 | www.myuhc.com

12



UnitedHealthcare Incentive PPO Plan At-A-Glance Network National Options PPO 30

Plan Year Deductible (PYD) In-Network Out-of-Network*Per Member $50

Per Family $150

Waived for Class I (Preventive) Services? Yes Yes

Plan Year Benefit MaximumPer Member $2,000

Class I Services: Diagnostic & Preventive CareRoutine Oral Exam (1 Every 6 Months)

Plan Pays: 100%Deductible Waived

Plan Pays: 100%Deductible Waived

(Subject to Balance Billing)

Routine Cleanings (1 Every 6 Months)

Bitewing X-rays (1 Series of Films Per 12 Months)

Complete X-rays (1 Set Every 36 Months)

Class II Services: Basic Restorative CareFillings (Amalgam or Composite)**

Plan Pays: 100% After PYD



Simple Extractions

Oral Surgery

Periodontal Maintenance (2 Per Year)

Endodontics

Class III Services: Major Restorative CareCrowns




Bridges

Dentures

Implants

Class IV Services: OrthodontiaPer Member Plan Year Deductible $50

Per Family Plan Year Deductible $100

Lifetime Maximum $1,000

Benefit Plan Pays: 50% After PYD Plan Pays: 50% After PYD (Subject to Balance Billing)

Locate a ProviderTo search for a participating provider, contact UnitedHealthcare's customer service or visit www.myuhcdental.com. When completing the necessary search criteria, select National Options PPO 30 network.

Plan References*Out-Of-Network Balance Billing: For information regarding out-of-network balance billing that may be charged by an out-of-network provider, please refer to the Out-of-Network Benefits section on the previous page.

**Plan will only reimburse based on the lesser cost of the treatment options available.

13



Vision InsuranceEyeMed Vision Plan Pasco County Clerk & Comptroller offers vision insurance through EyeMed to benefit-eligible teammates. The costs per pay period for coverage are listed in the premium table below and a brief summary of benefits is provided on the following page. For more information about the vision plan, please refer to the carrier’s summary plan document or contact EyeMed's customer service.

Vision Insurance – EyeMed Vision Plan 24 Payroll Deductions - Per Pay Period Cost

Tier of Coverage Teammate Cost

Teammate Only $3.13

Teammate + 1 Dependent $5.95

Teammate + Family $8.74

In-Network BenefitsThe vision plan offers teammate and covered dependent(s) coverage for routine eye care, including eye exams, eyeglasses (lenses and frames) or contact lenses. To schedule an appointment, covered teammate and dependent(s) can select any network provider who participates in the EyeMed Select network. At the time of service, routine vision examinations and basic optical needs will be covered as shown on the plan’s schedule of benefits. Cosmetic services and upgrades will be additional if chosen at the time of the appointment.

Out-of-Network BenefitsTeammate and covered dependent(s) may also choose to receive services from vision providers who do not participate in the Select network. When going out of network, the provider will require payment at the time of appointment. EyeMed will then reimburse based on the plan’s out-of-network reimbursement schedule upon receipt of proof of services rendered.

Plan Year Deductible There is no plan year deductible.

Plan Year Out-of-Pocket MaximumThere is no out-of-pocket maximum. However, there are benefit reimbursement maximums for certain services.

EyeMed | Customer Service: (866) 723-0513 | www.eyemedvisioncare.com

14



EyeMed Vision Plan At-A-GlanceNetwork Select

Services In-Network Out-of-Network

Eye Exam No Charge Up to $25 Reimbursement

Frequency of Services

Examination 12 Months 12 Months

Lenses 12 Months 12 Months

Frames 24 Months 24 Months

Contact Lenses 12 Months 12 Months

Lenses

Single

$25 Copay

Up to $25 Reimbursement

Bifocal Up to $40 Reimbursement

Trifocal Up to $55 Reimbursement

Frames

Allowance$0 Copay, Up to $130 Allowance

20% Off Balance Over $130Up to $65 Reimbursement

Contact Lenses*

Non-Elective (Medically Necessary; With Prior Authorization) No Charge Up to $200 Reimbursement

Elective (Fitting, Follow-up & Lenses)$0 Copay, $130 Allowance

15% Off Balance Over $130Up to $104 Reimbursement

LASIK

Discount Programs15% Off Retail Price or

5% Off the Promotional PriceN/A

Locate a ProviderTo search for a participating provider, contact EyeMed's customer service or visit www.eyemedvisioncare.com. When completing the necessary search criteria, select Select network.

Plan References*Contact lenses are in lieu of spectacle lenses.

Important Notes• Teammate options such as LASIK,

are not covered in full, but may be available at a discount.

• Lens Options such as UV coating, tinting, polarizing etc. are covered benefits. Please refer to the carrier's summary plan document for details or contact EyeMed's customer service.

15



Flexible Spending AccountsPasco County Clerk & Comptroller offers Flexible Spending Accounts (FSA) administered through P&A Group. The FSA plan year is from October 1 to September 30.

If employee or family member(s) has predictable health care or work-related day care expenses, then employee may benefit from participating in an FSA. An FSA allows employees to set aside money from employee's paycheck for reimbursement of health care and day care expenses they regularly pay. The amount set aside is not taxed and is automatically deducted from employee’s paycheck and deposited into the FSA. During the year, employee has access to this account for reimbursement of some expenses not covered by insurance. Participation in an FSA allows for substantial tax savings and an increase in spending power. Participating employee must re-elect the dollar amount to be deducted each plan year. There are three (3) types of FSAs:

• Health Care FSA: Available to eligible employee not enrolled in the Florida Blue BlueCare 122/123 (HMO) with an HSA. Covers medical, dental, and vision expenses that are not paid by insurance.

• Limited Purpose FSA: Available to eligible employee enrolled in the Florida Blue BlueCare 122/123 (HMO) with an HSA. A Limited Purpose Health Care FSA may be used for qualified dental and vision expenses.

• Dependent Care FSA: Covers day care expenses for qualified dependents necessary for employee and legal spouse, if married, to work.

Health Care FSA Dependent Care FSA

This account allows participant to set aside up to an annual maximum of $2,700. This money will not be taxable income to the participant and can be used to offset the cost of a wide variety of eligible medical expenses that generate out-of-pocket costs. Participating employee can also receive reimbursement for expenses related to dental and vision care (that are not classified as cosmetic).

Examples of common expenses that qualify for reimbursement are listed below.

This account allows participant to set aside up to an annual maximum of $5,000 if single or married and file a joint tax return ($2,500 if married and file a separate tax return) for work-related day care expenses. Qualified expenses include day care centers, preschool, and before/after school care for eligible children and dependent adults.

Please note, if family income is over $20,000, this reimbursement option will likely save participants more money than dependent day care tax credit taken on a tax return. To qualify, dependents must be:

• A child under the age of 13, or• A child, spouse or other dependent who is physically or mentally incapable

of self-care and spends at least eight (8) hours a day in the participant’s household.

Please Note: The entire Health Care FSA election is available for use on the first day coverage is effective.

Please Note: Unlike the Health Care FSA, reimbursement is only up to the amount that has been deducted from participant’s paycheck for the Dependent Care FSA.

A sample list of qualified expenses eligible for reimbursement include, but not limited to, the following:

99 Ambulance Service 99 Experimental Medical Treatment 99 Nursing Services

99 Chiropractic Care 99 Corrective Eyeglasses and Contact Lenses* 99 Optometrist Fees*

99 Dental and Orthodontic Fees* 99 Hearing Aids and Exams 99 Prescription Drugs

99 Diagnostic Tests/Health Screenings* 99 Injections and Vaccinations 99 Sunscreen SPF 15 or Greater

99 Physician Fees and Office Visits 99 LASIK Surgery* 99 Wheelchairs

99 Drug Addiction/Alcoholism Treatment 99 Mental Health Care

*These items are eligible expenses under the Limited Purpose FSA.

Log on to http://www.irs.gov/publications/p502/index.html for additional details regarding qualified and non-qualified expenses.

16



Flexible Spending Account (Continued)

FSA Guidelines • Teammate may carry over $500 of unused Health Care FSA funds

into the next plan year after a plan year ends and all claims have been filed. Dependent Care funds cannot be carried over.

• The Health Care FSA has a 90 day run out period at the end of the plan year (October 1 to December 31) to submit reimbursement on eligible expenses incurred during the period of coverage within the plan year.

• When a plan year ends and all claims have been filed with the exception of the $500 rollover for the Health Care FSA, all unused funds will be forfeited and not returned.

• Teammate can enroll in an FSA only during the Open Enrollment period, a Qualifying Event, or New Hire Eligibility.

• Money cannot be transferred between FSAs.• Reimbursed expenses cannot be deducted for income tax purposes.• Teammate and dependent(s) cannot be reimbursed for services not

received. • Teammate and dependent(s) cannot receive insurance benefits or

any other compensation for expenses reimbursed through an FSA. • Domestic Partners are not eligible as federal law does not recognize

them as a qualified dependent.

Filing a ClaimClaim FormA completed claim form along with a copy of the receipt as proof of the expense can be submitted by mail or fax. The IRS requires FSA participants to maintain complete documentation, including copies of receipts for reimbursed expenses, for a minimum of one (1) year.

Debit CardFSA participants will automatically receive a debit card for payment of eligible expenses. With the card, most qualified services and products can be paid at the point of sale versus paying out-of-pocket and requesting reimbursement. The debit card is accepted at a number of medical providers and facilities, and most pharmacy retail outlets. P&A may request supporting documentation for expenses paid with a debit card. Failure to provide supporting documentation when requested, may result in suspension of the card and account until funds are substantiated or refunded back to Pasco County Clerk & Comptroller. Please keep the issued card for use next year. Additional or replacement cards may be requested, however, a small fee may apply.

HERE’S HOW IT WORKS!

A teammate earning $30,000 elects to place $1,000 into a Health Care FSA. The payroll deduction is $41.66 based on a 24 pay period schedule. As a result, the insurance premiums and health care expenses are paid with tax-free dollars, giving the teammate a tax savings of $227.

With a Health Care FSA

Without a Health Care FSA

Salary $30,000 $30,000

FSA Contribution - $1,000 - $0

Taxable Pay $29,000 $30,000

Estimated Tax 22.65% = 15% + 7.65% FICA

- $6,568 - $6,795

After Tax Expenses - $0 - $1,000

Spendable Income $22,432 $22,205

Tax Savings $227

Please Note: Be conservative when estimating health care and/or dependent care expenses. IRS regulations state that any unused funds remaining in an FSA, after a plan year ends and after all claims have been filed, cannot be returned or carried forward to the next plan year with the exception of the $500 carry over that may be allowed for the Health Care FSA. This rule is known as “use-it or lose-it.”

Claims Mailing Address | P&A Group 17 Court Street, Suite 500 | Buffalo, NY 14202

P&A Group | Customer Service: (800) 688-2611 | www.padmin.com

17



Basic Life and AD&D InsuranceBasic Term Life InsurancePasco County Clerk & Comptroller provides Basic Term Life insurance for all eligible teammates at no cost, through Sun Life. Teammate benefit amount is determined by eligibility classification as described in the table. Enrollment is automatic but teammate is required to designate a beneficiary. Beneficiary designations can be made online at www.mybentek.com/pascoclerk. A beneficiary confirmation statement can also be printed and retained for personal records.

Accidental Death & Dismemberment InsuranceFor Class 1 teammate's, Pasco County Clerk & Comptroller also provides Accidental Death & Dismemberment (AD&D) insurance, which pays in addition to the Basic Term Life insurance benefit when death occurs as a result of an accident. The AD&D benefit equals the Basic Term Life benefit, partial benefits may also be payable.

Age Reduction ScheduleBenefit amounts are subject to the following age reduction schedule:

› Reduces to 67% of the benefit amount at age 65 › Reduces to 45% of the benefit amount at age 70

Always remember to keep beneficiary forms updated. Teammate may update beneficiary information at anytime of the year by

logging onto Bentek at www.mybentek.com/pascoclerk.

Class Eligibility Classifications

Benefit Classifications

Class 1 Active Full-time Teammates1 times annual earnings, up to a maximum of $200,000

Class 2Retired Deputy Chiefs who retired prior to October 1, 2007

Flat $50,000

Class 3Retired Directors who retired prior to October 1, 2007

Flat $40,000

Class 4Eligible Retired Supervisors who retired prior to October 1, 2007

Flat $30,000

Class 5All Other Eligible Teammates who retired prior to October 1, 2007

Flat $20,000

Class 6All eligible teammates who retired on or after October 1, 2007 and prior to July 1, 2011

Amount in force prior to effective date up to a maximum of $200,000

Class 7All eligible teammates who retired on or after July 1, 2011 and prior to October 1, 2014

Amount in force prior to effective date up to a maximum of $200,000

Class 8All Eligible Teammates who retired on or after October 1, 2014 (Gold) but prior to October 1, 2017

Amount in force prior to effective date to a maximum of $200,000

Class 9All Eligible Teammates who retired on or after October 1, 2014 (Platinum) but prior to October 1, 2017

Amount in force prior to effective date to a maximum of $200,000

Class 10All Eligible Teammates who retired on or after October 1, 2017

Flat $10,000; terminates at age 70.

Sun Life | Customer Service: (800) 247-6875 | www.sunlife.com/us

18



Voluntary Life and AD&D InsuranceVoluntary Employee Life and AD&D InsuranceEligible teammate may elect to purchase additional Life and AD&D insurance on a voluntary basis through Sun Life. This coverage may be purchased in addition to the Basic Term Life and AD&D coverage. Voluntary Life insurance offers coverage for teammate, spouse and/or child(ren) at different benefit levels.

New Hires may purchase Voluntary Employee Life insurance without having to go through Medical Underwriting, also known as Evidence of

Insurability (EOI), up to the Guaranteed Issue amount of $150,000.

• Units can be purchased in increments of $10,000 to the maximum benefit of $300,000 (minimum benefit of $20,000), up to seven (7) times annual salary.

• Teammates can take this coverage with them if they terminate employment prior to normal retirement age. Rates will be similar but not identical.

• Benefit amounts are subject to the following age reduction schedule: › Reduces to 67% of the benefit amount at age 70 › Reduces to 45% of the benefit amount at age 75

Voluntary Spouse Life Insurance

New Hires may purchase Voluntary Spouse Life insurance without having to go through Medical Underwriting, also known as Evidence of Insurability (EOI), up to the Guaranteed Issue amount of $50,000.

• Teammate must participate in the Voluntary Employee Life plan for spouse to participate.

• Units can be purchased in increments of $5,000 to a maximum of $150,000 not to exceed 100% of the teammate’s Voluntary Life coverage amount.

• Benefit amounts are subject to the following age reduction schedule: › Coverage ends when Teammate turns age 70 › Benefits may be reduced when employee benefit amount is

reduced.

Voluntary Life and AD&D Insurance Rate TableMonthly Premium

Age Bracket (Based On Teammate Age)

Teammate's Voluntary Life

and AD&D RatesSpouse's

Voluntary Life RatesUnder 20 $0.080 $0.050

20-24 $0.080 $0.050

25-29 $0.080 $0.050

30-34 $0.084 $0.054

35-39 $0.104 $0.068

40-44 $0.151 $0.097

45-49 $0.243 $0.163

50-54 $0.359 $0.239

55-59 $0.587 $0.378

60-64 $0.664 $0.579

65-69 $1.213 $1.072

70-74 $1.979 Terms at Teammate age 70

75+ $6.483 Terms at Teammate age 70

Voluntary Dependent Child(ren) Life Insurance• Teammate must participate in Voluntary Employee Life plan for

dependent child(ren) to participate.• For eligible unmarried children, from 14 days old up to age 21; or to

age 25 if a full-time student. • Units may be purchased in increments of $5,000, to a maximum

of $10,000 not to exceed 100% of the teammate’s Voluntary life coverage amount.

• Rates are $0.90 per month for $5,000 or $1.80 per month for $10,000 per eligible dependent child(ren).

Always remember to keep beneficiary information updated. Beneficiary information may be updated at

anytime through Bentek.

Sun Life | Customer Service: (800) 247-6875 | www.sunlife.com/us

19



Voluntary Long Term DisabilityPasco County Clerk & Comptroller offers Voluntary Long Term Disability (LTD) insurance to all eligible teammates through SunLife. The LTD benefit pays teammates a percentage of monthly earnings if teammate becomes disabled due to an illness or non-work related injury. The benefit will be adjusted if teammates salary fluctuates throughout the plan year. A summary of the plan benefits is provided below.

Voluntary Long Term Disability (LTD) Benefits• LTD provides a benefit of 60% of Teammate's monthly earnings up

to a benefit maximum of $5,000 per month. • Teammate must be disabled for 90 consecutive days prior to

becoming eligible for benefits (known as the elimination period).• Benefit payments will commence on the 91 day of disability.• Teammate may continue to be eligible for partial benefits if

teammate returns to work on a part-time basis.• The maximum benefit period is determined based on age at the

time of disability.• Benefits may be reduced by other income.

Voluntary Long-Term Disability Rates

Age Band Monthly Rate

Under 25 $0.090

25-29 $0.090

30-34 $0.100

35-39 $0.100

40-44 $0.200

45-49 $0.400

50-54 $0.600

55-59 $0.700

60-64 $1.000

65-69 $1.000

70 and over $1.000

SunLife | Customer Service: (800) 247-6875 | www.sunlife.com/us

Voluntary Short Term DisabilityShort Term Disability is available on a voluntary basis through Aflac. The Short Term Disability benefit pays teammate a percentage of their weekly earnings up to $6,000 if teammate becomes disabled due to an illness or non-work related injury.

Aflac | Customer Service: (800) 992-3522 | www.aflac.com Agent: Jeff Nelson | Phone: (813) 929-9846 | Fax: (813) 929-9856

Supplemental Insurance Aflac offers a variety of voluntary supplemental insurance plans that may be purchased separately on a voluntary basis and premiums paid by payroll deduction. Aflac pays money directly to teammate, regardless of what other insurance plans they may have. Available Aflac plans include:

99 Accident Advantage

99 Cancer Care

99 Critical Care Protection

99 Hospital Choice

99 Short Term Disability

Aflac also offers access to MeMD. MeMD telemedicine service provides immediate medical assistance for many conditions from the comfort of the teammate's home or office.

The benefit is provided to all enrolled members. Registration is required and should be completed ahead of time. This program allows members 24/7 on-demand access to affordable medical care via phone and online video consultations when needing immediate care for non-emergency medical issues. MeMD, through Aflac, should be considered when a primary care doctor is unavailable, after-hours or on holidays for non-emergency needs. To activate an account, please visit www.MeMD.me/aflacstandard.

To learn more about these Aflac plans and/or to schedule a personal appointment, contact the Clerk and Comproller’s Aflac Agent, Jeff Nelson, at (813) 929-9846.

Aflac | Customer Service: (800) 992-3522 | www.aflac.com Agent: Jeff Nelson | Phone: (813) 929-9846 | Fax: (813) 929-9856

20© 2016, Gehring Group, Inc., All Rights Reserved


Pet InsuranceNationwidePasco County Clerk & Comptroller provides teammates the opportunity to purchase pet insurance on a voluntary basis through Nationwide.

Pet Insurance – NationwideMy Pet Protection

with Wellness My Pet Protection

Accidents & Allergic Reactions 9 9

Common Illnesses 9 9Surgeries & Hospitalization 9 9

X-rays, MRIs and CT Scans 9 9

Prescription Medications 9 9

Wellness Exams 9Preventive Dental Cleaning 9

Spay/Neuter 9

Routine Blood Tests 9Heartworm Testing & Prevention 9

Nationwide: Enrollment Process1. Go directly to: www.petinsurance.com/pascoclerk2. Visit petsnationwide.com and enter your company name3. Call (877) 738-7874 and mention you are a teammate of Pasco

Nationwide Customer Service: (877) 738-7874 | www.petinsurance.com/pascoclerk

Employee Assistance ProgramPasco County Clerk & Comptroller cares about the well-being of all teammates on and off the job and provides, at no cost, a comprehensive Employee Assistance Program (EAP) through Guidance Resources. EAP offers teammate and each family member access to licensed mental health professionals through a confidential program protected by State and Federal laws. EAP is available to help teammate gain a better understanding of problems that affect them, locate the best professional help for a particular problem, and decide upon a plan of action. EAP counselors are professionally trained and certified in their fields and available 24 hours a day, 7 days a week.

What is an Employee Assistance Program?An Employee Assistance Program offers covered teammates and family members free and convenient access to a range of confidential and professional services to help address a variety of problems that may negatively affect teammate or family member’s well-being. Coverage includes five (5) face-to-face visits with a specialist, phone crisis intervention and referrals to outside resources when necessary. EAP offers counseling services on issues such as:

99 Child Care Resources

99 Legal Resources

99 Grief and Bereavement

99 Stress Management

99 Depression and Anxiety

99 Work Related Issues

99 Adult & Elder Care Assistance

99 Financial Resources

99 Family and/or Marriage Issues

99 Substance Abuse

Are your services confidential?Yes. Receipt of EAP services are completely confidential. If however, participation in the EAP is the direct result of a Management Referral (a referral initiated by Human Resources), we will ask permission to communicate certain aspects of the teammate’s care (attendance at sessions, adherence to treatment plans, etc.) to Human Resources. Human Resources will only receive reports on whether the referred teammate is complying with the prescribed treatment plan.

Guidance Resource | Customer Service: (877) 595-5284 www.guidanceresources.com | web ID: EAPComplete

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Retiree Insurance NoticeBenefit-eligible retirees participating in Pasco Clerk & Comptroller's group insurance plan(s) at the time of retirement shall be afforded the option to continue coverage as a retiree. For more detailed information about the health plan(s), please refer to the plan’s summary plan document or contact the carrier’s customer service.

Silver RetireeThis category is for teammates that had a retirement date prior to January 8th, 2019 and fall in one of the two categories below:

If hired prior to July 1, 2011, retirees with more than six (6) years of service but less than 30 at the Clerk & Comptroller’s Office. Minimum retirement age is 62 years of age for continuation of health benefits.

OR

If hired on or after July 1, 2011, retirees with more than eight (8) years of service but less than 33 at the Clerk & Comptroller’s Office. Minimum retirement age is 65 years of age for continuation of health benefits.

Gold RetireeThis category is for teammates that had a retirement date prior to January 8th, 2019 and fall in one of the two categories below:

If hired prior to July 1, 2011, retirees with 30 or more years of service at the Clerk & Comptroller’s Office.

OR

If hired on or after July 1, 2011, retirees with 33 or more years of service at the Clerk & Comptroller’s Office.

Platinum RetireeThis category is for teammates that have a retirement date on or after January 8th, 2019 and fall in one of the two categories below:

If hired prior to July 1, 2011, retirees with 30 or more years of combined service at one of the following Pasco County agencies: Clerk & Comptroller’s Office, Board of County Commissioners, Supervisor of Elections, Tax Collector, and/or the Property Appraiser.

OR

If hired on or after July 1, 2011, retirees with 33 or more years of combined service at one of the following Pasco County agencies: Clerk & Comptroller’s Office, Board of County Commissioners, Supervisor of Elections, Tax Collector, and/or the Property Appraiser.

Retiree Basic Life InsuranceAll eligible retirees will receive a $10,000 Basic Group Life Insurance policy will be provided by the Clerk & Comptroller's Office. The policy will terminate at age 70.

This information is applicable to the plan year indicated on this booklet and is subject to change with subsequent plan years and/or plan changes.

Retiree Premium PaymentsPremium payments for medical, dental and vision coverage(s) are due the 1st of every month. Coverage may be terminated if the payment is over 30 days past due. If coverage is terminated due to non-payment, it cannot be reinstated. Premium payments may be mailed to :

The Office of Nikki Alvarez-Sowles, Esq. Pasco County Clerk & Comptroller | Human Resources Department

7530 Little Road, Suite 106 | New Port Richey, FL 34654

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Retiree Medical InsuranceTier of Coverage Medical

Silver Retiree*BlueOptions 3900 (PPO)

BlueOptions 5781 (PPO)

BlueCare 52 (HMO)

BlueCare 56 (HMO)

Retiree Only $502.00 $624.00 $624.00 $760.00

Retiree + Spouse $898.00 $1,120.00 $1,120.00 $1,350.00

Retiree + Child(ren) $778.00 $972.00 $972.00 $1,170.00

Retiree + Family $1,266.00 $1,582.00 $1,582.00 $1,906.00

Gold Retiree**

Retiree Only $150.00 $150.00 $150.00 $150.00

Retiree + Spouse $323.00 $545.00 $545.00 $775.00

Retiree + Child(ren) $203.00 $397.00 $397.00 $595.00

Retiree + Family $691.00 $1,007.00 $1,007.00 $1,331.00

Platinum Retiree**

Retiree Only $150.00 $150.00 $150.00 $150.00

Retiree + Spouse $323.00 $545.00 $545.00 $775.00

Retiree + Child(ren) $203.00 $397.00 $397.00 $595.00

Retiree + Family $691.00 $1,007.00 $1,007.00 $1,331.00

Retiree Dental and Vision InsuranceTier of Coverage Dental Vision

Silver Retiree

Retiree Only $39.54 $6.26

Retiree + 1 Dependent $79.08 $11.90

Retiree + Family $118.62 $17.49

Gold Retiree




Platinum Retiree




Plan References*The monthly premium for Medical Insurance is discounted $5.00 per month per year of service until the retiree turns 65 years of age. At 65, retirees who continue coverage will pay the full monthly premium in effect at that time.

**The monthly premium for Medical Insurance is discounted until the retiree turns 65 years of age. At 65, retirees who continue coverage will pay the full monthly premium in effect at that time.

23



Claims, Billing & Benefit AssistanceIf teammates have questions on claims, receive bills from providers which they do not understand or would like general information on any of the teammate benefits provided, please contact the Gehring Group Service Team.

The Gehring Group Service Team works directly with Pasco Clerk and Comptroller and its teammates to provide claims and benefits service and will assist teammates with their concerns. Please remember this is in addition to the Pasco Clerk and Comptroller’s Human Resources and is not replacing assistance teammate may need from Human Resources.

Teammate may contact a claims specialist by:

1. Email: [email protected]

Please include your name, contact information and a brief description of the issue. A Gehring Group Claims Specialist will respond via a secure email or phone call to gather additional information.

OR

2. Call: (800) 244-3696

When calling, please identify yourself as a teammate of Pasco Clerk and Comptroller’s Office and ask to speak to a Claims Specialist or another member of Pasco Clerk and Comptroller’s designated team to assist with questions or concerns.

Office hours are Monday through Friday, 8:30am – 5:00pm. If calling after office hours, please leave a message indicating you are a Pasco Clerk and Comptroller teammate and would like to speak with a Claims Specialist. Please leave full name, contact information and a brief message and a Claims Specialist will be in contact with you the following business day.

At Gehring Group, our goal is to assist teammates in resolving issues as quickly as possible.

Q A&Retirement BenefitsFlorida Retirement System (FRS)The Florida Retirement System offers members the option of participating in two FRS retirement plans:

The FRS Investment Plan is a defined contribution plan in which employer and teammate contributions are defined by law, but your ultimate benefit depends in part on the performance of the member’s investment funds. The FRS Investment Plan is funded by employer and teammate contributions that are based off salary and FRS membership class. The investment Plan directs contributions to individual member accounts, and member allocates contributions and account balances among various investment funds.

The FRS Pension is a defined benefit plan, in which the teammate is promised a benefit at retirement if teammate meets certain criteria. The amount of the teammates future benefit is determined by a formula, based on earnings, length of service, and membership class. Teammates benefit is pre-funded by employer and teammate contributions.

More information is available at www.myfrs.com. Please register for an account, take advantage of the videos, work-shops and other information available to teammates.

FRS Agency | Plan# 61001 Customer Service: (866) 446-9377 | www.myfrs.com

Deferred CompensationIn addition to the FRS, teammates have the option to participate in Deferred Compensation (457) retirement plans. These tax-deferred, teammate-funded plans, allow the teammate to have a set amount deducted each paycheck and invested in select funds. Our Deferred Compensation participating companies are listed below.

Nationwide Retirement Solutions | Plan# 0044560001 Agent: Steve Duganieri | Office: (877) 677-3678 | Cell: (631) 767-2308

www.nrsforu.com

ICMA | Plan# 305701 Agent: Meghan Doherty | Phone: 866-620- 6070 ext. 4938 | www.icmarc.org

VALIC | Plan# 71440 Agent: Randy Ramos | Phone: (813) 269-3357 | www.valic.com

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NotesUse this section to make notes regarding personal benefit plans or to keep track of important information such as doctors' names and addresses or prescription medications.

4200 Northcorp Parkway, Suite 185Palm Beach Gardens, Florida 33410

Toll Free: (800) 244-3696 | Fax: (561) 626-6970www.gehringgroup.com

© 2016, Gehring Group, Inc., All Rights ReservedFINAL Revised

Last Modified: August 26, 2019 2:00 PM

2019 | 2020 TEAMMATE

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