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Town of Davie
2017
Benefit
Highlights
The Town of Davie strives to be the
preeminent community in South Florida to
live, work, learn, and play while treasuring
our preserved natural settings.
Table of Contents
Welcome to Your Benefits – What’s New? 2
Benefits Selection Form 3
Eligibility & Benefit Dollars 4
United Healthcare Plan Designs 5
United Healthcare Care 24 Services,
United Healthcare Health Discount Program & Optum Pharmacy Management Program
6
Humana Dental Plans 7
Humana VisionCare 8
The Standard Life Insurance UNUM Disability Insurance
9
Qualifying Events & Compliance Notices 10
Flexible Spending Accounts 11
457 Deferred Compensation, We Florida Financial Credit Union, 12
Long Term Care, & Treasury Direct Savings Bonds
Legal Plans & Nationwide Pet Insurance 13
Aflac Supplemental Benefits 14
Colonial Life & Accident Supplemental Benefits 15
Contact Phone Numbers and Websites 16
Welcome to Your Benefits
The Town of Davie offers a comprehensive benefit package for all eligible employees. A variety of these employee benefit
programs have been highlighted in this booklet as a general reference. Please refer to the Town of Davie’s Employee
Handbook and Operating Procedures and group insurance Certificates of Coverage for detailed descriptions of all available
employee benefit programs and stipulations therein. Questions and further clarifications regarding this booklet’s contents
may be directed to the Human Resources Department.
What’s New
The Health Insurance Marketplace - In complying with Federal law, the Town of Davie’s Human Resources Department has
distributed required notification to all Town employees regarding the Health Insurance Marketplace. This notification explained
that Americans are required to obtain health insurance coverage. Town employees and their dependents who are enrolled in
the Town’s United Healthcare coverage will not be affected by these new laws, but any dependents or spouses not covered
must have their own coverage. If you need additional information, please contact the Human Resources Department.
Online Benefit Enrollment with BenTek!
The Town of Davie puts you in charge of your benefit enrollment. All benefit eligible employees are provided access to
electronic enrollment through the BenTek Employee Benefit Center (EBC). The EBC provides you the ability to make
your group benefit elections online for the annual open enrollment, new hire enrollment and to make any changes to your
coverage election due to a qualifying life event.
BenTek is accessible 24 hours a day during the annual open enrollment period. Information about all of your employee
benefit options, premiums and carrier contact information is available to help you make informed decisions. You may also
log on any time throughout the year to review your benefit elections, access carrier contact information, review and update
your life insurance beneficiaries and report any qualifying life events that impact your benefit coverage needs.
To access the Employee Benefit Center:
< Log on to https://www.mybentek.com/davie
< First Time User? Click on First Time User to create your confidential user profile, including your user name and password.
< Enter the BenTek EBC to review your current benefit elections, learn about your benefit options and make any new
elections or changes in your elections.
< You may also review your life insurance beneficiary designation(s) and make any necessary changes.
Should you experience technical difficulties, please contact BenTek Support at [email protected] or call 888-5-BenTek
(888-523-6835) Monday through Friday, during regular business hours.
To access your group insurance benefits online, log on to the EBC at www.mybentek.com/davie
UNUM Disability Insurance
There are some plan design changes on the 2017 UNUM Short and Long Term Disability plans. See page 6 for details.
Humana Vision Plan
The new Humana Vision 130 Plan replaces last year’s plan and has some new benefits. See the chart on page 8.
$500 Carryover on the Medical FSA “Use It or Lose It” Rules - For 2017, the IRS has established the maximum amount
that can be contributed to a qualified FSA at $2,550. But, you can roll over up to $500 of unused FSA funds to the following
year! Your rollover will not impact your contribution limit, which means your total balance in the next plan year could be up
to $3,050. So, if you have any 2016 money you have not spent by the end of the 2016 plan year (12/31/2016) up to $500
maximum, it will carry over into your 2017 Medical FSA Account. This carryover is NOT for the Dependent Day care FSA –
ONLY the Medical FSA.
Remember – since 2011, Medical FSA funds cannot be used for over-the-counter medicines unless specifically prescribed
by a doctor. You must sign up each year for a Medical or Dependent Day care FSA. WageWorks is the company that
handles our FSA accounts and reimbursements, and there are WageWorks forms for signing up for an FSA and for
sending in claims. Claims may also be initiated online with WageWorks at www.takecarewageworks.com or emailed to
[email protected] An FSA participant can establish a secure online account at www.takecarewageworks.com
where they will be able to track their claims submissions, print claim forms, make address changes, etc. Employees can
get the forms and sign up with Human Resources or with your Aflac representative.
2
All benefits in the booklet are subject to change. This is an Employee Benefits Highlights Summary and not a contract. All benefits are subject to the provisions and
exclusions of the master contract.
TOWN OF DAVIE - 2017 EMPLOYEE BENEFIT HIGHLIGHTS
2017 Benefits Selection Form
$415
I. Benefit Choice Dollars
$675
B1
II. Required Insurance Selections
Medical
United HealthCare EPO
United HealthCare POS
$1,300 Ded/HSA w/$1000.00 in account
($41.67 deposited each pay period)
$645
B2
$885
B3
B4
per pay period
All premiums are per pay period
Employee
Only
Employee
+ Spouse
Employee +
Children
Employee +
Family
Selected
Amount
Pay Code
$369
$844
$790
$1146
22, 18, 17, 04
$362
$804
$733
$1083
24, 25, 26, 27
$325.67
$719.67
$654.67
$976.67
28, 29, 30, 31
/
32
Disability/Life Insurance
Long Term Disability
-
Adjustments to salary will alter premium
Post tax Deduction
Max benefit 50% to $ 7500/month
Short Term Disability
Adjustments to salary will alter premium
- Post Tax deduction
Maximum benefit 50% to $1500 per week
Life Insurance (AD&D, $50,000)
Base Life Insurance
$
LT
$
03
$2.95
BL
Selected
Amount
Pay Code
III. Optional Insurance Selections
Employee
Only
Employee &
Spouse
Employee &
Children
Employee &
Family
Humana HMO HS205
$6.08
$12.15
$13.67
$22.00
AD, A5, A6, 07
Humana (Adv Plus 3S)
$10.51
$21.51
$21.85
$35.93
15, A3, A4, 16
Humana PPO Plan (LOW)
$13.29
$26.55
$35.33
$50.70
10, A1, A2, 09
Humana PPO Plan (HIGH)
$17.68
$35.35
$47.02
$67.48
A7, A8, A9, A10
Dental
Miscellaneous
Supplemental
Long Term Disability –Buy Up Option - Additional 10%
Post tax Life - Additional/Supplemental Rates are based on age.
S1
Select amount in increments of $10,000 $___________
Dependent Life Insurance Coverage
(Post tax)
$10,000 dependent life coverage
$1.27
Spouse
$10,000 dependent life coverage (child/children)
DS
DC
$1.00
AFLAC - Attach new AFLAC enrollment card, or write in Current amount if you have no changes.
02
Colonial Life – Insurance Products
Legal Shield Services
Vision Care Plan
US Legal Services
COL
Legal $7.98
Identity Theft
$6.48/$6.97
Single-$3.40
Legal - $9.38
Combination $12.95
PP
Family-$9.72
Identity - $4.98
VS, VF
Combination $11.35
UL
Flex Spending - Medical - Pay period minimum $10.00/maximum $104.16
M1
Flex Spending - Dependent Care - Pay period minimum $10.00/maximum $200.00
C1
Additional Health Savings Account Contribution
33
TOTAL
$ _________
3
Group Insurance Eligibility
The Town’s group insurance plan year for 2017 is from January 1st through December 31st.
Employees are eligible to participate in the Town’s insurance plans if they are full time employees working at least 30 hours
per week. Coverage will be effective the 1st of the month following 30 days of employment. If you separate employment
from the Town, insurance will continue through the end of the month in which the separation occurred. COBRA continuation
of coverage is available as applicable by law.
Dependent Eligibility
A dependent is defined as the legal spouse (a person to whom the participant is legally married) and/or dependent children
of the participant or the spouse. Dependent children may be covered through the end of the calendar year in which the child
reaches age 26 for medical, and the 26th birthday for dental and vision. The term “child” includes any of the following:
l A natural child l A legally adopted child
l A stepchild l A foster child
l A newborn (up to age 18 months) of a covered dependent (Florida)
l A child for whom legal guardianship has been awarded to the participant or the participant’s spouse
Disabled Dependents
Coverage for an unmarried dependent child may be continued beyond age 26 if:
l The dependent is physically or mentally disabled and incapable of self-sustaining employment, AND
l The dependent is otherwise eligible for coverage under the group medical plan, AND
l The dependent has been continuously insured; AND
l Coverage began prior to the age of 19.
l Proof of disability will be required upon request. Please contact Human Resources if further clarification is required.
Tobacco Policy
Effective October 1, 2015, the Town adopted a non-tobacco hire policy for any employees hired on or after this date. In addition,
there will be a $50 monthly surcharge for any new dependent added to the health insurance if they are a tobacco user.
Group Insurance Premium Funding “Benefit Dollars”
The Town of Davie offers funding through “Benefit Dollars” to all benefit eligible employees. These Benefit Dollars are to be
used to contribute to the cost of insurance premiums each employee incurs. The employee may choose how the funds are
applied and to which plans they would like them to be applied. For more information regarding Benefit Dollars or how they
work, please contact Human Resources.
Summary of Benefits and Coverage
A Summary of Benefits & Coverage (SBC) for each Medical Plan Option is provided as a supplement to this booklet
which is being distributed to the New Hires and Existing Employees during open enrollment. These summaries are an
important item in understanding your benefit options. A copy of these SBC documents is also available as follows:
From:
Human Resources Department Address: 6591 Orange Dr.
Davie, FL 33314
Phone: 954-797-1100
Email: [email protected]
Through the enrollment software - BenTek: www.mybentek.com/davie
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 actual group certificate of coverage can be reviewed
and obtained by contacting the Human Resources Department or at the following web address: www.mybentek.com/davie.
If you have any questions about the plan offerings or coverage options, please contact the Human Resources Department at (954) 797-1100.
All benefits in the booklet are subject to change. This is an Employee Benefits Highlights Summary and not a contract. All benefits are subject to the provisions and
exclusions of the master contract.
TOWN OF DAVIE - 2017 EMPLOYEE BENEFIT HIGHLIGHTS
4
United Healthcare 2017
Schedule of
Benefit
Summary
EPO Select
Choice
Plus
Annual Deductible/Family
Maximum
POS
HDHP w/HSA
In Network
Out of Network
In Network
Out of Network
None
$200/$400
$500/$1,000
$1,300/$2,600
$3,250/$6,500
$2,500/$5,000
$2,500/$5,000
$3,000/$6,000
$2,600/$5,200
aggregate
$5,000/$10,000
aggregate
no
no
no
yes
yes
Physician Office Visit
$15 per visit
$15 per visit
Ded & 40%
Ded & 20%
Ded & 40%
Specialist Office Visit
$30 per visit
$30 per visit
Ded & 40%
Ded & 20%
Ded & 40%
$40 per visit
$40 per visit
Ded & 40%
Ded & 20%
Ded & 40%
Preventive Care Service
No Co-payment
No Co-payment
Ded & 40%
No Co-payment
Ded & 40%
Hospital –
Inpatient Stay
$100/Day
$300/Max
Ded & 20%
Ded & 40%
Ded & 20%
Ded & 40%
Hospital – Out Patient
$200
Ded & 20%
Ded & 40%
Ded & 20%
Ded & 40%
$100
Ded & 20%
Ded & 40%
Ded & 20%
Ded & 40%
No Co-payment
Ded & 20%
Ded & 40%
Ded & 20%
Ded & 40%
Urgent Care Center Services
$30 Co-pay
$30 Co-pay
Ded & 40%
Ded & 20%
Ded & 40%
Emergency Room
$200
$200
Ded & 40%
100% after Ded
100% after Ded
Out Of Pocket
Maximum
Premium Designated
Non Premium Designated
High End Diagnostic Testing
MRI, CAT Scans,
PET Scans, CT Scans
Low End Diag. Testing
X-Rays, Labwork,
Mammograms
Prescription Coverage
$10
$30
$50
Tier I
Tier II
Tier III
$10
$30
$50
Tier I
Tier II
Tier III
$10
$30
$50
Tier I
Tier II
Tier III
Ded then $10 Tier I
Ded then $30 Tier II
Ded then $50 Tier III
Ded then $10 Tier I
Ded then $30 Tier II
Ded then $50 Tier III
All benefits in the booklet are subject to change. This is an Employee Benefits Highlights Summary and not a contract. All benefits are subject to the provisions and
exclusions of the master contract.
TOWN OF DAVIE - 2017 EMPLOYEE BENEFIT HIGHLIGHTS
5
United Healthcare Care 24 Services – Employee Assistance Program
The Employee Assistance Program is available to ALL employees and their dependents living in the same household. It is
a great free source for health information and emotional support available 24 hours a day, 7 days a week at 1-888-887-4114
or on the web at www.myuhc.com. Nurses and specialists are available 24 hours a day to answer your questions on illness,
injuries, stress and anxiety, coping with grief and loss, finding a doctor, personal legal or financial concerns, prevention and
self-care, medications and general health information, and many more topics. Emotional support is also available from
master’s-level specialists when you need help dealing with life’s challenges. Get help with stress, anxiety, depression, grief,
marriage difficulties and more. You also have access to an audio library, a website, and a nurse online via Chat. Pick up a
brochure from HR and visit the website.
United Healthcare Health Discount Program
This is a discount plan that provides discounts at certain health care providers for medical services, and is NOT insurance.
The discount plan member is obligated to pay for all health care services, but will receive a discount from these health care
providers who have contracted with the discount plan organization.
Save on these wellness resources to help you live a healthier life:
vWeight management from Jenny Craig, Nutrisystem and other popular programs
vNutrition counseling
vFitness clubs including select locations of Golds Gym, Curves, Anytime Fitness, My Gym, Jazzercize,
Lifetime Fitness, Snap Fitness
vFitness equipment and apparel
vNatural products and foods
vStress reduction and relaxation resources
vSmoking cessation programs
vAcupuncture, Chiropractic Care
vMassage Therapy, Natural Medicine
vInfertility Treatment
vHearing Devices, Laser eye surgery
Find information on participating programs at www.myuhc.com, under Extra Programs and Discounts. A full brochure giving
more information can be obtained from Human Resources.
OptumRx Pharmacy Management Program
The pharmacy management program provides clinical pharmacy services that promote choice, accessibility and value. The
program offers a broad network of pharmacies (more than 56,000 nationwide) to provide convenient access to medications.
While most pharmacies participate in the network, you should check first – call your pharmacist or visit the online pharmacy
service at www.myuhc.com. The online service offers you home delivery of prescriptions, the ability to view personal
benefit coverage, access health and well being information, and check the location of network retail neighborhood
pharmacies by zip code.
Retail Network
Pharmacy
For up to a 31 day supply
Tier 1
Tier 2
Tier 3
$10
$30
$50
Home Delivery Network
Pharmacy
For up to a 90 day supply
$20
$60
$100
Retail Non-Network
Pharmacy
For up to a 31 day supply
$10
$30
$50
Respecting and Promoting Diverse and Sustainable Community
and Neighborhood Values with consideration of our historic roots
All benefits in the booklet are subject to change. This is an Employee Benefits Highlights Summary and not a contract. All benefits are subject to the provisions and
exclusions of the master contract.
TOWN OF DAVIE - 2017 EMPLOYEE BENEFIT HIGHLIGHTS
6
Dental Plans
The Town of Davie offers four different Humana dental plans. Two plans are network based only plans, and two plans
are PPO. Outlines of coverage and plan brochures along with costs for each plan are available in Human Resources.
The Humana HS205 plan is a DHMO prepaid plan that focuses on maintaining oral health, prevention and costcontainment. In order to receive services, a primary dentist from the network must be selected. There are no deductibles
to meet and no waiting periods. The plan provides covered services at a fixed co-pay applicable at either a participating
general dentist or participating specialist.
The Humana Advantage Plus plan is a network based plan. As long as you seek treatment from a Humana Advantage
plan network provider there is no need to choose a primary care dentist. This plan also has a list of fixed co-payments for
dental services. More services are covered under this plan. If a service is not listed on the schedule of benefits, dentists
will give you a 20 percent discount off their usual fee.
Both HS205 and Advantage Plus dental plans have no annual deductible and no annual maximum.
The Humana PPO Low and PPO High dental plans provide the freedom to see any dentist of your choice. The PPO plans
have both in-network and out-of network-coverage. These plans have an annual deductible and a calendar maximum.
The PPO Low plan provides $1,000 annual maximum coverage, based on provider’s reduced contracted network fees.
The PPO High plan provides a maximum allowable fee coinsurance with $2,000 annual maximum coverage
HumanaHS205
HS205
Humana
Humana
Advantage
Plus
3S
Humana
Advantage
Plus
Must use participating providers.
Plan pays 100% after fixed
co-payment for service.
Must use participating providers.
Plan pays 100% after fixed
co-payment for service.
None
None
None
None
Preventative Care
No Co-pay
No Co-pay
Basic Services
Fixed Co-pay Schedule
Fixed Co-pay Schedule
Fillings, Periodontics &
Endontics
Fixed Co-pay Schedule
Fixed Co-pay-Schedule
Fixed Co-pay-Schedule
Children $1,800
Adults $2,000
Fixed Co-pay-Schedule
Benefit Description
Calendar Year
Maximum Benefit
Annual Deductible
(Individual/Family)
Major Services
Orthodontics
PPO
Low
Low
PPO
Children $2,100 Adults $2,300
Humana PPO
Solstice
PPO
High
High
PPO
In Network/Out of Network
In Network/ Out of Network
Plan payment is based on provider's
reduced contracted fees.
Plan payment is based on reasonable and
customary allowances.
$1,000 per participant
$2,000 per participant
$50/$150
$50/$150
Preventative Care
Covered at 100%
Covered at 100%
Basic Services
Fillings, Periodontics,
Endodontics
80% after deductible
80% after deductible
80% after deductible
80% after deductible
Major Services
50% after deductible
Children only - 50% Lifetime
maximum of $1, 000
50% after deductible
Benefit Description
Calendar Year
Maximum Benefit
Annual Deductible
(Individual/Family)
Orthodontics
Children only - 50% Lifetime maximum of $1, 000
All benefits in the booklet are subject to change. This is an Employee Benefits Highlights Summary and not a contract. All benefits are subject to the provisions and
exclusions of the master contract.
TOWN OF DAVIE - 2017 EMPLOYEE BENEFIT HIGHLIGHTS
7
Humana VisionCare for the Town of Davie
Open your eyes to high-quality vision care! The VisionCare plan is simple to use. Select a doctor from the provider directory
and call for an appointment. At the time of the appointment, present your ID Card to the participating provider. Members pay
only their co-payments and any extra cosmetic options selected. There are no additional forms to complete or claims to file.
Members can also choose an out-of-network provider, pay the doctor at the time of the visit, and submit receipts to Humana
for reimbursement. Benefits are paid according to a reimbursement schedule available online or in the Humana Vision
Summary of Benefits available from Human Resources.
Through the Humana website at www.HumanaVisionCare.com, you have access to a variety of online services: view your
benefits, view your claims, check the status of a claim, get an up-to-date listing of participating vision providers, and more.
The chart below is a basic outline of benefits. Please consult the Humana Enrollment Vision Summary of Benefits brochure
for more details, limitations, procedures, exclusions, and a vision provider directory.
This schedule shows only a few of the covered procedures. The full benefits of each plan will be determined by the contract.
For a complete listing of benefits, exclusions, and limitations, please see the full VisionCare brochure available from Human
Resources and reference the certificate of coverage.
Nurturing the health, safety, and welfare of the community
All benefits in the booklet are subject to change. This is an Employee Benefits Highlights Summary and not a contract. All benefits are subject to the provisions and
exclusions of the master contract.
TOWN OF DAVIE - 2017 EMPLOYEE BENEFIT HIGHLIGHTS
8
The Standard
Life/AD&D Employee Benefits
The Standard Insurance Company provides Group Life and Accidental Death & Dismemberment Insurance for the employees
of the Town of Davie. A summary of these benefits are listed below. A complete description of conditions and exclusions
can be found in The Standard brochures and outlines of coverage available at Human Resources.
Group Term Life Insurance
zThe Town provides $50,000 of Life Insurance for each employee.
zAccidental Death and Dismemberment (AD&D) is also covered for each employee.
zThis coverage is paid for by your employer, Town of Davie.
zEmployee benefits reduced on a schedule starting at age 65.
Voluntary Additional Life Insurance
Additional life and additional AD&D insurance may be purchased via payroll deduction. An employee may purchase in
increments of $10,000 to a maximum of $400,000, not to exceed a 5 times annual earnings.
Dependent Life – Spouse/Children
Life and AD&D insurance may be purchased on a spouse or children with the following limits:
zUp to $10,000 for a spouse
z$10,000 for a child
zDependent coverage includes unmarried children from live birth through age 20, or through age 24 if the child is
a full-time registered student.
zSpouse coverage will reduce on a schedule starting at age 65.
zA Member must be enrolled in the Additional Life to enroll in the Spouse Life plan
Additional Plan Features
zTravel Assistance: This service provides access to appropriate medical care and other emergency services whenever traveling at least 100 miles from home or in a foreign country for trips lasting up to 180 days.
Travel Assistance offers a range of professional, 24-hour medical and legal assistance and coordination services.
zFamily Benefits Package: It provides extra AD&D benefits to help families transition due to the loss of an insured member. The package includes a Child Care Benefit (child care expense reimbursement for children under age 13); a Career Adjustment Benefit (education expense reimbursement for spouses); and a Higher Education Benefit (college expense reimbursement for children).
zAccelerated Benefit: Terminally ill members may withdraw up to 75% of their Life benefit to a maximum of $500,000 (when Basic Life and any Additional Life are combined).
zIf you terminate employment or become ineligible for this coverage, you have the option to take your coverage with
you by either porting or converting all or a portion of your eligible insurance coverage’s in force.
UNUM Short-Term & Long-Term Disability Insurance
UNUM provides Group Short-Term Disability and Group Long-Term Disability Insurance for the Town of Davie. Following
are some of the details, but complete descriptions, conditions, and exclusions can be found in the UNUM brochures and
outlines of coverage available at Human Resources.
Short-Term Disability UNUM
aThe Town provides short-term disability insurance, which is intended to protect part of your income for a short duration in
case you become ill or injured and, under doctor’s orders, cannot work.
aThe policy provides 50% of weekly salary up to $1,500 per week for up to 10 weeks maximum.
aBenefits begin on the 21st day for an off-the-job accident or illness.
aCoverage terminates when you terminate employment with the Town of Davie or at retirement.
Long-Term Disability UNUM
aThe Town provides long-term disability insurance which is intended to protect part of your income for a longer duration
after you have depleted short-term disability or any sick leave you might have.
aThe policy pays 50% of salary up to $7,500 per month, after 90 days and an additional 10% of salary with an optional
employee-paid buy up.
aThis coverage terminates when you terminate employment with the Town of Davie or at retirement.
See brochures for more details, conditions and limitations. Controlling provisions are provided in the policy, and this summary does not modify those
provisions or the insurance in any way. This is not a binding contract. A certificate of coverage will be made available to you that describes the benefits in
greater detail. Should there be a difference between this summary and the contract, the contract will govern.
See brochures for more details, conditions and limitations.
All benefits in the booklet are subject to change. This is an Employee Benefits Highlights Summary and not a contract. All benefits are subject to the provisions and
exclusions of the master contract.
TOWN OF DAVIE - 2017 EMPLOYEE BENEFIT HIGHLIGHTS
9
Qualifying Events and IRS Code Section 125
Premiums for medical, dental, vision and certain supplemental insurance policies and contributions to FSA accounts (Health
Care and Dependent Care FSA’s) and HSA accounts are deducted through a Cafeteria Plan established under Section 125
of the Internal Revenue Code and are pre-tax to the extent permitted. Under Section 125, changes to your pre-tax benefits
can be made ONLY during the Open Enrollment period unless you or your qualified dependents experience a qualifying
event, and the request to make a change is made within 30 days of the qualifying event.
Under certain circumstances, you may be allowed to make changes to your benefits elections during the plan year, if the
event affects your own, your spouse’s, or your dependent’s coverage eligibility. An “eligible” qualifying event is determined
by the Internal Revenue Service (IRS) Code, Section 125.
Examples of qualifying events include the following:
vGain or loss of eligibility for Medicaid or CHIP coverage (60 day notification period) vAn increase or decrease in your work hours causes eligibility or ineligibility vA covered dependent no longer meets eligibility criteria for coverage
vYou, your spouse, or dependent(s) terminate or start employment
vYou have a child, gain legal custody or adopt a child
vA child gains or loses coverage with an ex-spouse vYour spouse and/or other dependent(s) die(s)
vGain or loss of Medicare coverage
vYou get married or divorced
IMPORTANT – If you experience a qualifying event, you must contact Human Resources within 30 days of the qualifying
event to make the appropriate changes to your coverage. Beyond 30 days, requests will be denied, and the employee may
be responsible both legally and financially for any claim and/or expense incurred as a result of the employee or a dependent
who continues to be enrolled but no longer meets eligibility requirements. If approved, changes will take place on the first
of the month following the qualifying event, except for newborns, which are effective on the date of birth. Any cancellations
will be processed at the end of the month, except coverage terminates on the date following a death. You may be required
to furnish valid documentation supporting a change in status or “Qualifying Event.”
Compliance Notices
Health Information Privacy Notice - the employer/plan
sponsor of a Group Health Plan must comply with applicable
federal and state laws to maintain the privacy of your
Protected Health Information (PHI). PHI may not be used
or disclosed for purposes other than enrollment, treatment,
payment, operations and disclosures required by HIPAA law
without a valid authorization.
Health Insurance Portability & Accountability Act
(HIPAA) - HIPAA nondiscrimination provisions state that
individuals may not ne denied eligibility or continued eligibility
to enroll in a group medical plan based on health factors, nor
charged more for coverage than similar employees.
Special Enrollment Rights - If you are declining enrollment
for yourself or your eligible dependents because of other
health coverage, HIPAA Special Enrollment Rights may in
the future allow you to enroll yourself or your dependents
in the plan, provided that you request enrollment within 30
days after your other coverage ends. In addition, if you have
a new dependent as a result of marriage, birth, adoption or
placement for adoption; you may be able to enroll yourself
and your dependents, provided you request enrollment
within 30 days of the event.
Notice of Privacy Practice of The Town of Davie - The
Town’s Privacy Notice is available and you can obtain a
copy by contacting the Human Resources Department.
COBRA Continuation of Medical Coverage Benefits Under the Consolidated Omnibus Budget Reconciliation Act
(COBRA), employees and/or dependents may be able to
continue their enrollment in certain medical plans such as
health and dental, if such coverage is terminated or changed
due to a qualifying event.
Medicare Part D Creditable Coverage - The Town’s
prescription drug coverage is considered Creditable
Coverage under Medicare Part D. If you or your dependents
are or will be eligible for Medicare, you may obtain more
information by requesting a Medicare Part D Disclosure of
Creditable Coverage Notice.
Woman’s Health and Cancer Rights Act of 1998
(WHCRA) - The Town’s medical plans provide medical
and surgical benefits for post-mastectomy related services
including all stages of reconstruction, surgery to achieve
symmetry, prostheses and treatment of complications,
including lymph edema.
All benefits in the booklet are subject to change. This is an Employee Benefits Highlights Summary and not a contract. All benefits are subject to the provisions and
exclusions of the master contract.
TOWN OF DAVIE - 2017 EMPLOYEE BENEFIT HIGHLIGHTS
10
Flexible Spending Accounts (FSA’s)
Flexible Spending Accounts allow you to use pre-tax dollars to pay for eligible out-of-pocket medical expenses for yourself
and your dependents, and/or dependent care expenses. Our FSA’s are administered by WageWorks, and all applications,
forms, brochures and information are available through the Aflac Reps or Human Resources.
The Healthcare Flexible Spending Account “Use It or Lose It” Rule has Changed –
Now Features a $500 Carryover
Recently the U.S. Department of the Treasury modified the “Use It or Lose It” rule which required any leftover balance in
a Healthcare FSA to be forfeited at the end of the plan year. Under the new rule, you will be able to carryover up to $500
of your unused WageWorks Healthcare FSA balance remaining at the end of a plan year, so you no longer end up losing
unused funds up to $500. This rule change limits your risk of losing any unused funds (up to $500.00) and gives you more
control and flexibility in managing your out-of-pocket healthcare expenses.
For 2017: Please review your current balance and your planned expenses for the remainder of this year. Note that up to
$500 of any remaining balance from 2016 will be carried over into your 2017 account. It will not affect your election limit for
2017 – you can carry a total balance of the full election amount for 2017 ($2,550), plus any carryover from 2016 (up to $500)
for a total balance of up to $3,050.
Health Care Spending Account (Medical FSA)
Uncovered, unreimbursed healthcare expenses (out-of-pocket) for purposes of a Medical FSA are defined by the IRS, and
can include medical, dental, vision deductibles, co-pays and coinsurance, eyeglasses and contact lenses, prescription drug
co-pays, and more. By using your Medical Healthcare FSA, you can pay for eligible medical expenses with pre-tax dollars
and reduce your taxable income. The maximum you can contribute to your Medical FSA is $2,550 per the IRS. Expenses
must be incurred within the Plan Year (1/1/2017 – 12/31/2017) except for the new $500 carryover amount.
Dependent Care Spending Account
With a Dependent Care FSA, you can set aside dollars on a pre-tax basis to pay for dependent day care expenses. You
can contribute a maximum of $5,000 per plan year (1/1/2017 – 12/31/2017), pay the expenses, and submit a reimbursement
form after paying for the day care. You cannot participate in this account and take a dependent care tax credit on your taxes
at year-end (it is one or the other). These expenses must be for the care of a child age 12 and under, or for a dependent
who is not capable of self-care. You will be reimbursed from your Dependent Care Spending Account only up to the amount
you have contributed at any given time. Reimbursement requests must be submitted and received by WageWorks within
30 days after the end of the plan year. There is no carryover on the Dependent Care Account.
Medical Healthcare and Dependent Care Spending Accounts are separate, and you cannot transfer money from one
account to the other. You may not use money in your Healthcare Spending Account for reimbursement of a domestic
partner’s medical, dental or vision expenses (per the IRS).
Some questions on FSA Accounts should be directed to a tax advisor.
Dedication to Excellence in Service Delivery
All benefits in the booklet are subject to change. This is an Employee Benefits Highlights Summary and not a contract. All benefits are subject to the provisions and
exclusions of the master contract.
TOWN OF DAVIE - 2017 EMPLOYEE BENEFIT HIGHLIGHTS
11
457 Plan Deferred Compensation Administered by VOYA
As a Town Employee, you can participate in a 457 Deferred Compensation Plan, under which you can make pre-tax
contributions through payroll deduction into a variety of investment options to save for retirement. By setting aside a portion
of your income to accumulate on a tax-deferred basis, you pay fewer tax dollars now, and your savings and investment
earnings accumulate tax-deferred until you start drawing from the plan at retirement.
Your 457 Plan is a non-qualified tax-deferred compensation plan that works very much like other retirement plans such
as a 401(k) and 403(b). Your payroll-deducted contributions are deferred into the 457 Plan on a pretax basis, lowering
your taxable income. The 457 assets grow tax-deferred until they are withdrawn from the account, at which time you pay
the taxes. You may use this plan to save for retirement through systematic deposits each pay period, while also reducing
taxable income, your contributions and earnings grow tax-free, and you only pay taxes when you withdraw the funds.
Contributions may also be made to a Roth 457 Plan after-tax. When you take your money out at retirement, your contributions
and earnings do not get taxed.
You can get more information on these plans through Human Resources, or calling the
plan representative Erik Sherman, at 305-579-4026.
We Florida Financial Credit Union
We Florida Financial Credit Union is a financial cooperative that offers many banking-type
services such as savings and checking accounts, auto loans, mortgages and home equity loans,
credit cards and atm’s, as well as having on-line member assistance programs, calculators, and
seminars. The Credit Union is located at 2000 N. Flamingo Road in Pembroke Pines, and can
be reached at 954-745-2400. Visit their website at www.wefloridafinancial.com.
Long Term Care Insurance
Long term care insurance can help you plan for future financial security if you need help with care in a nursing home,
assisted care facility (including Alzheimer’s facilities), adult day care, or in your own home. Learn about protecting your
assets with a state qualified long-term care partnership policy. Help protect your family and your financial plan with a
policy from a leader in the long-term care industry. Because of the complexity and details of these policies, individual
long-term care meetings can be scheduled .
TreasuryDirect Payroll Savings Plan for Purchasing Savings Bonds
TreasuryDirect offers a Payroll Savings Plan feature that allows employees
to make recurring purchases of electronic savings bonds by having money
from each paycheck sent automatically to a TreasuryDirect account, just like
sending your pay to a bank by direct deposit. Once your Payroll Savings Plan
is set up in TreasuryDirect, the system will automatically purchase the type and dollar value of bond you want every time
you have accumulated enough money in your Account to make the purchase. For example: If you want to buy $50 Series I
Savings Bonds, and you ask your employer to withhold $25 from each pay, TreasuryDirect will purchase a $50 bond for you
every other payday. You don’t have to think about it again or do anything else. The purchase is automatic until you change
it or end the payroll funding. More information is available on the website www.treasurydirect.gov or at Human Resources.
All benefits in the booklet are subject to change. This is an Employee Benefits Highlights Summary and not a contract. All benefits are subject to the provisions and
exclusions of the master contract.
TOWN OF DAVIE - 2017 EMPLOYEE BENEFIT HIGHLIGHTS
12
Legal Plans
The Town offers employees the opportunity to participate in a voluntary legal insurance program provided by either Legal
Shield or U.S. Legal Services through payroll deduction. These plans are portable if you leave the Town of Davie or retire,
and both plans help cover the costs of legal services, motor vehicle legal services, trial defense services, IRS audit legal
services, etc. Each has an optional plan covering services for identity theft, credit reports, credit monitoring and identity
restoration. One price covers the family (See brochures for more details).
LegalShield & Identity Theft Shield
LegalShield gives you the ability to talk to an attorney on any matter without worrying
about high hourly costs. For one flat monthly fee you can access legal advice, no
matter how traumatic or trivial the issue.
< Advice – unlimited issues
< Assistance with traffic-related Issues
< Access for covered emergency situations 24/7 < Trial Defense – Pre-Trial & Representation at trial
< Letters/calls made on your behalf
< Assistance on IRS audit issues
< Lawyers prepare your will, living will, and < Extensive list of online legal forms
healthcare power of attorney
< Review contracts & documents up to 10 pages in length
Optional Identity Theft Shield puts the experts in the field of identity restoration on your side.
U.S. Legal Services & Legal & Identity Protection Plans
By enrolling in this plan, participants will have direct access to attorneys who
will provide services for a variety of issues that include, but are not limited to:
f Divorce
f Child Custody & Support f Domestic Adoption
f Bankruptcy
f Foreclosure Assistance
f Criminal Law
f Traffic Tickets, DUI
f Debt Collection Defense
f Estate Planning
f
f
f
Consumer Law
Real Estate
Wills & Trusts
The optional Identity Defender program assists at the inception of a fraud-related emergency, helps restore identity and
good credit, helps with ID theft, and educates on preventive steps to protect identity.
Nationwide Pet Insurance
Part of the Nationwide Insurance family, VPI Pet Insurance is the largest provider of pet insurance,
and has insured over 1 million pets since 1982. Coverage is provided for dogs, cats, birds and
exotics, with your choice of several plans and optional wellness coverage. You can use any
veterinarian, and 4 out of 5 vets recommend VPI. Visit the following link for a 5% discount on
plans, view an informational video on pet insurance, and get a quote on coverage for your pet:
www.petinsurance.com/affiliates/davieflgov.
Creating an Environment that is Conducive to
Innovation, Creativity, and Collaboration
All benefits in the booklet are subject to change. This is an Employee Benefits Highlights Summary and not a contract. All benefits are subject to the provisions and
exclusions of the master contract.
TOWN OF DAVIE - 2017 EMPLOYEE BENEFIT HIGHLIGHTS
13
Aflac Voluntary Supplemental Benefits
During each annual open enrollment period, you can meet individually with an Aflac representative to discuss adding new
voluntary benefits or to review the plans in which you are currently enrolled. New hires will have the opportunity to meet with
a representative to sign up for policies. If the policies are pre-taxed, you can only add/change/delete a policy at the Open
Enrollment period or if you have a change in family status. Below are the various Aflac plan options.
Aflac pays cash directly to you, (unless you assign the benefits)
Affordable premiums and convenient payroll deduction
Compliments your health insurance benefits – provides quick, additional income for your initial out-of-pocket
expenses such as deductibles, co-insurance, and living expenses
q Portable – if you terminate your employment or retire, you may continue your Aflac coverage at the same price
and same benefits, even into retirement. Dependent children covered to age 26
q Coverage is available for your spouse and qualifying, dependent children on all of the following products
q
q
q
Off-the-Job Accident Indemnity Plan: Provides cash if you have an off-the-job accident and receive medical care. If you
break a tooth and go to a dentist, if you hurt your back in a fall and go to a chiropractor, or if your child is injured at school and
is taken to an ER or Urgent Care, etc. – you have a claim. Helps cover co-pays, deductibles, and out of pocket expenses.
Family coverage available. Dependant children are covered to age 26 on the family plan. You can purchase separate, nonpayroll Accident coverage for other family members and older children. There is a $60 wellness benefit (one per policy) each
“plan year” after the first year.
Cancer Indemnity Plan: Pays cash benefits and helps create a cash flow if you are diagnosed with cancer and for cancer
treatments. Four levels available. Family coverage available, and dependent children are covered until age 26. Covers skin
cancer, as well as internal cancer. Totally portable at the same price if you leave or retire – keep it all your life. $40 or $75
wellness benefit for each covered person each calendar year.
Hospital Indemnity Plan: Pays a benefit when a covered person requires hospital confinement for 23 hours or more for a
covered sickness or injury and a charge is incurred. Family coverage available. Can be used for maternity.
Covered Dependants: If your children are on your Aflac policy, they are each covered up to their 26th birthday. When
the youngest child reaches age 26, you should notify your Aflac representative who will take care of changing the policy
coverage (and perhaps the deduction amount) to either Individual or Employee & Spouse coverage.
All Aflac policies are totally portable at the same price if you leave or retire. Be sure to collect your wellness benefits!
It’s very important to carefully read the brochures and outlines of coverage for each policy, as well as speak individually to
an Aflac Representative to get the details, applications, and necessary information on each plan. Your Aflac Reps:
Gene
Villa
phone 561-714-4224 [email protected]
Gloria Schulze phone 954-560-4150 [email protected]
All benefits in the booklet are subject to change. This is an Employee Benefits Highlights Summary and not a contract. All benefits are subject to the provisions and
exclusions of the master contract.
TOWN OF DAVIE - 2017 EMPLOYEE BENEFIT HIGHLIGHTS
14
Colonial Life
Benefits that Count!
Whole Life - Guaranteed Issue up to $50,000 face amount (no health questions asked) for employees of Town of
Davie. The guaranteed purchase option rider allows you to increase the face amount to a maximum of $100,000 without
any health questions (available to purchase up to age 55). Face amounts up to $300,000 for employees, $100,000 for
spouse. Colonial Whole Life policy builds cash value. Your premiums will never increase because of health or age. The
Accelerated Death Benefit allows you to request up to 75% of the face amount if you are diagnosed with a terminal illness.
Colonial Life Whole Life Policy is paid up at either age 65 or age 95. Available for Employee and/or Spouse.
Universal Life Insurance with Long Term Care Universal Life is a flexible premium and adjustable death
benefit that accumulates cash value. The Colonial Long Term care rider can advance up to 4% of the face amount of
your universal life policy’s death benefit to provide payments for qualified long term care service. Example $100,000 of
Universal Life will provide $4,000 month benefit for up to two years at a long term care facility such as a nursing home,
assisted living facility, home health care or adult day care.
Juvenile Universal Life Insurance This is a policy which builds cash value. Example - When each of my
grandchildren were born I purchased a basic $25,000 policy for under $10 month. At age 12 my grandson was diagnosed
with diabetes. The policy issued at his birth is the only life insurance coverage he will ever have. Protect your children/
grandchildren with this permanent, economical policy. -Donna Tilton
Critical Illness coverage compliments your major medical insurance by providing a lump sum of $10,000 - $75,000 Benefit
Amount – You choose the amount! Use to pay the direct or indirect costs related to one of the following covered critical illnesses:
<
<
<
<
<
Cancer Heart Attack Major Organ Failure End Stage Renal(Kidney) Failure Permanent Paralysis <
<
<
<
<
Occupational HIV
Stroke
Coma
Blindness
Occupational Infectious Hepatitis B, C or D
DON’T FORGET!!!
Apply online for your
$50.00 Annual Wellness Screening Benefit
Term Life Insurance 10 Year Term/ 20 Year Term/ 30 Year Term offers level death benefits for specific term. Includes
Accelerated Death Benefit. You can convert your policy to a Colonial Life Cash Value Insurance.
Donna Tilton
Phone: 954-968-6799
[email protected]
Colonial Life
Phone: 1-800-325-4368
www.Coloniallife.com
* Benefits are paid directly to you
* Coverage can continue if you retire
or change jobs with same benefits and premium
* Coverage available for employee, spouse, dependant children
All benefits in the booklet are subject to change. This is an Employee Benefits Highlights Summary and not a contract. All benefits are subject to the provisions and
exclusions of the master contract.
TOWN OF DAVIE - 2017 EMPLOYEE BENEFIT HIGHLIGHTS
15
Contact Information
Town of Davie –
Human Resources Department
Grace Garagozzo, HR Director
Shaun Gelvez, Administrative Aide
LaSabrylia Ware, HR Assistant
Sandra Scott, HR Manager
Daniele Graydon, HR Manager
Kettly Calixte, Risk Coordinator
Bendra Caseneuve, Risk Assistant
Aflac
Gloria Schulze, Rep
Gene Villa, Rep
Aflac Claims Depar tm ent
Aflac Customer Service
We Florida Financial Credit Union
2000 N. Flamingo Rd.
Pembroke Pines, FL 33028
Colonial Life
Donna Tilton, Rep
Colonial Client Services
Long Term Care
Gloria Schulze, Rep
Gene Villa
Phone and Fax numbers
Email and/or website
Phone
Phone
Phone
Phone
Phone
Phone
Phone
Phone
954-797-1100 Main No.
954-797-1094
954-797-1169
954-797-1022
954-797-1093
954-797-1172
954-797-1097
954-797-1110
Email:
Email:
Email:
Email:
Email:
Email:
Email:
Email:
Phone
Phone
Phone
Fax
Phone
Fax
954-560-4150
561-714-4224
800-992-3522
877-442-3522
800-992-3522
800-448-8922
Email: [email protected]
Email: [email protected]
Claims
Claims
Cust. Svc.
Cust. Svc.
www.aflac.com
Phone 954-745-2400
www.wefloridafinancial.com
Phone 954-829-4930
Phone 800-325-4368
Email: [email protected]
www.coloniallife.com
Phone 954-560-4150
Phone 561-714-4224
Email: [email protected]
Email: [email protected]
Humana Dental
Customer Service for Dental
Phone 800-233-4013
www.humanadental.com
Humana Vision Care
Customer Service for Vision
Phone 866-537-0229
www.humanavisioncare.com
Phone
Phone
Phone
Phone
Fax
www.voyaretirementplans.com
Voya - 457 Plan & Roth IRA
Erik Sherman, Rep
Voya Customer Service
LegalShield
Yvette Mayo, Rep
The Standard Life Insurance Co.
Group Service
305-579-4026
800-584-6001
407-719-4897 cell
407-657-1940 office
407-671-2496
Phone 800-378-4668
TreasuryDirect for Savings Bonds
United Healthcare
Customer Service
CARE24-Employee Asst. Prog.
Optum Mail Order Pharmacy
Health Discount Program
U.S. Legal
Dixie Kuehn, Rep
16
davie-fl.gov
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
Email: [email protected]
www.legalshield.com/info/TownofDavie
Customer Service: 800-654-7757
www.standard.com
www.treasurydirect.gov
866-633-2446
888-887-4114
888-739-5820
800-377-0263
www.myuhc.com
www.myuhc.com
www.optumrx.com
www.myuhc.com under Extra
Programs and Discounts
Phone 321-799-2986 office
321-403-0156 cell
Phone 800-356-LAWS
Email: [email protected]
Phone
Phone
Phone
Phone
www.uslprotects.com
Customer Service
UNUM
Short and Long Term Disability
Nationwide Pet Insurance
Lisa Widner
Phone 800-858-6843
www.unum.com
Phone 714-706-5476
Email: [email protected]
WageWorks
Flexible Spending Accounts
Phone 800-950-0105
Fax
877-782-8889
www.takecarewageworks.com
email claims to:
[email protected]
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