2022 EMPLOYEE BENEFITS GUIDE - Effective January 1, 2022 - St. Croix County
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2022 Benefits Guide
2022
EMPLOYEE BENEFITS GUIDE
Effective January 1, 2022
St. Croix County 1
2022 Benefits Guide
A letter from the County Administrator
St. Croix County is committed to your overall health and well-
being and we are pleased to offer a quality, competitive
benefits package that provides valuable healthcare and
financial protection for you and your family. We believe that
supporting our employees with a comprehensive total rewards
package is core to who we want to be as an employer. As
you review this guide, please know that our goal is to provide
you with access to services and solutions that will add value
for you and your family.
As always, we seek to balance cost, benefit scope and quality
in providing you with your benefits package.
Ken Witt,
County Administrator
St. Croix County 2
2022 Benefits Guide
Inside This Guide Welcome to your
St. Croix County
Welcome 2
2022 Benefits!
Access Your Benefits 4
Your benefits are an important part of
Benefits Overview 5
your total compensation at St. Croix
Eligibility and Enrollment 6-7 County. Please take the time to
Health Insurance 8 review and evaluate all the options
Prescription Drugs 9 available to you and your family.
Telemedicine 10
Where to Seek Care 11
How to Save $$ 12
Understand Types of Care 13
Omada 14
Care Advocacy - Alithias 15-16
Wellbeats 17
Wellness Benefits 18
Flex Spending Account (FSA) 19
Dental 20
Vision 21
Life Insurance 22
Disability and Identity Theft 23
Optional Protection Benefits by Aflac 24
Retirement Savings Plans 25
Employee Assistance Programs 26
Additional Benefits 27-31
Cost of Coverage Summary 32
Resource Contact information 33-34
This guide is not intended to be a complete description of the
insurance coverage offered, nor is it a binding contract.
Controlling provisions are provided in each benefit plan policy.
Should there be a difference between this guide and the official
plan documents, the official plan documents will govern.
More information about specific terms and conditions of each plan
is included in the Summary Plan Description (SPD) and Summary of
Benefits and Coverage (SBC).
St. Croix County 3
2022 Benefits Guide
Access your St. Croix County Benefits
Anytime, Anywhere!
As a St. Croix County employee, you
can access your benefit guide when
you’re “on the go” from your computer,
tablet, or smartphone.
From any County Computer
►Access the Bridge
►Click on HR & Career
►Click on Benefits
►Click on Benefits Guide under Quick
Links on the right side of the page
From any non-County Computer:
► www.sccwi.gov
► Click on Employee Access under quick links at the bottom of the page
► Click on HR & Career
► Click on Benefits
► Click on Benefits Guide under Quick Links on the right-hand side of the page
St. Croix County 4
2022 Benefits Guide
Benefits Overview
Many of the benefits we offer are paid for in full by St. Croix County. For some, it is a shared contribution between you
and the County. Other benefits are also available to you at reasonable group rates.
Benefit Who Pays Tax Treatment
The County and
Medical Pre-tax
You
The County and
Dental Pre-tax
You
Vision You Pre-tax
Flexible Spending
You Pre-tax
Accounts (FSA)
Long-Term Disability The County After-tax
Basic Life and Accidental
Death & Dismemberment The County After-tax
(AD&D Insurance)
Supplemental Life
You After-tax
Insurance
Voluntary Short-Term
Disability, Hospital
You After-tax
Insurance, Accident,
Critical Illness
Identity Theft You After-tax
457 Deferred
You Pre-tax
Compensation Plans
Wisconsin Retirement The County and
Pre-tax
System (WRS) You
Employee Achievement
The County N/A
Program (EAP)
St. Croix County 5
2022 Benefits Guide
Eligibility and Enrollment
Who is Eligible? When Can You Enroll in Benefits?
You are eligible for St. Croix County benefits if You can enroll in benefits:
you are:
• Within 31 days of first becoming eligible for
• An active full-time employee working 30 or benefits
more hours* per week.
• During the annual Open Enrollment period
• Coverage is available to you, your legal
• During the plan year, if you experience a
spouse, and your eligible child(ren)** up to
Qualifying Life Event (see next page for
age 26.
additional details)
*Employees working at least 1200 hours in 12
months become eligible for the Wisconsin
Retirement System Pension Plan
** Includes natural, step, legally adopted/or a
child placed for adoption, or a child under your
legal guardianship. Open Enrollment
Open Enrollment is your once a year
opportunity to review your benefit plan
When Does Coverage Begin? elections and make adjustments that
Benefits for new hires, unless explained meet the needs of you and your family.
otherwise, will become effective on the first of
the month following date of hire. Changes to benefits made during Open
Enrollment will go into effect January 1st.
St. Croix County 6
2022 Benefits Guide
Eligibility and Enrollment (continued)
How to Enroll
Online Enrollment: To enroll (or make Making Benefit Changes
changes) to your benefits, you must log into During the Year
the Employee Self-Service portal and complete
the enrollment process. The benefit elections you make during your
initial enrollment period will be in effect
through December 31, 2022.
Initial Enrollment: You are automatically
enrolled in employer-sponsored (paid) benefits.
If you have a “qualifying life event”, you may
All other benefits are automatically waived. You be eligible to make changes to certain
must actively enroll in any benefits that require benefits if you apply for the change and
employee contributions if you want to elect provide supporting documentation to Human
Resources. Proof of life events are subject
coverage. Exception: You are automatically
to approval by St. Croix County. Changes
enrolled in the WRS Retirement Pension are effective retroactive to the date of the
Benefit upon your eligibility date. event.
Open Enrollment: You must actively enroll in Qualifying life events include:
the Flexible Spending Account (FSA). All other • Your marriage
coverages will roll over into the upcoming • Your divorce or legal separation
renewal year if you don’t make any changes. • Birth, adoption or placement for adoption
of an eligible child
• Death of your spouse, partner or covered
Termination of Coverage child
If you or a covered dependent no longer meet
• Change in work status that affects
the eligibility requirements or if your benefits eligibility (for example, starting a
employment ceases, your coverage termination new job, leaving a job, changing from
date will vary by plan, please refer to your plan part-time to full-time, starting or returning
documents for more detailed information. from an unpaid leave of absence, etc.) for
you or your spouse.
• Your spouse’s Open Enrollment
• A change in your child’s eligibility for
Please Note:
benefits
Federal regulations require St. Croix County to obtain the
• Gain or loss of Medicare or Medicaid
following information during enrollment: during the year
• Social Security numbers for your dependents covered
Other qualifying events may also apply.
by the medical plan
Please contact Human Resources.
• Dates of birth and your relationship to your dependents
St. Croix County 7
2022 Benefits Guide
Health Insurance
St. Croix County offers comprehensive, affordable group health insurance coverage through PreferredOne.
This is a summary of coverage only. Please refer to the summary of benefits and coverage for complete
information.
$500/$1,000-$20-10% $1,000/$2,000-30%
PreferredOne
In-Network Only Out-of-Network Only
You Pay You Pay
Preventive Care (Including eye exams) $0 Deductible then 30%
Telemedicine Consultation –
$0 Subject to provider charges
MDLive & OnCare
$500 Single $1,000 Single
$750 Single +1 $1,500 Single +1
Plan Year Deductible*
$1,000 Family $2,000 Family
(Not to Exceed $500 for one Person) (Not to Exceed $1,000 for one Person)
Office Visit - $20
Non-Preventive Care Co-pays
Specialty Visit - $35
(Other services provided during visit are subject to Deductible, then 30%
Urgent Care - $75
deductible/co-insurance)
Emergency Room - $200
Inpatient/Outpatient Hospital Services Deductible, then 10% Deductible, then 30%
Plan Year Out-of-Pocket (OOP) Max1 $2,000 Single $4,000 Single
Plan Year Out-of-Pocket Maximum includes $3,000 Single +1 $6,000 Single +1
deductibles, copays and coinsurance, with the $4,000 Family $8,000 Family
exception of prescription co-pays. (Not to Exceed $2,000 for one Person) (Not to Exceed $4,000 for one Person)
Important Information About How Your
Deductible and Out-of-Pocket Maximum Work Health Insurance Premiums
• Your deductible and OOP Max are based on
Employee County
your coverage tier (Single, Single + 1 or Family) Coverage
• If you have Single +1 or Family coverage, you
Bi-weekly Bi-weekly
Tier
have an embedded deductible and OOP Max Contribution Contribution
• Each person on the plan has a maximum Single $38.65 $347.82
limit of the embedded (single) deductible
or OOPM Single +1 $79.58 $716.22
• As a family, you stop paying when the
aggregate (by coverage tier) amount is Family $113.78 $1,023.99
met
Access to Your Healthcare
After you are enrolled in the St. Croix County medical plan, log on to the PreferredOne website and register to
access self-service tools and resources. You can print temporary ID Cards, manage your medical benefits,
and find in-network medical providers. You can also call customer service at 800-997-1750. Under ‘Find a
Healthcare Provider’, click Preferred Open Access Complete Network.
St. Croix County 8
2022 Benefits Guide
Prescription Drugs
When you enroll in the health insurance plan, you receive comprehensive prescription drug coverage
through ClearScript.
$500/$1,000-$20-10% $1,000/$2,000-70%
PreferredOne
In-Network Only Out-of-Network Only
Retail (up to 90-day supply) You Pay You Pay
Preventive $0 copay
Generic $15 copay (per unit)
Brand Preferred $25 copay (per unit)
Brand Non-preferred $40 copay (per unit)
ClearScript Prescription Mail Service
You Pay You Pay
(90-day supply)
Preventive $0 copay
Generic $30 copay (90-day supply)
Not covered
Brand Preferred $50 copay (90-day supply)
Brand Non-preferred $80 copay (90-day supply)
Specialty (34 day supply – Fairview
You Pay You Pay
Specialty Pharmacy)
Generic $15 copay
Brand Preferred $25 copay Not covered
Brand Non-preferred $40 copay
$500 Single
Pharmacy Out-of-Pocket Max $750 Single +1 No maximum
$1,000 Family
Three Ways to Obtain Prescription Drugs
① Retail Pharmacy ② ClearScript ③ Fairview Specialty
(up to 90-day supply) Prescription Mail Service Pharmacy
(up to 90-day supply) (34-day supply)
Use for maintenance drugs such as Medications used to treat
Locate a participating retail
medication for high blood pressure, complex conditions like
pharmacy
arthritis or diabetes multiple sclerosis, hepatitis C
View a list of approved drugs
Pay less than retail pharmacy for a and rheumatoid arthritis
90-day supply Prescription can only be filled
No additional cost for delivery once every 30 days
Log into your PreferredOne portal and click “View my Pharmacy Information” under My Account for more
information on options for filling your prescriptions and Preventive Drug List!
Some medications may be subject to prior authorization, quantity limits or step therapy requirements to be approved for coverage.
For a list of approved drugs, log on to www.preferredone.com/pharmacy-information/formulary
St. Croix County 9
2022 Benefits Guide
Telemedicine
FREE telemedical services through MDLive
for covered St. Croix County employees!
The St. Croix County medical plan includes
MDLive visits, which provides 24-7-365 access
to board-certified Doctors, Therapists and
Dermatologists by secure video chat or phone.
For an illness or injury that is not an
emergency, MDLive’s virtual medicine
program offers a convenient, cost-effective Create and register for account today so the
alternative to hospital emergency rooms and service is ready for you when you need it!
urgent care clinics.
Access online, via app or phone at
MDLive is not intended to replace your www.mdlive.com/preferredone or 800-657-
relationship with your doctor, rather it provides 6169 (be sure to have your PreferredOne ID
access to healthcare when reaching the doctor card ready!
is difficult or inconvenient.
Doctors in the MDLive network diagnose, Benefits of Telemedicine
recommend treatment and write short-term
prescriptions for minor, non-life-threatening • Free to covered employees and
dependents!
conditions including, but not limited to:
• Less time away from work
• Acne • Insect Bites
• No travel expenses or time
• Allergies • Sinus Infections
• Less interference with child or elder care
• Arthritic Pain • Nausea/Stomach Aches
responsibilities
• Bronchitis • Pink Eye
• No exposure to other potentially contagious
• Cold/Flu Symptoms • Skin Infections patients
• Ear Infections • Sore Throat
• Headaches/Migraines • Upper Respiratory MN Residents
Infections PreferredOne also covers OnCare telemedicine at no
charge for Minnesota residents. Visit www.Oncare.org
Now offering care for: or your PreferredOne web portal for details.
• Counseling
• Psychiatry
• Dermatology
Fees apply for additional services with MDLive
Access information about Telemedicine with MDLive and OnCare on your
PreferredOne portal at www.preferredone.com under “Online Care”
St. Croix County 102022 Benefits Guide
Where to Seek Care
MDLive
MDLive
Urgent Care Copay $0
Emergency Care • Moderate fever
• Colds, cough or flu
• Bruises and abrasions
When you need help in a hurry, you have choices. • Eye, ear, or skin infections
Of course, when it’s a life-threatening problem, • Skin irritations/rashes
you should call 911 or go straight to the nearest • Urinary tract infections
hospital emergency room (ER).
OR
In the ER, true emergencies are treated first, so
unless your life is in danger, you’ll wait –
sometimes for hours. The ER is also the most Urgent Care
expensive option for care. Copay $75
For non-life-threatening problems, utilize MDLive, • Cuts and minor lacerations
or visit your nearest urgent care. • Minor burns and skin irritations
• Eye, ear, or skin infections
• Sprains or strains
• Possible fractures
• Respiratory infections
OR
Emergency Room
Copay $200
• Heart attack or stroke
• Chest pain or intense pain
• Shortness of breath
• Severe abdominal pain
• Head injury or other major trauma
• Loss of consciousness
• Major burns or severe bleeding
• One-sided weakness or numbness
• Open fractures
• Poisoning or suspected overdose
**Non-emergency services received in an emergency room are not covered. Emergency services are
defined as services provided due to symptoms severe enough that the absence of immediate medical
attention could reasonably result in: placing the members health in serious jeopardy; serious
impairment to bodily functions; or serious dysfunction of any bodily organ or part.
St. Croix County 112022 Benefits Guide
How To Save $$$!
When Using Your Medical and Prescription Plans:
Use In-Network Doctors
By using preferred or in-network doctors,
clinics, hospitals and pharmacies, you pay the
lowest cost for care. When you visit out-of-
network doctors, our health plan covers less of
the cost.
Choose the Right Type of Care
When you need care, know your options.
Urgent care centers, online doctor visits or a
call to the medical plan nurse line can help Ask Your Doctor for Generic Drugs
save time and money.
The next time you need a prescription, ask your
Use freestanding imaging centers for MRIs, CT doctor if it is appropriate to use a generic drug
scans and other imaging. rather than a brand name drug. Generic drugs
contain the same active ingredients, are identical in
Use Your Preventive Care dose, form and administrative method AND are less
expensive than their brand name counterparts.
Benefits
Most preventive care services are covered at If you must take a brand name drug, ask your
100% when you use in-network providers. doctor for samples or coupons. Also check the drug
Getting regular exams, screenings and manufacturer’s website for available rebates and
immunizations can save you a lot of money in discounts.
the long run by catching problems early or
preventing them altogether. Use Alithias
If you need a medical procedure,
Use ClearScript an Alithias Care Advocate can help you find
Rather than visiting a pharmacy month after the best provider at the best price. Alithias will
month, save time by having the medication also help you review Explanation of Benefits to
delivered to your home. make sure you are being billed accurately after a
service or procedure.
Through ClearScript, you can also save money
by getting up to a 90-day supply for less than
what you would pay through a retail pharmacy.
And because shipping is free, you’ll also save
on gas money!
St. Croix County 122022 Benefits Guide
Understanding Types of Care
Understanding the Difference Between Preventive, Diagnostic and Chronic
Care and the Costs Associated to Each.
If a medical service is coded as Preventive Care it is covered at 100% (Deductible waived) but if the medical
service is coded as diagnostic or routine chronic care, deductibles, copays and coinsurance will apply. It’s
important to know what type of service you are getting as you may have copayment and coinsurance charges.
Preventive Care
Any medical service that helps prevent against health emergencies, such as annual physicals, well-women
exams and immunizations.
Diagnostic Care
Care that involves treating or investigation of a health issue. It may include treatment for specific symptoms,
risk factors, ongoing care and lab or other tests needed to manage or treat a medical issue or health condition.
Chronic Care
Care that is provided for pre-existing or long-term conditions. Some examples include asthma, diabetes,
emphysema, chronic bronchitis, congestive heart disease, cirrhosis of the liver, hypertension and depression.
Test/Service/Exams Preventive Diagnostic Routine Chronic Care
A person with risk factors
A person with no history of A person with history of
for high blood pressure,
high blood pressure gets a high blood pressure gets a
like being overweight or
Blood Pressure Check routine blood pressure blood pressure check to
smoking. Visits doctor
check to screen for high be sure his or her
because they have early
blood pressure. medication is helping.
morning headaches.
A 55-year old woman who A 55-year old woman who
A 55-year old woman gets a noticed a lump in her had a lump removed from
Mammogram routine mammogram to breast gets a her breast two years ago
screen for breast cancer. mammogram to evaluate for cancer gets a follow-up
the lump. mammogram.
An asymptomatic 50-year
old man with no personal or
family history of colon polyps A 55-year old man who
or cancer gets a routine has gastrointestinal
screening. If polyps are symptoms and who has
Colonoscopy Not applicable
found, removed or biopsied past or present polyps or
during a routine screening gastrointestinal disease
colonoscopy they will gets a colonoscopy.
typically be re-classified as a
diagnostic colonoscopy.
St. Croix County 132022 Benefits Guide
Omada
Omada is a FREE online behavioral counseling program designed to help at-risk individuals combat
obesity-related chronic disease. Participants in the Omada program learn how to make modest health
changes that can lead to weight loss and reduced risk for type 2 diabetes, hypertension and heart
disease.
How does It Work
Omada starts with a core 16-week Foundations phase, organized into four areas:
1. Changing Food Habits
2. Increasing Activity Levels
3. Preparing for Challenges
4. Reinforcing Healthy Choices
Participants then enter the Focus phase for the remainder of the first year to continue building healthy
habits.
Who is Eligible
Employees and their adult family members who are enrolled in St. Croix County’s group Health
Insurance plan and are at risk for or have been diagnosed with Hypertension or Type 2 Diabetes.
How to Enroll
Take a 1-minute health screener to see if you’re eligible at:
www.omadahealth.com/sccwi
If you meet the clinical enrollment criteria to enroll in the program, you can then complete an application
and you will receive an email letting you know if you qualify to participate.
Participants receive:
St. Croix County 142022 Benefits Guide
Care Advocacy
St. Croix County 152022 Benefits Guide
Incenting High-Value Provider Utilization
Finding the highest-value provider to perform your future, non-emergent care can be tricky in
the current health care world. By using Alithias Care Navigation, you’ll not only be supported in
finding a high-value provider, but also receive a cash incentive to do so.
St. Croix County 162022 Benefits Guide
Wellbeats
Not a PreferredOne member? No Problem!
All St. Croix County employees have access to
Wellbeats. Registration details coming soon for non-
PreferredOne members.
St. Croix County 172022 Benefits Guide
Wellness Benefits
Health & Wellness
Reimbursement
The Health and Wellness Reimbursement
Program supports the overall health and
wellness of employees.
Each employee working at least 20 hours
per week can qualify to be reimbursed up to
$300 per year (taxable benefit). The
reimbursement is paid each January for
expenses paid the prior year.
Employees do not need to be enrolled in the
County’s health insurance plan to be eligible
to claim the Health and Wellness
Reimbursement
Examples of qualifying expenses for
employees and dependents include gym
memberships, youth sports program fees
and equipment, home gym equipment,
home exercise program, tobacco
cessation programs and weight loss
programs.
Participation Based Wellness
Non-qualifying expenses include Program
massage, clothing or uniforms, vitamins, In order to promote health, prevent
prescriptions, magazines, food, etc. disease, and help reduce the cost of
health insurance premiums, St. Croix
County offers a voluntary Wellness
Program to its employees (and their
benefited spouses). Every year you are
enrolled in the County’s group health
insurance plan you will be eligible to
participate in a Wellness Program to earn
valuable incentives.
St. Croix County 182022 Benefits Guide
Flexible Spending Accounts (FSA)
New
The County is excited to be partnering with Wex to
provide you with a Flex plan that is easy to use and Partner!
has the technology to bring you the best
experience! Please read this information to learn
how Wex can help!
How the FSA Works
Flexible Spending Accounts (FSA) allow you to set As a new hire (and again during Open Enrollment),
money aside for certain eligible expenses and draw you select the amount of money you wish to deposit
from it throughout the year to pay for those into the Healthcare and/or the Dependent Care
expenses. The money is set aside pre-tax, reducing Account for the entire plan year. The plan year for
your taxable income. Two types of FSAs are the FSA benefit is January 1 to December 31. The
available: Health Care & Dependent Care. total amount is then equally divided by the number
of pay periods remaining in that year and that
Healthcare FSA amount is deducted from each paycheck. The
This FSA allows you to submit eligible medical, money is set aside in your FSA account.
dental and vision expenses for reimbursement.
You can deposit up to $2,750 to the Healthcare Employees who enroll in the Healthcare FSA will
FSA for the 2022 calendar year. For a list of receive an FSA debit card to pay for qualified
eligible expenses visit: https://www.wexinc.com/ Go purchases, eliminating the need to submit a paper
to: Insights > Benefits Toolkit > Eligible Expenses claim and wait for reimbursement. You must submit
or use your Wex Mobile app and scan bar codes on claims no later than 90 days after the end of the
items for instant eligibility. plan year.
Healthcare FSA Roll Over How to get connected
To register and log into your FSA account, go to
If you enroll in a Healthcare FSA, you have the
https://go.wexonline.com/login
option to carry forward up to $550 to the following
plan year. These funds will not count against your
Download the Wex Mobile App:
future FSA election plan contribution limit. Any
Access benefits 24/7 with the free app.
unused balances in excess of $550 at the end of
2022 will be forfeited. • File a claim and get instant claim status
• Scan bar codes on items to determine FSA
eligibility
• Report lost/stolen cards for instant replacement
Dependent Care FSA
Dependent Care FSAs are used to pay for the costs of dependent care that enable you to work. This care may be
for a child under age 13 and for older dependents, including children, spouses and parents who are physically or
mentally unable to care for themselves and who live with you for more than half the year. Eligible expenses include
daycare, before-school and after-school care, babysitters and elder daycare. For the 2022 calendar year, you can
deposit up to $5,000 to a Dependent Care FSA ($2,500 if you are married and filing separately).
Please refer to the Plan Documents for rules, regulations, and exclusions.
St. Croix County 192022 Benefits Guide
Dental
Regular dental exams can help detect problems in the early stages when treatment costs are lower. St. Croix
County offers a dental plan through Delta Dental. PPO coverage is provided when you use Delta Dental of WI
providers. To search for providers, go to www.deltadentalwi.com click on Members, and Find a dental provider
Delta Dental of WI Delta Dental of WI PDP Plus
Premier
PPO
or Out-of-network
Calendar Year Deductible $50 Individual
(applies to Basic and Major Services) $150 Family
Benefit Plan Pays Plan Pay
Calendar Year Maximum Up to $1,250 per person
Diagnostic & Preventive Services
Exams, Cleanings, Fluoride Treatments, X-Rays, Space
100%
Maintainers, Sealants, Emergency Treatment for Pain
(no deductible)
Basic Services
Fillings & Simple Extractions 100% 80%
(after deductible)
Major Services
Crowns, Bridges, Dentures, Repairs and Adjustments to Bridges
and Dentures, Implants, Root Canals, Treatment of Gum 70% 50%
Disease and Oral Surgery
(after deductible)
Orthodontia (to age 19) 50%
Orthodontia Lifetime Maximum
$1,000
(per person, to 19 years)
Benefit Enhancements
Enhanced benefits from Delta Dental for members
CheckUp Plus: Lets you obtain Dental Insurance Premiums
diagnostic and preventive services, including Bi-Weekly Bi-Weekly
examinations, X-rays, regular cleanings, and other Coverage Employee County
related treatment- without the cost of those services Contribution Contribution
applying to your individual annual maximum.
Single $12.12 $4.04
Evidence-Based Integrated Care Plan:
Provides additional benefits for persons with Single + Spouse $24.22 $8.08
medical conditions that have oral health implications.
Single +
Conditions include: Diabetes, Pregnancy, Specific Heart $29.21 $9.74
Child(ren)
Conditions, Kidney Failure or Dialysis, Cancer Therapy,
and Periodontal Disease. Members must self-enroll in Family $47.30 $15.77
the EBICP by contacting Human Resources or calling
800-236-3712
St. Croix County 202022 Benefits Guide
Vision
Routine eye exams are important for maintaining good vision and can also provide early warning of other
health conditions. The Guardian vision plan provides coverage for exams, glasses and contact lenses, as
shown below.
St. Croix County offers two vision networks to choose from: Davis Vision and VSP.
VSP Vision: Significant out-of-pocket savings available with your Full Feature plan by visiting one of VSP’s
network locations. Members can use their in network benefits on line at www.Eyeconic.com
Davis Vision: Significant out-of-pocket savings available with your Full Feature plan by visiting one of Davis
Vision's network locations including retail centers such as Costco®, Wal-Mart®, JCPenney®, Sears®,
Target®, Sam’s Club®, Pearle®, Visionworks®. You can also use your network benefits online at
www.Visionworks®.com, glasses®.com, or www.1800contacts®.com
Go to www.GuardianAnytime.com to access secure information about your Guardian benefits including
access to an image of your ID Card. Your on-line account will be set up within 30 days after your plan
effective date.
Guardian Frequency In-Network Davis Vision In-Network VSP
Eye Exam* Once every 12 months $10 copay
Prescription Glasses
Once every 24 months $130 allowance
Frame
20% off remaining balance
Lenses $25 copay
(Single vision, bifocal, Once every 12 months (cost is for standard lenses;
trifocal, lenticular) add-ons are available at a discount)
Contacts— Once every 12 months $130 allowance
$130 allowance
instead of glasses 15% off remaining balance
Contacts— Once every 12 months 100% 100%
Medically Necessary
Vision Insurance Premiums
20% discount on unlimited number of prescription
VSP DAVIS
glasses and non-prescription sunglasses for 12
Coverage Bi-weekly Bi-weekly
months after initial examination.
Contribution Contribution
*An annual eye exam is covered at 100% by Single $3.39 $2.64
PreferredOne through the County’s group health
plan Single + Spouse $5.70 $4.44
Laser Correction Surgery- up to 15% off the usual Single + Child(ren) $5.82 $4.53
charge or 5% off promotional price.
Family $9.20 $7.17
St. Croix County 212022 Benefits Guide
Life Insurance
Basic Life/AD&D
St. Croix County provides Basic Life insurance and Basic Accidental Death & Dismemberment
Insurance at no cost to you. Coverage is for the employee only, no spouses or dependents. The
coverage is equal to one times your base annual earnings, up to a maximum benefit of $100,000.
You are automatically enrolled in the Basic Life/AD&D plan.
(According to federal law, only the first $50,000 of employer-paid life insurance is not taxable. Premium paid by St. Croix
County for coverage levels over $50,000 will be taxable to you and will be included on your year-end W-2 statement.)
Voluntary Life Amounts Available
Voluntary Life Increments of 1, 2, 3, 4 or 5 times your
annual earnings, with a maximum benefit
This year, eligible employees and new hires, can (basic and additional benefits combined)
purchase Voluntary Life insurance for you, your legal Employee
of $500,000
spouse and dependent children without providing Guarantee Issue: The lessor of 4x annual
medical information up to guarantee issue (GI) earnings, or $300,000
amounts (see chart). This does not apply to those Increments of $5,000, $10,000 or
who have been previously denied coverage. An Spouse $25,000
Evidence of Insurability (EOI) will be required for Guarantee Issue: $25,000
amounts over the guarantee issue (GI).
$1,000 (age birth to 6 months)
Child(ren) $10,000 (age 6 months to 19 or to 26 if
If you choose not to enroll in coverage during this (to age 26) full-time student)
enrollment period (or as a new hire) you will be Guarantee Issue: $10,000
eligible to enroll in coverage during future open
enrollment periods, but all amounts elected will be
subject to EOI provisions. Voluntary Life Insurance Premiums
Employee/Spouse
• Rates are based on your age as of November 1
Age Band Monthly Rate
and will change when you enter a new age band.
per $1,000 of benefit
• Voluntary Spouse Life is based on the employee’s
< 25 $0.060
age.
25 – 29 $0.048
• In order to enroll in Spouse or Child Life, you must
30 – 34 $0.056
be enrolled in Employee Life.
35 – 39 $0.079
• Benefit amounts reduce by 50% at age 70. Please
40 – 44 $0.122
refer to the benefit summary for details.
45 – 49 $0.189
• If you leave St. Croix County, this coverage can
be taken with you. 50 – 54 $0.279
55 – 59 $0.398
60 – 64 $0.510
65 – 69 $0.727
70 + $1.756
Child(ren) $2.00 (per $10,000)
St. Croix County 222022 Benefits Guide
Long-Term Disability Insurance
Long-Term Disability (LTD) benefits are provided as income protection in the event you become
disabled for an extended period. St. Croix County provides long-term disability coverage at no cost
to you. You are automatically enrolled in this benefit. Your long-term disability plan provides partial
replacement of your monthly base salary (60% of your monthly earnings) if you are disabled and
qualified for benefits. Proof of disability is required.
Long-Term Disability
County Paid Benefit
Benefit
After 90 days of qualified disability
Begins
Monthly up to $6,000 per month
Benefit 60% of basic monthly earnings
Benefit Social Security Normal
Duration Retirement Age (SSNRA)
Identity Theft
St. Croix County offers an Identity Theft benefit through ID Watchdog. ID Watchdog is the leader in
providing identity theft protection services; delivering superior identity monitoring and alerting and
resolution services.
Services Include: New
Credit Monitoring Premiums
Equifax credit lock through the ID Watchdog mobile app
Non-Credit Loan Monitoring
Payday Loan Monitoring
Public Records & National Change of Address Monitoring
High-Risk Transaction Monitoring
Internet Black Market & Hacker Surveillance Identity Theft Premiums
Instant-On Monitoring Bi-weekly
Social Network Alerts
Registered Sex Offender Reporting & Notifications Employee $3.75
National Provider Identifier (NPI) Alerts
Identity Profile Report Family $6.75
Credit Freeze Assistance
Lost Wallet Vault & Replacement
Expense Reimbursement for costs associated with identity restoration.
Enhanced Single plan that will allow a dependent under the age of 18 to your account
Should an employee’s identity be compromised, ID Watchdog’s certified resolution experts step in and work
on the victim’s behalf to fully restore their identity to its pre-theft condition with 100% resolution guarantee.
St. Croix County 232022 Benefits Guide
Optional Protection Benefits
St. Croix County offers additional voluntary Accident Insurance
benefit plans through Aflac. These plans are not Accident insurance pays a cash benefit when
medical insurance and do not replace your you or your covered family members suffer
medical coverage, but rather pay cash directly injuries sustained in an accident. Covered
to you in addition to any benefits you receive injuries include fractures, burns, concussions,
from your health plan. tears, lacerations, broken teeth and eye
injuries. Additional benefits may be paid,
Insurance policies available for purchase including ambulance, emergency care, testing
(through after-tax payroll deductions) include and therapy.
Critical Illness, Accident and Hospital Indemnity.
These benefits may help fill the gap until you
meet your medical plan deductible. Critical Illness Insurance
This insurance pays a lump sum cash benefit
All Aflac benefit plans are portable, which
directly to the insured following the diagnosis of
means you can take these benefits with you if
a covered critical illness or event, including (but
you leave the company.
not limited to) Alzheimer’s disease, invasive
Rates are based on age, tobacco status and cancer, heart attack, kidney failure, stroke, and
policy elected. major organ transplants.
Annual Cash Benefit Hospital Indemnity Insurance
Hospital Indemnity insurance pays a lump-sum
The Accident and Critical Illness plans also provide
benefit to help you manage expenses that arise
an annual cash benefit (per calendar year) for
if you or an eligible family member ends up in
eligible health screenings and prevention
the hospital. You can use the money however
measures. Since these screenings are often paid at
you’d like — from paying for medical copays
100% under the medical plan, you could walk away
and deductibles to everyday expenses such as
with cash in your pocket for practicing good
the mortgage, transportation, groceries and
preventive care.
utilities.
Short-Term Disability Insurance
Short-Term Disability (STD) provides paycheck
protection in case of a non work-related injury or
illness that requires you to be on leave and not
working. There is a 3-month benefit period with
premiums and benefit amounts varying on
employee age and income.
For pricing and enrollment information contact
Charlotte Heimer at 715-834-0911.
St. Croix County 242022 Benefits Guide
Retirement Savings Plans
Wisconsin Retirement System (WRS)
St. Croix County’s Wisconsin Retirement System offers a pension benefit to eligible employees.
Employees who work at least one year and a minimum of 1,200 hours (880 for faculty) are
eligible for WRS upon hire.
• St. Croix County will match 6.5% of your contributions. (Total benefit contribution is 13% of
earnings.)
• Employees contribution of 6.5% is a pre-tax deduction that is taken bi-weekly.
Supplemental Retirement Options (457)
The County provides employees with an opportunity to invest in 457 Deferred Compensation
plans which offer a convenient way to save for your future through payroll deductions. You
are eligible to participate in the plan as of your start date with the County and thereafter.
Employees that wish to enroll in a new account or want to review and/or change their existing
account can contact one of the three available representatives:
1) Orion – Ron Gloe: 866-708-3894
2) Nationwide – Eric Glinsky: 715-245-7408
3) Wisconsin Deferred – 877-457-9327
Deferred Compensation is a pre-tax retirement savings payroll deduction. It offers a means to
postpone income taxes now, build savings, and create a portfolio of investments. The Roth
IRA is an after-tax retirement savings plan in which, if certain requirements are met,
distributions from the account may be received tax-free.
St. Croix County 252022 Benefits Guide
Employee Achievement
Programs (EAP)
We understand how challenging it can be to
balance your work and personal life, and we are
committed to helping you do just that. St. Croix
County offers an Employee Achievement
Program through REALiving at no cost to the
employee.
REALiving can provide you and your family with
confidential information and assistance on a
wide range of topics and issues including work
stress, debt problems, family issues,
relationship worries, parenting challenges,
anxiety, grief and much more.
Counselors are available for support by phone
24 hours a day, seven days a week at 855-233-
1048.
To help get you started, the program includes:
Four face-to-face Sessions
24/7 call center support
Free Online Trainings
Health and Wellness Information
Financial and Legal Tools
Online resources are also available by logging
on to www.realiving.com
Username: STCroix
Password: StCemployee
St. Croix County 262022 Benefits Guide
Additional Benefits
St. Croix County 272022 Benefits Guide
Additional Benefits
Delta Dental of Wisconsin provides you with a comprehensive hearing care program administered
through Amplifon Hearing Health Care. You can use the program to get a baseline hearing evaluation to
determine if hearing loss is present.
Amplifon hearing care program offers you a choice of the industry's leading hearing aid brands at
significant savings – an average of 64% off manufacturers suggested retail price.
St. Croix County 282022 Benefits Guide
Additional Benefits
St. Croix County 292022 Benefits Guide
Additional Benefits
T-Mobile
• Monthly Discount for St. Croix County employees.
• Existing T-Mobile Customers enrolling the monthly discount – Call 877-334-7099
• New Customers registering for the program – Call 855-570-9947
• Account Manager – Vicki Schultz 312-878-2498
Verizon
• 15% Discount for St. Croix County employees and their families.
• Website: www.verizonwireless.com/b2c/employee/eleuLanding.jsp
Dell’s Member Purchase Program
• Best Price Guarantee, up to 30% off desktops/laptops,
exclusive monthly offers.
• Website: www.dell.com/mpp/cosaintcroix
• Member ID: US41702853
Enterprise Rent-A-Car
• St. Croix County Corporate Discount rate –
Up to 20% off reservations for a vehicle for “personal use”
• Acct: 19B2600
County Park Pass
• All Employees are eligible to receive 1 county pass per family
• Available in the HR Office
• https://www.sccwi.gov/333/Parks
AAA
• AAA offers 24 Hour Roadside Assistance, exclusive Discounts and a wide range of insurance services. New
members receive a 20% discount on Classic Primary membership dues plus they can add one family member
for FREE and additional family members at HALF PRICE!
• Discount Group Code: GTSTCRC
• Call: 1-800-236-1300
TicketsAtWork
• Access to exclusive savings on movie tickets, theme parks, hotels, tours, Broadway and Vegas shows &
more.
• Website: www.ticketsatwork.com
• Company Code: SCC2018
Benefit Hub
• Benefit Hub provides discounts on: Travel, Auto, Electronics, Apparel, and much more. Register for an
account through the Preferred One portal under ‘Member Discount Programs’ or at
https://preferredone.benefithub.com/
• When registering for an account, use employee number BH41592850
Student Loan Forgiveness Program
• Employees of St. Croix County are eligible for Student Loan Forgiveness under the Federal Public Sector
Loan Forgiveness Program (PSLF). The Program was established to encourage individuals to work in public
service by forgiving the remaining student loan balance of their Federal Direct Loans after they have made
120 qualifying payments while employed by a qualifying employer.
St. Croix County 302022 Benefits Guide
Additional Benefits – Payroll and Time Off
St. Croix County employees are fairly compensated on a regular market research of each position and we
strive to give an adequate amount of time toff to maintain a healthy work-life balance. Employees working an
average of 20 or more hours per week are eligible for Holiday and Paid Time Off benefits.
Standard Work Week and Payroll
The standard work week is 40 hours. Pay periods
are biweekly and the 2022 payroll schedule can be
found on The Bridge.
Long-Term Sick Bank
Accrued Long-Term Sick Bank hours are available to
employees anytime a single occurrence/injury results
in the loss of more than three days’ work at a time.
There is no maximum accrual balance. If an
employee retires from the County their Long-Term
Sick Bank Hours will be deposited into a Retirement
Health Savings Plan.
Paid Time Off
Paid time off (PTO) is available to employees and may
be used for both scheduled and non-scheduled time
off. PTO is earned every pay period based on regular
Holiday Time Off hours worked and tied to a multiplier based on years of
Employees receive 10 paid holidays each service.
year.
The maximum accrual balance is 320 hours for full-
• New Year’s Day time employees, and 240 hours for part-time
• Martin Luther King Day employees. There is an annual election period for PTO
• Presidents Day to roll into a long-term sick bank or cash-out for
• Memorial Day employees with at least 120 hours of PTO accrued.
• Independence Day
• Labor Day
• Thanksgiving Day
• Friday After Thanksgiving
PTO Calculator
• Christmas Eve Day Years of
Multiplier Full-Time Accrual
• Christmas Day Service
Note: Holiday time off is pro-rated for part- 0-4 0.0885 7.08 hours/pay period or 23 days per year
time employees working at least 20 hours 5-9 0.1077 8.616/pay period or 28 days
per week.
10-14 0.1173 9.384/pay period or 30 days
15-19 0.1269 10.15/pay period or 33 days
20+ 0.1384 11.07/pay period or 36 days
St. Croix County 312022 Benefits Guide
Cost of Coverage Effective January 1, 2022
Contributions made from each paycheck toward your medical, dental, and vision benefit elections, as well as
contributions to FSA, will automatically be deducted from your gross pay before Federal Income taxes and
Social Security taxes are calculated. Since these contributions are deducted before-tax, your taxes will be
based on a lower gross pay and you will end up paying lower taxes on the same salary.
Voluntary Life, Identity Theft, and AFLAC contributions are taken from your paycheck after taxes.
VSP DAVIS
Biweekly Premiums MEDICAL DENTAL PLAN
VISION PLAN VISION PLAN
Employee Only $38.65 $12.12 $3.39 $2.64
Employee + Spouse $79.58 $24.22 $5.70 $4.44
Employee + child(ren) n/a $29.21 $5.82 $4.53
Employee + Family $113.78 $47.30 $9.20 $7.17
Voluntary Life Insurance Premiums Identity Theft Premiums
Bi-weekly
Employee/Spouse
Employee Age Employee $3.75
Rate per $1,000 of
benefit Family $6.75
< 25 $0.060
25 – 29 $0.048
30 – 34 $0.056 For Aflac pricing information contact
Charlotte Heimer 715-781-1762
35 – 39 $0.079
40 – 44 $0.122
45 – 49 $0.189
50 – 54 $0.279
55 – 59 $0.398
60 – 64 $0.510
65 – 69 $0.727
70 + $1.756
Child(ren) $2.00 (per $10,000)
St. Croix County 322022 Benefits Guide
Resources/Contact Information
Benefit Provider Phone Website / Email
PreferredOne
Medical 763-847-4477 www.preferredone.com
Network: CompleteHealth
Prescription ClearScript 866-718-2845 www.ClearScript.org
Care Advocacy Alithias 855-577-2755 Just Call!
Prevention Health Omada 888-409-8687 Support@omadahealth.com
Dental Delta Dental of WI 800-236-3712 www.deltadentalwi.com
VSP:877-814-8970
Vision Guardian www.guardiananytime.com
Davis: 877-393-7363
Flexible Spending www.wexinc.com
Wex 866.451-3399
Accounts (FSA) www.customerservice@wexhealth.com
Life and Long-Term
Unum 800-421-0344 www.unum.com
Disability
Short-Term Disability,
Hospital Insurance, Aflac 715-781-1762 Charlotte_heimer@us.Aflac.com
Accident, Critical Illness
Identity Theft ID Watchdog 800-970-5182 www.idwatchdog.com
Orion - Ron Gloe 866-708-3894 ronald.gloe@securitiesamerica.com
457 Deferred Nationwide - Eric Glinsky 715-245-7408 glinske1@nationwide.com
Compensations Plans Wisconsin Deferred- 608-241-6604 stephanie.rautio@empower-
Stephanie Rautio retirement.com
Wisconsin Retirement ETF- Department of
877-533-5020 www.etf.wi.gov
System (WRS) Employee Trust Funds
www.eap.realiving.com
Employee Achievement
REALiving 877-256-9302 Username: StCroix
Program (EAP)
Password: STCemployee
Employee Assistance
Unum 800-854-1446 www.unum.com/lifebalance
Program
At Home Fitness Program Wellbeats 855-520-7500 www.wellbeats.com
HR Benefits Analyst Audrie Haycraft 715-381-4343 Audrie.Haycraft@sccwi.gov
Broker - JA Counter
Alicia Schwartz 715-246-8067 aschwartz@jacounter.com
Account Manager
Broker - JA Counter Alyssa Little
715-246-3811 advocate@jacounter.com
Benefit Advocate Sara Turner
St. Croix County 332022 Benefits Guide
Your benefits team is pleased to inform you that you have resources
with our broker partner for your benefits plan.
The JA Counter Advocate Team provides you with an extra level of customer service and care
in relation to your benefits. The Advocate Team will work on your behalf with your insurance
plans and providers to ensure you understand your benefits and can utilize them to their
highest potential.
Please take advantage of this resource by using the following information
to ensure you get the right service in the right spot.
When do I call the insurance When do I call the JA Counter
company or vendor directly? Advocate Team?
Replacement ID cards Questions about how your benefits work
Benefit coverage questions Help with making benefit choices (choosing
between options)
I’m planning to have surgery; how will
Escalated issues related to:
that work with my insurance?
• A bill you received
Locating network providers
• EOB
Pre-authorizations for services
• Claims process
Initial questions:
• Note: a signed HIPAA release is needed in
• About a bill you received order for the Advocate Team to help with
• About an explanation of benefits (EOB) these escalated issues
you received
Note: It’s a best practice to write down the
• How claims were paid date and time of your call and who you spoke
with!
Contact your Insurance Company directly by utilizing the specific contact information found on the prior page of
this Benefit Guide.
Contact the JA Counter Advocate Team: advocate@jacounter.com or 715-246-3811
St. Croix County 34You can also read
