Annual Enrollment Begins October 1st at Noon Ends October 29th at Noon
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Insurance & Risk Management Department
303 North Church Street, Suite 100
Murfreesboro, TN 37130
Annual Enrollment
Begins October 1st at Noon
Ends October 29th at Noon
2022 Benefits Enrollment Guide
Rutherford County Employees
E-mail: benefits@rutherfordcountytn.gov
Website: http://rm.rutherfordcountytn.gov
Hours: Monday – Friday 8:00 am – 4:30 pm
Phone: (615) 898-7715 Fax: (615) 713-3451
Inside this Guide
What’s New for 2022 ..................................................................................................................................................... 3
Medical Plan Details ...................................................................................................................................................... 4
HSA Plan and Account ................................................................................................................................................... 5
Medical Rates ................................................................................................................................................................ 6
Important Financial Details ........................................................................................................................................... 7
Health Savings Account Contributions ...................................................................................................................... 7
Spending Account Limits............................................................................................................................................ 7
Special Note for Rutherford County Schools/BOE Employees .................................................................................. 7
Full Medical Plan Charts ................................................................................................................................................ 8
Cigna Resources ........................................................................................................................................................... 10
MedPoint Medical Clinics ............................................................................................................................................ 12
MotivateMe Wellness Program................................................................................................................................... 13
Dental and Vision......................................................................................................................................................... 14
Flexible Spending Accounts (FSA)................................................................................................................................ 15
Healthcare Flexible Spending Account (HCFSA) ...................................................................................................... 15
Dependent Care Flexible Spending Account (DCFSA).............................................................................................. 15
Limited Purpose Flexible Spending Account (LPFSA) .............................................................................................. 15
Life and Accidental Death and Dismemberment (AD&D) Benefits ............................................................................. 16
Disability Benefits ........................................................................................................................................................ 17
Voluntary Benefits ....................................................................................................................................................... 18
How to Enroll ............................................................................................................................................................... 19
Reminders .................................................................................................................................................................... 20
Dependent Verification ............................................................................................................................................... 21
Annual Required Notices ............................................................................................................................................. 22
Creditable Prescription Drug Coverage and Medicare ............................................................................................ 26
Retirement Information .............................................................................................................................................. 26
Key Words to Know ..................................................................................................................................................... 27
Contact List………………………………………………………………………………………………………………………………………………Back Cover
While every effort has been made to ensure accuracy of this benefits guide, the plan documents and contracts will prevail in case of
discrepancy between this guide and the plan documents and contracts. In addition, Rutherford County reserves the right to modify or
terminate any benefit plans at any time.
The information in this booklet constitutes a Summary of Material Modifications (SMM) of the Rutherford County Benefits Handbook for
the noted plan changes. Effective January 1, 2022, this benefits guide, along with a copy of the Summary Plan Description (SPD) in the
Rutherford County Benefits Handbook, will comprise the SPD. Please retain this guide for reference. The Rutherford County Benefits
Handbook is accessible on http://rm.rutherfordcountytn.gov/benefits.htm. If you have questions or need to request a hard copy of your
Benefits Handbook, please contact Insurance and Risk Management Department at 615-898-7715.
2
What’s New for 2022?
As part of our ongoing efforts to provide a competitive and sustainable benefits program that best meets the needs of our employees,
we’re making the following changes for 2022. All benefits elected during the Annual Open Enrollment period and plans offered herein are
effective January 1, 2022.
NETWORK OPTIONS (See page 4 for further details)
Cigna will remain the medical carrier, with a new network added for 2022.
• The Open Access Plus (OAP) is our current network. This is a large network with more doctors and facilities than the newly offered
LocalPlus (LP) network. Current medical plan members can access OAP information at www.mycigna.com. To view Local Plus
providers, you will need to visit www.cigna.com.
• The LocalPlus (LP) network is new for 2022. If you select this network you still have access to care across Tennessee, but LP excludes
certain providers and facilities. Information regarding network availability for a physician or facility can be found at www.cigna.com.
• Your choice of network will affect your monthly premium cost.
• Both network options, (OAP or LP), are available on the HDHP/HSA, Copay, or Deductible Plan.
NEW MEDICAL PLAN
HIGH DEDUCTIBLE HEALTH PLAN (HDHP) with HEALTH SAVINGS ACCOUNT (HSA) - HDHP/HSA PLAN
• The HDHP is coupled with a tax-free HSA that will include monthly funding by Rutherford County.
• You will have the option to contribute additional tax-free funds to your HSA, up to IRS limits.
• Money in your HSA can be saved, used to pay for qualified medical expenses, and/or invested over time.
• The HSA is yours to keep, even if you retire or leave employment.
IMPORTANT: HSA plan participants will not have the option to enroll in a Healthcare Flexible Spending Account (HCFSA) for 2022. Any
rollover balance $550 and under that you have in your HCFSA at the end of 2021 will be rolled into a Limited Purpose Flexible
Spending Account. Limited Purpose FSA funds are restricted to dental and vision claims only. (See pages 7 and 15 for further details).
EXISTING MEDICAL PLAN CHANGES (See page 4 for further details)
HEALTH REIMBURSEMENT ACCOUNT (HRA) PLAN
• The HRA Plan is being replaced with the HDHP/HSA (see above).
• County funding remaining in your existing HRA will not rollover or be available for services rendered after December 31, 2021.
IMPORTANT: Employees currently enrolled in the HRA Plan that do not elect a new plan or do not decline medical coverage will be
automatically enrolled in the new HDHP/HSA in the OAP network effective January 1, 2022.
COPAY PLAN
• Deductibles and out of pocket limits have changed. See page 9 for further details.
• Rates have changed. Please review the options carefully on page 6.
DEDUCTIBLE PLAN
• This is a grandfathered plan and is not available to new enrollees. If you are currently enrolled in the Deductible plan, you are
allowed to switch to the LP Network or a different plan. Remember, if you opt out of the Deductible plan completely you may not re-
enroll in it at any time.
SPENDING ACCOUNTS
• There are important changes to spending accounts due to the new HDHP w/HSA plan. Review the details on page 15 carefully.
TAKE ACTION DURING THE ANNUAL OPEN ENROLLMENT PERIOD
IMPORTANT: All eligible employees should participate in Annual Enrollment, even if you have recently enrolled or made changes.
• Current HRA Plan participants will need to elect a new medical plan for 2022. (Failure to elect a new replacement plan will result in
default enrollment to the new HDHP/HSA in the OAP network)
• Verify your beneficiary assignments are up-to-date for all Life and Accident plans.
• Enroll in a Healthcare Flexible Spending Account (HCFSA) and/or Dependent Care Flexible Spending Account (DCFSA) for 2022. FSA
plans require a new election each calendar year. HCFSA is not available for HSA plan participants.
• Remove or add eligible dependents to benefit plans and change or review current benefit enrollments.
• Review demographic information on file. (Changes to your address must be initiated through your Human Resource Department).
3Medical Plans Detailed
For 2022, you have a choice of two medical plans and two networks with a range of coverage levels and costs. This gives you
the flexibility to choose what is best for your needs and budget.
2022 MEDICAL PLAN OPTIONS (see pages 8 and 9 for detailed plan designs and page 6 for plan rates)
• (NEW PLAN - Replaces the HRA Plan) High Deductible Health Plan (HDHP/HSA): This is a consumer-driven health plan
that puts you in charge of your spending through lower paycheck contributions, higher deductibles, and a tax-free, em-
ployee owned Health Savings Account (HSA). Details regarding the Health Savings Account (HSA) can be found on page 5.
• Copay Plan: A Preferred Provider Organization (PPO) plan that reduces your out-of-pocket responsibility when you need
care by offering a moderate deductible and higher paycheck contributions.
NETWORK CHOICES
CIGNA will offer two network options for medical plan members.
• Open Access Plus (OAP) - This network offers flexible access to thousands of in-network health care providers, specialists,
hospitals, virtual care and preventive services. Employee premium cost is higher in the OAP network.
• LocalPlus (LP) - (New Option) This network has a more limited number of local health care providers, specialist and hospi-
tals available. The LocalPlus plan options provide the same level of quality care, specialty services, virtual care, preventive
services and an Away From Home feature when care is needed while traveling. Your LocalPlus network providers are
based on your home zip code. LocalPlus network is designed for value, so your premium cost is lower than the OAP.
IMPORTANT: Prior to enrolling in the LocalPlus network plans you should verify that your providers, hospitals, and other fa-
cilities are available in that network to get the most cost savings from your plan. You will not be able to change plans or net-
works unless you have a qualifying event such as the birth of a child, marriage, divorce, etc. A provider or hospital leaving a
network is not a qualifying event, choose a network that best fits your needs carefully.
KEY FEATURES OF ALL MEDICAL PLANS
• Comprehensive, affordable coverage for a wide range of health care services including office visits, hospital stays, behav-
ioral health, chiropractic treatments, physical therapy, prescription drugs and other services.
• Free in-network preventive care, with services such as annual physicals, recommended immunizations, well-woman and
well-child exams, flu shots, and routine cancer screenings covered at 100%. Remember, there is no out-of-network cover-
age for preventive care.
• Prescription drug coverage included with each medical plan.
• Financial protection through annual out-of-pocket maximums that limit the amount you will pay each year.
How does medical coverage work?
Stretch your healthcare dollars!
• See in-network providers – They have agreed to lower
negotiated rates.
1
Preventive Care
You pay nothing for in-network
preventive care.
• Use the mail-order pharmacy – It saves time and money
when refilling long-term prescriptions.
• Don’t forget about virtual health – Utilize MDLIVE to get
healthcare without having to visit a doctor’s office 2
Deductible
You pay your medical expenses up to the
annual deductible amount.
How do I find if a doctor, hospital or pharmacy is in 3
Coinsurance
After meeting your deductible, the plan
starts to pay coinsurance. You’ll
only pay a percentage of each bill.
network?
4
• Visit www.cigna.com
You’re protected by an annual limit
• Call Cigna 24/7/365 at (800) 244-6224 on costs. The plan starts to pay 100% once
Out-of-Pocket you’ve paid this amount during the year.
Maximum
4Health Savings Account (HSA)
The HRA Plan is being replaced by the HDHP/HSA Plan. This plan costs less than the Copay Plan, so you keep more of your
money. This plan rewards you for taking an active role as a healthcare consumer and making smart decisions about your
healthcare spending. As a result, you could pay less for your annual medical costs.
HSA Plan Advantages
• Lower monthly premiums. Your per-paycheck costs are lower compared to the Copay plan, giving you the opportunity to
contribute the cost savings to a tax-free Health Savings Account (HSA). You pay for your initial medical costs until you meet
your annual deductible, and then you pay a percentage (coinsurance) of any further costs until you reach the annual out-
of-pocket maximum.
• Tax-advantaged savings account. To help pay your deductible and other out-of-pocket costs, the High Deductible Health
Plan allows you to open a Health Savings Account (HSA) and make pre-tax contributions directly via payroll deduction.
Rutherford County will also contribute up to the following amounts for 2022 to your HSA to help cover qualified out-of-
pocket healthcare expenses.
Rutherford County Annual Contribution Amounts
- $500 for Employee Only coverage
- $1,000 for Employee plus Spouse, Child(ren), or Family coverage
- This account is funded per pay period; see page 7 for additional details.
Are you eligible for an Health Savings Account (HSA)?
- Must be enrolled in the qualified High Deductible Health Plan.
- Cannot be covered by any other non-compatible health plan such as Medicare Parts A and B , or TriCare.
- Cannot be enrolled in your own or covered by a spouse’s Full-Purpose Healthcare Flexible Spending Account.
- Cannot be claimed as a dependent on another person’s tax return (unless it’s your spouse)
IMPORTANT: A married couple who has a combination of spending accounts (FSA and HSA) could create a complicated tax
situation. For example, if you have an FSA through Rutherford County and your spouse has an HSA through their employer,
your spouse may not be able to contribute to their HSA. Contact a tax advisor or see IRS Publication 969 for more details.
This is not an exhaustive list. Contact a tax advisor if you have any questions regarding your eligibility.
How does an Health Savings Account (HSA) work?
• You will receive a Welcome Packet and Debit Card from HSA Bank.
• An account will be setup on your behalf with HSA Bank. You will be required to pass the Customer Identification Program
(CIP) in order to initiate all account funding.
• You can contribute additional before-tax dollars to your HSA via payroll deduction up to the IRS limits. Additional contribu-
tions, for payroll deduction, can be elected online during the Annual Enrollment process.
• You can use your HSA funds to pay for qualified medical expenses with your Health Benefits Debit Card directly to your
medical provider or pay out of pocket. You have the flexibility to reimburse yourself or keep the funds in your HSA to grow
your savings for the future.
• You can manage your HSA account all in one place with your MyCigna app or online account.
• You own your HSA. Unused funds roll over each year and are yours to keep, even if you retire or leave employment with
Rutherford County. After age 65, funds can be withdrawn for any purpose without penalty, subject to income taxes.
2022 Annual IRS Health Savings How Do I Learn More? What If I Need Help?
Account (HSA) Contribution Limits
HSA Bank provides educational resources. Cigna and HSA Bank partner to
Individual: $3,650; Family: $7,300 administer your HSA. Contact Cigna
Catch-Up Contribution: $1,000 Visit this website for more information:
customer service or call the number
See page 7 for additional details. www.hsabank.com/cigna/Education/What_Is_An_HSA
on the back of your debit card.
5Medical Rates
You can earn a $300 annual credit toward your medical premiums by participating in the MotivateMe Wellness Incentive program. See page 13 for details.
Note: there are two sets of rates for each plan. Open Access Plus (OAP) network rates are on the left, and Local Plus (LP) network rates are on the right.
Rates Including $300 MotivateMe Wellness Credit
County 12 Month Payroll Deduction Plan Cost
County General, Highway Department, Solid Waste, RCSO, Judicial, etc.
IMPORTANT
Copay Plan HSA Plan Deductible Plan
County General
OAP Local Plus OAP Local Plus OAP Local Plus employees pay for
Employee Only $82.04 $65.63 $24.96 $14.98 $270.52 $243.47 benefits over a 12 month
period. Deductions occur
Employee + Spouse $344.55 $310.09 $104.82 $83.86 $568.11 $511.30 either monthly or
bi-weekly. Rates shown
Employee + Child(ren) $303.53 $273.17 $92.34 $73.87 $500.46 $450.41 here are on a monthly
Family $475.80 $428.22 $144.75 $115.80 $784.49 $706.05 basis.
Rutherford County Schools / Board of Education 10 Month Payroll Deduction Plan Cost County School and Board
of Education employees
Teachers, School System Support Staff, Central Office, etc.
pay for benefits over a 10
Copay Plan HSA Plan Deductible Plan month period. Deductions
occur 10 times for 12
OAP Local Plus OAP Local Plus OAP Local Plus months of coverage.
Employee Only $98.44 $78.75 $29.95 $17.97 $324.63 $292.17
Total annual costs are the
Employee + Spouse $413.46 $372.11 $125.79 $100.63 $681.73 $613.55 same.
Employee + Child(ren) $364.23 $327.81 $110.81 $88.65 $600.55 $540.49
Family $570.96 $513.86 $173.71 $138.96 $941.39 $847.25
Rates without $300 MotivateMe Wellness Credit
County 12 Month Payroll Deduction Plan Cost
County General, Highway Department, Solid Waste, RCSO, Judicial, etc.
IMPORTANT
Copay Plan HSA Plan Deductible Plan
County General
OAP Local Plus OAP Local Plus OAP Local Plus employees pay for
Employee Only $107.04 $90.63 $49.96 $39.98 $295.52 $268.47 benefits over a 12 month
period. Deductions occur
Employee + Spouse $369.55 $335.09 $129.82 $108.86 $593.11 $536.30 either monthly or
bi-weekly. Rates shown
Employee + Child(ren) $328.53 $298.17 $117.34 $98.87 $525.46 $475.41 here are on a monthly
Family $500.80 $453.22 $169.75 $140.80 $809.49 $731.05 basis.
Rutherford County Schools / Board of Education 10 Month Payroll Deduction Plan Cost County School and Board
of Education employees
Teachers, School System Support Staff, Central Office, etc. pay for benefits over a 10
Copay Plan HSA Plan Deductible Plan month period. Deductions
occur 10 times for 12
OAP Local Plus OAP Local Plus OAP Local Plus months of coverage.
Employee Only $128.44 $108.75 $59.95 $47.97 $354.63 $322.17
Total annual costs are the
Employee + Spouse $443.46 $402.11 $155.79 $130.63 $711.73 $643.55 same.
Employee + Child(ren) $394.23 $357.81 $140.81 $118.65 $630.55 $570.49
Family $600.96 $543.86 $203.71 $168.96 $971.39 $877.25
6Important Financial Details
Health Savings Account Contributions
If you enroll in the HDHP/HSA Plan, Rutherford County will contribute to your Health Savings Account (HSA) fund annually.
If you are enrolling during Annual Enrollment, you will receive:
- $500 for Employee Only coverage
- $1,000 for Employee plus Spouse, Child(ren), or Family coverage
Funds are deposited into your HSA per pay period. For example, if benefits are normally deducted from your check 24 times
per year, you would receive $20.83 per deduction cycle if you cover only yourself; you would receive $41.67 per deduction
cycle if you cover a spouse, child, or family.
If you experience a life event and enroll in the HDHP/HSA plan mid-year, the amount you receive will differ based on the
number of payroll deduction cycles left in the year. Following the example above, you receive $20.83 per deduction cycle if you
only cover yourself. If there are four payroll deductions left in the year, you would receive $83.33 from Rutherford County.
IMPORTANT: You must be employed in the pay period in order to receive funds.
Spending Account Limits
The IRS establishes annual limits on all spending accounts. The limits below are effective as of January 1, 2022.
Healthcare Flexible Spending Account (HCFSA)
- $2,750 per employee
Dependent Care Flexible Spending Account (DCFSA)
- $5,000 ($2,500 for married filing separately)
Limited Purpose Flexible Spending Account (LPFSA)
- This account is only available to you if you were enrolled in a HCFSA in 2021 but enroll in the HSA plan for 2022.
- Any balance $550 and under remaining in your HCFSA at the end of 2021 will be rolled into a LPFSA.
- Rollover funds in the LPFSA are limited to Dental and Vision claims only.
- You may not make any other contributions to this account.
Health Savings Account (HSA)
• $3,650 if you only cover yourself
• $7,300 if you cover a spouse, child, or family
• Add $1,000 to these limits if you are 55 or older
IMPORTANT: These limits include all sources of funding. The family HSA limit includes any contributions your spouse may
make to their own HSA. You must take any contribution from Rutherford County into account when deciding how much to
contribute to your account. Consult a tax professional if you have any questions.
Special Note for Rutherford County Schools/Board of Education (BOE) Employees
IMPORTANT: Rutherford County Schools/Board of Education (BOE) employees pay their insurance premiums over 10 months
(September-June) for 12 months of coverage (September-August). BOE employees may be subject to collection of back premi-
ums, known as “arrears.” This is the amount needed to fully pay up July and August insurance. This occurs if an employee
changes his/her medical, dental or vision options or coverage tiers, resulting in a higher monthly premium than previously en-
rolled. It can also occur if premiums increase for the new calendar year, or if an employee not enrolled in 2021 adds coverage
for 2022. Alternatively, a refund will be issued if an employee makes a coverage change resulting in a lower monthly premium
or drops coverage for 2022.
7Medical Plans
High Deductible Health Plan
Medical Highlights IMPORTANT: All medical (HDHP/HSA)
What is an Embedded Deductible? plans are available with the
In-network Out-of-network
An embedded deductible only applies to family Open Access Plus (OAP) or
coverage. Each family member has an individual Local Plus (LP) Networks. This plan offers lower paycheck deductions and
deductible “embedded” in the family deductible.
a Health Reimbursement Account (HRA), with
If one person meets their $3,000 deductible, the
higher deductibles.
plan will begin paying coinsurance for that
person. Once the family deductible is met, the
plan pays coinsurance for the whole family. County HSA Contribution
$500/$1,000
(Individual/Family)
Network Choices Annual Deductible $3,000/$6,000 $6,000/$12,000
You can choose between the Open Access Plus (Individual/Family) Embedded Embedded
(OAP) or Local Plus (LP) Networks.
Out-of-Pocket Maximum $5,000/$10,000 $10,000/$20,000
Find a Provider (Individual/Family) Embedded Embedded
Visit www.cigna.com,
Call Cigna 24/7/365 at (800) 244-6224 Lifetime Maximum Unlimited
HSA Contributions
Rutherford County will contribute to your HSA Preventive Care 100% Not Covered
account!
- $500 for Employee Only coverage
- $1,000 for Spouse, Child, or Family coverage Primary Physician Office Visit 80%* 60%*
Rutherford County’s contribution will be
Specialist visits 80%* 60%*
prorated based on the number of pay periods
remaining in the year. See page 7 for details.
Inpatient/Outpatient Hospital 80%* 60%*
MotivateMe Wellness Incentive
Rutherford County employees have the oppor-
tunity to earn a $300 annual medical premium Urgent Care Facility 80%*
credit for the 2022 plan year. (The reduction is
based on your payroll deduction frequency). See MedPoint Medical Clinics
page 13 For more details. Preventive Services 100% N/A
Non-Preventive $30 Charge
Spending Accounts
You have the choice to enroll in different
Chiropractic Care
spending accounts, but the type of account you 80%* 60%*
(26 visits per year)
are eligible for depends on the medical plan you
selected. See page 15 for more details.
Healthcare Flexible Spending Account (HCFSA)
- Copay and Deductible Plan Only Emergency Room Care 80%*
Dependent Care FSA (DCFSA)
- Copay, Deductible, or HSA Plans
Prescription Drug
Health Savings Account (HSA)
Out-of-Pocket Maximum Included in Medical Maximum
- HDHP Plan Only
(Individual/Family)
Limited Purpose FSA (LPFSA)
- If you were enrolled in a HCFSA in 2021 but Retail Prescription
enroll in the HSA plan for 2022, any balance (30 - day supply) Note: You pay all prescription costs until you
$550 and under that you have in your HCFSA Generic meet your medical deductible.
at the end of 2021 will be rolled into a Limited Brand Preferred 20% after deductible.
Purpose Flexible Spending Account. You may Brand Non-preferred
not make any other contributions to this Mail Order Prescription
account. LPFSA funds are limited to dental (90 - day supply)
and vision claims only. Funds remaining in this Generic 20% after deductible.
account as of 12/31/22 will be forfeited. Brand Preferred
Brand-Non-preferred
*After medical deductible is satisfied; **waived if admitted
8Medical Plans
Copay Plan Deductible Plan
*Not available to new enrollees*
IMPORTANT: All medical
plans are available with the In-network Out-of-network In-network Out-of-network
Open Access Plus (OAP) or
Local Plus (LP) Networks. This plan offers lower deductibles, with higher
If you are currently enrolled in the Deductible Plan,
you can remain in it. Once you opt out, only the Co-
paycheck deductions
pay and HSA Plans will be available to you.
County HSA Contribution
(not applicable) (not applicable)
(Individual/Family)
Annual Deductible $1,500/$3,000 $3,000/$6,000 $750/$1,500 $1,500/$3,000
(Individual/Family) Embedded Embedded Embedded Embedded
Out-of-Pocket Maximum $5,000/$10,000 $10,000/$20,000 $3,000/$6,000 $6,000/$12,000
(Individual/Family) Embedded Embedded Embedded Embedded
Lifetime Maximum Unlimited Unlimited
Preventive Care 100% Not Covered 100% Not Covered
100% after
Primary Physician Office Visit 60%* 80%* 60%*
$30 copay
100% after
Specialist visits 60%* 80%* 60%*
$50 copay
Inpatient/Outpatient Hospital 80%* 60%* 80%* 60%*
Urgent Care Facility 100% after $60 copay 80%*
MedPoint Medical Clinics 100% N/A 100% N/A
80% 60% 80% 60%
Chiropractic Care
(26 visits per year)
after separate $150 deductible after separate $150 deductible
Emergency Room Care 100% after $300 per visit copay** 100% after $300 per visit copay**
Prescription Drug
Out-of-Pocket Maximum $1,250/$2,500 $1,250/$2,500
(Individual/Family)
Retail Prescription
(30 - day supply)
Generic $5 copay $5 copay
Brand Preferred $30 copay Member pays 20%
Brand Non-preferred $60 copay Member pays 35%
Mail Order Prescription
(90 - day supply)
Generic $12 copay $12 copay
Brand Preferred $75 copay Member pays 15%
Brand-Non-preferred $150 copay Member pays 30%
*After medical deductible is satisfied; **waived if admitted
9Cigna Resources
Need Help Choosing Your Medical Plan for 2022? Use the CIGNA Easy Choice Tool!
Answer the questions to see a side by side comparison of the available plans. Go to: https://decisionsupport.cigna.com
Enter: RK3MLPF7 (for Rutherford County Schools / Board of Education)
Enter: 39A7FJFW (for County General)
Need Help Navigating the Healthcare System? Use the CIGNA OneGuide!
Resolve health care issues, get cost estimates, understand your bills
Find the right hospitals, dentists, and other health care providers in your plan’s network
Call 24/7, 365 days a year – 800-244-6224
CIGNA PROGRAMS
MyCIGNA: RADIOLOGY PRECERTIFICATION
Access identification cards, search for providers, costs, Precertification means getting approval from the
and much more on your personalized dashboard. health plan before getting care. Your plan requires this
Download the myCigna app on your smart phone or certification approval for radiology services. Here is
go to: www.myCigna.com how it works:
• You and your physician decide if you need a
VIRTUAL HEALTHCARE
MRI, CT or PET scan
Connect with a virtual board-certified physician/
behavioral health specialists via video chat or phone. • Your physician starts the precertification process
Get the care you need including if you are in-network. You should start the
prescriptions, doctor visits and process if your physician is not in-network.
behavioral health: • Your request is reviewed, and you and your
physician are notified of the decision
• Choose phone or video chat
RADIOLOGY INFORMED CHOICE PROGRAM
• Access board certified Doctors
• CIGNA informs patients of available credentialed,
24/7/365 – even on weekends
cost-effective facilities for MRI, CT and PET scans
and holidays
• Access licensed counselors for • Provides cost comparison information to assist pa-
mental health virtual care tients when choosing a facility
appointment online in minutes • Enhances the patient experience by offering real-
• Have a prescription sent time scheduling with the patient and facility to-
directly to a local pharmacy, if appropriate gether on the phone
Contact MDLive by phone at 888-726-3171, or online • Delivers a consistent, standardized experience
at www.mdliveforcigna.com. while offering cost transparency
Example of Potential Savings
SUMMARY OF BENEFITS AND COVERAGE (SBC) Place of Service CT Scan MRI
For the latest version of your plan summaries, visit this link: Free-standing radiology
$376 $608
center
Medical: http://rm.rutherfordcountytn.gov/medical.htm Average outpatient
$1,402 $1,772
hospital
Dental: http://rm.rutherfordcountytn.gov/dental.htm
If you have questions, call the number on the back of
Vision: http://rm.rutherfordcountytn.gov/vision.htm your medical I.D. card.
10Cigna Resources Continued
ADDITIONAL PROGRAMS CONTINUED
LIFESTYLE MANAGEMENT PROGRAMS HEALTHY PREGNANCIES, HEALTHY BABIES PROGRAM
Wellness coaching, workbooks and toolkits are offered Designed to help you and your baby stay heathy pre and
and include weight management, tobacco cessation post-delivery. Enroll by the end of your first trimester
and stress management programs. You can connect and receive a $150 gift card; Enroll by the end of your
over the phone or online. second trimester and receive a $75 gift card.
• Weight Management Download the app to:
Reach your goal of maintaining a healthy • Enroll in the CIGNA Healthy Pregnancies, Healthy
weight—all without fad diets. They will help you Babies program
create a personal healthy-living plan that will help • Look up symptoms and learn about pregnancy
you build your confidence, be more active and health issues
eat healthier. And, you’ll get the support you • Keep a list of things to talk about with your
need to stick with it. doctor, and set reminders
• Tobacco Cessation • View educational videos about your baby’s weekly
Get the help you need to finally quit tobacco. development
Create a personal quit plan with a realistic quit • Connect with your baby using the Baby Boost
date, and get the support you need to kick the relaxation tool
habit for good. You’ll even get free over-the-
BE READY FOR BABY!
counter nicotine replacement therapy (patch or
Your CIGNA medical plan includes coverage for a breast
gum).
pump. Once you reach the 28th week of pregnancy you
• Stress Management can get a breast pump from CIGNA at no additional cost.
Get help lowering your stress levels and raising • You do not need a prescription, unless you are
your happiness levels. Learn what causes you ordering a hospital grade pump
stress in your life and develop a personal stress • A starter kit is included at no cost, but you will be
management plan. And, get the support you need have the option to purchase upgrades and accesso-
to help you cope with stressful situations—both ries at a CIGNA discounted rate
on and off the job • Pumps are usually delivered within two weeks of
Call 800-244-6224 or visit myCIGNA.com receiving all documentation
• To order your pump, please contact CareCentrix at:
PRESCRIPTION DRUG PROGRAM: CIGNA 90 NOW 800-435-8316 or go to medeladeliverys.com
Long-term medication needs (maintenance medications
taken regularly) are offered in a 90 day supply at Cigna’s OMADA DIABETES PREVENTION PROGRAM
participating retail pharmacies. Cigna 90Now pharmacies • The Omada program can help you lose weight and
include CVS, Walmart and Kroger. reduce your risk of type 2 diabetes
• Learn how to eat healthier, move more, sleep
Prefer home delivery? better and manage stress
Call 800-835-3784 Option 3, or go to: • This program is available to all members enrolled in
www.cigna.com/home delivery-pharmacy the Rutherford County Medical plan who are at risk
for diabetes or heart disease, and are accepted into
Why fill a 90-day supply? the program
Filling your prescription in a 90-day supply may help you What you’ll get:
stay healthy because having a 90-day supply of your • Wireless smart scale
medication on-hand typically means you won’t run out of • Personalized program
your medication. • Professional health coach
Visit www.cigna.com/rx90network for more details. Get started at: omadahealth.com/Rutherfordcounty
11MedPoint Health Centers
About MedPoint
The MedPoint Health Centers, in partnership with Ascension Saint Thomas,
provides primary care services ranging from preventive care, chronic disease
management, medication therapy management, healthcare navigation/patient
advocacy, behavioral health services, dietetic services, and health coaching.
The MedPoint Health Centers provide accessible health and wellness
resources that improve the wellbeing of our employees and their dependents
age 3 and up. The MedPoint staff practice evidence-based, lifestyle medicine to
treat common illnesses and injuries and prevent disease.
Copay/Deductible Plans:
If you are covered under the Copay and Deductible Plans, all services are
available at no additional cost for employees and their dependents age 3 and up.
HDHP/HSA Plan:
If you visit the MedPoint Health Center for services that are not considered
preventive care, you will be charged $30. This charge counts toward your
deductible. Preventive services are rendered at no cost. Be sure to ask your
provider if services you receive are considered preventive or not.
Services Offered
Note: This is not a full list of services. Contact MedPoint for additional details.
Clinic Visits Vaccinations Procedures
Annual physical exams Flu Skin tag removal
Sports physicals Shingles Minor laceration repair (non-work related)
Well child exams (age 3 and up) Pneumonia Suture/staple removal
Sick visits Meningitis Minor wound care
Preventive Exams and Screenings Wellness & Medication Management Laboratory
Breast cancer Onsite generic medication dispensing Blood work
Cervical cancer/PAP smear Medication review Urinalysis
Prostate cancer Diabetes education Mono tests
Skin cancer Dietitian/nutrition consultation Blood glucose
MedPoint Health Center Locations
Ascension Medical Group Saint Stewarts Creek Elementary Walter Hill Elementary
Thomas New Salem Care Center 202 Red Hawk Pkwy 220 West Jefferson Pike
2723 New Salem Hwy Smyrna, TN 37167 Murfreesboro, TN 37129
Murfreesboro, TN 37128 7 a.m.- 6 p.m. Monday—Friday 7 a.m.– 4 p.m. Monday—Friday
7 a.m.- 6 p.m. Monday—Friday Phone: 615-410-9360 Option 2 Phone: 615-410-9360 Option 3
8 a.m.– 5 p.m. Saturday Fax: 833-944-2294 Fax: 833-944-2294
Phone: 615-410-9360 Option 1
Fax: 833-944-2294
Walk-in appointments available
Schedule an appointment online
http://rm.rutherfordcountytn.gov
12MotivateMe Wellness Program
Rutherford County employees have the opportunity to earn a
$300 annual medical premium credit for the 2023 plan year.
(The reduction is based on your payroll deduction frequency).
Here’s How: Accumulate points from October 1st – September 30th of a calendar year; the premium credit is reflected the
following January 1 for those completing the program.
How do you earn points?
Simply earn 3 points per person (Employee and Spouse) enrolled in a medical plan by completing any of the options below.
Options to earn points include:
Healthy Action Description Points Earned
An annual exam can identify health concerns before they
Complete an annual check-up 2
become more serious
Complete an online health assessment A confidential online survey that provides a personalized
1
at myCigna.com or the myCigna app assessment of your current health
Check your blood pressure, cholesterol, blood sugar level and
Get a biometric screening 1
your body mass index (BMI) - (Must complete and return
Get a mammogram To help detect breast cancer early 1
Can identify early ovarian and cervical cancers, as well as HPV
Get your annual OB/GYN exam 1
(human papillomavirus virus)
Get a colon cancer screening Colon cancer can be treated easier when detected early 1
Pap and HPV tests can help detect changes that can lead to
Get a cervical cancer screening 1
cervical cancer
Get a prostate screening Can detect changes that may lead to prostate cancer 1
The flu can lead to more serious issues, help protect yourself
Get a flu shot 1
and others
Sign up for Omada diabetes prevention
Complete 16 weeks of the Omada Program. 1
program (See page 11 for details)
Talk to a coach and achieve a goal to overcome a chronic
Sign up for chronic condition coaching 1
health condition
Sign up for lifestyle management
Talk to a coach and achieve a health goal 1
program
The maximum premium reduction that can be earned per household is $300. If you have a spouse on your medical plan,
you and your spouse must each earn 3 points for a total of 6 points to qualify for the $300 maximum reduction.
All actions must be completed while active on the Rutherford County Medical Plan during the accumulation period,
October 1st – September 30th.
The Cigna Wellness Screening Form is available on the Insurance and Risk Management website at:
http://rm.rutherfordcountytn.gov/wellness-program.html
For more details and questions concerning the Motivate Me Wellness Program, contact:
Rutherford County Insurance and Risk Management Department
benefits@rutherfordcountytn.gov
(615) 898-7715
13Dental
County 12 Month Payroll Deduction Plan Cost New for 2022
County General, Highway Department, Solid Waste, RCSO, Judicial, etc.
Option 11 Option 2 DHMO
Children are eligible for Dental
Employee $21.27 $35.63 $14.46 and Vision benefits up to age 26,
Employee + Spouse $66.11 $110.84 $44.94 regardless of student or marital
Employee + Child(ren) $66.11 $110.84 $44.94 status.
Family $66.11 $110.84 $44.94
Rutherford County Schools / Board of Education 10 Month Payroll Deduction Plan Cost
DHMO Plan
Teachers, School System Support Staff, Central Office, etc.
This is a copayment plan. When you
Option 11 Option 2 DHMO
receive a dental service, Cigna
Employee $25.52 $42.75 $17.35 allows your in-network dentist to
Employee + Spouse $79.34 $133.00 $53.93 charge a certain amount. Then you pay
Employee + Child(ren) $79.34 $133.00 $53.93 a fixed portion of that cost and your
Family $79.34 $133.00 $53.93 plan pays the rest. There are NO annual
deductibles or maximums. Refer to the
Option 11 Option 2 DHMO patient charge schedule:
In-Network DPPO Advantage DPPO DHMO http://rm.rutherfordcountytn.gov/
dental.htm
In-Network Choose an in-network
Dental Providers Any Dentist
Providers Only general dentist
Orthodontia Waiting Period
Annual deductible
$50/$150 $50/$150 None The covered person must have
(Individual/Family)
12 consecutive months of dental
Annual maximum $1,500 per individual $1,500 per individual None
coverage, with Rutherford County,
Routine Cleaning, x-rays, before beginning treatment for
Diagnostic and
100%, no deductible2 100%, no deductible2 oral exams, topical fluoride orthodontia or major services.
Preventive Care
No charge
Refer to your Patient Charge Important Note
Basic services 80% after deductible 80% after deductible
Schedule
Refer to your Patient Charge
About Orthodontia
Major services 50% after deductible3 50% after deductible3 Orthodontia benefits are only available
Schedule
Orthodontia 50% after separate $50 50% after separate $50 Refer to your Patient Charge for children to age 19.
(Child only up to age 19) deductible deductible Schedule
Orthodontia Lifetime Maximum $1,000 per person $1,000 per person None Find A Provider
1
Benefits shown above are for in-network providers and are based on negotiated fees. Out-of-network coverage is based on Find a dentist or eye doctor by
reasonable and customary (R&C) charges. visiting www.mycigna.com, or
2
Bitewing x‐rays are covered at each preventive visit; panoramic x‐rays are covered every 5 years.
3 call 800‐244‐6224.
Major and Orthodontia services benefits are payable after enrollee has been in the plan for 12 consecutive months
Vision
In-Network Out-of-Network
County 12 Month Payroll Deduction Plan Cost
Exam $10 copay Up to $45 County General, Highway Department, Solid Waste, RCSO, Judicial, etc.
Employee Only $7.47
Hardware $15 copay See below
Employee + Spouse $15.70
Frequency
Exam 12 months 12 months Employee + Child(ren) $13.84
Lenses 12 months 12 months
Frames 24 months 24 months Family $21.68
Plan pays up to $100 retail
Frames Up to $55
allowance
Lenses Rutherford County Schools / Board of Education
Single vision lenses You pay $15 copay Up to $32 10 Month Payroll Deduction Plan Cost
Bifocal lenses You pay $15 copay Up to $55 Teachers, School System Support Staff, Central Office, etc.
Trifocal lenses You pay $15 copay Up to $65 Employee Only $8.97
Lenticular You pay $15 copay Up to $80
Medically necessary contact Employee + Spouse $18.83
Covered at 100% Up to $210
lenses
Elective contact lenses Up to $100 (Copay doesn’t Employee + Child(ren) $16.60
Up to $87
in lieu of glasses apply)
Family $26.02
Note: Only one copay required when you buy frames and lenses together.
14Flexible Spending Accounts (FSA)
Flexible Spending Accounts are available through Wageworks/Health Equity for Rutherford County. Tax-advantaged FSAs are a
great way to save money. The money you contribute to these accounts comes out of your paycheck without being taxed, and
you withdraw it tax-free when you pay for eligible health care and dependent care expenses. See the chart below to make sure
you choose the Flexible Spending Account that meets your needs.
Keep in mind: FSAs are “use it or lose it” accounts. Any money remaining in your Healthcare FSA over $550 as of December 31
will be forfeited. Any money in your Dependent Care FSA or Limited Purpose FSA as of December 31 will be forfeited.
IMPORTANT NOTE FOR 2022 HSA ENROLLEES: If you are enrolled in a Healthcare FSA (HCFSA) but are enrolling in an HSA for
2022, any remaining funds in your HCFSA as of December 31, 2021 will be placed into a Limited Purpose FSA (up to $550). IRS
rules prevent you from having funds in an HCFSA and an HSA at the same time; placing those funds in a Limited Purpose FSA
(LPFSA) ensures you do not lose them. You may not make any further contributions to this account, and any funds remaining in
it as of December 31, 2022 will be forfeited. Funds in a LPFSA are limited to dental and vision claims only.
Healthcare Flexible Dependent Care Flexible Limited Purpose Flexible
Spending Account (HCFSA) Spending Account (DCFSA) Spending Account (LPFSA)
Up to $2,750 in 2022 – tax free.
*If both you and your spouse work Up to $5,000 in 2022, or $2,500 if
for Rutherford County, you can you are married and filing
Not eligible for additional contri-
both contribute to the Healthcare separately – tax free
butions. This account is solely for
You can contribute… FSA up to the IRS Maximum.
enrollees who transition from a
You may contribute to this account
HCFSA in 2021 to an HSA in 2022.
You may only contribute to this regardless of the medical plan you
account if you are enrolled in the enroll in.
Copay or Deductible plans.
Eligible dependent care expenses,
Health care expenses, such as Plan
Child day care, babysitters, home Expenses for a variety of dental
deductibles, copays, coinsurance,
To reimburse yourself care for dependent elders, and and vision care products and
and other health care expenses. To
for… related expenses. To learn more, services. To learn more, see IRS
learn more, see IRS Publication 502
see IRS Publication 503 at Publication 502 at www.irs.gov.
at www.irs.gov.
www.irs.gov.
To Educate yourself https://www.healthequity.com/ https://www.healthequity.com/ https://www.healthequity.com/
visit and/or review… learn/flexible-spending-account learn/dcfsa learn/lpfsa
Make it easy on yourself. IMPORTANT NOTE FOR 2022 HCFSA ENROLLEES
The EZ Receipts mobile app by WageWorks lets you manage Your card will use funds from the plan year you are
your account from anywhere. It puts the WageWorks web currently in. You cannot use your current card for the
portal in the palm of your hand. previous plan year’s health expenses. The amount of
- Check balances your carryover will be determined at the end of the
run-out period, typically around March of each year.
- Submit claims
- View transactions If you need assistance, contact WageWorks/Health
To learn more, visit www.wageworks.com/myezreceipts Equity at 877-924-3967.
15Life and AD&D Insurance
Rutherford County provides all benefit eligible employees Basic Life and AD&D Insurance equal to $35,000 at no cost to you,
through MetLife.
You have the opportunity to enroll in Employee Supplemental Life insurance. You can choose coverage in increments of
$10,000 up to $500,000 or 5x your salary, whichever is less. If you are not already enrolled in Supplemental Life Insurance or
you are enrolled and wish to increase your amount of coverage, you must complete medical evidence of insurability3.
Additional Coverage for Dependents
You have the option to purchase additional Life and AD&D coverage for your family. If your spouse is not already enrolled, or
you wish to increase their amount of coverage in either Basic or Supplemental Life and AD&D, your spouse will need to com-
plete medical evidence of insurability. In order to enroll your spouse in supplemental coverage, you must enroll in supple-
mental coverage for yourself.
Some exclusions may apply if experiencing a qualifying event, see page 20 for details.
Guaranteed Issue
Increment Amount Maximum
Amount
Supplemental Lesser of five (5) times All increases require
Employee Life & $10,000 your base annual EOI during Open
AD&D1 salary or $500,000 Enrollment.
Basic Spouse/ All increases require
Domestic Partner Life $5,000 $25,000 EOI during Open
& AD&D1 Enrollment.
Supplemental All increases require
Lesser of $250,000 or 50%
Spouse/Domestic $5,000 EOI during Open
of employees’ election
Partner Life & AD&D1 Enrollment.
Child(ren)2 N/A $5,000 or $10,000 N/A
1
Your elected amount will begin to reduce at age 70. Please visit http://rm.rutherfordcountytn.gov/benefits.htm to obtain additional plan details.
2
From birth up to age 26 (age 26 and older if child is disabled and became disabled prior to age 26); you must submit proof of child’s disability
3
If you are required to complete medical evidence of insurability, Insurance & Risk Management will send the necessary documents to complete and
submit to MetLife.
Other Benefits
MetLife offers a variety of other services included with your supplemental life
insurance plan, including:
Grief Counseling—up to five face-to-face sessions to help you and your family. Please enter your Life
Will Preparation Services—Access to attorneys to prepare or update your will. Insurance Beneficiary
Estate Resolution Services—Help your beneficiaries settle your estate. details when you
Accelerated Benefit Option— Get a portion of your insurance early in case of
complete your
terminal illness.
Portability—Continue your coverage if you retire or leave Rutherford County.
enrollment
Funeral Discount and Planning—Pre-plan arrangements with a licensed counselor.
16Short Term Disability
What happens to your income if an injury or illness keeps you from working?
Short Term Disability insurance can replace part of your weekly paycheck if you can’t work due to a qualifying disability, including injury,
physical disease, a mental health issue or pregnancy. Premiums for this coverage are paid 100% by the employee.
What Your Benefit Provides
Option 1: 30 percent of the first $4,167 of your eligible earnings Important!
Option 2: 40 percent of the first $3,125 of your eligible earnings Standard Insurance Company (The
This is the benefit you’d receive if you Option 3: 50 percent of the first $2,500 of your eligible earnings Standard) is the Disability carrier
suffer a qualifying disability. Eligible Option 4: 60 percent of the first $2,083 of your eligible earnings for Rutherford County.
earnings are your weekly insured
pre-disability earnings. Maximum benefit may be
Plan maximum benefits: $1,250 per week
reduced by other sources of in-
Plan minimum benefit: $25 per week come (Medicare, Social Security,
etc.)
Benefit Waiting Period
If you suffer a qualifying disability, your If you are receiving Short Term
0 days for accidental injury Disability payments, you may use
benefit waiting period is the length of
time you must be continuously disabled sick days to “top off” your pay up
before you can begin receiving your to 100%. You cannot use sick days
7 days for physical disease, pregnancy or mental disorder to be paid more than 100% of your
weekly benefit.
pre-disability earnings.
How Long Your Benefits Last
Short Term Disability cannot be
This is the maximum length of time you used in conjunction with an on-the
could be eligible to receive a weekly 180 days -job injury claim.
disability benefit
Short Term Disability Exclusions
Extended Benefit Waiting Period: If you do not apply for short term disability coverage within 31 days of becoming eligible, were eligible
for coverage under a prior plan for more than 31 days but were not insured, apply for an increase in coverage, or if your coverage is rein-
stated because you failed to pay your premium, your waiting period for physical disease, pregnancy, or mental disorder is 60 days
(instead of 7). Once you have been covered for 12 months, the wait periods listed above apply. Contact The Standard for assistance.
Long Term Disability
What happens if your injury or illness keeps you out of work for longer than 180 days?
Long Term Disability insurance helps provide financial protection by promising to pay a monthly benefit in the event of a covered disability.
Rutherford Country pays for this coverage on your behalf.
Benefits
Monthly Benefit 66 2/3% of the first $9,000 of monthly pre-disability earnings.
Important!
Standard Insurance Company (The
Maximum Monthly Benefit $6,000 Standard) is the Disability carrier for
Minimum Monthly Benefit $100 or 10 percent of the Long Term Disability benefit Rutherford County.
Benefit Waiting Period 180 days
Maximum benefit may be
If you become disabled before age 62, Long Term Disability
reduced by other sources of income
benefits may continue during disability until age 65, or to the
(Medicare, Social Security, etc.)
Social Security Normal Retirement Age. If you become disabled
Maximum Benefit Period
at age 62 or older, the benefit duration is determined by the
age when disability begins. See the policy documents at
rm.rutherfordcountytn.gov/disability.htm for more details.
Long Term Disability Exclusions
Pre-Existing Limitation: There is a pre-existing limitation for the long term disability coverage. If you become disabled during your first
year of coverage as a result of a condition you had in the 90 days prior to your disability effective date, no benefits are available for that
specific disability.
17Voluntary Benefits
An economical way for you to supplement your health care plan and be prepared for the unexpected.
Accident and Critical Illness insurance work to complement your medical coverage—and pay in addition to what your medical plan may or
may not cover. As part of the Rutherford County benefits package, you have access to a variety of additional programs through MetLife that
can help save you money and provide important assistance with everyday needs.
Accident Insurance
You can’t always avoid accidents — but you can help protect yourself from accident-related costs that can strain your budget. Accident
insurance through Metlife supplements your primary medical plan and disability programs by providing cash benefits in cases of
accidental injuries. You can use this money to help pay for non-covered medical expenses, such as your deductible or coinsurance, or for
ongoing living expenses, such as your mortgage or rent. Benefits are paid directly to you — unless assigned to someone else — and are
also paid in addition to other coverages you may have, such as medical or an AD&D plan.
County 12 Month Payroll Deduction Plan Cost
Benefit Type MetLife Pays YOU County General, Highway Department, Solid Waste, RCSO, Judicial, etc.
Fractures $25—$6,000 Employee Only $14.06
Dislocations $25—$6,000 Employee + Spouse $27.32
Emergency Care $50—$150 Employee + Child(ren) $28.85
Hospital Admission (non-ICU) $1,000 Family $36.20
Hospital Admission (ICU) $2,000
Rutherford County Schools / Board of Education
10 Month Payroll Deduction Plan Cost
Teachers, School System Support Staff, Central Office, etc.
Important! Employee Only $16.87
This is not the full list of covered conditions. For more
Employee + Spouse $32.78
details, see your policy documents located here:
Employee + Child(ren) $34.62
http://rm.rutherfordcountytn.gov/voluntary.htm
Family $43.44
Critical Illness Insurance
When a serious illness strikes, critical illness insurance can provide financial support to help you through a difficult time. It protects
against the financial impact of certain illnesses, such as a heart attack or cancer. You receive a lump-sum benefit to cover out-of-pocket
expenses for your treatments that are not covered by your medical plan. You can also use the money to take care of your everyday living
expenses, such as housekeeping services, special transportation services, and day care. Benefits are paid directly to you, unless assigned
to someone else.
Eligible Person Initial Benefit Benefit Type MetLife Pays YOU
Employee $10,000 or $20,000 Full Benefit Cancer 100% of Initial Benefit
Partial Benefit Cancer 25% of Initial Benefit
Spouse 50% of employee’s elected amount
Stroke 100% of Initial Benefit
Child(ren) 25% of employee’s elected amount Kidney Failure 100% of Initial Benefit
Alzheimer’s Disease 100% of Initial Benefit
Important!
This is not the full list of covered conditions. For more details, see your policy documents.
A 12 month pre-existing condition clause will apply for all new applicants
A $50 cash reimbursement will be paid to each covered person for completing a covered health screening test. To obtain access to your
wellness reimbursement form or file a claim visit www.metlife.com/rutherford.
Cost is based on employee age and elected benefit coverage level.
18You can also read
