Benefits Guide - Rutherford County, TN Open Enrollment begins October 15th and will end November 5th at noon
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Benefits Guide Open Enrollment begins Action Required October 15th and will end November 5th at noon Rutherford County, TN
ANNUAL ENROLLMENT WORKSHEET
THINGS TO DO: WHAT’S NEW FOR 2019? (cont.)
REVIEW benefits offered MEDICAL
• Medical
• Dental
COPAY PLAN
• Vision
• In‐network deductible is increasing to
• Life Insurance
$1,250\individual and $2.500\family.
• Voluntary Benefits
• Employer contribution is decreasing by 1%.
• Short Term Disability
• 1% Increase to total premium.
• Flexible Spending Account / Dependent Care
Account
HRA PLAN
• No changes to current plan design.
REGISTER for an online account in the new ADP WorkForce
• No change to the Employer contribution.
Now benefits enrollment system (if not completed in
• 8% Increase to total premium.
September) at https://workforcenow.adp.com. Instructions
on how to register as a first‐time user are located in Section
2 of this Benefits Guide. DENTAL
ENROLL/CHANGE/DROP benefits at OPTION 1
https://workforcenow.adp.com. Instructions on how to • Calendar year maximum is increasing to $1,500.
Enroll/Change/Drop benefits are located in Section 2 of this • Dental implants are included in coverage.
Benefits Guide. • 4% Increase to total premium.
PRINT AND SAVE the Benefit Summary for your records. OPTION 1 BUY UP
• No longer available to new enrollees.
SUBMIT the Dependent Verification Information, if • Plan will remain available for one year for existing
applicable. enrollees.
• Plan will not be available as of January 1, 2020.
• 4% Increase to total premium
OPTION 2
WHAT’S NEW FOR 2019? • Calendar year maximum is increasing to $1,500.
• Dental Implants are included in coverage.
• 4% Increase to total premium.
MEDICAL
DENTAL HMO (DHMO) ‐ NEW PLAN
DEDUCTIBLE PLAN
• No longer available to new enrollees. • Review the DHMO information in this Benefit Guide
• Those currently enrolled in the Deductible plan can in Section 1 for more details.
remain enrolled in the plan.
• Once an existing enrollee elects another medical VISION
insurance option, they cannot return to the • No changes to plan design.
Deductible Plan. • 6% Increase to total premium.
• Employer contribution for Employee Only coverage
reduced from 90% to 82%. All other insurance tiers VOLUNTARY BENEFITS
(EE+Spouse, EE+Child, and EE+Family) reduced to • MetLife is replacing Unum for the Critical Illness and
80% employer contribution. Accident Policies. Refer to Section 1 of this Benefit
• 16% Increase to total premium. Guide for additional information.
2
SECTION 1
3
Your Medical Coverage
Rutherford County offers a choice of medical plan options, the Copay
plan and the HRA plan, so you can choose the plan that best meets
your needs – and those of your family. Each plan includes
comprehensive health care benefits including free preventive care
services and coverage for prescription drugs.
HOW DO THE COPAY AND HRA OPTIONS DIFFER?
Both Are Open Access Plus plans (OAPs) which center around a
network of providers and facilities that provide medical services at a
discount. These are known as in‐network providers.
Here are some key differences between the plans:
• The Copay plan covers office visits and certain other services at
100% after you pay a copay (generally $30 or $50 per visit).
• The HRA plan offers lower payroll deductions and has a County‐
funded account, in which the County contributes $750/single or
$1,500/family, that you can use to pay for qualifying medical PRESCRIPTION DRUG COVERAGE
expenses that helps meet your deductible. Both medical options (HRA & Copay Plans) include coverage for
prescription drugs. You have two ways to buy prescription
HOW DOES THE HEALTH REIMBURSEMENT ACCOUNT (HRA) WORK? drugs: at a retail pharmacy that is part of Cigna’s network or
The HRA is a medical plan. It is not a medical reimbursement plan, or through mail order.
FSA, which allows you to contribute towards it.
RETAIL PROGRAM
Here’s how the HRA works in four easy steps: For your short‐term medication needs, you can buy up to a
• The money in your HRA automatically pays for your eligible 30‐day supply at one of Cigna’s participating retail
medical expenses, such as doctor visits and prescription drugs. pharmacies. If you use a pharmacy that is not part of the
• You are responsible for 100% of eligible charges until the Cigna network, you must pay for the prescription, then
deductible is satisfied. Your County‐funded HRA can help offset submit a claim for benefits up to the plan’s contracted
these costs. amount.
• Once you meet your deductible the plan pays 90% of the cost of
eligible medical services when you use in‐network providers; you For maintenance medications that are taken regularly, you
pay the other 10%. The family deductible and out‐of‐pocket can choose to fill your prescription in a 90‐day supply at one
maximum can be met by one or more family members. of the 90‐day retail pharmacies in the new pharmacy
• If the amount you have spent (including the deductible and your network or through the Cigna Home Delivery Pharmacy, as
HRA money) reaches the out‐of‐pocket maximum the plan pays noted below.
100% for the rest of the year.
If you choose to fill your maintenance medication at a retail
location, please visit www.cigna.com/rx90network for a list of
participating pharmacies. Remember, for the HRA Plan, all
medications are paid out at retail cost during the medical
deductible accumulation.
MAIL ORDER PROGRAM
The mail order program saves you money when you take
medication for any ongoing or chronic condition. You can
purchase up to a 90‐day supply and have your prescriptions
shipped directly to your home. Visit www.mycigna.com or the
mycigna app to get started.
4
Medical Plan Comparison
OAP Copay Plan HRA Plan
Plan Provision
In‐Network Out‐of‐Network In‐Network Out‐of‐Network
County Contribution to HRA
(not applicable) $750/$1,500
(Individual/Family)
Annual Deductible $2,000/$4,000 $3,000/$6,000
$1,250/$2,500 $2,000/$4,000
(Individual/Family) Family Collective Family Collective
Out‐of‐Pocket Maximum $5,000/$10,000 $10,000/$20,000 Family
$4,000/$8,000 $8,000/ $16,000
(Individual/Family) Family Collective Collective
Lifetime Maximum Unlimited
Preventive Care 100% Not Covered 100% Not Covered
Primary Physician Office Visit 100% after $30 copay 60%* 90%* 60%*
Specialist Office Visit 100% after $50 copay 60%* 90%* 60%*
Inpatient Hospital Services 80%* 60%* 90%* 60%*
Outpatient Hospital Services 80%* 60%* 90%* 60%*
Urgent Care 100% after $60 copay 90%*
MedPoint Medical Clinics 100% N/A 100% N/A
Chiropractic Care
80% after separate $150 deductible 90%*
(26 visits per year)
Emergency Room Care 100% after $300 per visit copay 90%*
Prescription Drug Out‐of‐Pocket Max
$1,250/$2,500 Included in Medical Maximum
(Individual/Family)
Retail Prescription Drugs Note: Prescriptions are paid at retail cost during the medical
deductible accumulation.
(30‐day supply)
Generic $5 copay 70% after medical deductible
Brand Preferred $30 copay 60% after medical deductible
Brand Non‐preferred $60 copay 50% after medical deductible
Mail Order Prescription Drugs
(90‐day supply)
Generic $12 copay 75% after medical deductible
Brand Preferred $75 copay 65% after medical deductible
Brand Non‐preferred $150 copay 55% after medical deductible
Note: This is a summary of your coverage only. Please refer to your summary plan description for the full scope of coverage. In‐network services are based on negotiated
charges; out‐of‐network services are based on reasonable and customary (R&C) charges.
*After deductible is satisfied.
5
Affordable Patient‐Centered
Care is available to…
Active Employees, retirees, their spouses and dependents (age 3 and older)
who are enrolled in a Rutherford County medical plan are eligible for FREE
services offered by MedPoint.
PERSONABLE CARE LOCATIONS
The clinics are managed by Premise Health, an independent MedPoint at Walter Hill
company, and staffed by highly qualified, board certified
6309 Lebanon Pike
physicians and licensed nurse practitioners with expertise in
Murfreesboro, TN 37129
the areas of primary care, family practice and women’s health.
Mon 12p‐7p
Most services you receive from your primary care doctor are
Tues 7a‐1p
available at the clinics, including:
Wed 1p‐5p
Thurs 7a‐12p
Acute and chronic condition care
Fri 7a‐5p: Closed 12p‐1p
Lab services Sat 7a‐12p
Minor surgical procedures
Immunizations and vaccinations MedPoint at Blackman Elementary
Allergy management
Sports physicals 588 Fortress Blvd.
Minor complaints about pain/sprains/strains Murfreesboro, TN 37128
Annual preventive exams (men and women) Mon, Tues, Wed, Fri 7a‐6p
Injections (allergy, hormones, etc.) even when they Thurs 6:30a‐6:30p
are prescribed by your primary care doctor Sat 7a‐1p
EKG’s
Telemedicine Service MedPoint at Stewarts Creek Elementary
MedPoint also stocks many generic medications to be 202 Red Hawk Pkwy.
dispensed at no cost to you when it is prescribed by a Smyrna, TN 37167
MedPoint board‐certified physician or licensed nurse Mon‐Fri 7a‐6p
practitioner. (Closed 12p‐1p for lunch)
Scheduled appointments and Walk Ins seen 7a‐11a
WE ARE HERE FOR YOU and 1p‐5p
MedPoint’s qualified staff can meet many of your medical
needs. To schedule an appointment, call 615‐904‐6770, email
medpoint@premisehealth.com or visit our patient portal at In addition to the three employer clinics available,
www.rcmedpoint.com. you can also visit all in‐network convenience care
centers at no cost.
Please visit mycigna.com to locate all in‐network
providers.
6
AN EXCITING
UPGRADE AND
You can download your existing
INNOVATION IS IN health information from the current
patient portal anytime between now
THE WORKS! and November 5, 2018. But, don’t
worry, after that date it will still be
available at MedPoint. If you have
more questions, or need help, be
MedPoint is undergoing a new electronic health record (EHR)
transformation and launching your new patient portal, My sure to check out the frequently
Premise Health, on November 5, 2018. asked questions below or contact
MedPoint.
My Premise Health will connect you with your healthcare
experience by providing convenient virtual visits, access to your
providers, health records, visit history, test results, and more. It is
a secure online and mobile tool that will put your health
information in your hands.
Frequently Asked Questions about your new patient portal,
With My Premise Health you will be able to:
My Premise Health:
Conduct Virtual Visits
View your health record
Do I have to create a new login for My Premise Health?
Book and manage appointments
Yes. Effective 12:00 a.m. CST, November 5, 2018, you will
View your immunization history and health reminders have to create a new login to access My Premise Health.
Review lab results
Request medication refills How do I complete sign up for My Premise Health?
Message your providers and care team My Premise Health is offered only to users who are 18 years
Complete forms and eCheck‐In of age or older and reside in the United States. Effective
November 5, 2018, you can call or visit the center to receive a
Stay tuned for more details on how to register for My Premise personalized link via email or text that allows you to register.
Health after November 5, 2018. Thank you for your patience You also have the option of emailing
during this transition! mypremisehealthsupport@premisehealth.com, or registering
at the time of your visit by using the welcome tablet.
Is there an app for My Premise Health?
Yes. You can download the My Premise Health app from the
App Store or Get it on Google Play. You must first register
(using your legal name) for a new My Premise Health account
via the website on a desktop, laptop or mobile browser, and
then you can download and log in to the mobile app using
that same login created via the website.
7
Frequently Asked Questions (Continued)
What is My Premise Health? Will my future appointments be visible in the new EHR and
My Premise Health is your new patient portal. It is a secure online the new portal?
and mobile tool that puts your health information in your hands. Any future appointments will be handled with an appointment
My Premise Health connects you with your healthcare experience conversion effort. All appointments will show up for any
by providing convenient access to book and manage patients who have a My Premise Health account. Please note
appointments, message your providers, conduct virtual visits, view that at this time you may only schedule appointments in the
visit history, test results, and more. existing portal, www.rcmedpoint.com, through October 5,
2018. If you need an appointment for after this date and want
When is the last day patients can access their health information to pre‐book, please contact your preferred center.
on the current portal?
The current portal at www.rcmedpoint.com will be accessible until
11:59 p.m. CST, November 4, 2018. At that point, the current What is the new EHR platform?
portal will redirect to My Premise Health – stay tuned for direct The new EHR and patient portal platform is Epic, the nation’s
URL for access. leading ambulatory electronic medical record provider for
nearly 20 years. Epic offers a fully integrated suite of leading
Can I download my health information from the current portal?
technology products, has the distinction of being the #1
Yes. You can create a PDF of your Consolidated Clinical Document
Overall Software Suite in KLAS , and 50% of the U.S. Health
Architecture (CCDA) – which includes visit history, Rx history, and
Systems are actively using the Epic Network.
vitals. Remember to complete these downloads prior to 11:59
p.m. CST, November 4, 2018 – after this date you will need to
contact the center to request a copy of your health records.
Will my past health information be visible in My Premise Health?
No historical patient data will be available on My Premise Health
on day one. However, as you have encounters with providers and
information is documented in the new EHR, your personal health
record data will be available in My Premise Health.
Will my past health information be visible to my healthcare
provider?
Yes. Your historical patient data will be accessible by your
healthcare provider and health center team in order to ensure
continuity of care.
Do I have a right to and how do I obtain a copy of my health
records from Premise Health?
Yes. To obtain a copy of your individual patient record from
Premise Health, you will be asked to complete an Authorization
for Release of Medical Information Form, with the purpose stated
“for Individual’s Use” if no other purpose is given.
8
Your Dental Plan
It is important to have regular dental exams and cleanings
so problems are detected before they become painful—and
expensive. Keeping your teeth and gums clean and healthy
will help prevent most tooth decay and periodontal disease
and is an important part of maintaining your medical health.
You have a choice of three dental plans this year, each
administered by Cigna. You can see any dentist you choose,
but benefits are highest when you use a provider in Cigna’s
network. Option 1 uses the Cigna DPPO Advantage Network,
Option 2 uses the Cigna DPPO Network and Option 3 uses
the Cigna DHMO Network.
DENTAL PREVENTIVE CARE IS FREE
Regardless of the dental option you elect, you and each
covered family member get one free dental exam/cleaning
and x‐ray every six months. This benefit alone can offset a
significant portion of the cost of coverage, and it helps keep
your smile healthy. For Option 1 and the DHMO you must Provision Option 1* Option 2* DHMO
use an in‐network provider for free preventive care.
ORTHODONTIA BENEFIT/RESTORATIVE SERVICES Annual deductible
The covered person must have 12 consecutive months of $50/$150 $50/150 None
Individual/Family
coverage in a County dental plan before he/she can receive
benefits for orthodontia or major restorative services.
Annual maximum
$1,500 None
NEW THIS YEAR – CIGNA DHMO per individual
Your Cigna DHMO plan is a copayment plan. When Routine Cleaning,
you receive a dental service, Cigna allows your Diagnostic and 100%, no 100%, no x‐rays, oral exams,
network dentist to charge a certain amount. Then Preventive Care deductible deductible topical fluoride –
you pay a fixed portion of that cost and your plan No Charge
pays the rest. There are NO annual deductibles or
Refer to your
maximums. 80% after 80% after
Basic Services Patient Charge
deductible deductible
Schedule
HOW THE PLAN WORKS
You must choose a network general dentist to Major Services
50% after 50% after
Refer to your
manage your overall care. Services will not be (Dental Implants Patient Charge
deductible deductible
covered if you go to a dentist that is not in the Included for 2019) Schedule
Cigna DHMO network. Orthodontia 50% after 50% after Refer to your
Each family member may choose their own dentist (Child only up to age separate $50 separate $50 Patient Charge
Referrals are required for specialty care services. 26) deductible deductible Schedule
Exceptions are pediatric dentists for children under
7, orthodontics and endodontics. Orthodontia
Additional details are included on the insert of your Lifetime Maximum $1,000 None
packets. (per person)
*Out‐of‐Network benefits are subject to reimbursable limits
FIND PARTICIPATING PROVIDERS *Bitewing x‐rays are covered at each preventive visit; panoramic x‐rays are covered every 5 years
*Major restorative and orthodontia benefits are payable after enrollee has been in the plan for 12
Visit www.cigna.com or call 1‐800‐244‐6224. consecutive months.
NOTE: This is a summary of your coverage only. Refer to the Summary Plan
Description for the full scope of coverage and plan eligibility.
9
Your Vision Plan
Your vision plan is provided through Cigna Vision. It provides coverage
for routine eye exams and pays for all or a portion of the cost of
glasses or contact lenses. You can see in‐ or out‐of‐network providers;
however, you always save money if you see in‐network providers. In‐
Network providers will also file claims for you.
FIND PARTICIPATING PROVIDERS
Visit www.cigna.com or call 1‐877‐478‐7557.
Benefit In‐Network Out‐of‐Network
Exam $10 copay Up to $45
Hardware $15 copay See below
Frequency
Exam 12 months 12 months
Lenses 12 months 12 months
Frames 24 months 24 months
Plan pays up to $100 retail
Frames Up to $55
allowance
Lenses
Single vision lenses Up to $32
Bifocal lenses Up to $55
You pay $15 copay
Trifocal lenses Up to $65
Lenticular Up to $80
Medically necessary contact lenses Covered at 100% Up to $210
Up to $100
Elective contact lenses in lieu of glasses Up to $87
(copay doesn’t apply)
*Only one copay is required when you buy frames and lenses together
NOTE: This is a summary of your coverage only. Refer to the Summary Plan Description for
the full scope of coverage and plan eligibility.
10Flexible Eligible Expenses
Annual
Benefit
Contribution Limits
Spending Health Care FSA
Most medical, dental
Accounts and vision care
expenses that are not Minimum contribution Saves on eligible
covered by your health is $100 per year expenses not
plan (such as covered by
copayments,
Maximum contribution insurance; reduces
A Flexible Spending Account (FSA) is a program that helps you coinsurance,
pay for health care and dependent care costs using tax free deductibles, eyeglasses is $2,650 per year your taxable income
dollars. Each pay period, you decide how much money you and doctor‐prescribed
would like to contribute to one or both accounts. Your over the counter
medications)
contribution is deducted from your paycheck on a pretax
basis and is put into the Health Care FSA, the Dependent Care Dependent Care FSA Minimum contribution
FSA, or both. When you incur expenses, you can access the is $100 per year
Dependent care
funds in your account to pay for eligible health care or expenses (such as day
dependent care expenses. care, after school Maximum contribution Reduces your
programs or elder care is $5,000 per year taxable income
This chart shows the eligible expenses for each FSA; how programs) so you and
your spouse can work ($2,500 if married and
much you can contribute to each FSA each year, and how you
or attend school full‐ filing separate tax
benefit by using an FSA.
time returns
IMPORTANT INFORMATION ABOUT FSAs *For a detailed list of eligible expenses, visit www.wageworks.com/employees/.
Your FSA elections are effective from January 1 through
December 31. Please plan your contributions carefully. The
County’s Medical Reimbursement Account allows you to
carryover $500 in unused funds to the 2020 plan year. Any EXAMPLE
money remaining in your Medical Reimbursement Account Here’s a look at how much you can save when you use an FSA to pay
over $500 and any amount in your Dependent Care for your health care and dependent care expenses.
Reimbursement as of December 31, 2019 will be forfeited.
This is known as the “use it or lose it” rule and it is governed Account Type With FSA Without FSA
by IRS regulations. You have until January 31, 2020 to submit
claims to Wage Works for eligible expense incurred in 2019.
Your taxable income $50,000 $50,000
MY SPOUSE ALSO WORKS FOR THE COUNTY – CAN WE
BOTH CONTRIBUTE TO THE FSA? Pretax contribution to Health Care
$2,000 $0
Yes, you can both contribute to the Medical Reimbursement and Dependent Care FSA
Account (FSA). You may each contribute up to the $2,650
annual limit. Federal and Social Security taxes* $11,701 $12,355
Note: FSA elections do not automatically continue from year After‐tax dollars spent on eligible
$0 $2,000
to year; you must actively enroll each year. If you click “I do expenses
not want to make any changes” during Annual Enrollment,
your FSA participation has NOT been renewed for 2019. Spendable income after expenses
$36,299 $35,645
and taxes
Tax savings with the Medical and
$654 N/A
Dependent Care FSA
*This is an example only; not your actual experience. It assumes a 25% federal income
tax rate marginal rate and a 7.7% FICA marginal rate. State and local taxes vary, and are
not included in this example. However, you will save on any state and local taxes as
well.
11Your Life and Accidental Short Term Disability &
Death & Dismemberment Long Term Disability
(AD&D) and Disability Insurance Coverage
Insurance Plans
BASIC LIFE & AD&D INSURANCE SHORT‐TERM DISABILITY INSURANCE COVERAGE
Life insurance is an important part of your financial security, Disability insurance provides income replacement should you
especially if you support a family. Accidental Death & become disabled and unable to work due to a non‐work‐related
Dismemberment (AD&D) insurance is designed to provide a illness or injury. Rutherford County provides eligible employees
benefit in the event of accidental death or dismemberment. with optional short‐term disability coverage through Cigna. To
get a quote, log into your ADP/WorkForce Now account.
Rutherford County provides all benefit eligible employees
Basic Life and AD&D Insurance equal to $35,000 at no cost LONG‐TERM DISABILITY INSURANCE COVERAGE
to you through The Standard. Additionally, Rutherford County provides long‐term disability
coverage to all benefits eligible employees at no cost, with no
SUPPLEMENTAL LIFE & AD&D INSURANCE enrollment required. Long‐term disability coverage, provided
In addition to the company paid insurance, Rutherford through Cigna, continues a portion of your paycheck if a
County provides you an opportunity to purchase disabling illness or injury keeps you from working for longer than
Supplemental Life Insurance for yourself, spouse and 180 days.
children through payroll deductions. Additional coverage
options are shown below. There is a pre‐existing limitation for STD and LTD disability
coverage. If you become disabled during your first year of
coverage as a result of a condition you had in the 12 months
Supplemental Life
Schedule Amount prior to your disability effective date no benefits are available for
& AD&D
that disability.
Up to 5x your base annual salary or $500,000
Employee1 (in $10,000 increments), whichever is less
Coverage Benefit
Spouse1,2 Up to $250,000 (in $5,000 increments)
Benefits are paid based on a percentage of
your income – you may select from 30%‐
Children3 $5,000 or $10,000 – Without EOI Short‐Term 60%, up to a $1,250 weekly maximum.
Disability/Salary Benefits begin on 8th day of disability due to
Continuation illness, or on the first day due to an
1 Evidence of Insurability (EOI) is required if you elect more than $350,000 in
accident. Benefits generally continue up to
employee supplemental life and/or more than $50,000 in supplemental
spouse/domestic partner life when first eligible; or increase/add any amount as
26 weeks. Certain rules apply.
a late entrant.
2 You must elect supplemental life for yourself in order to elect it for your
spouse/domestic partner; however, your spouse/domestic partners total life Covers 66.67% of your monthly pre‐
insurance amount cannot exceed 50% of your supplemental life insurance disability earnings – up to a $6,000 monthly
Long‐Term
amount. maximum. Benefits begin after 180 days of
Disability
3 From birth through age 25 (age 26 and older if child is disabled and became disability or illness and continue to the
disabled prior to age 26; you must submit proof of child’s disability) earlier of recovery or retirement age.
If you wish to enroll or make a change to
your existing life insurance election,
contact Risk Management.
12Additional Benefits
You can’t always plan for accidents or a serious illness, but you can
be better prepared financially when they do happen with accident
and critical illness insurance.
Rutherford County has teamed up with MetLife to bring you this
opportunity to enroll for coverage, during this enrollment period,
with competitive employee rates and guaranteed coverage for you
and your eligible family members!
Quality health and disability insurance plans aren’t always enough.
There may still be coverage gaps. For example, your medical
coverage may have deductibles and copays and may not fully
cover out‐of‐network treatments. And if you’re out on disability,
only a portion of your income may be covered. Most people will
need the means to cover these extra medical and daily living
expenses, such as groceries, housing expenses, car payments, and
more. You pay the cost through convenient payroll deduction.
YOUR EMPLOYEE ASSISTANCE PROGRAM
CRITICAL ILLNESS INSURANCE WITH CANCER RIDER
(In person or virtual)
Critical Illness insurance assists with out‐of‐pocket expenses
following the diagnosis of a covered illness, including heart attack, If you find yourself in need of some professional support to
stroke, kidney failure, life‐threatening cancer and more. This deal with personal, work, financial or family issues, your
benefit helps pay expenses not normally covered under traditional Employee Assistance Program (EAP) can help. You and your
health insurance, which means you and your family can immediate family (spouse, dependent children, parents and
concentrate on getting well without worrying about money. This parents‐in‐law) receive up to six free counseling sessions with
coverage also pays a once‐a‐year $50 cash reimbursement to each an EAP professional.
covered person for completing a covered health screening test.
EAP counselors will assist you with concerns such as:
Coverage is available in your choice of $10,000 or $20,000 all at Marriage and family problems
guarantee issue. This means no medical questions asked. Spouse Alcohol and drug abuse
coverage is available at 50% of the employee elected amount as Stress management
well as child(ren) at 25% of the employee elected amount. Parent and child relationships
Legal assistance
A 12‐month pre‐existing condition clause will apply to all new Wellness information
applicants. Work relationships
And much more
ACCIDENT INSURANCE
While you can count on health insurance to cover medical Our provider is LifeServices EAP. If you need help or guidance
expenses, it doesn’t usually cover indirect costs that can arise with you may reach out to the EAP at 1‐800‐822‐4847 or visit
a serious, or even a not‐so‐serious, injury. You may end up paying www.lifeserviceseap.com
out of your own pocket for things like transportation, over‐the‐ (username: Rutherford; password: employee)
counter medicine and day care or sitters. With accident insurance,
the benefit you receive can help take care of these extra expenses.
It pays a lump‐sum benefit for on‐ and off the‐ job accidents, in
addition to other insurance you may have. To get quotes on
coverage, log into your ADP/WorkForce Now account.
13Employee Rates
All contributions are pre‐tax. Monthly Medical, Dental, and Vision premiums are below. Premiums for Life and AD&D, short‐term
disability and voluntary critical illness and accident plans are shown on the online enrollment system.
*For those enrolled in the grandfathered Deductible / Option 1 Buy‐Up plans, your rates will be visible in the
online enrollment system.
Medical County Board of Education
Monthly Premium (based on 12 months) (based on 10 months)
OAP Copay HRA Plan OAP Copay HRA Plan
Employee Only $89.86 $25.00 $107.84 $30.00
Employee + Spouse $270.19 $74.91 $324.23 $89.89
Employee + Child(ren) $240.99 $60.17 $289.19 $72.21
Family $363.59 $107.70 $436.30 $129.24
*Employees hired before August 1, 2018 and their covered spouses on the 2018 Medical policy, who completed the Know Your Numbers (Biometric
& Health Risk Assessment) campaign, will receive a monthly premium reduction of $30 for BOE employees and $25 for all others. Employees hired
on or after August 1, 2018 will receive the premium reduction through the upcoming plan year (2019).
Dental County Board of Education
Monthly Premium (based on 12 months) (based on 10 months)
Option 1 Option 2 DHMO Option 1 Option 2 DHMO
Employee $21.06 $35.28 $13.90 $25.27 $42.34 $16.68
Family $65.46 $109.74 $43.21 $78.55 $131.69 $51.85
Vision County Board of Education
Monthly Premium (based on 12 months) (based on 10 months)
Employee Only $7.40 $8.88
Employee + Spouse $15.54 $18.65
Employee + Child(ren) $13.70 $16.44
Family $21.47 $25.76
NOTE: 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 premiums, 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 or dental option or coverage tier, resulting in a higher monthly premium than previously enrolled. It can also occur if premiums
increase for the new calendar year, or if an employee not enrolled in 2018 adds coverage for 2019. Alternatively, a refund will be issued is an employee makes a
coverage change resulting in a lower monthly premium or drops coverage for 2019. Arrears/refunds will be administered through the payroll function by July 1, 2019.
14SECTION 2
15Before You Enroll…
WHO CAN I ENROLL IN BENEFITS? What if I need more information than
If you are eligible for coverage, you can also enroll your eligible spouse this guide provides?
and eligible dependents for medical, dental, vision, spouse and/or child
life insurance, spouse AD&D, and the voluntary insurance plans. You
must provide documentation proving that your spouse and/or Visit:
child(ren) meet eligibility requirements. See page 31 for further www.rutherfordcountytn.gov/rm
Dependent Verification information. for more details on benefit plans,
including summary plan
Eligible dependents include: descriptions. (click Employee
Your legal spouse (for medical coverage: your spouse is Insurance Benefits on the left side of
only eligible if he/she does not have access to employer
the screen)
group medical coverage through his/her employer;
regardless if they take their employers insurance or not).
Your domestic partner (for life insurance only)
Your children (or stepchildren) by birth, marriage, legal
adoption or legal guardianship.
o Up to age 26 for medical
o Up to age 19 (25, if unmarried and a full‐time
student) for dental and vision WHEN CAN I MAKE CHANGES?
Your children, of any age, who become totally and What if I change my mind about benefits I elected?
permanently disabled before age 19 while covered by the You may only make or change your existing benefit elections
plan(s). during the open enrollment window. However, you may
Dependents covered under a Qualified Medical Child change your benefit elections during the year if you
Support Order (proper documentation required). experience a qualified life event such as:
Marriage
Once your benefit elections become effective, they remain in Divorce or legal separation
effect until the end of the year. You may only change coverage Birth of your child
within 30 calendar days of a qualified life event. Death of your spouse or dependent child
Adoption of or placement for adoption of your
My spouse and I both work for Rutherford County and/or child
Board of Education. What options do we have for Health Change in employment status of employee,
coverage (Medical/Dental/Vision)? spouse or dependent child
If you are NOT covering eligible dependent children: Qualification by the Plan Administrator of a child
You may each enroll in Employee Only coverage support order for medical coverage
One employee may enroll in Employee + Spouse coverage New entitlement to Medicare or Medicaid
and the other decline coverage.
If you ARE covering eligible dependent children: You must notify the Risk Management Department
One employee may enroll in Family coverage and the within 30 calendar days of the qualified life event. You
other decline coverage. will be asked to provide documentation of the event. If
One employee may enroll in Employee + Child(ren) and you do not contact the Risk Management Department
the other enroll in Employee Only coverage. within 30 days of the qualified event, you will have to
Each employee may enroll in Employee + Child(ren) wait until the next annual enrollment period to make
coverage if you are covering more than one eligible changes (unless you experience another qualified life
child. event). For more information about your benefits, visit
www.rutherfordcountytn.gov/rm/benefits.htm.
You are NOT allowed to duplicate medical, dental, or vision
coverage on any family member. If you are currently violating
eligibility rules you must correct this to prevent further action,
including loss of insurance. Contact Risk Management for
assistance. 615‐898‐7715
16READY TO ENROLL?
Rutherford County is announcing a new enrollment portal with ADP‐WorkForce Now.
This is a two‐step process to gain access to enroll, cancel, change, or confirm benefits during the Annual Enrollment period.
STEP 1: REGISTER
You will need to register for access to the enrollment portal and activate your online account. If you have not previously
registered for a NEW ADP‐WORKFORCE NOW account, you will need to complete the following Registration Instructions.
STEP 2: ENROLLMENT
Login to your NEW account at https://workforcenow.adp.com.
Follow the Enrollment Instructions to walk you through the benefits options offered for 2019.
HELPFUL TIPS
• You will need a working email address that you can access before you begin. You cannot register or enroll in benefits
unless you have a working email address.
• The latest version of Mozilla Firefox is the recommended browser.
• Initial activation code in Step 1 is ruthcounty‐benefits
• You will need to retain the user ID and password you create during this process. We will not be able to retrieve it for
you, if forgotten or lost.
17REGISTRATION INSTRUCTIONS
Skip the Registration Process if you registered for your account at an earlier time. Login in to the URL listed
below with the user ID and password you created at that time, then proceed to the Enrollment Instructions.
STEP 1:
From any computer go to URL:
https://workforcenow.adp.com
Click “First Time Users” to get started.
Click here to register!
Enter the Registration Code ruthcounty‐benefits
Enter the Registration Code
exactly as shown
Step 2:
Use legal first
Enter your personal data as shown.
and last name.
Do not use a
nickname.
18Step 3:
Verify your identity: Your email Choose email or
address and/or cell phone number will text on file to
receive Personal
display in this step; choose the method Registration Code.
in which you wish to receive your
personal activation code.
Note: The code will come from ADP Security
Services.
Step 4:
Retrieve code from selected source in
Step 3, and then enter in the box Enter the code
indicated. you receive here
.
Step 5:
Update any
Review and update personal and/or incorrect contact
work contact information. information.
19Step 6:
Create your user name and password for your account. (Retain your User ID and password to access
the online benefits portal)
You may now use
your user ID and
Password to access
your online benefits
account.
Note: You may receive a text or email to confirm your registration.
20ENROLLMENT INSTRUCTIONS
Click Start This Enrollment
to begin.
1. Review Dependents and
Beneficiaries.
Information on file will be displayed in
this section.
(Skip to the next page for instructions on
how to add an individual not listed, before
clicking Continue.)
2. Status
Choose “Walk Me Through My Benefit
Options” to proceed through each category
available, then click Continue.
21Instructions to Add a Dependent/Beneficiary not listed
Click ADD
DEPENDENT/BENEFICIARY and
select the type of individual you wish
to add that is not already listed.
Please note the following
descriptions:
Dependent/Beneficiary – Choose
this option for a child and/or spouse
you wish to enroll in any benefit
plan(s) and assign as a beneficiary to
a Life or Accident Plan.
Beneficiary Only (Person) – Choose
this option to name a person as a
beneficiary only to a Life or Accident
Plan.
Beneficiary Only (Organization) ‐
Choose this option to name an
organization as a beneficiary only to a
Life or Accident Plan.
Click the drop‐down arrow
to choose Tax Information
Type (Tax ID Type most
commonly used is an SSN)
*The SSN is required for
dependents enrolled in a
benefit.
If the dependents address
is different than the
employee, uncheck Use
Employee Address box
and enter the correct
address.
22You must click through each benefit option to
proceed to the next plan category. If you do
not wish to enroll in a benefit, you may click
the next option without enrolling.
Medical Plans
To view the cost for other Tier
options, click on More Info on
each plan.
1. Choose your Coverage Level
2. Choose Dependents
Select the name of any
Dependent you wish to enroll in
If you wish to enroll in a
the benefit plan chosen.
Medical benefit plan you
must Click ENROLL IN
THIS PLAN.
(If you DO NOT wish to
enroll in a plan click the
next plan category)
23Dental and Vision Plans
To view the cost for other
Dental and Vision Tier
options, click on More Info
on each plan option.
If you wish to enroll in a Dental
and/or Vision benefit plan you
must click ENROLL IN THIS
PLAN on the plan category
desired.
(If you DO NOT wish to enroll in
a plan click the next category)
1. Choose your Coverage Level
2. Choose Dependents
Select the name of any
Dependent you wish to enroll in
the benefit plan chosen.
24Flexible Spending Accounts (FSA)
If you wish to enroll in a Medical
and/or Dependent Care Flex
Spending Account, you must
click ENROLL IN THIS PLAN on
each plan option.
(If you DO NOT wish to enroll in
a plan click the next category)
From the drop‐down menu,
Select the Per Pay Period or
Per Year option and enter
desired amount to be
withheld from your
paycheck.
From the drop‐down menu,
Select the Per Pay Period or
Per Year option and enter
desired amount to be
withheld from your
paycheck.
25MetLife Accident and Critical Illness Plans
If you wish to enroll in an Accident and/or Critical
Illness benefit plan you must click ENROLL IN THIS
PLAN on each plan category.
(If you DO NOT wish to enroll in a plan click the next
category)
1. Choose your Coverage Level
2. Choose Dependents
Select the name of any Dependent you
wish to enroll in the benefit plan
chosen.
3. Assign Beneficiaries
(Designations must equal a total of
100% each.)
Use the scroll arrow to
view more coverage
options available.
Critical Illness is available in $10k and
$20k amounts. Choose the coverage
amount and coverage level that meets
your needs.
Click “Enroll In This Plan”, then select
your age range, as of January 1, 2019,
for your premium cost per pay period.
26Life Insurance Plans
Employee Basic Life is free to the
employee, this amount cannot be
changed.
To Review/Change beneficiary
assignments to this plan, click on
EDIT PLAN.
Designate a Beneficiary and
the percentage desired for
each beneficiary listed. (Total
percentage combined must
equal 100%.)
Employee Supplemental, Spouse Basic
and Spouse Supplemental Life benefits
are not available for changes
online. To add/drop/change any
amount to these benefits, contact Risk
Management.
27Life Insurance Plans (cont.)
If you wish to enroll in a
Child Life benefit plan you
must click ENROLL IN
THIS PLAN.
(If you DO NOT wish to
enroll in a plan click the
next category)
1. Choose Coverage Level
You may view the cost for
Child Life benefits by clicking
on the drop‐down menu. Click
on the amount you wish to
add.
2. Choose Dependents
Select the name of any
Dependent you wish to enroll
in the benefit plan chosen.
Long Term Disability
(LTD) is free to the
employee, this amount
cannot be changed.
28Short Term Disability Plans
If you wish to enroll in a
Short‐Term Disability
(STD) benefit plan or
inquire about plan cost,
you must
click ENROLL IN THIS
PLAN.
(If you DO NOT wish to
enroll in this plan go to
Review & Complete in the
top right corner of this
Select your coverage
option, available up to
60% of your earnings.
The cost for each
coverage option will
appear by clicking on
the desired percentage.
You must click Review & Complete to
finish the enrollment process when final
selections are made.
If you fail to click Review & Complete, any
changes or new elections you made will not
be recorded. Therefore, the changes will
not be in effect January 1, 2019.
29Print and retain a copy of
the elections made during
this process for your
records.
Review the elections made during this process. If you wish to make changes, click on RETURN TO
CHOOSE PLANS. Once you have reviewed your elections for accuracy, click on COMPLETE
ENROLLMENT. You must complete this step to record any changes made during this process. If you
fail to click COMPLETE ENROLLMENT, any changes or new elections you made will not be recorded.
Therefore, the changes will not be in effect January 1, 2019.
30AFTER YOU ENROLL
WHAT DOCUMENTATION IS REQUIRED IF I ADD DEPENDENTS TO MY COVERAGE?
For a list of required documentation, go to:
www.rutherfordcountytn.gov/rm/benefit_enrollments.htm and click on the link “List of Acceptable Documents for Verification”.
Documentation is required for newly added dependents only.
IS THERE A DEADLINE TO SUBMIT DEPENDENT VERIFICATION DOCUMENTATION FOR DEPENDENTS ADDED
DURNING OPEN ENROLLMENT?
Yes, documentation for a newly added spouse and/or any eligible dependent child must be received in the Risk Management
Department by December 5, 2018. You may submit your documentation via upload to a secure website at
http://secure.rutherfordcountytn.gov/rmuploads/default. The password for the secure upload website is oeverify2019. You
may also fax your information to 615‐867‐4602. Keep a copy of the successful fax transmission for your records. Include your
name, email address, and best telephone contact number on ALL information sent to Risk Management.
IMPORTANT! You will NOT be contacted by the Risk Management Department requesting this documentation. It is your
responsibility to ensure it is submitted in a timely manner. Eligibility documentation is not required again for dependents
already enrolled and verified in the current plan year.
WHAT IF I FAIL TO PROVIDE THE REQUIRED DOCUMENTATION BY THE DEADLINE?
If documentation is not provided by the deadline, coverage for the dependent will be denied.
31SECTION 3 32
Retirement Plans
Rutherford County is a member of the Tennessee
Consolidated Retirement System (TCRS), a program that
provides a pension to eligible County retirees. The plan
you participate in is determined by when you become a
TCRS member as follows:
TCRS LEGACY PLAN
County General and BOE Classified employees will participate in
the TCRS Legacy Plan. Additionally, teachers who were TCRS
members as of 06/30/2014 will participate in the Legacy Plan.
Visit www.treasury.state.tn.us/tcrs or call 1‐800‐770‐8277 for
more information.
TCRS HYBRID PLAN
Teachers who became TCRS members on or after 7/1/14 will
participate in the TCRS Hybrid Plan. This plan is a combination
of a defined benefit plan and a state of Tennessee 401(k) plan.
It is administered by Great West. To enroll or set a meeting HOW DO I START A VALIC 403 (B) OR 457(B) ACCOUNT?
time with a financial advisor call 1‐800‐922‐7772 or visit Call VALIC at 615‐221‐2541 to make an appointment with a
www.treasury.tn.gov/dc. financial advisor who can guide you in setting up an account.
You can also visit www.valic.com/rutherford to get
Teachers and other BOE employees can participate in the 401(k) information on available investment options, enroll online,
plan via employee contributions. Visit and view prospectuses. For the Portfolio Director’s Choice
www.treasure.state.tn.us/tcrs for more information. annuity program, follow the annuity links. For the Profile
Retirement mutual fund program, follow the mutual fund
403 (B) AND 457(B) RETIREMENT PLANS links. VALIC also offers the Schwab Personal Choice
A 403(b) or 457(b) plan is a tax‐deferred retirement plan Retirement Account (PCRA), a self‐monitored brokerage
available to educational institution employees. There are two investment program for more experienced investors.
types of accounts available with each plan:
• Traditional account – with pre‐tax contributions. You’ll pay CONTRIBUTIONS
taxes as you withdraw funds during retirement. To participate in either plan, there’s a required minimum payroll
• Roth account – with after‐tax contributions. Funds are not deduction of $20/month for salaried staff and $10/payday for
subject to federal income taxes as you withdraw during classified staff. You can start your 403(b) or 457(b) account at any
retirement. time during the year. If you want to change your contribution
amounts, BOE employees must contact Central Office Payroll
All Rutherford County School employees are eligible to (615‐893‐5812) and County General employees must contact
participate in the 403(b) or 457(b) tax‐deferred retirement Human Resources (615‐494‐4480). A revised payroll deduction
savings plans through VALIC. Contributions to both plans are form must be received no later than 10 days before the payday
made through payroll deductions. you want the change to begin. The 2019 limit for 403(B) or 457(B)
contribution is $19,000.
WHO IS ELIGIBLE TO PARTICIPATE IN THE 403(B) OR 457(B)
PLANS? WITHDRAWALS
• BOE employees ‐ Board of Education employees can save There are withdrawal limitations on both plans until you reach
for retirement through Traditional or Roth 403(b) or age 59 ½ or are no longer employed by Rutherford County. In the
457(b) plans, offered through VALIC. To enroll or set a event of financial hardship, death or disability, hardship
meeting time with a financial advisor, call 615‐221‐2541 withdrawals are possible. There is a 10% IRS surcharge on early
or visit www.valic.com/rutherford. 403(b) withdrawals. Short‐term needs can sometimes be met by
• County Employees ‐ The County offers an optional non‐taxable loans.
457(b) deferred compensation plan. Contact HR at 615‐
494‐4480 for more information. This plan is not This information is not intended as tax or legal advice. Neither
available to BOE employees. your employer nor the investment providers that offer products
under the plan can provide you with tax or legal advice.
33Glossary of
Medical Plan
Brand Name Drugs—Drugs that have trade names and are
protected by patents. Brand name drugs are generally the
most costly choice.
Coinsurance—The percentage of a covered charge paid by
the plan.
Copayment (Copay)—A flat dollar amount you pay for
medical or prescription drug services regardless of the
actual amount charged by your doctor or health care
provider.
Mail Order Pharmacy—Mail order pharmacies generally
Deductible—The annual amount you and your family must provide a 90‐day supply of a prescription medication for the
pay each year before the plan pays benefits. same cost as a 60‐day supply at a retail pharmacy. Plus,
mail order pharmacies offer the convenience of shipping
Generic Drugs—Generic drugs are less expensive versions directly to your door.
of brand name drugs that have the same intended use,
dosage, effects, risks, safety and strength. The strength and Inpatient—Services provided to an individual during an
purity of generic medications are strictly regulated by the overnight hospital stay.
Federal Food and Drug Administration.
Outpatient—Services provided to an individual at a hospital
Health Reimbursement Account (HRA)—A fund you can facility without an overnight hospital stay.
use to help pay for eligible medical costs not covered by
your medical plan. Funds are contributed to the HRA by Out‐of‐Pocket Maximum—The maximum amount you and
your employer. your family must pay for eligible expenses each plan year.
Once your expenses reach the out‐of‐pocket maximum, the
In‐Network—Use of a health care provider that participates plan pays benefits at 100% of eligible expenses for the
in the plan’s network. When you use providers in the remainder of the year, except for prescriptions under all
network, you lower your out‐of‐pocket expenses because medical plans except the HSA Plan.
the plan pays a higher percentage of covered expenses.
Primary Care Physician (PCP)—physician (generally a family
Out‐of‐Network—Use of a health care provider that does practitioner, internist or pediatrician) who provides ongoing
not participate in a plan’s network. medical care. A primary care physician treats a wide variety
of health‐related conditions.
Specialist—A physician who has specialized training in a
particular branch of medicine (e.g., a surgeon,
gastroenterologist or neurologist).
34CONTACTS:
Plan Provider Phone Numbers Website
615‐898‐7715
General Risk Management www.rutherfordcountytn.gov/rm
615‐867‐4602 (fax)
Cigna 800‐285‐4812 (Cigna Tel‐Drug) www.cigna.com
Medical
MedPoint Clinics 615‐904‐6770 www.rcmedpoint.com
Dental Cigna 800‐244‐6224 www.cigna.com
Vision Cigna 877‐478‐7557 www.cigna.com
Flexible Spending Accounts Wage Works 877‐924‐3967 www.wageworks.com
Short‐Term & Long‐Term 800‐362‐4462 (STD claims only)
Cigna N/A
Disability Insurance LTD: Contact Risk Management
COBRA Allegiance 800‐259‐2738 N/A
Life & AD&D The Standard Contact Risk Management www.thestandard.com
www.lifeserviceseap.com
Employee Assistance
Life Services 800‐822‐4847 User Name: Rutherford
Program (EAP)
Password: employee
Critical Illness and Accident MetLife 800‐438‐6388 mybenefits.metlife.com
Retirement Plan (TCRS) 800‐770‐8277 www.treasury.state.tn.us/tcrs
Retirement/Savings
403(b) (Valic) 615‐221‐2541 www.valic.com/rutherford
SmartSteps 615‐898‐7715 www.rutherfordcountytn.gov/rm/wellness.htm
Wellness Program
Health Risk Assessment 615‐898‐7715 www.mycigna.com
35Rutherford County 2019 Benefits Guide 36
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