2020

RETIREEBENEFITS

Open Enrollment Period November 8, 2019, through November 22, 2019.

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Table of Contents ...

Introduction

EMB Enroll Online

Health Plan Changes

Dependent Eligibility

Side-by-Side Medical Summaries

Health Plan Premium

Dental Plan Options

Dental Summaries

Important Contacts

Tips for Controlling Costs

2020 Legal Notice & Disclosures

WELCOME TO ANNUAL ENROLLMENT!

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Important Updates about the POS and PPO Plans offered at the City

We are replacing the POS and PPO plans with a new High Deductible Health Plan (HDHP). Replacing the POS and PPO plans will allow the City to continue to provide a high-quality, affordable coverage alternative for retirees and their families.

Please note: If you are enrolled in the POS or PPO plan, your coverage will default to the new HDHP plan during Open Enrollment. If you want to change your default election, you will be required to login to EMB during Open Enrollment and change your benefit election.

Open Enrollment Period November 8, 2019, through November 22, 2019.

INTRODUCTION

Human Resources Open Enrollment Staff Email Phone

954-597-3603

954-597-3616

Sadhana Swaroop HR Support Specialist II

Nancy Rivera HR Technician

Joshua Appelt Benefits Manager

sadhana.swaroop@ tamarac.org

nancy.rivera@tamarac.org

joshua.appelt@tamarac.org

954-597-3608

NOTE: Every attempt has been made to ensure that the information presented here is accurate; however, the information provided in this guide is only intended to be a brief description of the plans offered and does not constitute an insurance certificate or policy. The City’s benefit programs are governed by plan documents and insurance contracts. If there is a discrepancy between the information in the guide and a plan document or contract, the plan document and/or contract will prevail.

Key dates to remember …

Open Enrollment Election Period:

November 8 through 22, 2019

Last day to make elections:

November 22, 2019

Benefits Effective Date:

January 1, 2020

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Open Enrollment is your annual opportunity to review and update your current benefits to meet your needs and the needs of your family. The benefits programs provide comprehensive coverage and offer a range of plans to fit a variety of needs and budgets. This Guide will describe programs that are included in the City’s Retiree Open Enrollment period and are subject to an annual enrollment process. These programs include health and dental coverage. You can find more detailed information about your benefits and how to enroll at the City’s new on line benefit enrollment portal at: www.explainmybenefits.com/tamarac.

IMPORTANT NOTICE: Beginning January 1, 2015, the City’s policies were amended to allow retirees a “one-time opt in period” for retiree health insurance upon retirement and separation of employment, or at a subsequent date with a qualifying life status change as defined by the Internal Revenue Service or during the City’s annual open enrollment period.

Retirees may choose to keep their health insurance when they retire and separate from service or terminate on the last day of the month in which retirement and separation of service occurred. Retirees are permitted a one-time opt in if they experience a Qualifying Life Event as defined by Internal Revenue Code Section 125 or during the City’s Annual Open Enrollment period. Retirees who utilize the one-time opt in and subsequently elect to cancel benefits will not be permitted to re-enter the City’s medical insurance plan in subsequent years.

The City of Tamarac uses Explain My Benefits (EMB) for all Open Enrollment elections, enabling a more efficient communication and administration process. Retirees will enroll on-line using any internet connected computer or mobile device. Enrollment instructions are available in the EMB portal.

It is the responsibility of each retiree to review the open enrollment information, which includes certain conditions and expectations. Failure to observe these important responsibilities may have serious consequences and result in a loss of coverage for 2020.

Open Enrollment Period November 8, 2019, through November 22, 2019.

EMB - ENROLL ONLINEThe City requires all benefit election changes to be made using Explain My Benefits (EMB, a HIPAA compliant, secure and user friendly benefit portal. EMB offers eligible employees the ability to make benefit elections and changes online during new hire orientation, the annual open enrollment and qualifying events.

EMB is your one-stop-shop for benefit information and resources. Benefit eligible retirees are required to complete the enrollment process through the online benefit portal, whether you are electing benefits, keeping benefits the same, making changes, or waiving benefits in order to confirm your choices. You can log into the EMB portal at anytime or download the Mobile App to review your benefits, access carrier links and process qualifying life events. Your enrollment process should take you approximately 10-15 minutes to complete.

How to Enroll

� Online at www.explainmybenefits.com/tamarac, or by using the EMB App in Google Play or the Tunes App store� First time EMB users can click here to access their "Getting Started" tutorial.� Review the Retiree Benefits Guide and plan summaries to help you with your benefit decisions.� Click on the green “Log Into Your Benefit System” button using your Tamarac User Name and

Password, or download the Mobile App and move through the enrollment system at your own pace.� Once logged in, click the “Enroll Now” button to enroll for the first time or make changes to

your selections.� Be sure to click “Submit” at the end of the process and make note of your confirmation number. If you

do not receive a confirmation number, you have not completed your enrollment and you will not be enrolled in your benefits.� Return to the system or Mobile App anytime and click your confirmation number to view your

confirmation statement.

Reminders prior to going through the enrollment process:

� Be sure to review the Benefit Guide and plan summaries.

� Gather your dependent information (i.e. Marriage & Birth Certificates, Social Security Numbers andDates of Birth) if you are adding or changing dependents on your health and/or dental plans.

� If you stop an enrollment or the system times you out, your benefit elections will NOT be saved. Whenlogging back in, you will have to start a new enrollment and re-enter all of your information. All of yourcurrent benefit choices will be pre-selected for you, based on your position group classification.

� Please make sure you get to the Final Confirmation page to ensure you have completed yourenrollment or change(s).

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Open Enrollment Period November 8, 2019, through November 22, 2019.

HEALTH PLAN CHANGES Effective January 1, 2020 the City will no longer be offering the POS and PPO Medical Insurance plans from CIgna. A new High Deductible Health Plan will be available as an affordable alternative to the Open Access HMO. A Summary of Benefits and Coverage for each plan will be provided as a supplement to this booklet, available during the Open Enrollment period through the Explain My Benefits Enrollment portal.

� Open Access HMO� High Deductible Health Plan (HDHP)

The Open Access HMO plan has a higher premium than the HDHP. The HMO also has a lower annual deductible and fixed costs for some services which means less risk, so one of the biggest things to review when considering the HMO is your tolerance for risk! Other things to consider include the premium cost per month, your out-of-pocket maximum, and whether your provider is *in-network.

The HDHP is an affordable coverage alternative for retirees who have a greater tolerance for risk when it comes to paying the deductible earlier in the plan year. The HDHP can be very beneficial because savings are realized immediately. Other things to consider include your out-of-pocket maximum, the coinsurance amount, and whether your provider is in-network.

HDHP plan designs vary by employer, but the distinguishing feature is a higher annual deductible. The City of Tamarac offers an HDHP plan with a $1,500.00 individual deductible. The average HDHP deductible in the United States is about $2,350.00, but many plans have individual deductibles which exceed $3,000.00.

Both the HMO and the HDHP plans allow members the freedom to seek care from any in-network provider or facility without a referral. In addition, HDHP members may also choose to seek care outside the network, without a referral, but with a higher deductible and out-of-network expense. If you choose a higher cost out-of-network provider, you may be responsible for filing your own claims and requesting any necessary reviews.

All of the Cigna health plans cover annual routine eye exams and each have a three-tier prescription drug benefit: generic, preferred brand and non-preferred brand. Cigna’s Step Therapy, a prior authorization program, is incorporated in the plan for new prescriptions.

Before you enroll in a health plan, you will want to confirm what providers are participating in the plan’s network. The most up-to-date network directories are available from the Cigna website, www.cigna.com. Once you’re enrolled, you can search for a network provider by name, specialty or location at mycigna. com (registration required). This information is also available on the mycigna mobile app.

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Open Enrollment Period November 8, 2019, through November 22, 2019.

DEPENDENT ELIGIBILITYThe dependent eligibility criteria are the same for the City of Tamarac Cigna health and dental plans. In accordance with the respective plan documents, eligible dependents are:

� Your legal spouse, and

� Any child of yours (including natural, foster, step, legally adopted children, proposed adoptive children,a child under court order) 26 years of age and under;

� Any child of yours 26 years or older, unmarried and supported by you and incapable of self-sustainingemployment by reason of mental or physical disability which arose while the child was covered by youas a dependent under this Plan or a prior plan with no break in coverage.

Documentation verifying eligibility of dependents must be submitted to Human Resources when enrolling dependents in the health and/or dental plans. Examples of the types of documents you may be required to submit include, but are not limited to, the following:

� Marriage certificate

� Birth certificate

� Court-approved adoption papers

� Court-awarded legal guardianship/custody papers

� Evidence of disability

� Most recent tax return (page 1 only) w/financial and complete SSN’s redacted.

Extended healthcare coverage for 26 to 30-year-old adult children: City of Tamarac retirees can obtain healthcare coverage for their 26 to 30-year-old adult children who do not have health insurance coverage. This provision complies with the State of Florida Statute 627.6562 and is not applicable to the City’s dental plan. To be eligible for extended coverage, a dependent must satisfy the following:

� Child is unmarried and does not have dependents of his or her own.

� Is a resident of Florida or a student.

� Is not eligible for Medicare and is not covered under another group or individual health plan.

An retiree's adult child who chooses to continue health plan coverage under this provision must pay the full single premium rate for that coverage. Interested employees must complete and submit an Affidavit to the City’s Human Resources Department no later than Friday, December 6, 2019.

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Open Enrollment Period November 8, 2019, through November 22, 2019.

HEALTH BENEFIT SUMMARY2020 CIGNA Health Benefit Summary

Open Access HMO High Deductible Health PlanBenefits Highlights In Network Only In Network Out of NetworkDeductibleSingle $300 $1,500 $3,000Family $600 $3,000 $6,000Coinsurance $0 10% 30%Out-of-Pocket LimitSingle $2,000 $3,000 $6,000Family $4,000 $6,000 $12,000Lifetime Maximum Unlimited UnlimitedPhysician Services Open Access Open AccessPCP Office Visits $25 10% after deductible 30% after deductibleSpecialist Visits $40 10% after deductible 30% after deductiblePreventive CareWell Child Care $0 $0 30% after deductibleRoutine Adult Physical Exam $0 $0 30% after deductibleWell Woman/GYN Exam $0 $0 30% after deductibleHospital Services (includes Mental Health & Substance Abuse)

Inpatient $400 per admission after deductible 10% after deductible 30% after deductible

Outpatient Surgery $150n per visit after deductible 10% after deductible 30% after deductible

Emergency ServicesEmergency Room $300 10% 10%Urgent Care Center $75 10% 10%Convenience Care Clinic $25 10% n/aTelehealth $25 10% n/aOther Health Care Facilities/ServicesAdvanced Radiology Imaging $0 10% after deductible 30% after deductibleVision BenefitExam $25 every 12 monthsPrescription DrugsRetail - 30 day supplyGeneric $10 $10 copayPreferred Brand $35 $35 copay Non-Preferred Brand $65 $65 copay Mail Order - 90 day supply 2.5x copay 2.5x copay

Note: This benefit summary of your coverage is for illustration purposes only.

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CIGNA High Deductible Health Plan

Coverage Tier Total Per MonthSingle Coverage $588.15Retiree+Spouse $1,506.64Retiree+Child(ren) $1,306.10Family $1,640.83

CIGNA Open Access HMOSingle Coverage $639.29Retiree+Spouse $1,637.65Retiree+Child(ren) $1,419.67Family $1,783.51

HEALTH BENEFIT PREMIUM 2020 CIGNA Health Benefit Premium

DENTAL PLAN OPTIONSThe City offers two separate dental insurance programs with Cigna, a traditional Dental HMO and a Dental PPO.

� The Dental HMO Plan provides in-network benefits only. Enrolled members pre-select a networkgeneral dentist to manage your overall dental care. Under this Plan, you won’t be covered if you go toa dentist who is not in the network. The plan is structured with defined co-payments and there are no annual maximums and no deductibles. Each family member can choose their own dentist. Referrals are required for specialty care services with the exceptions of pediatric dentists for children under age 7, orthodontics and endodontics.

� The Dental PPO Plan allows members to visit any licensed dentist or dental specialist – however, outof pocket costs are lower when you go to a participating dentist. The plan is structured with definedcalendar year deductibles and annual maximum benefits.

Members are not allowed to switch between these plans during the plan year.

Through their Dental Oral Health Integration Program, Cigna dental plans provide enhanced dental coverage for dental plan participants with certain medical conditions.

As recommended with the health plan options, when trying to select a dental plan, look at the whole cost for the plan — the amount you pay from your paycheck and the amount you’re likely to pay out-of-pocket. Compare the deductibles, annual out-of-pocket maximums and co-pays. Before you enroll in a dental plan, you will also want to see which dentists are participating in the plan’s network.

The most up-to-date network directories are available from the Cigna website. Until you are enrolled and registered, you may locate network providers by following these steps:

� Go to cigna.com, click on “Find a Doctor, Dentist or Facility” at the top of the screen.

� Then, choose a Directory by clicking on the “Plans through Your Employer or School” option.

� Next, click on “Find a…Dentist.”� Enter SEARCH LOCATION – city, state or zip code.

� SELECT A PLAN by clicking on the drop down icon and choosing:

� “Cigna Dental Care Access (formerly Cigna Dental Care HMO)” for the Dental HMO network.Then press choose. Look for the dentists that state “In-Network”, or� “Cigna DPPO Advantage/Cigna DPPO” for the Dental PPO network. Then press choose.

� If you want to narrow your search, you can also type in key words, like dentist name, specialist type ofoffice name. Then, click “Search.”� From the Search Results page, you can further refine your search results – by distance, specialty,years in practice and additional languages

� Click on a dentist’s name for more details, including multiple location listings with map view.

� Once you’re enrolled, you can search for a network dentist by name, specialty or location atmycigna.com (registration required). This information is also available on the mycigna mobile app.

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DENTAL INSURANCE2020 CIGNA Dental Benefit Summary

Dentall HMO Dental PPOBenefits In Network Only In Network Out of NetworkDeductibleSingle None $50 $100

Family None$150

(Waived for Preventative)

$300 (Waived for

Preventative)Annual Maximum Benefit N/A $2,000 $1,000Office Visit Co-pay Observation $3 N/A N/APreventive Services Member PaysOral Exam / 0120 $0Bitewing X-rays / 0210 $0X-rays Intraoral complete / 0330 $0 0% 20%Cleaning / 1110 $0Fluoride Treatment / 1206 $0Basic ServicesAmalgam Restoration / 2150 $0Resin Restoration / 2331 $0Root Canal Treatment / 3330 $195 20% 50%Surgical Extraction / 7240 $80Major Restorative ServicesCrowns / 2750 $130Partial / 5214 $140 40% 50%Upper Denture / 5110 $135Orthodontic ServicesAdult / 8670 $1,728 50%

No Ortho Deductible$1,000 Lifetime maximum,

Dependent children only, up to age 19Child / 8670 $1,224

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Dental HMO Total Cost Per Month

Retiree $17.31Retiree+1 $30.30Retiree+2 or more $47.61

Dental Premium Effective January 1, 2020Cigna Dental HMO

Retiree $38.20Retiree+1 $77.06Retiree+2 or more $129.45

Cigna Dental PPO

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IMPORTANT CONTACTS

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City of Tamarac

Joshua Appelt, Benefits Manager

Email: Joshua.Appelt@Tamarac.org

Phone: 954-597-3608

Nancy Rivera, Human Resources Technician

Email: Nancy.Rivera@Tamarac.org

Phone: 954-597-3616

Sadhana Swaroop, HR Support Specialist II

Email: Sadhana.Swaroop@Tamarac.org

Phone: 954-597-3603

MedicalCigna

Customer service: 800-244-6224 Website: www.mycigna.com

DentalCigna

Customer service: 800-244-6224 Website: www.mycigna.com

VisionCigna

Customer service: 877-478-7557

Website: www.mycigna.com

Cigna

Customer service: 877-622-4327 Website: www.mycigna.com

EMB has developed a guide to help users through the process of updating their user account to comply with the site’s enhanced security measures. Additionally, EMB has prepared an instructional video providing a step-by-step overview of the process available online at www.explainmybenefits.com/mfa/.

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TIPS FOR CONTROLLING COSTSWhile we can’t tell you exactly which health or dental care plan to choose, we can offer these tips to help keep your medical costs down.

� When purchasing prescription drugs, ask your doctor to prescribe generics instead of brand namedrugs. Also, if you need more than a month’s supply, order a 3-month supply via mail order or online.

� Another way to save on prescription drugs is to check out local pharmacy retailers for their “discountprescription lists”, for example: the Wal-Mart $4 Drug Program or the Publix Free Medication Program.

� Avoid emergency room visits for situations that can be handled through your Primary Care Provider, aparticipating Urgent Care Center/Convenience Care Clinic or Cigna’s Telehealth Connection.

� Always make sure that your current doctor, dentist and other ancillary service providers are“in network” in your plan.

� Carefully review your Explanation of Benefit (EOB) statements for services and report anyinconsistencies to the respective provider and insurance carrier.

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LEGAL NOTICESDetailed information on these notices is located on the City’s new online benefit enrollment portal at: www.explainmybenefits.com/tamarac or by contacting the Human Resources Department at 954-597-3618.

CONTINUATION OF COVERAGE NOTIFICATION – COBRAThe Federal Consolidated Omnibus Budget Reconciliation Act (COBRA) gives you the right to choose continuation of insurance coverage under certain health plans if you and/or your eligible dependents lose coverage under the plan(s). You may continue eligible coverage for up to 18, 29 or 36 months, depending on the situation and who is being covered. Within a couple of weeks of the loss of coverage, you will receive a separate COBRA notification from the City’s Human Resources Department explaining these rights.

If you think you or your dependents’ health care coverage will end because an event is occurring causing ineligibility under the plan(s), there are certain things you must do to continue coverage under COBRA. In some cases, you must notify the City of the event. If COBRA is an option for you, you must make an election and pay for coverage within certain time periods to continue the coverage.

If eligible, the City will notify you and your dependents of your right to continue healthcare coverage under COBRA. This notification will explain in detail how COBRA works. If you die, the City will notify your dependents of their right to continue health care coverage under COBRA. This notification will explain in detail how COBRA works.

If you divorce or legally separate or your child loses dependent status under an eligible plan, you or your covered dependents are responsible for notifying the City within 30 days from the date of these events. The City’s Human Resources Department will then notify your dependents of their right to continue coverage under COBRA. This notification will explain in detail how COBRA works. COBRA rights will be forfeited if the City is not notified within 30 days of the qualifying event.

SPECIAL ENROLLMENT NOTICEIf you are declining enrollment for yourself or your dependents (including your spouse) because of other health insurance or group health plan coverage, you may be able to enroll yourself or your dependents in this plan if you or your dependents lose eligibility for that other coverage (or if the employer stops contributing towards your or your dependents’ other coverage). However, you must request enrollment within 30 days after your or your dependents’ other coverage ends (or after the employer stops contributing toward the other coverage).

In addition, if you have a new dependent as result of marriage, birth, adoption, or placement for adoption, you may be able to enroll yourself and your dependents. However, you must request enrollment within 30 days after the marriage, birth, adoption, or placement for adoption.

Special enrollment rights also may exist in the following circumstances:

� If you or your dependents experience a loss ofeligibility for Medicaid or a state Children’s HealthInsurance Program (CHIP) coverage and you request enrollment within 60 days after that coverage ends; or

� If you or your dependents become eligible for a statepremium assistance subsidy through Medicaid or astate CHIP with respect to coverage under this plan and you request enrollment within 60 days after the determination of eligibility for such assistance.

Note: The 60-day period for requesting enrollment applies only in these last two listed circumstances relating to Medicaid and state CHIP. As described above, a 30-day period applies to most special enrollments.

To request special enrollment or obtain more information, contact: Jjoshua Appelt, Benefits Manager at 954-597-3608 or joshua.appelt@tamarac.org.

MEDICARE PART D CREDITABLE COVERAGEThe Medicare Prescription Drug, Improvement and Modernization Act of 2003 (MMA) added a new prescription drug program to Medicare effective January

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1, 2006. (See Part D of Title XVIII of the Social Security Act (Act), referred to here as “Part D” of Medicare.)

Eligible members can join a Medicare Prescription Drug Plan or join a Medicare Advantage Plan (like an HMO or PPO) that offers prescription drug coverage. All Medicare drug plans provide at least a standard level of coverage set by Medicare. Some plans may also offer more coverage for a higher monthly premium.

There are two important things you need to know about your current coverage and Medicare’s prescription drug coverage:1. Medicare prescription drug coverage became

available in 2006 to everyone with Medicare. You canget this coverage if you join a Medicare PrescriptionDrug Plan or join a Medicare Advantage Plan(like an HMO or PPO) that offers prescription drugcoverage. All Medicare drug plans provide at least astandard level of coverage set by Medicare. Someplans may also offer more coverage for a highermonthly premium.

2. The City of Tamarac has determined that theprescription drug coverage offered by the City ofTamarac Health Plan is, on average for all planparticipants, expected to pay out as much asstandard Medicare prescription drug coverage paysand is therefore considered Creditable Coverage.Because your existing coverage is CreditableCoverage, you can keep this coverage and not pay ahigher premium (a penalty) if you later decide to joina Medicare drug plan.

Eligible participants can join a Medicare drug plan when they first become eligible for Medicare and each year from October 15 through December 31. However, upon loss of coverage under the City’s plan due to termination or retirement; participants are eligible to join a Part D plan at that time using an Employer Group Special Enrollment Period.

Contact the City’s Human Resources Department at 954-597-3618 for further information. Eligible employeesand dependents will receive a notice each year inNovember, or sooner, if this coverage through the City ofTamarac changes. For more information about Medicareprescription drug coverage, visit medicare.gov.

AVAILABILITY OF NOTICES OF PRIVACY PRACTICESThe City of Tamarac is committed to the privacy of your health information. The administrators of the City’s Cigna Health, Dental, Vision and Flexible Spending Account Plans (the “Plans”) use strict privacy standards to protect your health information from unauthorized use or disclosure.

The Plans’ policies protecting your privacy rights and your rights under the law are described in the respective Plans’ Notice of Privacy Practices. You may receive a copy of the Notice of Privacy Practices by contacting the City’s Human Resources Department at 954-597-3618.

WOMEN’S HEALTH AND CANCER RIGHTS ACT (WHCRA) NOTICESpecial Rights Following Mastectomy. A group health plan generally must, under federal law, make certain benefits available to participants who have undergone a mastectomy. In particular, a plan must offer mastectomy patients benefits for:

� Reconstruction of the breast on which themastectomy has been performed

� Surgery and reconstruction of the other breast toproduce a symmetrical appearance

� Prostheses � Treatment of physical complications of mastectomy

Our Plan complies with these requirements. Benefits for these items generally are comparable to those provided under our Plan for similar types of medical services and supplies. Of course, the extent to which any of these items is appropriate following mastectomy is a matter to be determined by consultation between the attending physician and the patient. Our Plan neither imposes penalties (for example, reducing or limiting reimbursements) nor provides incentives to induce attending providers to provide care inconsistent with these requirements.

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NOTES

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The descriptions of the benefits are not guarantees of current or future employment or benefits. If there is any conflict between this guide and the official plan documents, the official documents will govern.

www.tamarac.org Benefits Guide 2020 www.tamarac.org

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