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HomeMy WebLinkAbout2024 Benefit Book CITY OF TWIN ---- ��I wlN FALLS l; _ City of Twin Falls t� -� - ICI r ,a.`.' F_ ----= c - r i d YOUR HEALTH I YOUR FAMILY I YOUR LIFE Benefit Plan Information / Reminders - - - - - - - - - - - - - - - - - - - - - - - - - Medical: ■ Out of state - PPO wrap network: United Health Care. You may access care outside Idaho, Nevada, and Utah using this network. (Refer to ID card) ■ Intermountain Connect Care is covered 100% after deductible. ■ Virtual Visits for Primary Care Providers is covered 100% after deductible. Reminders: ■ Deductible and Out of Pocket Maximum reset effective 10/1. They are based on plan year,not calendar year. ■ The City of Twin Falls will continue to contribute $1,000 to the Health Savings Accounts (HSA) for those enrolled in the City's health plan. ■ Specific preventive drugs are covered before the deductible with small copay. ■ SelectHealth Wellness Rewards program is included.You can earn up to $240 per person or $580 per family. ($240 for employee; $240 for dependent; & additional$1 00 for 3rd dependent.) ■ Voluntary offerings: • Long Term Care • Supplemental - Short Term Disability, Accident/ Critical Illness / Hospital Indemnity Medical Bridge • Pet Insurance ■ Benefit Spot mobile application is included. Login: TFCity2020 ■ Legal documents and notices are included on your group's intranet. Important Note:The material in this benefits brochure is for informational purposes only and is neither an offer of coverage or medical or legal advice.It contains only a partial description of plan or program benefits and does not constitute a contract.Please refer to the Summary Plan Description(SPD)for complete plan details.In case of a conflict between your plan documents and this information,the plan documents will always govern.Annual Notices:ERISA and various other state and federal laws require that employers provide disclosure and 2 Welcome Inside Your benefits are an important part of your overall Page 4 compensation. We are pleased to offer a comprehensive array of valuable benefits to protect Cost of = Page 5 your health, your family and your way of life. This guide answers some of the basic questions you may have Medical Plan - Page 10 about your benefits. Employee . . Open Enrollment Dates: August 5, 2024 to September 13, 2024 PVoluntary Vision - age 16 On an annual basis, even if declining coverage, all employees must complete benefit election Life and Page changes, including additions and deletions of Choose Carefully family members and return forms to payroll by Long Term Disability- Page 27 September 1, 2024. Due to IRS regulations, you cannot change your elections until the next annual Open Enrollment period, unless you have a qualified life event during Eligibility the year. Following are examples of the Page You are eligible for benefits if you are a most common qualified life events: regularly scheduled employee working 20 or Marriage or divorce Term Care - Page 31 more hours per week.You may also enroll your ■ Birth or adoption of a child ' eligible family members under certain plans you ■ Child reaching the maximum choose for yourself. Eligible family members age limit include: Page ■ Death of a spouse, or child ■ Your legally married spouse ■ A loss of coverage ■ Your children who are your biological N Open enrollment of a spouse children, stepchildren, adopted children or children for whom you have legal You gain access state coverage custody(age restrictions may apply). under Medicaid orr CHIP Disabled children age 26 or older who meet certain criteria may continue on your health coverage. Making Changes To make changes to your benefit elections,you must contact Human Resources within 30 days of the qualified life event(including newborns). Be prepared to show documentation of the event such as a marriage license, birth certificate or a divorce decree. If changes are not submitted on time,you must wait until the next Open Enrollment period to make your election changes. 3 contact Qnformatrn i Medical Select Health G1017524 800-538-5038 selecthealth.org Delta Dental 3135 888-333-3582 deltadentalid.com Dental Willamette Dental ID310 855-433-6825 willamettedental.com Voluntary Vision VSP 30042591 800-877-7195 vsp.com Life Insurance and Accidental Death & Standard 4859088 800-628-8600 standard.com Dismemberment Long Term Disability Employee Assistance Program BPA 800-726-0003 bpahealth.com Voluntary Accident, Individual plan Cancer, Critical Illness, Colonial numbers for 800-325-4368 coloniallife.com Short Term Disability employees Voluntary Pet Insurance Pet's Best 1037065566 888-984-8700 petsbest.com/CTFPETS Voluntary Life Insurance NCPERS 800-525-8056 NCPERS@healthsmart.com Flexible Spending Account & Health Savings Account HealthEquity 866-346-5800 healthequity.com Administration Voluntary Long Term Care LTC Solutions, Inc. 02467V 877-286-2852 LTCiBenefitsTeam@ Itc-solutions.com - - - - - - - - - - - - - - - - - - - - - - - - Questions? If you have additional questions, you may contact: Toni Price, Broker 208-737-6438 toni.price@hubinternational.com Christee Nelson,Account Manager 208-737-6428 christee.nelson@hubinternational.com Gretchen Scott,Assistant City Manager 208-735-7251 gscott@tfid.org Kristen Kohntopp, Human Resources 208-735-7328 kkohntopp@tfid.org 4 City of Twin Falls 10.1.2024 BI-WEEKLY FIGURES High Deductible Health Plan Option (HDHP) Employee Cost Option 1 Employee Cost Option 2 Employee Contribution Non- Net Employee Biweekly Net Employee Biweekly NO Nicotine Nicotine Contribution Contribution Use Total Monthly Health Premium Incentive Employee $783 $12.50 ($12.50) $0.00 $18.00 Employee+1 $1,163 $55.00 ($12.50) $44.00 $56.50 Employee+2 $1,384 $72.50 ($12.50) $62.00 $74.50 Employee&Spouse $1,705 $97.50 ($12.50) $87.50 $100.00 Family $2,173 $130.00 ($12.50) $121.00 $133.50 MONTHLY FIGURES High Deductible Health Plan Option (HDHP) Employee Cost Option 1 Employee Cost Option 2 Employee Contribution Non Net Employee Monthly Net Employee Monthly NO Nicotine Nicotine Contribution Contribution Use Total Monthly Health Premium Incentive Employee $783 $25.00 ($25) $0.00 $36.00 Employee+1 $1,163 $113.00 ($25) $88.00 $113.00 Employee+2 $1,384 $149.00 ($25) $124.00 $149.00 Employee&Spouse $1,705 $200.00 ($25) $175.00 $200.00 Family 1 $2,173 $267.00 ($25) $242.00 $267.00 1. Non-Nicotine Use Incentive -No nicotine use for either the employee or covered spouse, monthly premium is reduced by$25. 5 Dental and Vision Costs: Delta Dental of Idaho: 1 tip 'on 1 2024-2025 Rates Bi-Weekly Monthly Employee Only $40.00 City Paid City Paid Employee/Spouse $89.00 $24.50 $49.00 Employee/Child $89.00 $24.50 $49.00 Employee/2+Children $135.00 $47.50 $95.00 Employee/Spouse/Child(ren) $135.00 $47.50 $95.00 Willamette Dental Group:Option 2 2024-2025 Rates Bi-Weekly Monthly Employee Only $47.00 $3.50 $7.00 Employee/Spouse $112.00 $36.00 $72.00 Employee/Child $112.00 $36.00 $72.00 Employee/2+Children $171.00 $65.50 $131.00 Employee/Spouse/Child(ren) $171.00 $65.50 $131.00 ----------------------------------------------------------------- Voluntary Vision: VSP Standard Option Voluntary Vision:VSP Easy 0113tion Bi-Weekly Monthly Bi-Weekly Monthly Employee Only $5.50 $11.00 Employee Only $7.00 $14.00 Employee/Spouse $7.50 $15.00 Employee/Spouse $10.00 $20.00 Employee/Child $7.50 $15.00 Employee/Child $10.00 $20.00 Employee/2+Children $13.50 $27.00 Employee/2+Children $17.50 $35.00 Employee/Spouse/Child(ren) $13.50 $27.00 Employee/Spouse/Child(ren) $17.50 $35.00 Rates are effective October 1,2024 thmugh September 30,2025 Forms must be completed electronically through Laserfiche Forms please follow this link:https://forms.tfid.org/Forms/ BenefitandlnsuranceEnrollment 6 FAr. US City of Twin Falls N Plan Date: October 1, 2024 - September 30,2025 ° Medical deductible & out of pocket maximum reset annually effective October 1st - - - - - - - - - - - - - - - - - - - - - - - - SelectHealth - Medical — High Deductible Health Plan ($1,000 HSA contribution paid by the City) Individual Deductible: $2,500 In Network/$2,750 Out of Network Family Deductible: $5,000 In Network/ $5,500 Out of Network (2 or more) Out of Pocket Maximum Individual: $4,000 In Network/ $5,500 Out of Network Out of Pocket Maximum Family: $8,000 In Network/$11,000 Out of Network Coinsurance: 80% In Network/ 60% Out of Network (Non-Embedded deductible&OutofPocket Maximum-must meet family deductible if two or more are enrolled. Delta Dental of Idaho- Dental Option 1 (Employee cost is paid by the City) Deductible: $50 Individual/$150 Family Willamette Dental Group - Dental Option 2 (A portion of cost is paid by the City) Office Visit:$20 Copay, Preventive: $20 Copay, Fillings: $25 Copay, Routine Extractions: $25 Copay VSP -Voluntary Vision (2 plan options to choose from — Choice & Easy Options) Annual exam every 12 months: $20 Copay/ Frames/Lenses/Contacts—every 12 months Group Life Insurance and Accidental Death & Dismemberment- Standard (Paid by City) $25,000 Employee Life $25,000 Employee Accidental Death & Dismemberment $1,000 Spouse and Child Life (age reduction: 35% at age 65, reduces 50% at age 70, and 65% at age 75) Long-Term Disability - Standard (Paid by City) 60% of the first$10,000 of monthly pre-disability earnings; $6,000 maximum 180-day elimination period Payable to 65+ Employee Assistance Program (EAP) - Business Psychology Associates (Paid by City) Up to 6 sessions per incident per program year Voluntary Short-Term Disability/Accident/Cancer/Critical Illness/Hospital Indemnity — Colonial Life Voluntary Long-Term Care - LTC Solutions, Inc. Voluntary Pet Insurance - Pet's Best Voluntary Life Insurance - NCPERS (Refer to attached outline of benefits) 7 City of Twin Falls Qualified High Deductible Health Plan (HDHP) with Health Savings Account (HSA) (7/22/24) 2024 IRS HSA maximum contribution amounts:Individual$4,150; Family$8,300 20251RS HSA maximum contribution amounts:Individual$4,300; Family$8,550 High Deductible Health Plan specifics: • Employees receive $1,000 contribution to their HSA account paid by the City. It is up to the employee to notify the City HR department if they don't qualify for HSA contributions. Employee may also contribute income tax-free up to IRS maximum amount shown above. • You must meet the deductible before the health plan will pay. Exceptions: preventive care and medications mentioned below. • If you are enrolled with 2 or more on the plan, the family deductible must be met first before the health plan pays (same exceptions as mentioned above) • Copays for doctor visits are eliminated. You pay cost for visit until deductible is met. • Copays for prescriptions are eliminated. You pay cost for the prescription until deductible is met. Exception: Medications in one of the following categories:Asthma & COPD, Cardiovascular Antiadrenergic, Cardiovascular, Cholesterol, Diabetes-Insulin, Diabetes Non-Insulin, Mental Health, and Osteoporosis. Refer to SelectHealth `Deductible Waived' list. Copays included: $7/$21/$42/$100 Flexible Spending Account(FSA)/ Limited FSA: • You (or anyone else) are not eligible to contribute to an HSA account if you have funds in a health FSA. The IRS allows one or the other. • Exception: you may enroll in a `Limited FSA for vision and dental expenses' up to $2,600 and `Dependent Care FSA'. Your HSA account may also be used to pay for dental and vision expenses. The limited FSA allows for additional tax-free money to be set aside for dental and vision expenses including orthodontia and Lasik. • If you plan to open an HSA account, use FSA money ASAP by 12/31 and do not re-enroll in the FSA medical plan. If money is remaining in your FSA account after 12/31, you are considered re- enrolled. 8 High Deductible Health Plan specifics (continued): • HealthEquity is the administrator that oversees the HSA accounts for employees. The employee authorizes the account to be opened in their own name. • IRS rules state that HSA's can only be funded when an employee is enrolled in a qualified high deductible health plan. You are not eligible to contribute to an HSA if you are enrolled on a non- HDHP (traditional type plan say with your spouse or parents). • Employer and employee may contribute to the HSA up to the total individual or family amount per year. The IRS determines the annual amounts, and they typically increase annually. • Money in the HSA account may be used by the employee to help meet their medical or dental deductibles; vision copays; office visit copays and to help pay for`qualified' medical/dental/vision expenses. • Money in the employee's HSA account is owned by employee and goes with employee if they leave employment at group. • Money in an HSA account carries forward from year to year. (Unlike the FSA— use it or lose it.) • Contributions that the employee chooses to make are made pre-tax from the employee's pay. • You can use HSA funds for all family member expenses whether they are covered under the HDHP or not. • You can contribute the family amount if there are 2 or more individuals enrolled on the HDHP. • Money in an HSA grows tax-deferred and is withdrawn tax-free if money is used for a `qualified' medical expense. (Qualified expenses list may be found on the IRS website.) • Money may also earn interest as the funds in the HSA account grows. You may also invest your money. • Employee can make a one-time transfer from IRA to HSA subject to specific limit (as of 2008). • There is a $1,000 per year`catch up' amount allowed at age 55 and older. • Employee may also use the money in the HSA account to pay COBRA insurance premiums. Long term care insurance premium (subject to IRS mandated limits based on age and adjust annually); Long term care services and decisions; Health care coverage while receiving unemployment compensation under federal or state low; Medicare and other health care coverage if you were 65 or older (other than premiums for a Medicare supplemental policy, such as Medigap.) • HDHP medical plans help individuals become better consumers as it makes us more responsible for medical care purchases and medical decisions. We learn to shop for our care and needs like we do when purchasing a car or other major purchases. • You are unable to use HSA funds to pay for dependent child or adult care. • You cannot contribute new funds to an HSA savings account if you are enrolled in Medicare. If you had HSA prior to age 65 and Medicare, you could keep and use the money, but no new contributions can be made to the HSA account. • If employee is enrolled on HDHP and spouse is on Medicare, employee can add spouse to HDHP and contribute the family amount. (Spouse can't open HSA account.) • IRS rules state you are unable to contribute to an HSA if you are claimed as dependent on someone else's taxes. • Keep receipts for expenses in case you are audited by the IRS. • Mistaken distributions can be returned to HSA account. • If death occurs, the spouse becomes owner of the HSA account. If spouse is not beneficiary, the money in the account will become taxable to the dependent. 9 CITY OF 11 1 Select MEMBER PAYMENT SUMMARY Health IN-NETWORK OUT-OF-NETWORK S E L E C T H EALT H NETWORK/ H SA QUALIFIED When using In-Network Providers,you are responsible When using Out-of-Network Providers,you are to pay the amounts in this column. responsible to pay the amounts in this column. MEDICAL DEDUCTIBLE AND MEDICAL OUT-OF-POCKET"6 IN-NETWORK OUT-OF-NETWORK Self Only Coverage,1 person enrolled-per plan Year Deductible $2,500 $2,750 Out-of-Pocket Maximum $4,000 $5,500 Family Coverage,2 or more enrolled-per plan Year Deductible $5,000 $5,500 Out-of-Pocket Maximum $8,000 $11,000 (Medical and Pharmacy Included in the Out-of-Pocket Maximum) IN-NETWORKINPATIENT SERVICES OUT-OF-NETWORK Medical,Surgical and Hospice 20%after Deductible 40%after Deductible Skilled Nursing Facility4-Up to 60 days per plan Year 20%after Deductible 40%after Deductible Inpatient Rehab Therapy:Physical,Speech,Occupational 20%after Deductible 40%after Deductible Up to 40 days per plan Year for all therapy types combined Physician's Fees-(Medical,Surgical,Maternity,Anesthesia) 20%after Deductible 40%after Deductible PROFESSIONAL SERVICES IN-NETWORK OUT-OF-NETWORK Office Visits&Minor Office Surgeries Primary Care Provider(PCP)1 $15 after Deductible 40%after Deductible Primary Care Provider(PCP)Virtual Visitsl Covered 100%after Deductible 40%after Deductible Specialist/Secondary Care Provider(SCP)1 $25 after Deductible 40%after Deductible Allergy Tests See Office Visits Above 50%after Deductible Allergy Treatment and Serum 20%after Deductible 50%after Deductible Major Surgery 20%after Deductible 40%after Deductible Physician's Fees-(Medical,Surgical,Maternity,Anesthesia) 20%after Deductible 40%after Deductible PREVENTIVE SERVICES AS OUTLINED • ' Primary Care Provider(PCP)I Covered 100% 50%after Deductible Specialist/Secondary Care Provider(SCP)1 Covered 100% 50%after Deductible Adult and Pediatric Immunizations Covered 100% 50%after Deductible Elective hmmunizations-herpes zoster(shingles),rotavirus Covered 100% 50%after Deductible Diagnostic Tests:Minor Covered 100% 50%after Deductible Other Preventive Services Covered 100% 50%after Deductible VISION • ' OUT-OF-NETWORK Preventive Eye Exams Covered 100% 50%after Deductible All Other Eye Exams $25 after Deductible 40%after Deductible • • ' • • ' Outpatient Facility and Ambulatory Surgical 20%after Deductible 40%after Deductible Ambulance(Air or Ground)-Emergencies Only 20%after Deductible See hi-Network Benefit Emergency Room $75 after Deductible See In-Network Benefit Urgent Care Facilities $35 after Deductible 40%after Deductible Intermountain Connect Carew Covered 100%after Deductible See Professional,Inpatient,Outpatient, or Miscellaneous Services Radiation 20%after Deductible 40%after Deductible Dialysis 20%after Deductible 40%after Deductible Diagnostic Tests:Minor Covered 100%after Deductible 40%after Deductible Diagnostic Tests:Major 20%after Deductible 40%after Deductible Home Health,Hospice,Outpatient Private Nurse 20%after Deductible 40%after Deductible Outpatient Cardiac Rehab Covered 100%after Deductible 40%after Deductible Outpatient Rehab/Habilitative Therapy:Physical,Speech,Occupational $25 after Deductible 40%after Deductible ID-MPS HDHP 01/01/24 See other side for additional benefits 10 CITY OF 11 1 Select MEMBER Health IN-NETWORK OUT-OF-NETWORK SELECTHEALTH NETWORK/ HSA QUALIFIED MISCELLANEOUSW• OUT-OF-NETWORK Durable Medical Equipment(DME)4 20%after Deductible 40%after Deductible Miscellaneous Medical Supplies(MMS)3 20%after Deductible 40%after Deductible Autism Spectrum Disorder See Professional,Inpatient,Outpatient,or See Professional,Inpatient,Outpatient,or Mental Health and Chemical Dependency Mental Health and Chemical Dependency Services Services Maternity4 See Professional,Inpatient or Outpatient 40%after Deductible Cochlear Implants,Hearing Aids,or Auditory Osseointegrated Devices2'4 See Professional,Inpatient or Outpatient 50%after Deductible One device every 36 months per ear. Up to 45 language/speech therapy visits during the 12 months after the delivery of the covered device. Infertility-Select Services 50%after Deductible 50%after Deductible TMJ(Temporomandibular Joint)Services-Up to$2,000 lifetime See Professional,Inpatient or Outpatient 50%after Deductible OPTIONAL BENEFITS IN-NETWORK OUT-OP-NETWORK Mental Health and Chemical Dependency (combined benefits) Office Visits $15 after Deductible 40%after Deductible Virtual Visits Covered 100%after Deductible 40%after Deductible Inpatient 20%after Deductible 40%after Deductible Outpatient 20%after Deductible 40%after Deductible Residential Treatment 20%after Deductible 40%after Deductible Chiropractic $30 after Deductible 40%after Deductible (up to 20 visits per plan Year) Injectable Drugs,Chemotherapy,and Specialty Medications 20%after Deductible 40%after Deductible Bariatric Surgery(Up to one surgery/lifetime)4 See Professional,Inpatient or Outpatient 40%after Deductible PRESCRIPTIONDRUGS Prescription Drug List(formulary) RxSelecte Prescription Drugs-Up to 30 Day Supply of Covered Medications 4 Tier 1 $7 after In-Network Deductible Tier 2 $21 after In-Network Deductible Tier 3 $42 after In-Network Deductible Tier 4 $100 after In-Network Deductible Maintenance Drugs-90 Day Supply(Mail-Order,Retail90*)-selected drugs 4 Tier 1 $7 after In-Network Deductible Tier 2 $42 after In-Network Deductible Tier 3 $126 after In-Network Deductible Deductible Waiver Certain prescription drugs are not subject to the Deductible Generic Substitution Required Generic required or must pay Copay plus cost difference between name brand and generic 1 Refer to selecthealth.org/findadoctor to identify whether a Provider is a primary or secondary care Provider. 2 Refer to your Certificate of Coverage for more information. 3 Frequency and/or quantity limitations apply to some Preventive care and MMS Services. 4 Preauthorization is required for certain Services.Benefits may be reduced or denied if you do not preauthorize certain Services with Out-of-Network Providers.Please refer to Section 11--"Healthcare Management",in your Certificate of Coverage,for details. 5 All Deductible/Copay/Coinsurance amounts are based on the Allowed Amount and not on billed charges.Out-of-Network Providers or Facilities may not accept the Allowed Amount for Covered Services.When this occurs,you may be responsible for Excess Charges. 6 Certain Services as noted on this document and in your Certificate of Coverage are not subject to the Deductible. All Covered Services obtained outside the United States,except for routine,Urgent,or Emergency conditions require preauthorization. To contact Member Services,call 800-538-5038 weekdays,from 7:00 a.m.to 8:00 p.m.,Saturdays,from 9:00 a.m.to 2:00 p.m. TTY users should call 711. Benefits are administered and underwritten by SelectHealth,Inc.sM(domiciled in Utah). ID-MPS HDHP 01/01/24 03/14/24 selecthealth.org 11 17 Deductible Waived - -� Drugs, Devices, J� and Tests What's covered? Some of our High Deductible Health Plans (HDHPs) provide coverage for maintenance medications, devices, and tests before you meet your deductible. Below we've listed the most commonly covered medication,device, and test categories.To find out if your plan includes this benefit,call Member Services. • Asthma and COPD • Cardiovascular • Cardiovascular Antiadrenergics • Cholesterol • Diabetes - Insulin • Diabetes - Non-Insulin • Diabetes -Testing Supplies • Anti-depressants • Osteoporosis a- Questions? Call Member Services at 800-538-5038. .,c ❑E . i 4 Intermountain Connect Care' Get started What's Connect Care? Download the Intermountain Connect Care app or visit Get primary care, mental health care, nutritional and lactation support, Connect Care and 24/7 urgent care from home with virtual doctor visits at no or low intermoconnecuntainhealthcare.org/ out-of-pocket cost to you.The typical wait time for urgent care is under 10 minutes, and you can save an average of$400 per visit compared with the emergency room*(ER). *For emergencies,call 911 or go to the ER. ti Commonly treated conditions: 0 _ • Stuffy and runny nose • Painful urination • Allergies • Lower back pain • Sore throat • Joint pain or strains • Eye infections • Minor skin problems • Cough �, '%% Oi " l Other virtual care options For virtual care outside of Connect Care,your doctor's office may use various apps or websites for virtual visits.Call Member Services for your plan-specific details. LargeIF-IR Select Employer Member •- Idaho 2024 • 1 08123 Health iry.i ••�7 'S. ACCESS YOUR BENEFITS ANYTIME, ANYWHERE -WITH Benefmp f T-11 _ Spot POWERED BY HUB INTERNATIONAL BIG NEWS... WE 'VE GONE MOBILE !, To help you access your benefits and HR information— WITH BENEFIT SPOT, even when you're away from work and need it most— YOU'LL BE ABLE TO: we've launched Benefit Spot! Call HR directly • Access your Benefits Guide DOWNLOADING THE APP IS EASY! SIMPLY: and basic plan information • Watch educational videos Q Search "Benefit Spot" on the Apple App Store • Look up carrier contact or Google Play or scan this QR code. information • Estimate costs for common Download the app to your smartphone or health care procedures using our cost comparison tools other mobile device. And more! Whenever you launch the app,TFCity202O to CITY OF U access our plan information. ❑ TWIN FALL NOTE:The company code is case sensitive. N i That's it—you're ready to go! Q .eta memo Quo 14 Employee Assistance Program Your Employee Assistance Program (EAP)is a well-being benefit that provides: • Free &Confidential Counseling • Personal Growth Support • Stress Management Assistance • Legal Assistance &Will Maker Programs • Financial Consultations & Calculators • Wide Range of Member Resources: Mental Health, _ • • Parenting, Eldercare Support, & more. - - • _ • • _ Accessing your benefits is easy,confidential,and no cost to you. You can start your counseling sessions in three easy • ways: Call,Text,or Go Online. 11 Call1-800-726-0003 EO Text 208-336-4275 oGo Online at: www.bpahealth.com/portal-login/ Next, you can browse Member Resources, locate a O preferred Provider, and access Virtual Counseling through the BetterHelp Login. • • Get started today at www.bpahealth.com 0 r0 Username: City of Twin Falls ri. ti is Password:8007260003 Number of sessions:6 . . _ - . : 99 off - • - deltadentalid.com d DELTA DENTIN,,%- Benefit Summary GENERAL BENEFIT PLAN SUMMARY City of Twin Falls Group Number: 3135 Contract Effective Date: 10/01/2024 Benefit Overview PPO Premier Non-Participating Per Person Deductible $50 $50 $50 Excluding Diagnostic and Preventive services per benefit year Family Deductible $150 $150 $150 Excluding Diagnostic and Preventive services per benefit year Maximum Benefit $1,000 $1,000 $1,000 Per eligible person per benefit year Maximum Benefit Rollover $3,050* $2,500* $0 Services You pay the % below Preventive & Diagnostic Services 0% 20% 20% Examinations, X-rays, teeth cleaning Basic Services 20% 30% 30% Fillings, root canals, extractions, oral surgery Major Services 50% 60% 60% Crowns, implants, onlays, bridges, dentures Late enrollee waiting period is 24 months PARTICIPATING AND NON-PARTICIPATING DENTISTS If the dentist is a network participating dentist, Delta Dental will base payment on the lesser of the Submitted Amount or the Contract Fee. Delta Dental will send payment to the participating dentist and the subscriber will be responsible for any co-payment and/or any non-covered services. If the dentist is a non-participating dentist, Delta Dental will base payment on the lesser of the Submitted Amount or Delta Dental's non-participating dentist Fee. It is the subscriber's responsibility to make full payment to the non-participating Dentist. For dental services rendered by an out-of-state dentist, Delta Dental will base payment on the lesser of the Submitted Amount or the Contract Fee in that area, if the out-of-state dentist is a participating dentist with a Delta Dental plan in the state in which the service is rendered. See back page for benefits and limitations Delta Dental of Idaho Customer Service 555 E Parkcenter Blvd (208) 489-3580 Boise, ID 83706 (800) 356-7586 DDI Ben Book 0318 16 d DELTA DENTAL deltadentalid.com Benefits and Limitations Class I Preventive and Diagnostic Services Periodic exam is allowed 2 times every benefit year. Single bitewing x-ray is allowed 1 time every 12 months from last date of service. Full mouth series or panoramic x-rays are allowed 1 time every 5 years from last date of service . Adult and child cleanings are allowed 2 times every benefit year (restricts against periodontal maintenance within the same time period). Fluoride treatment is allowed 1 time every 12 months from last date of service through age 18. Class II Basic Services Fillings restricted to same tooth/surface are allowed 1 time every 24 months . Periodontal surgeries per quadrant are allowed 1 time every 3 years from last date of service . Periodontal scaling and root planing-per quadrant is allowed 1 time every 24 months from last date of service. Periodontal maintenance procedure is allowed 1 time every 6 months from last date of service. Class III Major Restorative Services Porcelain, porcelain substrate, and cast restorations are not payable for children less than 12 years of age. Crowns, stainless steel crowns, onlays, or bridges on same tooth are allowed 1 time every 7 years from last date of service . Partials or dentures per arch are allowed 1 time every 7 years from last date of service for ages 16 and older. Implants Implants are a covered benefit per tooth (including crowns) with a maximum lifetime benefit of $900 or the plan's annual maximum, whichever is less. Ages 19 and over. Dependents Eligible children must be under age 26. GENERAL PLAN INFORMATION 1. Optional treatment: If the subscriber or eligible dependent selects a more expensive service than is customarily provided. For example, if teeth can be restored satisfactorily with amalgam or composite material, the cost of inlays, onlays and crowns are not covered and the cost difference between the covered and the non-covered procedure is to be borne by the patient. 2. Payment provisions: The following guidelines will be used to determine the date on which a service shall be paid: a. Full dentures or partial dentures: On the date the final impression is taken. Delta Dental of Idaho Customer Service 555 E Parkcenter Blvd (208) 489-3580 Boise, ID 83706 (800) 356-7586 DDI Ben Book 0318 17 �11.7 CITY OF TIVIN FALLS Willamette Fo Dental Group <e SeRv1NG DENTAL CARE INSURANCE TOGETHER AND SIMPLIFIED We believe dental insurance should be simple so we've eliminated ----------_)0[.----------- the guessing game.We blend preventive dental care with broad insurance coverage, making it affordable,with no annual maximum* or deductibles and predictable out of pocket costs. We practice evidence-based dentistry and partner with you to make ,' `♦ _ sure you have the knowledge you need to practice healthy habits �--`♦ Traditional ♦� ���- ',` and we don't recommend any unnecessary treatments. ♦ Dental t ♦ Insurance I� ♦ ♦ ♦� i ♦ ♦♦ , ♦♦ ♦ �,' ,♦ NEARLY 50 NORTHWEST LOCATIONS As a member,you'll have access to our top quality dental providers across our convenient dental offices. Learn more about our offices and 4.5 Average For All Offices providers at willamettedental.com,complete with unfiltered patient star 10i I c ratings and comments. HEALTH *Benefits for implant surgery have a benefit maximum,if covered. 18 CITY OF TWIN FALLS 49 Willamette Dental Group OA`e SFRvN'Q�OQ CONVENIENT PLAN FEATURES • No annual maximum', deductible or waiting periods with predictable out-of-pocket costs • Benefit coverage at all Willamette Dental Group locations • Extended hours: Monday — Friday 7am — 5:30pm and rotating Saturdays regionally • Easy appointment scheduling —just call 1.855.433.6825 • Emergency services available in-person in 48 hours or less and on-call 24/7 • All dental specialty services available, including orthodontics for all ages YOUR BENEFITS EFFECTIVE DATE: 10/1/2024 COVERED SERVICE BENEFIT Annual Maximum No Annual Maximum* Deductible No Deductible General &Ortho Office Visit You Pay$20 per Visit Diagnostic& Preventive Services Covered with Office Visit Copay Fillings You Pay a $25 Copay Porcelain-Metal Crown You Pay a $150 Copay** Complete Upper or Lower Denture You Pay a $300 Copay** Bridge(per Tooth) You Pay a $150 Copay** Root Canal Therapy—Anterior/Bicuspid/Molar You Pay$100/$125/$150 Copays Osseous Surgery(per Quadrant) You Pay a $150 Copay Root Planing (per Quadrant) You Pay a $65 Copay Routine Extraction (Single Tooth) You Pay a $25 Copay Surgical Extraction You Pay a $85 Copay Comprehensive Orthodontia Treatment You Pay a $2,000 Copay Dental Implant Surgery Benefit maximum of$1,500 per calendar year Nitrous Oxide You Pay a $40 Copay Specialty Office Visit You Pay a $30 Copay per Visit Out of Area Emergency Care Reimbursement You pay charges in excess of$100 *Benefits for implant surgery have a benefit maximum,if covered. **Dental implant-supported prosthetics(crowns,bridges,and dentures)are not a covered benefit. Underwritten by Willamette Dental of Idaho,Inc. Please refer to your Certificate of Coverage for limitations and exclusions. QUESTIONS? Contact our Member Services team via email at memberservices@willamettedental.com or by phone at 1.855.433.6825. 019-ID(10/21) 19 Idaho Provider List Willamette .- . . For Appointments or Customer Service, please call 1.855.433.6825. Boise Twin Falls 607 N Mitchell St Boise, ID 83704 452 Cheney Drive West, Suite 150 Mervin Young, DDS Twin Falls, ID 83301 Randell Terry, DMD Jared K Rowberry, DMD Jon Ryan T Miler, DDS, OS, Orthodontist Nate Peterson, DDS Kelley Dunay, DMD, Orthodontist Coeur d'Alene 943 West Ironwood Drive, Suite 200 Idaho Falls Coeur d'Alene, ID 83814 2860 Valencia Drive, Suite 100 Hannah Ingram, DDS Idaho Falls, ID 83404 Daniel Shaw, DDS Mark Chambers, DDS Andrew Reichert, DDS Trent Buehler, DMD Lana Nysse, DDS MSD, Orthodontist Dwight D. Baker, DDS, Orthodontist Meridian Nampa 1075 S Wells Street 16145 N High Desert St. Meridian, ID 83642 Nampa, ID 83687 Jeremy Draper, DMD Terry Taylor, DMD David Seegmiller, DDS Benjamin Armstrong, DDS Wesley Brimhall, DMD Troy Smith DDS, Orthodontist Daniel B Jenks, DDS, Endodontist Jeremy Hixson, DMD, Oral Surgeon Visit us on the web at www.WillametteDental.com Rev 3.29.2023 *This provider list is subject to change at any time 20 Vsp vision care 21 VSP. vision care VSP Choice with EasvOptions (Easy Options Not Available at Costco, VSP Choice Walmart or Sam's Club). With so many in-network choices,VSP makes it easy to get the most out of your benefits.You'll have access to preferred private practice,retail,and online in-network choices.Log in to vsp.com to find an in-network provider. Your plan provides the following out-of-network reimbursements: Exam.................................................up to$45 Lined Bifocal Lenses..............................................up to$50 Progressive Lenses...............................up to$50 Frame................................................up to$70 Lined Trifocal Lenses.............................................up to$65 Contacts....................................................up to$105 Single Vision Lenses....................up to$30 22 Enjoy . • Beyond 0 Your • Benefits ! VSPexclusive . membe extras Take advantage of Exclusive Member Extras for you and the whole family! Get access to more than $3,000 in savings from VSP and other popular brands. Offers shown below are available at all VSP network doctor locations or participating partner locations. Click on the offers below to learn how to save on everyday products and services that go beyond vision care and help make your life healthier and easier. • Sunglasses edge Extra +iOYA $20 - • savings Get 6-month satisfaction . Premier Edgerm guaranteed protection on to Spend HOYA lenses. • • • at Get an Extra $20 to Premier Edgelocations. spend on Featured Frame Brands.'Z BAUSCHtLOMB See better.Live better. Get up to a $40 rebate when Save t to $310 on an annual supply Extra you spend $200 or more on a complete pair of Maui Jim of contact lenses. $An prescription sunglasses. BAUSCH+LOMB to Spend Biotrue ONEday lenses Get an Extra $40 to Get a free 30-day supply of Biotrue spend on select Featured Save 20% on additional pairs ONEday contact lenses and an Frame Brands." of Nike glasses and sunglasses. +FOYA Get 12-month satisfaction guaranteed Up to sunsync protection on HOYA lenses. 40% Off Save up to 40% on SunSync`°' M Lens Enhancements Save up to 40% off popular techshield Get up to a$50 rebate when you spend lens enhancements.23 Save up to 40% $200 or more on a complete pair of on all TechShield® Maui Jim prescription sunglasses. eyec-onic Premier Edge Promise a vsp vision company un-, Get a worry-free eyewear Shop and save online for glasses, guarantee with triple protection.' sunglasses, and contacts with Try Unity° lenses worry-free your VSP benefits. for six months with un1t9 The Unity Promise. Try Unity lenses worry-free with 1. 000 The Unity Promise for 12 months. enchroma® M M WORLD'S BEST COLOUR BLIND GLASSES'" Get up to 20% off popular Try ZEISS Lenses risk-free Try ZEISS Lenses risk-free for EnChroma collections. for six months. 12 months. 23 Improve Your Health vsp.member extras and Increase Your Savings As a member, you can save on everyday products and services that fit your needs beyond vision care—like discounts on fitness, nutrition, prescription drugs, and access to diabetes resources. Contacts • BAUSCH+COMB Diabetes OptOmaR See better.Live better. Management Support Save up to $300 on an annual Save on testing supplies Get not-to-exceed $39 supply of contact lenses. and find resources to help special pricing on prevent or manage Diabetes. optomap images! The LasikPlus4 LASIKo Vision N V I S I<>N T LC* INSTI UM EYE CENTERS Laser Eye Centers° Save up to $1,100 Save up to $1,100 Save up to $1,200 off all Save up to $1,100 off LASIK. off LASIK. custom LASIK and PRK. off LASIK. HearingHealth Leisure . • Lifestyle TruHearing® vsp.simplle values Save up to 60%on prescription and over-the- Access a variety of savings on fitness, counter hearing aids, get deals on batteries, prescription drugs, entertainment, travel, and access a free online hearing screening.' cash rewards, and more.' Home and • ACareCredit ® everplans smartcredit" Get instant, in-office promotional Organize, securely store, and Get smart about your credit,money, financing offers for eye care assign access to important and privacy with SmartCredit, and eyewear. documents like wills, passwords, helping you meet your financial and more. All for just $27 a year. goals for just$8.95 a month. See how your savings can add up at vsp.com/offers. Offers subject to change without notice.Some members may not be eligible for all offers.Premier Edge Offers may not be available to some consumers in Texas.Members who participate in a Medicaid/ state-funded plan are not eligible for the above offer.Visit vsp.com/offers for terms and conditions on specific offers. 1.Brands and promotions are subject to change.2.Available to VSP members with applicable plan benefits.Check your benefits to see if this offer applies.3.Savings based on doctor's retail price and vary by plan and purchase selection;average savings determined after benefits are applied.4.Restrictions may apply;visit vsp.com/offers/Premler-edge-offers/glasses-and-sunglasses/Premier-Edge- Promise for terms and conditions.5.Not all locations are on the VSP Laser VisionCare Network.Please call VSP Member Services at 800.877.7195 to confirm the location you're interested in visiting is in-network.6.VSP is providing information to its members but does not offer or provide any discount hearing program.VSP makes no endorsement,representations,or warranties regarding any products or services offered by TruHearing,a third-party vendor.TruHearing is not insurance and not subject to state insurance regulations.For additional information please visit vsp.com/offers/special-offers/ hearing-aids/truhearing.For questions,contact TruHearing directly.Not available directly from VSP in the states of Washington and California.7.Some members may not be eligible for this program;visit vsp.eom/slmplevalues for terms and conditions. To learn about your privacy rights and how your protected health information may be used,see the VSP Notice of Privacy Practices on vsp.com. ©2024 Vision Service Plan.All rights reserved. VSP and Eyeconic are registered trademarks,and VSP Premier Edge is a trademark of Vision Service Plan. Unity,TechShield,and SunSync are registered trademarks of Plexus Optix,Inc.All other brands or marks are the property of their respective owners.124816 VCCM Classification:Public 24 Employer Paid Life Insurance provided to you at no cost. Standard Insurance Company City of Twin Falls 70 Group Policy#485908 Effective Date March 1,2002 Group Basic Life and Accidental Death and Dismemberment Insurance Group Basic Life insurance from Standard Insurance Company helps provide financial protection by promising to pay a benefit in the event of an eligible member's, or his or her dependent's covered death. Basic Accidental Death and Dismemberment (AD&D} insurance may provide an additional amount in the event of a covered death or dismemberment as a result of an accident. The cost of this insurance is paid by City of Twin Falls. Eligibility Definition of a Member You are a member if you are an active Council Member or employee of City of Twin Falls and regularly working at least 20 hours each week.You are not a member if you are a temporary or seasonal employee, a full-time member of the armed forces, a leased employee or an independent contractor. Class Definition Class 1- Members hired on or after the first of the month through the 15th of the month Class 2- Members hired on or after the 16th of the month through the last day of the month EligibilityWaiting Period You are eligible on the first of the month that follows or coincides with 60 consecutive days as a member. Benefits Basic Life Coverage Amount Your Basic Life coverage amount is$25,000. Basic AD&D Coverage Amount For a covered accidental loss of life,your Basic AD&D coverage amount is equal to your Basic Life coverage amount. For other covered losses, a percentage of this benefit will be payable. Life Age Reductions Basic Life and AD&D insurance coverage amount reduces to 65 percent at age 65,to 50 percent at age 70 and to 35 percent at age 75. 25 Group Basic Life and Accidental Death and Dismemberment Insurance Basic Dependents Life Coverage The Basic Dependents Life coverage amount for your eligible spouse is Amount $1,000.Your spouse is the person to whom you are legally married. The Basic Dependents Life coverage amount for each of your eligible children is$1,000. Child means your child from live birth through age 20 (through age 24 if a registered student in full-time attendance at an accredited educational institution). Other Basic Life Features and Services - Accelerated Benefit - Right to Convert Provision - Life Services Toolkit - Travel Assistance - Portability of Insurance Provision - Waiver of Premium - Repatriation Benefit Other Basic AD&D Features - Air Bag Benefit - Family Benefits Package - Seat Belt Benefit This information is only a brief description of the group Basic Life/AD&D and Basic Dependents Life insurance policy sponsored by City of Twin Falls.The controlling provisions will be in the group policy issued by The Standard.The group policy contains a detailed description of the limitations,reductions in benefits,exclusions and when The Standard and City of Twin Falls may increase the cost of coverage, amend or cancel the policy.A group certificate of insurance that describes the terms and conditions of the group policy is available for those who become insured according to its terms. For more complete details of coverage,contact your human resources representative. Standard Insurance Company 1100 SW Sixth Avenue Portland OR 97204 www.standard.com SI 13279-0-10-485908 (7/19) 61,0393-386025 Standard Insurance Company 26 Employer Paid Long Term Disability provided to you at no cost. Standard Insurance Company City of Twin Falls Group Policy#485908 Effective Date October 1,2002 Group Long Term Disability Insurance Group Long Term Disability insurance from Standard Insurance Company helps provide financial protection for insured members by promising to pay a monthly benefit in the event of a covered disability. The cost of this insurance is paid by City of Twin Falls. Eligibility Definition of a Member You are a member if you are a regular employee of City of Twin Falls,actively working at least 20 hours per week, and a citizen or resident of the United States or Canada.You are not a member if you are a temporary or seasonal employee,a full-time member of the armed forces, a leased employee or an independent contractor. Class Definition Class 1-Safety Members hired on or after the first of the month through the 15th of the month Class 2-Safety Members hired on or after the 16th of the month through the last day of the month C lass 3-Non-safety Members hired on or afterthe first ofthe month through the 15th of the month Class 4- Non-safety Members hired on or after the 16th of the month through the last day of the month EligibilityWaiting Period You are eligible on the first of the month that follows or coincides with 60 consecutive days as a member. Benefits Monthly Benefit 60 percent of the first$10,000 of monthly predisability earnings, reduced by deductible income(e.g.,work earnings,workers' compensation, state disability,etc.) Maximum Monthly Benefit $6,000 Minimum Monthly Benefit $100 Benefit Waiting Period 180days 27 Group Long Term Disability Insurance Definition of Disability Class 1&2: For the benefit waiting period and the first 12 months that Long Term Disability benefits are payable,you will be considered disabled if, as a result of physical disease,injury,pregnancy or mental disorder: • You are unable to perform with reasonable continuity the material duties of your own occupation, and • You suffer a loss of at least 20 percent of your predisability earnings when working in your own occupation. You are not considered disabled merely because your right to perform your own occupation is restricted, including a restriction or loss of license. After the own occupation period of disability,you will be considered disabled if,as a result of a physical disease,injury,pregnancy or mental disorder,you are unable to perform with reasonable continuity the material duties of any occupation. Class 3&4: For the benefit waiting period and the first 24 months that Long Term Disability benefits are payable,you will be considered disabled if, as a result of physical disease,injury,pregnancy or mental disorder: • You are unable to perform with reasonable continuity the material duties of your own occupation, and • You suffer a loss of at least 20 percent of your predisability earnings when working in your own occupation. You are not considered disabled merely because your right to perform your own occupation is restricted, including a restriction or loss of license. After the own occupation period of disability,you will be considered disabled if,as a result of a physical disease, injury,pregnancy or mental disorder,you are unable to perform with reasonable continuity the material duties of any occupation. Maximum Benefit Period If you become disabled before age 62, Long Term Disability benefits may continue during disability until age 65. If you become disabled at age 62 or older,the benefit duration is determined by the age when disability begins: Age Maximum Benefit Period 62 3 years 6 months 63 3 years 64 2 years 6 months 65 2 years 66 1 year 9 months 67 1 year 6 months 68 1 year 3 months 69+ 1 year Other Features and Services • 24 hour coverage, including coverage for work-related • Return to Work Incentive disabilities • Survivors Benefit • Reasonable Accommodation Expense Benefit . Waiver of Premium while Long Term Disability benefits • Rehabilitation Plan Provision are payable Standard Insurance Company 28 Colonial Life. Voluntary benefits The benefits of good hard work.,, Choices to protect what you've worked so hard to build Each individual's lifestyle and needs are different from the next.Voluntary benefits from Colonial Life—on both an individual and group platform—offer a broad range of financial protection options for employees and their families. Disability Insurance ■ Individual Disability-A short-term disability product that replaces a portion of income for on/off-job or off-job only disabilities.Optional features include psychiatric and psychological conditions benefits and waiver of elimination period for first day hospital confinement.Guaranteed-issue and simplified-issue options are available. Accident Insurance ■ Individual Accident-Aguaranteed-issue,composite-rated,guaranteed-renewable accident product that offers several coverage levels to fit all budgets.Employer-optional benefits are available to customize the accident product offering.Additional employee- choice riders can create a comprehensive product package. Special Risk Insurance ■ Individual Cancer-A cancer product that pays indemnity-based benefits to help cover TWCITOF IN FALLS medical and non-medical expenses related to cancer diagnosis and treatment. ,J ■ Individual Critical Illness-A critical illness product that provides a lump-sum benefit A`FseR ,�Q�o for the diagnosis of a critical illness. Supplemental Health insurance ■ Individual Medical Bridges"'-A hospital confinement indemnity product that To learn more,contact: supplements your core medical coverage,offering benefits such as hospital confinement,health screening orwellness,rehabilitation unit confinement and doctor's TROY D GIFFORD 208-860-8294 troy@ apxbenefits.com Learn more about the products available to you and schedule an appointment with a benefit counselor by visiting the website below. https-Hlearn.colonialIife.com/cityoftwinfalls Colon ialLife.com NS-16028 3-17 1 NS-16028 29 Lr. Important coverage features: ■ With most products, coverage is available to spouses and eligible dependent children. ■ Benefits are paid directly to the insured,unless specified otherwise. ■ With most products, employees can continue coverage with no increase in premiums if they retire orchangejobs. ■ With most products, employees may receive benefits regardless of any other insurance. ■ Premiums are payroll deducted for easy administration. Learn more about what we have offer Colonat • ColonialLife.com ACCIDENT,CANCER,CRITICAL ILLNESS,AND HOSPITAL INDEMNITY PRODUCTS PROVIDE LIMITED BENEFITS. The policies,their names or their provisions may vary or be unavailable in some states.The policies have exclusions and limitations which may affect any benefits payable.See the actual policy or your Colonial Life representative for specific provisions a nd details of availabi lity. Insurance products are underwritten by Colonial Life&Accident Insurance Company,Columbia,SC. ©2018 Colonial Life&Accident Insurance Company.All rights reserved.Colonial Life is a registered trademark and marketing brand NS-16028 of Colonial Life&Accident Insurance Company. 30 0 LTC SOLUTIONS, INC. What is LTC Insurance? The Cost' ONursing home costs are averaging$116,800 per year. With an average O length of stay at 2.4 years,total costs can exceed $280,320. 2023 Annual Cost / Average Stay Long-term care insurance is designed to pay jII� for custodial care once you are in need of assistance with two or more Activities of Daily Living or have a cognitive impairment Home Care Assisted Living Nursing Home like dementia or Alzheimer's. 3 Years 2.5-3 Years 2.4 Years Long-term care insurance will pay for care received at home, in a nursing home or $75,000 $64,000 $116,800 assisted living facility. The Risk Ages 65+ 56%of couples without long- 67% term care insurances end their income down to 0.1% 2.3% 12.5% Ages 18+ the p House Fire Auto Accident Disability • 40% poverty level after one partner has spent 6 months in a nursing home.'When compared to using other lines of personal insurance, long- Long-Term Care term care is the highest risk. City of Twin Falls' Plan Highlights Benefit Features Available Plan Options Monthly Benefit Amount Nursing Home Facility(100%) $50,000, $100,000, Assisted Living Facility(100%) $200,000 or$300,000 Professional Home Care(100%) Monthly Access Limit 2% Inflation Protection None, 1%Compound, 3%compound or 5%compound Elimination Period 90 days Voluntary Long Term Care City of , City of Twin Falls has partnered with LTC Solutions, Inc., an expert in the long-term care insurance marketplace, and LifeSecure, a well-established carrier in the industry. Together,we bring you the opportunity to purchase a valuable long- term care insurance plan with discounted group rates. How Much Does a Plan Cost? Every benefit dollar makes a difference when you need care. LifeSecure offers many plan choices, allowing you to choose a plan that offers enough coverage to be meaningful to you and your family at an affordable rate. To give you an idea of pricing, here are Monthly Premium some examples of monthly premiums for a $100,000 benefit bank, 2% monthly access 30 $29.25 limit, no Inflation plan. 40 $40.17 Actual rates will vary based on age of 50 $58.17 applicant and plan design. 60 $96.83 Eligibility How Are Premiums Paid? Newly-eligible or newly-hired employees and their Spouses9 may apply Employee and spouse premiums will be for coverage with fewer health questions10for 90 days following date of payroll deducted. hire.This is a one-time opportunity that will not be offered at future open enrollments. If you leave City of Twin Falls, you will have All other benefit eligible employees and their Spouses9 who did not the opportunity to continue your coverage enroll during the qualifying period or would like to make changes to at the same rate. existing coverage may enroll at anytime with full underwriting. For More Information 1 Genworth 2019 Cost of Care Survey.Tenth Edition. Online Benefit Guide' 2 Based on an 8-hour day for a homemaker at$19/hour to a home health aide for$21/hour. 3 Health Insurance Association of America www.mVItcguide.com/twinfalls 4 Karter,Michael J.,Fire Loss in the United States during 2004,National Fire Protection Association. 5 Bureau of the Census Data,2000 and 2000 data collected from the federal Highway Administration, November 2001 Toll-Free: 6 US Department of Health and Human Services."National Clearinghouse for Long Term Care 877 286-2852 Information." 2011. 7 Long-Term Care.AHRQ Focus on Research.AHRQ Pub No.02-M028,March 2002.Agency for Healthcare Research&Quality Email: 8 US Department of Health and Human Services.What is Long-Term Care?2009. 9 Active employees ages 18-69 working at least 20 hours per week. LTCiBenefitsTeam@ltc-solutions.com 10 Active employees ages 18-64 working at least 20 hours per week.Eligible employees ages 65-69 may apply with full underwriting.Spouses ages 18-49 working 20+hours per week for their employer may apply with reduced underwriting provided the eligible employee also applies for coverage.Spouses ages 50-69 may apply with full underwriting. r Y�% AD Pets Best _ PET HEALTH INSURANCE will Flexible Pet Insurance Coverage insurance- How pet . OReady for anything. I Attend to Your Pet O 24/7 pet helpline support. When yourpet getinjured, they can get treatment s Customizable plans for cats and dogs. fromany veterinarianin the US or ... Be the best pet parent you can be 40 File a Claim You have an unbreakable bond with your pet which is You can easily file a claim through why our coverage eliminates the stress, heartache, and our app or online, and you don't uncertainty associated with unexpected events. When need to send us medical records your pet gets sick or injured, they can get treatment they unless we ask for them. need, when they need it. 0 Easy Reimbursement • Use any licensed veterinarian in the US or Canada — Your reimbursement can including specialty and emergency clinics be conveniently and easily Exclusive employee discount on a BestBenefit plan' deposited directly into yourbank • Optional coverage for routine care . you wonder • Around the clock support from the 24/7 pet helpline • Easy claims submission ENJOY • Self-service through our mobile app U P � O O EMPLOYE R TO DISCOUNT Pet insurance coverage offered and administered by Pets Best Insurance Services,LLC is underwritten by American Pet Insurance Company,a New York insurance company headquartered at 6100 4th Ave.S.Suite 200 Seattle,WA98108,or Independence American Insurance Company,a Delaware insurance company located at 11333 N.Scottsdale Rd,Ste.160,Scottsdale, City of Twin Falls AZ 85254.Pets Best Insurance Services,LLC(CAagency#O1737530)is a licensed insurance agency located at 10840 Ballantyne Commons Parkway,Charlotte,NC 28277.Each insurer has sole financial To begin, enroll responsibility for its own products.Please refer to your declarations page to determine the underwriter foryourpoticy.Terms and conditions apply.See yourpolicy for details.*5%group discount applies to BestBenefit plans;discount not available in AK,HI,or TN.Save 5%when you enroll more than one pet. www.petsbest.com/CTFPETS Discount applies to BestBenefit plans. or call 888-984-8700 synchrony I Pets Best is a Synchrony(NYSE:SYF)Health and Wellness solution. Reference discount code: CTFPETS 33 Pets 6est�'� J PET HEALTH INSURANCE t i ' . < Plan Overview Plan Coverage Essential Plus Elite Annual Coverage Limit for Unexpected $5,000 - $5,000 - $5,000 - Accidents and Illness Unlimited Unlimited Unlimited Annual Deductible $50 - $1,000 $50 - $1,000 $50 - $1,000 Reimbursement Percentage 70% - 90% 70% - 90% 70% - 90% Accidents, Illnesses, Cancer, Hereditary O O O Conditions, Emergency Surgeries & Rx Meds" Accidents & Illness Exam Fees Associated with O O the Diagnosis of Your Pet for an Eligible Injury or Illness. This is not intended to cover routine exams. Rehabilitative, Acupuncture & Chiropractic O Coverage to Treat Eligible Injuries and Illnesses. Wellness Add-On for Routine Care Coverage to help pay for regular and expected O O O veterinary visits. Please see Wellness Plans Summary for pricing information. Accident-Only Coverage If your pet currently has Addison's Disease, Cushing's Disease, Diabetes,Cancer, Feline Leukemia or Feline Immunodeficiency Virus,they can enroll for Accident Only coverage, but will be ineligible for illness coverage.The Accident Only plan does not cover medical issues such as illness or cancer, but provides up to$10,000 in annual coverage for things like broken legs,snake bites, accidental swallowing and more. Coverage starts at$9 per month for dogs,and$6 per month for cats.* • Pet insurance coverage offered and administered by Pets Best Insurance Services,LLC is underwritten by American Pet Insurance Company,a NewYorkinsurance company headquartered at 6100 4th Ave.S.Suite 200 Seattle,WA98108,or Independence American Insurance Company,a Delaware insurance company located at 11333 N.Scottsdale Rd,Ste.160, Scottsdale,AZ 85254.Pets Best Insurance Services,LI-C(CAagency 9OF37530)is a licensed insurance agency located at 10840 Ballantyne Corrarrons Parkway,Charlotte,NC 28277.Each insurer has sole financial responsibility for its own products.Please refer to your declarations page to determine the underwriter for your policy.Terms and conditions apply.See your policy for details.*Most plans cover prescription medications.Download our fomnrlary at petsbest.com/coverage.$7/month for cats and$1Ohnonth for dogs in WA Coverage applies to ebole conditions only and is subject to all temus, conditions,limitations and exclusions in the policy.Please reviewpohey loon for complete details. synchrony I Pets Best is a Synchrony(NYSE:SYF)Health and Wellness solution. 34 Pets Bes-�' _ PET HEALTH INSURANCE Routine Care Coverage Routine care coverage for dogs and cats helps pay for regular veterinary visits. There are two tiers of routine care coverage that can be added to one of our pet health insurance plans for an additional premium at the time you enroll, or at your annual renewal. Benefits are available to you on your policy start date, so you can start using your routine care plan as soon as your policy goes into effect. Essential Wellness BestWellnessTM O $14-21.75/per month' O $26-32.58 /per month' Total Annual Benefits up to $305 Total Annual Benefits up to $535 Benefits Include (04w-W Wellness Exams Spaying & Neuteringt Teeth Cleaningt Microchipping Diagnostic Panels Preventative Medications Vaccinations Routine care plans not sold as a stand-alone plan and if purchased must be added to a BestBenefit Accident and Illness Plan. *Price varies by state,and by pet age.Get a quote to see pricing and for your pet.t Benefits only available with BestWellness plan �' 1 1 Pet insurance coverage offered and administered by Pets Best Insurance Services,LLC is underwritten by American Pet Insurance Company,a NewYork insurance company headquartered at 6100 4th Ave.S.Suite 200 Seattle,WA98108,or Independence American Insurance Company,a Delaware insurance company located at 11333 N. Scottsdale Rd,Ste.160,Scottsdale,AZ 85254.Pets Best Insurance Services,LLC(CAagency#OF37530)is a licensed insurance agency located at 10840 BaHantyne Commons Parkway, Charlotte,NC 28277.Each insurer has sole financial responsibility for its own products.Please refer to your declarations page to determine the underwriter for your policy.Terms and conditions apply.See your policy for details. synchrony I Pets Best is a Synchrony(NYSE:SYF)Health and Wellness solution. 35 Pets Best''� PET HEALTH INSURANCE � FAG ` How long are Pets Best's waiting periods? procedures. We want your pet to receive the best A waiting period refers to the amount of time after possible care, which is why we also cover visits to enrolling before your pet is eligible for coverage.Waiting specialists and emergency after-hours clinics. periods vary by the type of coverage and start on the effective date of your policy. Once met, waiting periods Do I need to have the Routine Care option? are waived for continuous, uninterrupted policy renewals. Not at all!You can simply pay the annual expenses of Pets Best offers some of the shortest waiting periods in routine care, like dental cleaning,vaccinations and blood the industry following the policy effective date. Get a work, on your own. However, our routine care options quote for specific information on waiting periods in your are designed to save you money on expected and state. preventative care for your pet. When can I insure my pet with Pets Best? Will Pets Best cover my pet's dental needs? You can enroll your pet as young as 7 weeks. Like Good dental care is incredibly important to your pet's children, puppies and kittens have the highest risk of overall health. Our BestBenefit plans include coverage accidents. Their immune systems aren't mature, so for periodontal disease and other dental issues if proper they're more susceptible to infectious diseases. Pets Best preventative care as outlined in the policy document has plans have no upper age limits, so senior dogs and cats been performed. get the same great coverage as kittens and puppies. How do I file a claim? My pet is already sick or injured. Can pet The easiest and fastest way to file a claim is through your insurance help? customer account or one of our mobile apps. Once you Pets Best is here for unexpected accidents and illnesses. log in you can submit and view claims, and sign up for It does not cover preexisting conditions. However, direct deposit.You can also send your claim via email, many future accidents and illnesses should be covered fax, or standard mail. It's up to you! if something happens. We also offer accident-only coverage for pets with severe chronic conditions, and Do you use a benefit schedule? wellness coverage to help manage the cost of routine No,our BestBenefit plan does not use a benefit schedule care for your pet. but our BestWellnes plan does,which is a list that puts a limit on what each type of treatment can cost. Instead, Can I use my own veterinarian? we reimburse your choice of up to 90%* of your vet bill Yes. Pets Best has no networks, so you can use any after the deductible of your choice, up to your plan's licensed veterinarian in the US or Canada. We also maximum benefit. have no schedule of benefits and no pre-authorization Pet insurance coverage offered and administered by Pets Best Insurance Services,LLC is underwritten by American Pet Insurance Company,a NewYork insurance company headquartered at 6100 4th Ave.S.Suite 200 Seattle,WA98108,or Independence American Insurance Company,a Delaware insurance company located at 11333 N.Scottsdale Rd,Ste.160,Scottsdale,AZ 85254.Pets Best Insurance Services,LLC(CAagency#OF37530)is a licensed insurance agency located at 10840 Ballantyne Commons Parkway,Charlotte,NC 28277.Each insurer has sole financial responsibility for its own products.Please refer to your declarations page to determine the underwriter for your policy.Terms and conditions apply.See your policy for details.*Select a plan that reimburses 701/0,80°/y or 90%ofthe cost ofeligrble veterinary treatment.Limited to covered expenses. synchrony I Pets Best is a Synchrony(NYSE:SYF)Health and Wellness solution. 36