City of Nacogdoches 2021 Enrollment Guide.pptx
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EMPLOYEE BENEFITS<br />
ENROLLMENT GUIDE<br />
Plan Year <strong>2021</strong>-2022<br />
Effective October 1, <strong>2021</strong> to September 30, 2022<br />
2
Mark your calendar for<br />
OPEN ENROLLMENT!<br />
August 3 to August 20<br />
DEADLINE TO<br />
ENROLL IS<br />
20<br />
REMEMBER: Open <strong>Enrollment</strong> must be completed by the deadline or<br />
you may not be able to enroll yourself and/or your eligible dependents until our<br />
next open enrollment, or a qualifying event occurs.<br />
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CONTENTS<br />
04 Benefits Overview<br />
06 Medical Insurance<br />
13 Flexible Spending Accounts<br />
17 Dental Insurance<br />
19 Vision Insurance<br />
21 Basic Life and Accidental Death & Dismemberment Insurance<br />
24 Voluntary Life and Accidental Death & Dismemberment Insurance<br />
26 Long Term Disability Insurance<br />
28 Employee Assistance Program<br />
29 Open <strong>Enrollment</strong> Instructions<br />
31 Important Contacts<br />
3
BENEFITS OVERVIEW<br />
ENROLLMENT<br />
You can enroll in benefits or change your elections at the following<br />
times:<br />
• 30 days prior to your initial eligibility date (as a newly hired<br />
employee)<br />
• During the annual benefits open enrollment period<br />
• Within 30 days <strong>of</strong> experiencing a qualifying life event<br />
BENEFIT OPTIONS<br />
We <strong>of</strong>fer a comprehensive benefits package consisting <strong>of</strong>:<br />
• Medical Insurance<br />
• Flexible Spending Accounts<br />
• Dental Insurance<br />
• Vision Insurance<br />
• Basic Life and Accidental Death & Dismemberment Insurance<br />
• Voluntary Life and Accidental Death & Dismemberment Insurance<br />
• Long Term Disability Insurance<br />
• Employee Assistance Program<br />
4
BENEFITS OVERVIEW<br />
ELIGIBILITY<br />
Full-time employees working at least 30 hours per week are eligible for<br />
benefits on the first <strong>of</strong> the month following your date <strong>of</strong> employment.<br />
Many <strong>of</strong> the plans <strong>of</strong>fer coverage for eligible dependents, including:<br />
• Your legal spouse<br />
• Your children to age 26, regardless <strong>of</strong> student, marital, or<br />
tax-dependent status (including stepchild, legally adopted child, a<br />
child placed with you for adoption, or a child for whom you are the<br />
legal guardian)<br />
• Your dependent children over age 26 who are physically or mentally<br />
unable to care for themselves<br />
CHANGING BENEFITS AFTER OPEN ENROLLMENT<br />
You may pay your portion <strong>of</strong> your select coverages, and fund the flexible<br />
spending accounts, on a pre-tax basis. Thus, due to IRS regulations,<br />
once you have made your elections for the plan year, you cannot<br />
change your benefits until the next annual open enrollment period. The<br />
only exception is if you experience a qualifying event, and election<br />
changes must be consistent with your life event.<br />
To request a benefits change, notify Human Resources within 31 days<br />
<strong>of</strong> the qualifying life event. Change requests submitted after 31 days<br />
cannot be accepted. You may need to provide pro<strong>of</strong> <strong>of</strong> the life event.<br />
Qualifying life events include, but are not limited to:<br />
• Marriage, divorce, or legal separation<br />
• Birth or adoption <strong>of</strong> an eligible child<br />
• Death <strong>of</strong> your spouse or covered child<br />
• Change in your spouse’s work status that affects his or her benefits<br />
• Change in your child’s eligibility for benefits<br />
• Qualified Medical Child Support Order<br />
5
MEDICAL INSURANCE<br />
CARRIER: BLUE CROSS BLUE SHIELD<br />
Please refer to the <strong>of</strong>ficial plan documents for additional information on coverage<br />
and exclusions.<br />
COVERED BENEFITS<br />
BASE PLAN<br />
IN-NETWORK<br />
NON-NETWORK<br />
Calendar Year Deductible - Individual/Family<br />
Per Admission<br />
$3,000/$6,000<br />
None<br />
Three month deductible carryover applies<br />
$6,000/$12,000<br />
None<br />
Three month deductible carryover applies<br />
Out <strong>of</strong> Pocket Maximum - Individual/Family $7,900/$15,800 $10,000/$20,000<br />
Coinsurance 70 / 30% 50 / 50%<br />
Preventive Care 100% <strong>of</strong> allowable amount 70% <strong>of</strong> allowable amount after deductible<br />
Primary Office Visit 100% <strong>of</strong> allowable amount after $45 copay 70% <strong>of</strong> allowable amount after deductible<br />
Specialist Office Visit 100% <strong>of</strong> allowable amount after $45 copay 70% <strong>of</strong> allowable amount after deductible<br />
Virtual Visit MDLive (Medical or Behavioral Health) 100% <strong>of</strong> allowable amount N/A<br />
Diagnostic Test (x-ray, bloodwork) 100% <strong>of</strong> allowable amount 70% <strong>of</strong> allowable amount after deductible<br />
Imaging (CT/PET scans, MRI’s) 70% <strong>of</strong> allowable amount after deductible 50% <strong>of</strong> allowable amount after deductible<br />
Urgent Care 100% <strong>of</strong> allowable amount after $75 copay 70% <strong>of</strong> allowable amount after deductible<br />
Inpatient Services<br />
Penalty for failure to preauthorize<br />
70% <strong>of</strong> allowable amount after deductible<br />
None<br />
50% <strong>of</strong> allowable amount after deductible<br />
$250<br />
Emergency Room<br />
70% <strong>of</strong> allowable amount after $400 copay for facility; copay waived if admitted<br />
Physician charges: 70% after calendar year deductible<br />
RETAIL PHARMACY In-Network Non-Network<br />
Generic<br />
Preferred<br />
Non-Preferred<br />
Specialty Drugs<br />
$20 copay<br />
$50 copay<br />
$75 copay<br />
$150 copay<br />
80% <strong>of</strong> allowable amount minus applicable copay<br />
Employee Only<br />
COVERAGE LEVEL<br />
MONTHLY EMPLOYEE COST<br />
No cost to employee; paid by <strong>City</strong><br />
Employee & Spouse $497.05<br />
Employee & Child(ren) $454.38<br />
Employee & Family $867.08<br />
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MEDICAL INSURANCE<br />
CARRIER: BLUE CROSS BLUE SHIELD<br />
COVERED BENEFITS<br />
Buy-Up PLAN<br />
IN-NETWORK<br />
NON-NETWORK<br />
Calendar Year Deductible - Individual/Family<br />
Per Admission<br />
$1,500/$3,000<br />
None<br />
Three month deductible carryover applies<br />
$3,000/$6,000<br />
None<br />
Three month deductible carryover applies<br />
Out <strong>of</strong> Pocket Maximum - Individual/Family $7,150/$14,300 $10,000/$20,000<br />
Coinsurance 80 / 20% 60 / 40%<br />
Preventive Care 100% <strong>of</strong> allowable amount 70% <strong>of</strong> allowable amount after deductible<br />
Primary Office Visit 100% <strong>of</strong> allowable amount after $45 copay 70% <strong>of</strong> allowable amount after deductible<br />
Specialist Office Visit 100% <strong>of</strong> allowable amount after $45 copay 70% <strong>of</strong> allowable amount after deductible<br />
Virtual Visit MDLive (Medical or Behavioral<br />
Health)<br />
100% <strong>of</strong> allowable amount N/A<br />
Diagnostic Test (x-ray, bloodwork) 100% <strong>of</strong> allowable amount 70% <strong>of</strong> allowable amount after deductible<br />
Imaging (CT/PET scans, MRI’s) 80% <strong>of</strong> allowable amount after deductible 60% <strong>of</strong> allowable amount after deductible<br />
Urgent Care 100% <strong>of</strong> allowable amount after $65 copay 70% <strong>of</strong> allowable amount after deductible<br />
Inpatient Services<br />
Penalty for failure to preauthorize<br />
80% <strong>of</strong> allowable amount after deductible<br />
None<br />
60% <strong>of</strong> allowable amount after deductible<br />
$250<br />
Emergency Room<br />
80% <strong>of</strong> allowable amount after $300 copay for facility, copay waived if admitted<br />
Physician charges 80% after calendar year deductible<br />
RETAIL PHARMACY In-Network Non-Network<br />
Generic<br />
Preferred<br />
Non-Preferred<br />
Specialty Drugs<br />
$20 copay<br />
$50 copay<br />
$75 copay<br />
$150 copay<br />
80% <strong>of</strong> allowable amount minus applicable<br />
copay<br />
COVERAGE LEVEL<br />
MONTHLY EMPLOYEE COST<br />
Employee Only $68.20<br />
Employee & Spouse $650.69<br />
Employee & Child(ren) $599.75<br />
Employee & Family $1,092.35<br />
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REMINDER:<br />
Effective as <strong>of</strong> 10/1/2019, the city moved to the Performance Formulary Drug<br />
Plan. The plan is designated to drive members to over- the counter products, low<br />
cost generic drugs, or lower cost preferred brand-name drugs.<br />
For some drugs, prior authorizations and step therapy are required.<br />
Compound drugs are excluded. Coverage is only available through an exception<br />
review process only to ensure medical necessity.<br />
Proton Pump Inhibitors (i.e. Nexium, Prilosec, Omeprazole, etc) are excluded due<br />
to the abundance <strong>of</strong> over-the-counter products.<br />
Non-sedating Antihistamines (i.e. Claritin, Zyrtec, Allegra, loratadine, etc) are<br />
excluded due to the abundance <strong>of</strong> over-the-counter products<br />
To see if your prescriptions are covered:<br />
1. Go to www.myprime.com<br />
● click “Find medicines”.<br />
● Register as a user.<br />
● If asked for your drug list, choose “Performance-Annual Drug List”.<br />
● You may also call BCBS at 1-800-521-2227<br />
1. You can Contact<br />
● BXS Insurance at 936-564-1713<br />
● Human Resources at 936-559-2567<br />
8
VIRTUAL VISITS / MDLIVE<br />
When it comes to healthcare, access<br />
is important. You want care that is<br />
convenient, high-quality and<br />
low-cost. But depending on your<br />
condition, going to your personal<br />
physician or an urgent care clinic<br />
might not be your best option. We<br />
are proud to <strong>of</strong>fer telemedicine /<br />
virtual visits.<br />
TREATED THROUGH TELEMEDICINE<br />
Allergies<br />
Cold & Flu Symptoms<br />
Cough<br />
Ear Infection<br />
Pink Eye<br />
Prescription Refills<br />
Respiratory Infection<br />
Sinus Problems / Nasal Congestion<br />
Urinary Tract Infection<br />
And more!<br />
NOT TREATED THROUGH TELEMEDICINE<br />
Sprains, broken bones or injuries requiring bandaging<br />
Anything that needs a hands-on exam<br />
Anything that needs a lab test or X-ray<br />
Chronic conditions<br />
9
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FLEXIBLE SPENDING ACCOUNTS<br />
Why not use pre - tax dollars to pay for medical<br />
co-pays, prescriptions, and/or daycare fees, thereby<br />
reducing your taxable income and increase your taxhome<br />
pay? It’s a no-brainer.<br />
The pre-tax advantage <strong>of</strong> a Flexible Spending Account (FSA)<br />
allow you to save up to 30% on your eligible healthcare and/or<br />
dependent care expenses every year. Consider how much you<br />
spend on these costs for you and your qualified dependents in<br />
one year and how much you could save by using pre-tax<br />
dollars.<br />
How it Works<br />
Flexsystem FSA is <strong>of</strong>fered through your employer and is<br />
administered by TASC. When you choose to enroll in a<br />
FlexSystem Healthcare FSA and/ or Dependent Care FSA,<br />
you determine the dollar amount you want to contribute to<br />
each account based on your estimated expenses for the<br />
upcoming Plan Year. Your contributions will be deducted in<br />
equal amounts from each paycheck, pre-tax, throughout the<br />
Plan Year.<br />
The more you contribute to these accounts, the lower<br />
you reduce your taxable gross salary. And with less<br />
taxes, your take- home pay increases!<br />
Your total annual Healthcare FSA contribution amount is<br />
available immediately at the start <strong>of</strong> the Plan Year.<br />
Dependent Care FSA funds are available up to the current<br />
account balance only.<br />
Online <strong>Enrollment</strong> and Contributions<br />
Annual FSA contributions are set by your employer, but are<br />
limited to the IRS maximums per Plan Year. View current IRS<br />
limits at: www. tasconline.com/benefits-limits/<br />
<strong>2021</strong> Limits<br />
Healthcare FSA - $2,750<br />
Dependent Care FSA - $5,000<br />
0<br />
13
FLEXIBLE SPENDING ACCOUNTS<br />
14
FLEXIBLE SPENDING ACCOUNTS<br />
15
FLEXIBLE SPENDING ACCOUNTS<br />
16
DENTAL INSURANCE<br />
CARRIER: BLUE SHIELD BLUE CROSS<br />
● You will pay less out <strong>of</strong> pocket when you choose an in-network provider.<br />
● Locate an in-network provider at www.bcbstx.com.<br />
● Be sure to ask for a pre-treatment estimate.<br />
● Out-<strong>of</strong>-network providers can balance bill, or bill you for the difference<br />
between the provider’s charge and the allowed amount.<br />
ELECTION<br />
MONTHLY EMPLOYEE COST<br />
Employee Only $0.00<br />
Employee &<br />
Spouse<br />
Employee &<br />
Child(ren)<br />
$30.97<br />
$40.80<br />
Employee & Family $82.02<br />
CONTRACTING DENTIST<br />
NON-CONTRACTING DENTIST /<br />
UCR 90th<br />
Annual Calendar Deductible<br />
(waived for preventive)<br />
$50 per person, $150 per family $50 per person, $150 per family<br />
Annual Maximum $1,000 $1,000<br />
Annual Maximums are combined for preventive, basic, and major services.<br />
Lifetime Orthodontic Max $1,000 $1,000<br />
Orthodontic Coverage is available for dependent children up to age 19.<br />
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DENTAL INSURANCE<br />
CONTRACTING DENTIST<br />
NON-CONTRACTING<br />
DENTIST<br />
Diagnostic Services<br />
Oral evaluations<br />
Radiographs<br />
Films<br />
Preventive Services<br />
Prophylaxis (cleanings)<br />
Topical fluoride applications<br />
Sealants<br />
Space maintainers<br />
Basic Services<br />
Amalgams<br />
Resin-based composite restorations<br />
Non-surgical extractions<br />
Deep sedation / general anesthesia<br />
Palliative treatment<br />
Oral surgery<br />
Major Services<br />
Single crown restorations<br />
Inlay/Onlay restorations<br />
Labial veneer restorations<br />
Crowns placed over implants<br />
Periodontal scaling and maintenance<br />
Full mouth debridement<br />
Endodontic services<br />
Surgical Periodontal services<br />
Restorative and Prosthodontic services<br />
Crown/bridge repairs<br />
Adjustments<br />
Recemenations<br />
Orthodontics<br />
Diagnostic procedures<br />
Treatment<br />
100% 100%<br />
100% 100%<br />
80% 80%<br />
50% 50%<br />
50% 50%<br />
When the course <strong>of</strong> treatment will be in excess <strong>of</strong> $300, a predetermination request should be<br />
submitted to BCBSTX in advance <strong>of</strong> treatment.<br />
18
VISION INSURANCE - HIGH PLAN<br />
CARRIER: LINCOLN FINANCIAL<br />
NETWORK: SPECTERA<br />
● You will pay less out <strong>of</strong> pocket when you choose an in-network<br />
provider.<br />
● Locate an in-network provider at www.myspectera.com.<br />
● You must submit a claim form for out-<strong>of</strong>-network expenses.<br />
● LASIK surgery discounts available<br />
ELECTION<br />
MONTHLY EMPLOYEE COST<br />
Employee Only $9.33<br />
Employee & Spouse $17.68<br />
Employee & Child(ren) $20.75<br />
Employee & Family $29.19<br />
COVERED BENEFITS IN-NETWORK OUT-OF-NETWORK<br />
Eye Exam (every 12 months) $10 copay Up to $40 reimbursement<br />
Lenses (every 12 months)<br />
Single: 100% after $10 copay<br />
Bifocal: 100% after $10 copay<br />
Trifocal: 100% after $10 copay<br />
Lenticular: 100% after $10 copay<br />
Single: $40 copay reimbursement<br />
Bifocal: $60 copay reimbursement<br />
Trifocal: $80 copay reimbursement<br />
Lenticular: $80 copay reimbursement<br />
Frames (every 12 months) Up to $130 allowance Up to $45 reimbursement<br />
Contact Lenses (every 12 months)<br />
Elective<br />
Covered<br />
Medically Necessary<br />
Up to $125 allowance<br />
100% after $10 copay<br />
100% after $10 copay<br />
Up to $125 reimbursement<br />
Up to $125 reimbursement<br />
Up to $210 reimbursement<br />
19
VISION INSURANCE - LOW PLAN<br />
CARRIER: LINCOLN FINANCIAL<br />
NETWORK: SPECTERA<br />
● You will pay less out <strong>of</strong> pocket when you choose an in-network<br />
provider.<br />
● Locate an in-network provider at www.myspectera.com.<br />
● You must submit a claim form for out-<strong>of</strong>-network expenses.<br />
● LASIK surgery discounts available<br />
ELECTION<br />
MONTHLY EMPLOYEE COST<br />
Employee Only $8.67<br />
Employee & Spouse $16.43<br />
Employee & Child(ren) $19.27<br />
Employee & Family $27.12<br />
COVERED BENEFITS IN-NETWORK OUT-OF-NETWORK<br />
Eye Exam (every 12 months) $10 copay Up to $40 reimbursement<br />
Lenses (every 12 months)<br />
Single: 100% after $10 copay<br />
Bifocal: 100% after $10 copay<br />
Trifocal: 100% after $10 copay<br />
Lenticular: 100% after $10 copay<br />
Single: $40 copay reimbursement<br />
Bifocal: $60 copay reimbursement<br />
Trifocal: $80 copay reimbursement<br />
Lenticular: $80 copay reimbursement<br />
Frames (every 24 months) Up to $130 allowance Up to $45 reimbursement<br />
Contact Lenses (every 12 months)<br />
Elective<br />
Covered<br />
Medically Necessary<br />
Up to $125 allowance<br />
100% after $10 copay<br />
100% after $10 copay<br />
Up to $125 reimbursement<br />
Up to $125 reimbursement<br />
Up to $125 reimbursement<br />
20
BASIC LIFE AND AD&D INSURANCE<br />
CARRIER: LINCOLN FINANCIAL<br />
This coverage is provided by <strong>City</strong> <strong>of</strong> <strong>Nacogdoches</strong> at no<br />
cost to you.<br />
Safeguard the most important people in your life.<br />
Think about what your loved ones may face after you're gone. Term life insurance can help<br />
them in so many ways, like covering everyday expenses, paying <strong>of</strong>f debt, and protecting<br />
savings. AD&D provides even more coverage if you die or suffer a covered loss in an<br />
accident.<br />
AT A GLANCE:<br />
● A cash benefit <strong>of</strong> $20,000 to your loved ones in the vent <strong>of</strong> your death,<br />
plus a matching cash benefit if you die in an accident<br />
● A cash benefit to you if you suffer a covered loss in an accident, such as<br />
losing a limb or your eyesight<br />
● LifeKeys services, which provide access to counseling, financial and legal<br />
support<br />
● TravelConnect services, which give you and your family access to<br />
emergency medical assistance when you’re on a trip 100+ miles from<br />
home<br />
You also have the option to increase your cash benefit by securing additional coverage<br />
at affordable group rates. See the enclosed life insurance information for details.<br />
ADDITIONAL DETAILS<br />
Conversion: You can convert your group term life coverage to an individual life insurance<br />
policy without providing evidence <strong>of</strong> insurability if you lose coverage due to leaving your job<br />
or for another reason outlines in the plan contract. AD&D benefits cannot be converted.<br />
Continuation <strong>of</strong> Coverage: You may be able to continue coverage if you leave your job<br />
for any reason other than sickness, injury, or retirement.<br />
Benefit Reduction: Coverage amounts begin to reduce at age 65 and benefits terminate<br />
at retirement. See the plan certificate for details.<br />
For complete benefit descriptions, limitations and exclusions, refer to the certificate <strong>of</strong><br />
coverage.<br />
REMINDER<br />
Review your beneficiary designations<br />
21
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VOLUNTARY LIFE INSURANCE<br />
CARRIER: LINCOLN FINANCIAL<br />
Voluntary life insurance is <strong>of</strong>fered through your employer but is paid in full by<br />
employees.<br />
WHY PURCHASE VOLUNTARY LIFE INSURANCE?<br />
● This type <strong>of</strong> life insurance has limited underwriting required. This allows for people with health<br />
conditions or lifestyles that might otherwise disqualify them to qualify for life insurance.<br />
● The group rates are lower than what you could purchase on your own.<br />
● You may purchase a policy for your spouse and children IF you elect coverage for yourself.<br />
Employee Coverage<br />
Newly hired employee guaranteed coverage amount: $150,000<br />
Continuing employee guaranteed coverage annual increase amount: Choice <strong>of</strong> $10,000 or $20,000<br />
Maximum coverage amount: 5 times your annual salary, not to exceed $300,000<br />
Minimum coverage amount: $10,000<br />
AD&D coverage amount: Equal to the life insurance amount chosen<br />
Spouse Coverage - you can secure term life insurance for your spouse if you select coverage<br />
for yourself.<br />
Newly hired employee guaranteed coverage amount: $30,000<br />
Continuing employee guaranteed coverage annual increase amount: Choice <strong>of</strong> $5,000 or $10,000<br />
Maximum coverage amount: 50% <strong>of</strong> the employee coverage amount, not to exceed $150,000<br />
Minimum coverage amount: $5,000<br />
AD&D coverage amount: Equal to the life insurance amount chosen<br />
Dependent Children Coverage - you can secure term life insurance for your dependent children<br />
under age 26 when you select coverage for yourself.<br />
6 months to age 26 (if unmarried) guaranteed coverage amount: $20,000<br />
Age 14 days to 6 months guaranteed coverage amount: $250<br />
During open enrollment, an employee may choose to elect or increase his/her Voluntary Life and<br />
AD&D amount by $10,000 or $20,000 without providing evidence <strong>of</strong> insurability. An employee may<br />
also choose to elect or increase his/her spouse’s Voluntary Life and AD&D amount by $5,000 or<br />
$10,000 without providing evidence <strong>of</strong> insurability. Any amount requested over the allowed 2<br />
incremental amounts will require evidence <strong>of</strong> insurability.<br />
For those requiring evidence <strong>of</strong> insurability, please download from the Voluntary Life screen in<br />
Employee Navigator, complete, and return to Human Resources no later than 8/20/<strong>2021</strong>.<br />
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VOLUNTARY LIFE INSURANCE<br />
CARRIER: LINCOLN FINANCIAL<br />
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LONG TERM DISABILITY INSURANCE<br />
CARRIER: LINCOLN FINANCIAL<br />
90 Day Waiting Period<br />
Long-term disability (LTD) insurance will be calculated from your base<br />
rate <strong>of</strong> pay (hourly rate) unless you choose to have your benefit<br />
calculated from your prior year’s W2 earnings. Should you elect prior<br />
year W2 earnings, you MUST contact the Human Resources<br />
department to request this change.<br />
LTD insurance is designed to help you meet your financial needs during<br />
longer disability periods. Benefit may be <strong>of</strong>fset due to other benefits<br />
such as paid sick leave, workers’ compensation.<br />
• Benefits – 60% <strong>of</strong> your monthly salary limited to $5,000 per month<br />
• Elimination Period: 90 days<br />
• Maximum coverage period: Up to age 65 or SSNRA<br />
• Pre-Existing Condition: If you have a medical condition that begins<br />
before your coverage takes effect, and you recieve treatment for this<br />
condition within the 3 months leading up to your coverage start date,<br />
you may not be eligible for benefits for that condition until you have<br />
been covered by the plan for 12 months.<br />
REMINDER<br />
Review your beneficiary designations<br />
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LONG TERM DISABILITY INSURANCE<br />
CARRIER: LINCOLN FINANCIAL<br />
180 Day Waiting Period<br />
Long-term disability (LTD) insurance will be calculated from your base<br />
rate <strong>of</strong> pay (hourly rate) unless you choose to have your benefit<br />
calculated from your prior year’s W2 earnings. Should you elect prior<br />
year W2 earnings, you MUST contact the Human Resources<br />
department to request this change.<br />
LTD insurance is designed to help you meet your financial needs during<br />
longer disability periods. Benefit may be <strong>of</strong>fset due to other benefits<br />
such as paid sick leave, workers’ compensation.<br />
• Benefits – 60% <strong>of</strong> your monthly salary limited to $5,000 per month<br />
• Elimination Period: 180 days<br />
• Maximum coverage period: Up to age 65 or SSNRA<br />
• Pre-Existing Condition: If you have a medical condition that begins<br />
before your coverage takes effect, and you recieve treatment for this<br />
condition within the 3 months leading up to your coverage start date,<br />
you may not be eligible for benefits for that condition until you have<br />
been covered by the plan for 12 months.<br />
EMINDER<br />
eview your beneficiary designations<br />
REMINDER<br />
REMINDER<br />
Review your beneficiary designations<br />
Review your beneficiary designations<br />
27
EMPLOYEE ASSISTANCE PROGRAM<br />
CARRIER: LINCOLN FINANCIAL<br />
28 28
ENROLLMENT INSTRUCTION<br />
The <strong>City</strong> <strong>of</strong> <strong>Nacogdoches</strong> is using a new and improved enrollment platform called Employee<br />
Navigator. Each employee will need to login to review current elections and make elections for<br />
the new plan year.<br />
Web address for online enrollment is<br />
https://employeenavigator.com/benefits/Account/Login<br />
If you do not have a username, click “register as a new user”. You will be asked to enter<br />
your First Name, last Name, Company Identifier <strong>of</strong> NACTX , Pin (last 4 <strong>of</strong> SSN) and<br />
Birth Date. You will create a username and password, be sure to write this down and<br />
keep in a safe place for future use.<br />
Enter username & password and click Login. You will then be prompted to review your<br />
current elections and make any changes for the elections effective 10/1/<strong>2021</strong>.<br />
If you have previously logged in but do not remember your password, click “Reset a<br />
forgotten password”. You will be prompted to enter your username and birth year to<br />
reset your password.<br />
If you do not log in and request any changes for the new plan year, your current elections<br />
WILL automatically be rolled for the <strong>2021</strong>/ 2022 plan year with exception <strong>of</strong> Flexible<br />
Spending Accounts. You MUST login and re-elect that benefit each year.Please review the<br />
new plan year information closely. After you have completed your enrollment, be sure to hit<br />
the “click to sign” button on your <strong>Enrollment</strong> Summary page.<br />
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REMINDERS<br />
Employees are responsible for notifying Human Resources if a dependent is no longer<br />
eligible for coverage. Failure to notify HR will affect COBRA availability and premium<br />
refunds.<br />
From time to time additional information may be requested by the carriers as it relates to<br />
your benefits- please respond promptly to expedite processing.<br />
Questions & Answers<br />
What steps MUST be taken to complete my Open <strong>Enrollment</strong>?<br />
➢ Employees MUST go online to elect and/or decline benefits.<br />
➢<br />
Employees completing their enrollment online will have the option to choose Pre<br />
Tax or Post Tax for benefits such as Medical, Dental and Vision.<br />
When MUST my enrollment be completed?<br />
➢<br />
All benefit elections must be submitted online by August 20th.<br />
Who do I contact with questions?<br />
➢ Contact the Human Resources department at <strong>City</strong> <strong>of</strong> <strong>Nacogdoches</strong> at 936-<br />
559-2567 or Lacey Parmer with BXS Insurance at 936-564-1713 with any questions<br />
you may have.<br />
DEADLINE FOR ONLINE ENROLLMENT AND<br />
SUBMITTING ALL FORMS IS AUGUST 20th.<br />
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IMPORTANT CONTACTS<br />
BENEFIT CARRIER PHONE WEBSITE<br />
Medical and Pharmacy (Prime Therapeutics) BlueCross BlueShield <strong>of</strong> Texas 1-800-521-2227 www.bcbstx.com<br />
Flexible Spending Account TASC 1-800-422-4661 www.tasconline.com<br />
Dental Insurance BlueCross BlueShield <strong>of</strong> Texas 1-800-422-2567 www.bcbstx.com<br />
Vision Insurance Lincoln Financial 1-800-422-2567 www.lfg.com<br />
Basic and Voluntary Life AD&D Insurance Lincoln Financial 1-800-422-2567 www.lfg.com<br />
Long Term Disability Lincoln Financial 1-800-422-2567 www.lfg.com<br />
Employee Assistance Program Lincoln Financial 1-800-422-2567 www.lfg.com<br />
Human Resources 936-559-2567<br />
YOUR BXS INSURANCE ACCOUNT REPRESENTATIVE:<br />
Lacey Parmer<br />
936-564-1713<br />
Lacey.parmer@bxsi.com<br />
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<strong>City</strong> <strong>of</strong> <strong>Nacogdoches</strong><br />
936.559.2567