Open Enrollment. HSA: For 2017, the Federally mandated increase in the HSA contribution limits are $3,400 for individuals and $6,750 for families.

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1 A GUIDE TO2017 Open Enrollment Welcome to Open Enrollment 2017 Orange County is committed to supporting your good health and quality of life; your health and welfare benefits are one way we put this commitment into action. Open Enrollment takes place from October 3 through October 21, 2016, and is your once-a-year opportunity to review these valuable benefits and make important choices for the coming year. We have good news about our benefits! There are no major plan changes for 2017, however, there is a modest increase of premiums for all plans. Also our medical plans are getting a new look! Our HDHP will now be called OrangePrime Plus and our LDHP will now be called OrangePrime. Do you want to receive the High Plan Contribution? Will you be enrolling in a County medical plan and want to avoid the Tobacco/Nicotine User Surcharge? Will you be waiving a County medical plan and want to receive the Opt-Out Credit? Do you want to elect an FSA? HSA: For 2017, the Federally mandated increase in the HSA contribution limits are $3,400 for individuals and $6,750 for families. Before you make your enrollment choices for 2017, please take a moment to review your current benefits and covered dependents on myocinfo so you are prepared to make any needed changes during Open Enrollment. We also encourage you to carefully review this Open Enrollment Handbook, along with the valuable resources available on the County s website, to learn more about your options. Is Open Enrollment REQUIRED? If you answered YES to any of these questions, then you must participate in Open Enrollment and submit your elections on myocinfo. Enroll using myocinfo Enroll in your benefits using myocinfo, the same system you used last year for open enrollment and currently use to apply for County jobs, change your address, and view and print your paystubs. MyOCinfo can be accessed from any computer that has internet access, and you can launch it directly from the Open Enrollment page of the County website ( or from the CountyLine intranet. From the County website, click on the Open Enrollment 2017 slider. From the OrangeNet intranet, click on the thumbtack icon to the left and scroll down to MyOCinfo, log in, click on Main Menu, then Self Service, then Benefits,and finally Benefit Enrollment. You must log in to myocinfo between October 3 and October 21, 2015, to submit your Open Enrollment elections.

2 Medical Plan Highlights Cigna Choice Fund ORANGEPRIME PLUS PLAN High Deductible Health Plan (HDHP) The HDHP only has co-insurance and is made up of two parts the Medical Plan and the Employer Contribution: The Medical Plan: Preventive care coverage of 100% Annual deductible, 20% coinsurance and out-of-pocket maximum Pharmacy coverage without a separate deductible Preventive drugs covered outside of the deductible You pay the Co-insurance of 20% after you meet the calendar year deductible for all other medical services: Co-insurance amounts that you pay contribute to the out-of-pocket maximum The Employer Contribution: Helps offset the HDHP deductible Contribution based on level of medical coverage elected during Open Enrollment $750 contribution for employee only and $1,250 contribution for employee plus dependent(s) coverage Contribution can be made into a Health Savings Account (HSA) or contribution can be made into a Health Savings Account (HSA) or directly into your paycheck minus applicable taxes. You must have an open active HSA account by November 4, 2015 to receive the employer contribution into your HSA account. Cigna ORANGEPRIME PLAN Low Deductible Health Plan (LDHP) The LDHP is made up of two parts co-pays and co-insurance: Preventive care covered at 100% Tip You pay Co-pays for the following services: Doctor s office visits / $20 co-pay Specialist office visits / $35 co-pay Urgent care / $40 co-pay Outpatient Surgery (non hospital) / $100 co-pay You pay the Co-insurance of 20% after you meet the calendar year deductible for all other medical services: Co-pay and co-insurance amounts that you pay contribute to the out-of-pocket maximum. You can only make changes outside of Open Enrollment if you have a qualified status change event such as marriage, birth, divorce, death, adoption, change in spouse s employment, etc., and request the changes within 60 days of the event. However, you will not be able to change between the medical or dental plan options (High Plan to Low Plan, for example) until Open Enrollment of the following year. OrangePrime Plan: co-payments and co-insurance contribute to the annual out of pocket maximum for the plan year. Tobacco/Nicotine User Surcharge In response to the increasing cost of delivering employee healthcare benefits and the overwhelming evidence that tobacco/ nicotine usage is a leading cause of serious illness, Orange County assesses a tobacco/nicotine user surcharge of $25 per pay period. The surcharge is applicable only to employees enrolled in either the HDHP or LDHP. To avoid the surcharge during 2017, you must acknowledge your non-tobacco/non-nicotine usage and submit the Tobacco/ Nicotine Certification during your online open enrollment. This can only be done when you EDIT the Medical Benefit. 2

3 2017 Medical Plan COMPARISON Medical Benefit OrangePrime Plus Plan In-Network OrangePrime Plan In-Network Calendar Year Deductible (CYD) Individual/Family County Contribution Individual/Family Out-of-Pocket Maximum (OOP) Individual/Family $1,500/$3,000 $750/$1,500 $750 / $1,250 None $2,750/$5,500 $1,850/$3,700 Preventive Care $0 $0 Primary Care Visit 20% after CYD $20 Copay* Specialist Visit 20% after CYD $35 Copay* Inpatient Hospital Admission 20% after CYD 20% after CYD Outpatient Surgery (Hospital) 20% after CYD 20% after CYD Outpatient Surgery (Non-Hospital) 20% after CYD $100 Copay* X-Ray, Lab, CT, MRI, PET, Nuclear 20% after CYD 20% after CYD Durable Medical Equipment 20% after CYD 20% after CYD Urgent Care 20% after CYD $40 Copay* Emergency Room 20% after CYD 20% after CYD Ambulance 20% after CYD 20% after CYD Rehab/Therapy 20% after CYD 20% after CYD Pharmacy Preventive Treatment (after CYD) Tier 1: Generic Preventive & Treatment $10* $10 $10* Tier 2: Preferred Brand Tier 3: Non-Preferred Brand 10% + $30* 10% + $30* 10% + $30* 10% + $50* 10% + $50* 10% + $50* *DOES NOT apply to CYD; however, DOES apply to OOP. Comparison based on in-network benefits only. Details regarding specific eligibility, coverage exclusions, definitions and other information are included in the full summary plan document Open Enrollment HANDBOOK 3

4 Health Accounts Which Health Account can you have? Questions HSA Medical FSA Limited Purpose FSA Am I eligible for this account? You are if you are on the HDHP and meet IRS criteria You are if you are ineligible for an HSA You are if you do not have a Medical FSA Health Savings Account (HSA) Medical Flexible Spending Account (FSA) Limited Purpose FSA Is there a maximum contribution amount? Yes. The 2017 maximums are $3,400 for single coverage and $6,750 for employee with dependent coverage (includes County contribution) Yes. The 2017 maximum contribution amount is $2,550 In 2017, Orange County will again offer three different pre-tax, health-related accounts for health expenses: a Health Savings Account (HSA), a Medical Flexible Spending Account (FSA), and a Limited Purpose FSA. Use the chart to compare the three health-related accounts and determine your eligibility. Should you wish to contribute your own pre-tax dollars to a health-related account, you must make that election on myocinfo during Open Enrollment. When are the funds available for me to use? Who owns the account? How do I access the funds? Will the funds rollover to the next year? Is a mid-year deduction change allowed? For which types of expenses can the funds be used? Can I receive the County Contribution to this account? Upon deposit You do. With a debit card, Check or Online bill pay Yes. The account is yours and any money belongs to you Yes. A change is allowed for any reason All qualified medical, pharmacy, dental and vision expenses Yes, if you elect the HDHP on myocinfo during Open Enrollment and are eligible for HSA contributions From day one Orange County With a debit card or submit a reimbursement request No. March 15, 2018, will be the deadline to use or lose the funds A change is not allowed unless you have a qualifying event (no mid-year increase allowed) All qualified dental and vision expenses only (no medical or pharmacy) No. If you are not eligible for an HSA, your County contribution will be deposited into your payment and is subject to taxation. 4

5 Do you want to receive up to $1,250 next year? The County offers two financial contributions based on your Open Enrollment elections. If you are a benefits-eligible employee, you can receive a $750 or $1,250 contribution if you elect the OrangePrime Plus Plan (HDHP), or up to $25 per pay period if you decline both of the County s Cignamedical plans. Review the information below to learn more about these contributions. OrangePrime Plus Plan Contribution Only for employees who select the HDHP on myocinfo during Open Enrollment Deposit amount is based on your Open Enrollment election as of 10/21/2015 (Employee Only = $750; Employee plus Dependents = $1,250) Y ou must submit elections on myocinfo between 10/03/2015 and 10/21/2015 to receive this contribution Deposit will be made to your HSA Bank HSA account in January 2017 if you meet HSA eligibilityrequirements and have an open active HSA by11/04/2016, or into your paycheck minus applicable taxes if you don t have an open HSA account. Opt-Out Credit Up to $25 per pay period when you decline both of the County s Cigna Open Access Plus medical plans If enrolled in the TRICARE Supplement, this credit is used to offset the supplement s premiums Cannot be used to cover the cost of Spouse Life Insurance, Child Life Insurance or Short-Term Disability Insurance You MUST submit elections on myocinfo between 10/03/2016 and 10/21/2016 to earn the Opt-Out Credit Are you eligible for an HSA?* Tip Can you have a Medical FSA and a Limited Purpose FSA at the same time? No Can you have an HSA and a Medical FSA at the same time? No You CAN have an HSA and a Limited Purpose FSA at the same time! Yes You are eligible for an HSA if you meet the following criteria established by the IRS: You are enrolled in a High Deductible Health Plan (HDHP) You are not covered by another health plan that is NOT an HDHP You are not enrolled in Medicare or Medicaid (Parts A, B or D) You are not claimed as a dependent on someone else s tax return You are not entitled to TRICARE or TRICARE for Life You are not covered by a Medical FSA (yours or your spouse s) You have not received VA medical benefits within the past three months (other than disability benefits) * In order to receive the employer and employee contributions in 2017, you must have an open active HSA account with HSA Bank by 11/04/ Open Enrollment HANDBOOK 5

6 Plan Premiums 2017 WELLNESS FOR LIFE Plan Type and Coverage Level Premium Employee Contribution County Contribution MEDICAL PREMIUMS HDHP Employee only $ $2.70 $ HDHP Employee + spouse $ $88.56 $ HDHP Employee + child(ren) $ $81.00 $ HDHP Employee + family $ $ $ LDHP Employee only $ $13.50 $ LDHP Employee + spouse $ $ $ LDHP Employee + child(ren) $ $94.50 $ LDHP Employee + family $ $ $ TRICARE SUPPLEMENT PREMIUMS Employee only $31.15 $31.15 N/A Employee + spouse $61.15 $61.15 N/A Employee + child(ren) $61.15 $61.15 N/A Employee + family $82.38 $82.38 N/A DENTAL PREMIUMS Low Employee only $5.00 $5.00 N/A Low Employee + 1 $10.20 $10.20 N/A Low Employee + 2 or more $18.65 $18.65 N/A Middle Employee only $8.71 $8.71 N/A Middle Employee + 1 $18.06 $18.06 N/A Middle Employee + 2 or more $33.95 $33.95 N/A High Employee only $14.20 $14.20 N/A High Employee +1 $28.91 $28.91 N/A High Employee + 2 or more $52.53 $52.53 N/A VISION PREMIUMS (Updated Rates) Employee only $2.99 $2.99 N/A Employee + 1 $5.97 $5.97 N/A Employee + 2 or more $8.77 $8.77 N/A All Premiums are Bi-Weekly 6

7 Plan Type and Coverage Level Premium Employee Contribution County Contribution EMPLOYEE ADDITIONAL LIFE, AD&D AND SPOUSE LIFE, AD&D PREMIUMS* under 30 $0.42 $0.42 N/A $0.51 $0.51 N/A $0.78 $0.78 N/A $1.20 $1.20 N/A $1.71 $1.71 N/A $2.54 $2.54 N/A $2.91 $2.91 N/A $3.65 $3.65 N/A 65-69** $7.20 $7.20 N/A 70 & up** $14.31 $14.31 N/A * AD&D premiums are included with Additional Life and Spouse Life premiums **Age reductions apply CHILD LIFE INSURANCE PREMIUMS $5,000 per eligible child $0.16 $0.16 N/A $10,000 per eligible child $0.32 $0.32 N/A * Employee contribution includes all eligible children SHORT-TERM DISABILITY PREMIUMS 120 calendar day waiting period $0.042 $0.042 N/A 90 calendar day waiting period $0.060 $0.060 N/A 60 calendar day waiting period $0.106 $0.106 N/A 30 calendar day waiting period $0.139 $0.139 N/A 15 calendar day waiting period $0.162 $0.162 N/A *Long Term Disability Insurance is paid by the County All Premiums are Bi-Weekly FORMULA for calculating Short-Term Disability bi-weekly premium: 1. Divide your gross annual salary by 52 (this gives you your weekly gross salary). 2. Multiply your gross weekly salary by 60%. 3. Divide that number by Multiply that number by the rate shown above for the STD waiting period you selected to get your bi-weekly premium Open Enrollment HANDBOOK 7

8 Benefits Dental For 2017, there are moderate premium increases all three dental plans. All dental plans cover preventive services at 100% in and out of network All three plans feature an increase to the annual maximum paid by insurance of $250 per year if the insured receives at least one oral exam and one cleaning during the calendar year Vision For 2017, there is a moderate premium change to the vision plan. Low co-pays and discounts available Large network of providers Life Insurance Basic life insurance equal to your annual salary will continue to be paid for by the County. If you are interested in additional life insurance, you will be happy to know that there are no rate changes to the additional life insurance, spouse life insurance or child life insurance for Reductions apply to basic employee life, additional employee life, and spouse life as follows: Employee/Spouse Age Percentage 65 through 69 65% 70 through 74 50% 75 and up 35% Dependent Care Flexible Spending Account If you wish to contribute pre-tax dollars into a dependent care flexible spending account in 2017, be sure to make your election on myocinfo during open enrollment. Current deductions for this benefit DO NOT roll over from year to year. The annual maximum contribution to a dependent care flexible spending account is $5,000. This limit is not related to any of your other HSA or FSA contributions. * For full plan information on these benefit offerings, please refer to the 2017 Benefits Handbook which will be available via the County s website and the OrangeNet Intranet during Open Enrollment. Tip Normal medical underwriting rules are in effect for the 2017 Open Enrollment period. Additional Employee Life Any request to elect or increase additional Employee Life Insurance during Open Enrollment requires medical underwriting, unless: 1. You have not been previously denied through medical underwriting 2. Do not request an increase greater than $10,000, and 3. Your additional Employee Life Insurance amount does not total more than $200,000 Spouse Life and Child Life Any request to elect or increase spouse life insurance greater than $10,000 (up to $200,000 guarentee) during Open Enrollment requires medical underwriting. Short-Term Disability Any request to reduce the STD waiting period by more than one step, during Open Enrollment, requires medical underwriting. Tip If you presently carry Child Life Insurance, please be advised of the eligibility requirements. Child Life Insurance is only available to your unmarried children through age 20 (through age 24 if a full-time student), your unmarried stepchildren or the children of your domestic partner through age 20 if living with you (through age 24 if a full-time student), and your unmarried disabled children of any age. Please contact your HR Representative for more information and clarification of eligibility requirements. 8

9 HR Service Centers Please feel free to seek assistance at any location regardless of your worksite location. Administration Services & Office of Accountability Internal Operations (IOC1) Building 450 East South Street Orlando, Florida CEDS Parks and Recreation Barnett Park 4801 West Colonial Drive Orlando, Florida Convention Center South Concourse, Room S International Drive Orlando, Florida Corrections Cassady Building 2450 West 33rd Street Orlando, Florida CEDS Downtown Administration Building, 2nd Floor 201 South Rosalind Avenue Orlando, Florida Family Services Mable Butler Building 2100 East Michigan Street Orlando, Florida Fire Rescue Headquarters 6590 Amory Court Winter Park, Florida Public Works Main Building, 2nd Floor 4200 South John Young Parkway Orlando, Florida Utilities Utilities Administration Building 3rd Floor 9150 Curry Ford Road Orlando, Florida Open Enrollment HANDBOOK 9

10 Open Enrollment Assistance Sessions Need help enrolling? Try an Assistance Session If you need help submitting your Open Enrollment elections on myocinfo, find an assistance session near you. Unless otherwise specified below, assistance sessions are open to all County employees. Appointments are not necessary. If you have questions or prefer a scheduled time please contact your HR Service Center. Convention Center {APPOINTMENT ONLY} Employee Services Office 9899 International Drive, Room S-212 Oct. 5 9:00am 4:00pm Oct. 14 9:00am 4:00pm Oct. 7 9:00am 4:00pm Oct. 19 9:00am 4:00pm Oct. 12 9:00am 4:00pm Oct. 21 9:00am 4:00pm Corrections {CORRECTIONS STAFF ONLY, RESTRICTED AREA} (407) Vision Road Oct. 11 8:00am 12:00pm Oct. 12 8:00am 12:00pm Oct. 18 3:30pm 8:00pm Oct. 19 3:30pm 8:00pm Family Services & Health Services or E. Michigan Street, HR 1st Floor Each Day of Open Enrollment from 8:00am 4:00pm Fire Headquarters Amory Court, Room 110 Oct. 7 9:00am 12:00pm Oct. 21 9:00am 12:00pm Oct. 14 9:00am 12:00pm IOC-1/HR Building or 450 E. South Street, 1st Floor Oct. 5 8:30am 12:00pm Oct. 18 1:00am 4:30pm Orange County Administration Center or or S. Rosalind Ave., HR 2nd Floor Oct. 3 1:00pm 4:00pm Oct. 17 1:00pm 4:00pm Oct. 5 1:00pm 4:00pm Oct. 19 1:00pm 4:00pm Oct. 7 1:00pm 4:00pm Oct. 21 1:00pm 4:00pm Parks & Recreation Barnett Park 4801 W. Colonial Dr., 1st Floor, Art Room Oct. 9 7:30am 12:00pm Oct. 23 7:30am 12:00pm Oct. 16 1:30pm 6:00pm Public Works S. John Young Pkwy., 2nd Floor, Computer Room Oct. 4 7:30am 11:30am Oct. 18 7:30am 11:30am Oct. 6 7:30am 11:30am Oct. 20 7:30am 11:30am Utilities Administration Curry Ford Road, 2nd Floor, Computer Lab Oct. 3 1:00pm 4:00pm Oct. 21 1:00pm 4:00pm Oct. 13 7:00am 11:00am Field Services Presidents Drive, 2nd Floor Oct. 17 1:00pm 11:00pm Water Reclamation/Field Services Sandlake Road, Max Lab 1 (Utilities Staff Only) Oct. 6 7:00am 11:00am Oct. 20 7:00am 4:00pm Solid Waste/Landfill Young Pine Road, Room C/D/E Oct. 5 7:00am 11:00am Oct. 12 7:00am 11:00am A step-by-step user guide will be placed on the Open Enrollment page of the County webpage and on HR Corner of the OrangeNet intranet. 10

11 2017 Open Enrollment WORKSHEET Complete this worksheet and use it when you enroll in your benefits using myocinfo. IMPORTANT INFORMATION: 1) Open Enrollment begins on Monday, October 3, 2016, and ends on Friday, October 21, :59:59pmET 2) You must submit your elections online to avoid the Tobacco/Nicotine User Surcharge, receive the Opt-Out Credit, receive the Employer contribution to the HDHP, or re-enroll in a Flexible Spending Account 3) Dependent dates of birth and Social Security cards are required 4) Proof of dependent eligibility must be submitted to HR by November 4, 2016 myocinfo User ID: Password: Medical Plan (You must EDIT this benefit to affirm tobacco/nicotine usage) q OrangePrime Plus Plan (HDHP) q OrangePrime Plan (LDHP) q Waive Medical Enroll Your Dependents: q Spouse DOB: SSN: Dental Plan q BCC Dental Low Plan B-T q BCC Dental Middle Plan B-T q BCC Dental High Plan B-T q Waive Dental Enroll Your Dependents: q Spouse DOB: SSN: Vision Plan q BCC Vision Care Plan B-T q Waive Vision Enroll Your Dependents: q Spouse DOB: SSN: Supplemental Life (Medical underwriting may be required) q BCC Supplemental Life q Waive Supplemental Life Coverage Level: Dependent Life Child (Medical underwriting required) (Eligibility requirements for children through age 20) q BCC Child Life q Waive Child Life Coverage Level: Dependent Life Spouse (Medical underwriting required) q BCC Spouse Life q Waive Spouse Life Coverage Level: Short-term Disability (Medical underwriting required if reducing wait time by more than 1 step)) Select one of the following options: q BCC Short-term Disability 120 Day q BCC Short-term Disability 90 Day q BCC Short-term Disability 60 Day q BCC Short-term Disability 30 Day q BCC Short-term Disability 15 Day q Waive Supplemental Life Flex Spending Health (FSA) q Medical FSA / Annual Pledge: q BCC Limited Purpose FSA / Annual Pledge: q Waive Flex Spending Health Flex Spending Dependent Care q Dependent Care FSA / Annual Pledge: q Waive Flex Spending Dependent Care Health Savings Account (Must have an open HSA by November 4, 2016) Select one of the following options: q HSA Employer Contribution Only q HSA Employee & Employer Contribution Annual Contribution Amount: q Waive (You cannot contribute to an HSA, and your employer contributions will be deposited into your paycheck and subject to taxation) 2017 Open Enrollment HANDBOOK 11

12 What You Need to Do 2017 WELLNESS FOR LIFE 1 Review your Current Benefits Take a few minutes to review your current benefits and covered dependents on myocinfo so you are better prepared to make any needed changes during Open Enrollment. 2 Review the Open Enrollment Resources Visit and click on the open enrollment slider to review and download resources that will help you complete your 2017 benefits enrollment. 3 Complete the Online Enrollment Worksheet The online enrollment Worksheet will help you lan ahead and gather the information you will need to complete your enrollment online. The worksheet is available in this handbook as well as online. 4 Attend an Enrollment Assistance Session Do you need help completing your enrollment online? Attend an assistance session with HR and get hands-on help with making your 2016 benefits elections online. Refer to the list of assistance sessions in this handbook or contact your HR representative for a location near you. 5 Log in to myocinfo To enroll in your benefits, you must first log in to myocinfo. This is the same system that you use to view and print your paystubs, apply for County jobs, etc. Use your normal user ID and password to log in. You can launch myocinfo directly from the homepage of the Orange County website or from the OrangeNet Intranet. 6 Submit Your Elections You must click the Submit button to send your final enrollment choices and receive the County contribution or opt-out credit, and to avoid the tobacco/nicotine user surcharge. 7 Review and Print Your Enrollment Summary After submitting your elections on myocinfo, be sure to print your Enrollment Elections Summary page. Review it to make sure you didn t make any mistakes and keep it in a safe place with all of your other important records. No corrections or changes will be made once Open Enrollment ends on 10/21/ :59:59pm ET. 8 Open a Health Savings Account Do you need to open an HSA? A link to the HSA Bankwebsite is available on the open enrollment page of the OrangeNet internet. You must have an open active HSA by 11/04/ Submit Proof of Dependent Eligibility Are you adding dependents who were not previously covered or making changes to a dependent s name, birth date or relationship? Submit proof of their eligibility to HR by 11/04/ Submit Proof of Medical Underwriting Did you increase your life insurance by more than $10,000 each for yourself or your spouse beyond the $10K guarentee, or for your child(ren)? Did you reduce the wait time for your Short Term Disability by more than one step by more than 1 step? Did you add Short Term Disability coverage other than 120 day wait? If so, you must submit documentation by 11/01/2016.

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