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vs • City of Cocoa I Employee Benefit Highlights 12020-2021 Benefit Offset The City of Cocoa provides$100 per benefit payroll period to General Employees.The Benefit Off-Set will be used to help offset the cost of employee's benefits and any remaining funds will be put towards a City sponsored 457 Deferred Compensation benefit.With exception of FMLA or Military leave,employees on a continuous leave of absence without pay in excess of 30 days will not be eligible for this benefit. Married Credit Married couples who both work for the City of Cocoa and are eligible for City benefits are also eligible for the Married Credit.The Married Credit is an opportunity for married employees and dependent(s)to enroll in benefits under one(1)of the married employee's names for family coverage at no cost to either employee.This means that one of the two married employees may enroll with family coverage for medical,dental,and vision insurance at no cost.The other employee must opt-out of all benefits and also enroll for coverage under the employed spouse.The employee,who is opting out of all insurance plans,is not eligible for the opt-out benefit(see below).The employee who is enrolling all family members is required to enroll in the Core Plans available. Opt-Out Benefit Default Benefits for the Dental If eligible employee is covered by another medical plan,and meets certain and Vision Plans criteria as outlined below,the employee and eligible dependents have the opportunity to participate in the City's Employee Health Center.In the event Benefit-eligible employees will automatically be enrolled in employee only the employee opts-out of participating in the City's group medical plan and coverage for medical, dental and vision benefits, unless a different tier of declines participation in the Employee Health Center,the City will share a coverage is selected.Changes to default benefits will not be permitted until portion of monthly premium(an"Opt-out benefit").The amount of the Opt- the next applicable Open Enrollment period unless employee experiences a out benefit may vary from year to year. qualifying family status change(Qualifying Event). For the plan year 2020-2021,the Opt-out benefit available is$100 per month. This benefit is paid in the employee's last check of each month,and is available to benefit-eligible employees covered under another qualified minimum value, minimum essential group or governmental insurance plan as described below. This option must be renewed each year,is not available to non benefit-eligible employees, and is considered taxable income to the employee. Employees receiving the"Married Credit"are not eligible for the Opt-out benefit. As a result of recent legislative guidance,employee must provide proof that the employee,and all of employee's"tax dependents*"have enrolled or will enroll in"qualifying**"minimum value,minimum essential coverage(other than an individual insurance policy)for the plan year.A health coverage opt-out credit form must be completed and returned to the Human Resources Division with proof of coverage.This form can be found in Bentek. *A "tax dependent"includes any person for whom the employee reasonably intends to claim a personal exemption on the employee's tax return during the tax year(s)that begins or ends during the City's medical insurance plan year.The City's medical plan year is October 1,2020-September 30,2021. **"Qualifying"coverage may could include Medicare,Medicaid,TRICARK,student health insurance,or a spouse's employer's group health plan providing minimum value. 13 5 0 2016,Gehring Group,Inc.,All Rights Reserved