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�.. City of Cocoa I Employee Benefit Highlights 12020-2021 Medical Insurance Summary of Benefits and Coverage The City offers medical insurance through Cigna to benefit-eligible employees. A Summary of Benefits&Coverage(SBC)for the Medical Plan is provided as a The costs per pay period for coverage are listed in the premium table below supplement to this booklet being distributed to new hires and existing employees and a brief summary of benefits is provided on the following page.For more during Open Enrollment.The summary is an important item in understanding employee's benefit options.A free paper copy of the SBC document may be requested detailed information about the medical plans,please refer to Cigna's Summary or is also available as follows: of Benefits and Coverage(SBC)document or contact Cigna's customer service. From: Human Resources Division Medical Insurance—Cigna Core Plan Address: 65 Stone Street 24 Bi-Weekly Deductions-Per Pay Period Cost Cocoa,FL 32922 Tier of Coverage Employee Cost Phone: (321)433-8440 Email: humanresources@cocoafl.org Employee OnlyJ $0 -- Website URL: www.mybentek.com/dtyofcocoa Employee+One f $167.33 Employee+Family $328.36 The SBC is only a summary of the plan's coverage.A copy of the plan document,policy, or certificate of coverage should be consulted to determine the governing contractual provisions of the coverage.A copy of the group certificate of coverage can be reviewed and obtained by contacting the Human Resources Division or www.cocoafl.org. Dependents Age 26-30 If covering an overage dependent(a dependent child who will reach age 27-30 If there are any questions about the plan offerings or coverage options,please contact during the year),please refer to the"Taxable Dependents"section on page 3 as the Human Resources Division at(321)433-8440. employee may be subject to additional income tax. Please note:Rates are based on the plan year October 1 to September 30. Telehealth elehealth However,deductibles and annual maximums are January 1 to December 31. Cigna provides access to two(2)telehealth services as part of the medical plan at no cost to members.AmWell and MDLIVE are convenient phone and video Cigna I Customer Service:(800)244-6224 I www.mycigna.com consultation companies that provide immediate medical assistance for many conditions. Other Available Plan Resources The benefit is provided to all enrolled members.Registration is suggested and Cigna offers all enrolled employees and dependents additional services should be completed prior to using services.This program allows members 24 and discounts through value added programs. For more details regarding hours a day,seven(7)days a week on-demand access to affordable medical other available plan resources, please contact Cigna's customer service at care via phone and online video consultations when needing immediate care (800)244-6224,or visit www.mycigna.com. for non-emergency medical issues.Telehealth should be considered when employee's primary care doctor is unavailable, after-hours or on holidays MotivateMe and Omada for non-emergency needs. Many urgent care ailments can be treated with telehealth,such as: Cigna's MotivateMe program is offered through the City of Cocoa and allows V Sore Throat V Fever V Rash members to earn incentive points and rewarded with a Wellness Day Off. V Headache V Cold And Flu V Acne Employees can earn up to 300 incentive points when certain healthy activities V Stomachache V Allergies V UTIs And More are completed.For more details visit www.mycigna.com. Telehealth doctors do not replace employee's primary care physician but Members who have been diagnosed with pre diabetes and qualify may may be a convenient alternative for urgent care and ER visits. For further participate in Omada. Omada is a personalized lifestyle program designed information please contact Cigna. to help members make gradual changes, in eating, exercise, sleep and managing stress.This program is available at no additional cost to benefit- Cigna eligible employees and covered dependents. For more details, please visit AmWell I Customer Service:(855)667-9722 I www.AmWellforCigna.com omadahealth.com/cocoafl. MDLIVE I Customer Service:(888)726-3171 I www.MDLIVEforCigna.com 15 7 02016,Gehring Group,Inc,All Rights Reserved