All eligible employees are required to attend a 2017 Open Enrollment meeting (see page 2).

CITY OF ST.PETERSBURG, FLORIDA2017 BENEFITS LINEYOUR GUIDE TO THE INFORMATION YOU NEED TO MAKE AN INFORMED DECISION ABOUT YOUR BENEFITS.

2017 OPEN ENROLLMENT BEGINS FEBRUARY 27 AND ENDS MARCH 10, 2017

TOPIC PAGEIndex and New for 2017 Inside cover

Open Enrollment Help Session Schedule and Eligible Employees Attendance Required with Instructions on Acknowledgement 1

Wellness Center 2

UnitedHealthcare Group Health Plans 3

UnitedHealthcare & You and Using Non-Network Providers 4

HDP Basic Highlights 5

Choice HDP with Health Reimbursement Account Highlights 6

Choice Plan Highlights (EPO) 7

Choice Plus Plan Highlights (PPO) 8

Humana Dental Plans 9-10

Humana Vision Plans 10

Basic Life Insurance 11

Supplemental Life Insurance 12

Supplemental AD&D Plans & Rates 13

Flexible Spending Accounts 14

If You Are Retiring Soon 14

Frequently Asked Questions 15-16

COBRA and HIPAA & Other Programs 17

Contact Information Back cover

INSIDE BENEFITS LINEBenefits Line is a summary of the City of St. Petersburg’s group benefits. Review this information carefully in order to make an informed decision about your benefits. Open enrollment information is distributed via e-mail, interoffice mail, bulletin board postings and the City’s Intranet.

NEW FOR 2017Humana named new Dental carrier

• DHMO and PPO options

• Your current dental enrollment will automatically transfer to Humana

• If you are in DHMO plan you will need to enter your facility code into the enrollment system through Oracle Self-Service

• Unlimited maximum annual benefit allowance on PPO plan

• PPO premiums 5% lower than 2016

Vision Plan Rate Reduction Group Health Plan

• No plan changes for 2017 – 2018!

• UnitedHealthcare Virtual Visits available beginning April 1, 2017

Medical Flexible Spending Account Deduction Maximum increased to $2,600

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The city believes it is essential for employees to be well informed about all Benefit Programs, therefore:

ALL ELIGIBLE EMPLOYEES WILL BE REQUIRED TO 1) ATTEND AN OPEN ENROLLMENT HELP SESSION; OR

2) VIEW A SHORT, ONLINE OPEN ENROLLMENT PRESENTATION VIA ORACLE SELF SERVICE

IF YOU RECEIVED AN OPEN ENROLLMENT PACKAGE YOU ARE AN ELIGIBLE EMPLOYEE.

Help sessions will be held between February 28 and March 7. (Above) You must attend an Open Enrollment Help Session or view the short presentation online.

• The online video presentation can be found in Oracle Employee Self Service: Learning: Learner Home. Use the Keyword ‘open’ to search for the video.

• The Open Enrollment Help Session will be set up like a class in Oracle. An Oracle workflow will be sent directly to each employee notifying them they have been enrolled. Employees who do not have e-mail will be enrolled but will not receive a workflow notification.

• After you attend a Help Session in person or view the video presentation you MUST acknowledge your attendance in Oracle Employee Self-Service.

To view the video and to complete your acknowledgment, log into Oracle Employee Self-Service: Learning: Learner Home. Scroll down to view the Enrollments section. Locate the Open Enrollment Help Session class name and click the icon under the Play column (Launch this Class button). Click on the Continue button and follow the instructions given.

Failure to attend a meeting or view the video presentation may result in discipline.

You must attend an

Open Enrollment Help Session

or view the short presentation

online

MANDATORY OPEN ENROLLMENT SESSIONS

2017 OPEN ENROLLMENT HELP SESSIONS Location Date Time Fire Headquarters • First Floor Classroom February 28 9 a.m. to Noon

City Hall • Room 100 February 28 2 to 5 p.m.

Water Resources Operations Bldg. • Classrooms A & B March 1 7 to 10 a.m.

The Sunshine Center • Auditorium March 1 1 to 3:30 p.m.

Police Headquarters • Basement Classroom March 2 8 to 11 a.m. PD ONLY due to security requirements

Sanitation Operations Bldg. • Break Room March 2 12:30 to 5 p.m.

Water Resources Operations Bldg. • Classrooms A & B March 6 8 to 11 a.m.

Police Headquarters • Basement Classroom March 6 2 to 4 p.m. PD ONLY due to security requirements

MSC • Conference Room 800 March 7 10 a.m. to 2 p.m.

WELLNESSHealth and Wellness CenterThe City’s Health and Wellness Center offers employees* (except Part-Time Temporary employees) a full service primary care facility led by Dr. Israel Wojnowich, a Board-Certified Family Practice Physician. Services provided at the Center, including the dispensing of certain prescription drugs, is provided at NO COST.

*Dependents age 14 and over AND covered by the City’s Group Health Plan may also use the Center.

City of St. Petersburg Health and Wellness Center 603 7th St. S, Suite 350, St. Petersburg, FL 33701

Phone: 727-553-7474 for appointments

Hours of Operation:Monday, Wednesday and Friday • 7 a.m. to 5 p.m.Tuesday and Thursday • 10 a.m. to 7 p.m.

For additional information, visit the City Intranet and go to the Health and Wellness Center link.

Wellness Activities and Tools• Workshops and Seminars on physical, mental and financial

topics• Health Screenings, Flu Shots• Fitness classes• Real Appeal – an individually tailored weight loss program• Wellness Corner – a dedicated Intranet site• Wellness Portal – a web-based tool with health and

wellness resources and online coaching at: cospwellness.mycernerwellness.com

• Other Special Programs, Events and Initiatives• Go to the City Intranet and go to the Wellness

Corner link

Employee Assistance ProgramProvided by ComPsych, the employee assistance program services include short term counseling, access to legal and financial resources and other services to help employees and their dependents achieve a work/life balance.

The Employee Assistance Program is fully paid for by the City. To use the plan, call 1-888-327-5769 or visit ComPsych online at guidanceresources.com using Company Web ID: STPETE to set up your personal user account.

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Additional Services Provided with All Plans• Nurseline - Connects you with a registered nurse 24

hours a day, 7 days a week to obtain assistance on a wide range of health care questions and concerns. Call: 1-800-846-4678.

• Convenience Care Clinics - Walk-in clinics are located at some CVS and Walgreens stores to provide care for common illnesses and non-urgent medical care. The fee is the same as your primary care physician co-pay.

• Health4Me smart phone app and Advocate4Me.

• www.myuhc.com - Health Assessment Questionnaire, Wellness Programs and Tools, myHealthcare Cost Estimator and more.

• UHC Premium Program - Identifies in-network doctors and hospitals who demonstrate adherence to quality and cost efficiency standards based on evidence-based medicine. A premium-designated doctor will have a lower co-pay than other specialists.

• Prescription Drug Benefits - UnitedHealthcare’s

subsidiary, OPTUMRx, administers the pharmacy benefit and develops the prescription drug list (PDL). The PDL is comprised of FDA - approved generic and brand name medications categorized in four tiers. Tier placement is managed to provide the safest, most appropriate and lowest cost drug choices. The full PDL list can be reviewed at www.myuhc.com.

• Specialty medications - The UnitedHeathcare pharmacy benefit requires certain medications be filled at a designated Specialty Pharmacy. A reminder notice will be sent if your prescription requires use of the Specialty Pharmacy to receive coverage for that medication. Medications are delivered directly to your home and shipping is free.

• OPTUMRx Mail Service Pharmacy - Receive a 90-day supply of maintenance medications sent directly to your home; shipping is free. Call 1-800-562-6223, 24 hours a day, 7 days a week to begin mail order.

NOTE: All laboratory tests must be done at a LabCorp facility. LabCorp is the only laboratory contracted with UnitedHealthcare. To find a facility go to labcorp.com.

New! UnitedHealthcare Virtual VisitsUnitedHealthcare’s Virtual Visits service will be available to all covered members. Virtual Visits allow members to see and talk to a doctor from a mobile device or computer without an appointment. Virtual Visits are designed to provide treatment for minor, non-emergency medical conditions. Most visits take about 10-15 minutes and doctors can write a prescription, if needed, that can be picked up at a local pharmacy. To learn more login to www.myuhc.com.

UNITEDHEALTHCARE GROUP HEALTH PLANS

UnitedHealthcare & YouWhat is the difference between In-Network and Out-of-Network?

NOTE: Out-of-network benefits are not available if you are enrolled in the Choice Plan.

In-NetworkYou pay a lower co-insurance percentage; provider charges are based on the discounted rates UHC negotiates with in-network providers.

You pay prescription co-pays or co-insurance based on the placement of the applicable drug tier.

Your deductible and out-of-pocket maximum are lower in-network.

No claim forms.

Out-of-NetworkYou pay prescription co-pays or co-insurance based on the drug tier, plus any difference between network and non-network charges.

You pay a higher percentage of co-insurance coverage based on Medicare Allowable charges.

In general, you will have higher out-of-pocket costs when you use out-of-network providers.

Your deductible and out-of-pocket maximum are higher. You may have to pay 100% of the cost up-front and file claims for reimbursement.

HOW DO I KNOW IF MY DOCTOR IS IN THE UNITEDHEALTHCARE NETWORK?

1) Log on to the internet and visit-myuhc.com (you do not need a user name or password).

2) In “Links and Tools” click on “Find a Physician, Laboratory or Facility.”

3) Select plan: Either "UnitedHealth-care Choice" or "UnitedHealthcare Choice Plus" which includes Choice HDP and HDP Basic.

4) Enter any optional search informa-tion; click “Continue” for specialists to display.

5) Specialists that have achieved the Premium Specialist Tier 1 designa-tion will have a lower co-pay than non-premium specialists.

What should I know about choosing care outside the UHC network?

If you enroll in the Choice Plus, Choice HDP or HDP Basic and choose to receive care from a non-network doctor, facility or laboratory, it is recommended you understand your UnitedHealthcare benefits. Check your benefit plan documents to confirm that you have non-network benefits and to understand the details of your non-network benefits, including your deductibles and co-insurance.

Understand what YOU might have to pay BEFORE you receive services. Ask the doctor or facility about their billed charges for the services you need. Check your benefit plan and estimate the costs at www.myuhc.com or call the member number on the back of your health plan ID card to have a customer care professional help you estimate how much UnitedHealthcare will pay. Some services require you to notify UHC first in order to receive non-network benefits.

USING NON-NETWORK PROVIDERS? CHOOSE CAREFULLY

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HIGH DEDUCTIBLE PLAN (HDP) BASIC HIGHLIGHTSHDP Basic is a full coverage plan with in and out-of-network benefits. The deductible is higher and the premiums are lower than the other plans. You must meet the full deductible before the HDP Basic pays any benefits. See the Summary of Benefits and Coverage in your enrollment packet for more complete information.

YOU PAY First $5,000, Then Plan Pays 100%

Active Employees • Group Health Plan RatesHDP Basic • Effective April 1, 2017

In-Network Benefits Out-of-Network BenefitsAnnual Deductibles $5,000 Individual • $10,000 Family $15,000 Individual • $30,000 Family

Co-insurance 0% 30%

Hospital 100% after deductible 100% after deductible and co-insurance

Emergency Room 100% after deductible 100% after deductible and co-insurance

Urgent Care Center 100% after deductible 100% after deductible and co-insurance

Physician: Office 100% after deductible 100% after deductible and co-insurance

Physician: In-Hospital 100% after deductible 100% after deductible and co-insurance

Annual preventive care $0

Rehabilitation Service 100% after deductible 100% after deductible and co-insurance(Physical Therapy,Chiropractic, etc.)

Outpatient Surgery 100% after deductible 100% after deductible and co-insuranceHospital or FreeStanding Facility

Annual $5,000 Individual • $10,000 Family $15,000 Individual • $30,000 FamilyOut-of-Pocket Limit Total out-of-pocket maximum Total out-of-pocket maximum includes deductible includes deductible

Prescription Drugs 100% after deductible 100% after deductible and co-insurance

Total Cost City Cost Employee Deductions COBRABenefit Plan Monthly Monthly Monthly Bi-weekly Monthly

Single $457.92 $343.44 $114.48 $57.24 $467.08

Two Person $984.56 $738.42 $246.14 $123.07 $1,004.25 Family $1,295.94 $971.96 $323.98 $161.99 $1,321.86

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CHOICE HIGH DEDUCTIBLE PLAN HIGHLIGHTS

This is a full coverage plan with in and out-of-network benefits. If certain requirements are met, the City will contribute up to $700 for the employee (and up to an additional $450 for a spouse or covered child, if the child is the primary dependent) to a Health Reimbursement Account to help pay deductible costs. See the flyer “Understanding the Choice HDP Plan” for details. See the Summary of Benefits and Coverage in your enrollment packet for more complete information. *Premium Specialist is noted by Tier 1 designation for quality and efficient care at myuhc.com.

YOU PAY

Active Employees • Group Health Plan RatesChoice HDP • Effective April 1, 2017 Total Cost City Cost Employee Deductions COBRABenefit Plan Monthly Monthly Monthly Bi-weekly Monthly

Single $576.75 $432.56 $144.19 $72.10 $588.29

Two Person $1,240.04 $930.03 $310.01 $155.01 $1,264.84 Family $1,632.25 $1,224.19 $408.06 $204.03 $1,664.90

In-Network Benefits Out-of-Network BenefitsAnnual Deductibles $1,750 Individual • $3,500 Family $3,500 Individual • $7,000 Family Excludes co-pays Excludes co-pays

Co-insurance 10% 30%Hospital $300 co-pay/day (first 5 days per $300 co-pay/day (first 5 days per admission) plus 10% co-insurance and plan admission) plus 30% co-insurance and year deductible plan year deductible

Emergency Room $250 co-pay per visit $250 co-pay per visit and plan year deductible and plan year deductible

Urgent Care Center $50 and plan year deductible 30% and plan year deductible Physician: Office Annual Preventive Care visit $0 Primary Care $25 co-pay per visit Premium Specialist $35 co-pay per visit 30% and plan year deductible Non-Premium Specialist $45 co-pay per visit

Physician: In-Hospital 10% and plan year deductible 30% and plan year deductible

Rehabilitation Service $35 co-pay per visit • limit 60 visits 30% and plan year deductible • 60 visits(Physical Therapy, each type of service, multiple visits per day each type of service, multiple visits per dayChiropractic, etc.)

Outpatient Surgery 10% and plan year deductible 30% and plan year deductible Hospital or FreeStanding FacilityAnnual $3,500 Individual • $7,000 Family $7,000 Individual • $14,000 FamilyOut-of-Pocket Limit Total out-of-pocket maximum Total out-of-pocket maximum includes plan year deductible and co-pay includes plan year deductible and co-pay Prescription Drugs $15 co-pay generic • $35 co-pay brand $15 co-pay generic • $35 co-pay brandTier 2, 3 and 4 drugs have a $50 co-pay non-preferred generic $50 co-pay non-preferred generic and$200/$400 deductible. and brand • 25% specialty (30 day supply), brand • 25% specialty (30 day supply), (Accumulates to Annual Mail order is 3 co-pays for 90 day supply plus any difference between network and Out-of-Pocket Charges) non-network charges. Mail order not covered.

6

CHOICE PLAN HIGHLIGHTS (EPO)In-Network Benefits ONLY

YOU PAY

Active Employees • Group Health Plan RatesChoice (EPO) • Effective April 1, 2017

Annual Deductibles $750 Individual • $1,500 Family • Excludes co-pays

Hospital $300 co-pay/day (first 3 days per admission) and plan year deductible

Emergency Room $250 co-pay per visit and plan year deductible

Urgent Care Center $50 and deductible

Physician: Office Annual Preventive Care Visit $0 • Primary Care $30 co-pay per visit • * Premium Specialist $35 co-pay per visit Non-Premium Specialist $50 co-pay per visit

Physician: In-Hospital 0%

Rehabilitation Service $30 co-pay per visit • limit 60 visits each type of service, multiple visits/day(Physical Therapy,Chiropractic, etc.)

Outpatient Surgery Plan pays 100% after deductibleHospital or FreeStanding Facility

Annual $3,000 Individual • $6,000 Family • Total out-of-pocket maximum includesOut-of-Pocket Limit deductible and co-pay

Prescription Drugs $15 co-pay generic • $35 co-pay preferred brand • $50 co-pay non-preferred Tier 2, 3 and 4 drugs have a generic and brand • 25% specialty (30 day supply) • Mail order is 3 co-pays for $200/$400 deductible. 90-day supply(Accumulates to Annual Out-of-Pocket)

Total Cost City Cost Employee Deductions COBRABenefit Plan Monthly Monthly Monthly Bi-weekly Monthly

Single $669.66 $502.25 $167.41 $83.71 $683.05

Two Person $1,439.79 $1,079.84 $359.95 $179.98 $1,468.59 Family $1,895.14 $1,421.36 $473.78 $236.89 $1,933.04

See the Summary of Benefits and Coverage in your enrollment packet for more complete information.*Premium Specialist is noted by Tier 1 designation for quality and efficient care at myuhc.com.

7

CHOICE PLUS PLAN HIGHLIGHTS (PPO)

Active Employees • Group Health Plan RatesChoice Plus (PPO) • Effective April 1, 2017

Total Cost City Cost Employee Deductions COBRABenefit Plan Monthly Monthly Monthly Bi-weekly Monthly

Single $741.23 $555.92 $185.31 $92.66 $756.05

Two Person $1,497.33 $1,123.00 $374.33 $187.17 $1,527.28 Family $2,075.54 $1,556.65 $518.89 $259.45 $2,117.05

YOU PAY In-Network Benefits Out-of-Network Benefits

Annual Deductibles $750 Individual • $1,500 Family $1,500 Individual • $3,000 Family Excludes co-pays Excludes co-pays

Hospital $300 co-pay/day (first 3 days per admission) $300 co-pay/day (first 3 days per admission then 10% co-insurance and plan year deductible then 30% co-insurance and plan year deductible Emergency Room $250 co-pay per visit $250 co-pay per visit and deductible and deductible

Urgent Care Center $50 and plan year deductible 30% and plan year deductible

Physician: Office Annual Preventive Care Visit $0 Primary Care $30 co-pay per visit *Premium Specialist $35 co-pay per visit 30% and plan year deductible Non-Premium Specialist $50 co-pay per visit

Physician: In-Hospital 10% and plan year deductible 30% and plan year deductible

Rehabilitation Service $35 co-pay per visit • limit 60 visits $30 co-pay per visit • 60 visits each(Physical Therapy, each type of service, multiple visits per day type of service, multiple visits per dayChiropractic, etc.)

Outpatient Surgery 10% and plan year deductible 30% and plan year deductible Hospital or FreeStanding Facility

Annual $3,000 Individual • $6,000 Family $6,000 Individual • $12,000 FamilyOut-of-Pocket Limit Total out-of-pocket maximum Total out-of-pocket maximum includes plan year deductible and co-pay includes plan year deductible and co-pay

Prescription Drugs $15 co-pay generic • $35 co-pay brand $15 co-pay generic • $35 co-pay brandTier 2, 3 and 4 drugs have a $50 co-pay non-preferred generic and $50 co-pay non-preferred generic and$200/$400 deductible. brand • 25% specialty (30 day supply), brand • 25% specialty (30 day supply), (Accumulates to Annual Mail order is 3 co-pays for 90 day supply plus any difference between network andOut-of-Pocket Charges) non-network charges. Mail order not covered.

See the Summary of Benefits and Coverage in your enrollment packet for more complete information.*Premium Specialist is noted by Tier 1 designation for quality and efficient care at www.myuhc.com.

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New for 2017Dental Plans provided by Humana Insurance CompanyEmployees currently enrolled in a dental plan will automatically be enrolled in the comparable Humana Dental Plan. You may also change plans or drop coverage using Oracle Self-Service. If you are not currently enrolled in a dental plan, you may enroll for 2017 through Oracle Self-Service.

Note: Employees currently enrolled in or electing the DHMO must select a participating provider and enter this information through Oracle Self-Service. Go to humana.com for a list of participating providers.

Humana PPO

New! Unlimited plan year annual maximum. Choose any provider, in or out-of-network.

Use a network provider for a higher percentage of benefits covered by the plan. $50 annual deductible, maximum $150 per family applies to basic and major services, in-network and out-of-network.

Orthodontia benefits are offered for children up to 19 years of age with a lifetime benefit of $1000. In-network preventive services are covered 100%, basic services are reimbursed at 85% and major services at 55%.

Out-of-network preventive services are reimbursed at 90%, basic services at 70% and major services at 50%.

Humana DHMO HS195

Must receive services from participating general dentists and specialists.

Select your participating dentist from the Humana online directory.

No deductibles, claim forms, maximum level of benefits or waiting periods.

Most preventive and diagnostic services are no charge.

Co-pays apply to other benefits.

No referral needed. Member has direct access to participating specialists, if necessary. Orthodontia benefits are available for both adults and children.

Dental ID cards may be obtained on the Humana website (humana.com) after member registration, by calling Customer Service at 1-800-979-4760 or via the Humana Mobile app.

Plan Summaries are located on the City’s Intranet in the Benefits section or in the Benefits Division Office.

If you elect group dental, children are eligible for coverage through end of calendar year in which they turn 26, regardless of student status.

Humana Dental Plans • Employee PaidThe City will provide employees two choices for dental coverage, the Humana PPO which provides in and out-of-net-work coverage, and the Humana DHMO HS195 an in-network plan.

Basic• Covered members receive one routine eye exam each year with no co-pay required.• Covered members receive a 20% discount on lenses and a 35% retail discount on frames at participating providers.

High Option• Covered members receive one routine eye exam every 12 months for a $10 co-pay.• $15 co-pay for single vision, bifocal or trifocal lenses. • A $130 allowance for frames or a $135 annual allowance for contact lenses.

Please see the Humana Vision Plan summaries for full detail of plan benefits. Both plans require the use of network providers. Plan summaries are located on the City’s Intranet in the Benefits section or in the Benefits Division Office. Questions regarding the plans may be directed to Humana Member Services at 1-877-398-2980 or humana.com.

If you elect group vision, children are eligible for coverage through end of calendar year in which they turn 26, regardless of student status.

Total Cost Employee Deductions COBRABASIC Monthly Bi-weekly Monthly

Single $.93 $.47 $.95

Two Person $1.40 $.70 $1.43 Family $2.33 $1.17 $2.38

HIGH OPTION Monthly Bi-weekly Monthly

Single $5.80 $2.90 $5.92

Two Person $11.54 $5.77 $11.77

Family $15.44 $7.72 $15.74

Humana Vision Plans • Employee Paid

Total Cost Employee Deductions COBRAHumana HS195 Monthly Bi-weekly Monthly

Single $17.18 $8.59 $17.52

Two Person $30.05 $15.03 $30.65 Family $47.25 $23.63 $48.20

Humana PPO Monthly Bi-weekly Monthly

Single $25.73 $12.87 $26.24

Two Person $54.54 $27.27 $55.63 Family $84.20 $42.10 $85.88

Dental Insurance Rates

Vision Insurance Rates • Effective April 1, 2017

1010

Basic Life Insurance • City PaidAll eligible full-time employees are provided with Term Life and Accidental Death and Dismemberment (AD&D) Insurance provided by The Standard Life Insurance Company and paid for by the City of St. Petersburg. Designate a beneficiary using Oracle Self-Service. Beneficiary designations can be changed at any time. For questions on enrollment, contact the Benefits Division at 727-893-7279.

Remember to designate a

beneficiary using Oracle Self-Service

Benefit Classes Amount of Insurance Active Classified Employees (other than below) $10,000

Professionals $20,000

Firefighters, Firefighter/Paramedics, Fire Lieutenants, 1 X Annual Salary (to the nearest $1,000) Fire Captain, Fire District Chiefs

Police Sergeant, Police Lieutenant, Police Officers, 1 X Annual Salary (to the nearest $1,000) Forensics Services Technicians & Latent Print Examiners

Administrative Management $100,000

Elected Officials $100,000

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If you elect Supplemental Life coverage during your first eligibility period, you do not need to submit an Evidence of Insurability form. If you enroll after your initial eligibility or want to increase the amount of existing coverage, you must do so using Oracle Self-Service and complete an Evidence of Insurability form (available on the City’s Intranet in the Benefits section) and submit to The Standard for approval. The Standard makes all coverage determinations. Approval is not guaranteed.

Supplemental Life Insurance coverage levels depend on your base annual salary; if your salary increases to the next salary range, your coverage and premiums will automatically increase as well. Premiums may be waived in the event of a disability retirement.

For eligible hires, coverage becomes effective the first of the month nearest 60 days after full-time employment. Coverage elected during the open enrollment period becomes effective on April 1 or the date the Evidence of Insurability form, if required, is approved by The Standard Life Insurance Company, whichever is later.

Be sure to designate a beneficiary in Oracle Self-Service. You may change your beneficiary designation at any time. For questions on enrollment or beneficiary designations, contact the Benefits Division at 727-893-7279.

The Standard Life Insurance Company offers three levels of coverage. Employees may choose to cover

their spouses and children only if they elect coverage for themselves. Spouses may be covered for $10,000, $25,000 or $50,000 as long as the coverage of the employee is at least twice the amount of the spouse’s coverage. Unmarried dependent children up to age 20 (age 25 if enrolled as full-time student at an accredited school or college, over age 20 if disabled) may be insured for $5,000 or $10,000. An employee, spouse or dependent child who is a full-time member of the armed forces is not eligible for this coverage.

Supplemental Life Insurance • Effective April 1, 2017

Range in Low Cost Med Cost High CostDollars Option Monthly Option Monthly Option Monthly

$15,000 - 19,999 $15,000 $5.06 $30,000 $10.11 $45,000 $15.17

$20,000 - 24,999 $20,000 $6.74 $40,000 $13.48 $60,000 $20.22

$25,000 - 29,999 $25,000 $8.43 $50,000 $16.85 $75,000 $25.28

$30,000 - 34,999 $30,000 $10.11 $60,000 $20.22 $90,000 $30.33

$35,000 - 39,999 $35,000 $11.80 $70,000 $23.59 $105,000 $35.39

$40,000 - 44,999 $40,000 $13.48 $80,000 $26.96 $120,000 $40.44

$45,000 - $49,999 $45,000 $15.17 $90,000 $30.33 $135,000 $45.50

$50,000 or more $50,000 $16.85 $100,000 $33.70 $150,000 $50.55

Spouse $10,000 $2.58 $25,000 $6.45 $50,000 $12.90 Child $5,000 $0.70 n/a n/a $10,000 $1.40 Cost listed for each coverage level is monthly.

Supplemental Life Insurance • Employee Paid

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The Standard Life Insurance Company plan allows you to purchase coverage from $25,000 to $300,000 (up to amaximum of 10 times your annual salary). AD&D will pay benefits in the event of accidental death, paralysis,dismemberment, loss of eyesight, loss of speech, or loss of hearing due to an accident. See the plan summary on theCity Intranet or in the Benefits Division Office for complete information regarding this program. Evidence of Insurabilityis not required no matter when you enroll.

Supplemental Accidental Death and Dismemberment (AD&D) • Employee Paid

Coverage for Eligible Dependents/ChildrenUnder the family plan option, you may insure your spouse and/or dependent children. Unmarried children:

1) through age 20

2) through age 25 if enrolled as a full-time student at an accredited educational institution

3) over age 20 if disabled

An employee, spouse, or dependent child who is a full-time member of the armed forces is not eligible for this coverage.

If covered as an employee, you cannot be covered as a spouse of another employee.

Supplemental Accidental Death and DismembermentRATES • Effective April 1, 2017

Family Plan Coverage AmountsIf you choose this coverage, family members are covered by the policy as follows:

1) Spouse only: 50% of the employee amount

2) Child(ren) only: 10% of the employee amount for each child, not to exceed $25,000.

3) Spouse and child(ren): Spouse 40% of the employee amount; Child(ren) 5% of the employee amount for each child not to exceed $25,000.

Effective DateFor new employees, coverage is effective the first of the month nearest 60 days after employment. Coverage elected during annual open enrollment will be effective April 1, 2017.

The plan summary, located on the City’s Intranet under Human Resources/Benefits/Life Insurance, has a complete description of benefits, limitations, exclusions and costs.

Coverage Employee Only Family Plan Amount Monthly Cost Monthly Cost

$25,000 $0.58 $0.88

$50,000 $1.15 $1.75

$75,000 $1.73 $2.63

$100,000 $2.30 $3.50

$125,000 $2.88 $4.38

$150,000 $3.45 $5.25

$175,000 $4.03 $6.13

$200,000 $4.60 $7.00

$225,000 $5.18 $7.88

$250,000 $5.75 $8.75 $275,000 $6.33 $9.63

$300,000 $6.90 $10.50

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Flexible Spending Accounts (FSA)Flexible Spending Accounts for health care and/or dependent care allow you to set aside payroll dollars on a pre-tax basis to spend those dollars for qualified health or dependent care expenses.

HEALTH CARE ACCOUNTAt enrollment, enter an annual amount between $300 and $2,600. If you want a specific amount deducted per pay period, multiply that amount by 26 to obtain the annual amount.

Employees enrolling in the Health Care FSA receive two debit MasterCards to be used for co-pays, deductibles, coinsurance, prescriptions and other approved health care expenses (examples of approved expenses can be found at myuhc.com or on the Intranet).

Requests for reimbursement may also be submitted to United using a claim form. Debit card purchases and claims may be submitted prior to deductions being taken from your paycheck. Debit MasterCard activation and usage instructions come to you from UnitedHealthcare. If you had a FSA debit card during the 2016 plan year, retain the card if re-enrolling; it will be reloaded with the amount of your 2017 election.

Unspent health care FSA balances, up to a maximum of $500, will be carried forward to the next year (unspent amounts above $500 will be forfeited at the end of the plan year).

DEPENDENT CARE ACCOUNTAt enrollment, enter an annual amount between $600 and $5,000. If you want a specific amount deducted per pay period, multiply that amount by 26 to obtain the annual amount.

Eligible dependent care expenses include preschool, day care and some before-and after-school care expenses. Private school tuition is not eligible for reimbursement. Payroll deductions must occur before requesting a reimbursement. The debit MasterCard will not be issued for Dependent Care accounts.

DON’T FORGET!FLEXIBLE SPENDING ACCOUNTS MUST BE ELECTED ANNUALLY USING ORACLE SELF-SERVICE.

CLAIMS FOR SERVICES PROVIDED BETWEEN APRIL 1, 2017 AND MARCH 31, 2018 MUST BE SUBMITTED TO UNITEDHEALTHCARE BY MAY 15, 2018. CLAIM FORMS CAN BE FOUND ON THE CITY INTRANET UNDER BENEFITS, IN THE BENEFITS OFFICE AND AT MYUHC.COM.

If You Are Retiring SoonIf you are planning to retire between April 1, 2017 and March 31, 2018, this open enrollment period is your last chance to select the benefit plans you’ll be taking into retirement.NOTE: Generally, retirees do not have open enrollment periods: but may make changes if they have a Qualifying Life Event. It is important for a retiree or covered dependent to enroll in Medicare Parts A & B at the time they first become eligible for Medicare. Currently, retiree premiums differ for health and life insurance, but are the same for the dental, vision, and AD&D plans. More information can be found in the publication ‘Retiree Benefits Line’. This is available in the Benefits Division and can also be found online at: stpete.org/retireebenefits.

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Reminder:

OPEN ENROLLMENT ENDS MARCH 10, 2017

VIEW THE OPEN ENROLLMENT VIDEO. GO INTO ORACLE EMPLOYEE SELF-SERVICE: LEARNING: LEARNER HOME. USE THE KEYWORD “OPEN” TO SEARCH FOR VIDEO

FREQUENTLY ASKED QUESTIONSWhat is Open Enrollment and when are changes effective?Open Enrollment is when you can make changes to your group insurance coverage for the upcoming benefityear (April 1, 2017 to March 31, 2018). During Open Enrollment you may:

1) Enroll, if you previously waived coverage;

2) Cancel coverage;

3) Add or remove dependents;

4) Change coverage amounts for Supplemental Life and/or Accidental Death and Dismemberment insurance. Submit Evidence of Insurability form to The Standard to request an increase in Supplemental Life coverage.

You must make your selections in Oracle Self-Service prior to the close of business on March 10, 2017. Required documentation must be received in the Benefits Division Office by March 13, 2017.

Coverage enrollments and changes will be effective April 1, 2017. UnitedHealthcare will send new group health insurance cards to the home address of record prior to the coverage effective date. Changes cannot be made between Open Enrollment periods unless you have a Qualifying Life Event. (Details on page 16)

What do I need to enroll?• Your Oracle ID and Password are required. If you

do not know your password and have a City e-mail address, go to the Oracle E-Business Suite Login page and click on the “Login Assistance” link and follow the prompts. A new password will be e-mailed to you. If you do not have a City e-mail address, call the DoTS Help Desk at 893-7200 and request your Oracle password be reset. The Help Desk must speak to you and you must provide the last four digits of your Social Security number and the month and day of your birth for verification.

• A valid Social Security Number must be entered in Oracle Self-Service for each covered dependent.

• If you wish to start or continue a Flexible Spending Account election, you MUST enroll via Oracle Self-Service.

• All changes and new elections must be entered in Oracle Self-Service no later than March 10, 2017.

• If you newly elect group health coverage for a child age 26 or over, you must complete the “Dependent Child Age 26 or Over – Application for Coverage” form. A separate form for each child is required.

• Required documents must be submitted to the Benefits Office by March 13, 2017.

I am a new enrollee, what do I do?Collect the required information: Social Security Numbers, birth certificates and marriage certificates if applicable, and names of all dependents along with your Oracle password. Use Oracle Self-Service to select your benefits before the end of the enrollment period (within 30 days of your date of hire for new employees) and submit required documentation to the Benefits Division. For new employees, coverage elected becomes effective on the first of the month nearest 60 days after employment. Don’t want to participate in a plan? Choose “decline coverage” in Oracle Self-Service.

What if I don’t want to make changes to my current coverage or covered dependents?No action is required to keep your current health, dental or vision coverage. The DMHO requires facility code be entered in Oracle Self-Service. If you have a Flexible Spending Account (FSA) and wish to participate in 2017 or you wish to enroll in FSA for the first time, you must enroll via Oracle Self-Service.

Confirm your address, marital status, contact information and beneficiaries are up to date in Oracle Self-Service. You may change personal information and beneficiary designations at any time during the year,

What documentation will be required to add dependents?Eligible dependents are a legal spouse, and natural, adopted or stepchildren (under the age of 30 for group health; under age 26 for dental and/or vision).

1) Children: Verification of natural children must indicate you as the parent of the child. For step-children, verification must indicate your spouse as the child’s parent. A birth certificate (not Birth Registration Card), child support court order, court-certified guardianship papers, etc. may be used. Verification of adopted/foster children must be by

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official court documents indicating the child has been placed in your home.

2) Spouse: An official marriage certificate must be provided to the Benefits Division to enroll your spouse.

Social Security Numbers must be input via Oracle Self-Service for all dependents.

If you elect coverage for a child age 26 or over you must complete the “Dependent Child Age 26 or Over-Application for Coverage” form. A separate form for each child is required.

How do I pay for my benefits?With the City's Premium Payment Plan, the cost of benefits (except for Spouse and Children’s Life Insurance and Group Health coverage for non-qualifying dependents) is paid with pre-tax dollars. Deductions will be taken for 24 pay periods per year. Exception: Flexible Spending Account deductions are deducted each pay period. The Premium Payment Plan is automatic when you enroll, however, if you do not wish premium deductions to be made pre-tax, call the Benefits Office at 727-893-7279.

What is a Qualifying Life Event?The Internal Revenue Code requires that coverageselected remain in effect for the full plan year; however, you may make changes to group insurance coverage if you have a Qualifying Life Event.

• In the event of marriage, death, divorce, legal separation, or annulment, you may add or delete a spouse from coverage. NOTE: Former spouses must be removed from coverage within 31 days of the date the divorce is final.

• Birth, adoption, placement for adoption, or death of a dependent.

• Changes in your, your spouse’s or a dependent’s employment if the change results in a loss of coverage for one of you.

• A dependent satisfying or ceasing to satisfy a plan’s eligibility requirements.

• A change in work schedule resulting in a decrease or increase in hours of employment by you, your spouse or dependent, including a switch between

part-time and full-time; a strike or lockout; or the beginning of, or return from, an unpaid leave of absence.

NOTE: Ineligible dependents must be removed from the plan within 31 days of the date they become ineligible. If you have questions or need to confirm changes to your coverage, call 727-893-7279. You must be enrolled in a plan in order for dependents to be enrolled in the same plan.

If you have a Qualifying Life Event you may:

1) Enroll in a group insurance plan;

2) Change your coverage level;

3) Cancel your coverage for yourself and/or your dependents;

4) Switch from one Supplemental Life Insurance plan to another with Evidence of Insurability if increasing coverage;

5) Cancel your Supplemental Life Insurance coverage.

In order to make any change you must first update information in Oracle Self-Service, then notify and provide appropriate documentation to the Benefits Division within 31 days of the Qualifying Life Event.

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COBRA AND HIPAACOBRAIf a Qualifying Life Event occurs that causes you or a dependent to lose coverage under any of the City’s plans, the Consolidated Omnibus Budget Reconciliation Act (‘COBRA’) allows you to continue the coverage you had immediately before the Event occurred. A COBRA Qualifying Life Event is any of the following causing you or a dependent to lose coverage under any of the City’s plans: a covered employee’s death; divorce or legal separation; termination of employment for any reason other than gross misconduct or retirement under one of the City's retirement plans; reduction in hours to fewer than the number required for plan participation; a covered child’s loss of dependent status under a plan. UnitedHealthcare will send notification of your continuation rights to your address of record. You have 60 days to determine whether you wish to continue your coverage(s) through any of the City’s plans. The election period ends 60 days from the later of (1) the date that coverage would otherwise terminate or (2) you are notified of your continuation rights by United. If you have questions about continuation coverage, contact the Benefits Division at 727-893-7279.

OTHER PROGRAMSVoluntary BenefitsThe following individual coverage is underwritten by TransAmerica and available to employees during an open enrollment period each May. Additional details about the enrollment period and how to schedule an appointment with benefits enrollment representatives from FBMC will be distributed at a later date.

• Accident Advance® - Pays benefits you can use for medical bills and other out-of-pocket expenses – or for any other purpose, including paying your mortgage or other bills.

• CriticalAssistance Plus® - Helps pay the costs associated with the initial occurrence of a heart attack, stroke, cancer or other serious illness as defined in the policy.

• Trans$ureSM Interest-Sensitive Whole Life Insurance has benefits that never decrease and premiums that never increase.

Florida 529 Savings PlanThe Florida 529 Savings Plan is a tax-advantaged plan designed to encourage saving for future college costs. A contribution amount of your choosing is deducted, after-tax, from each paycheck and invested among the available investment options that you choose. Contributions may be started, stopped or changed at any time. Withdrawals made for qualified higher education expenses are tax-free. Restrictions and fees apply, call 727-892-5115 for more information.

457 Deferred Compensation PlanThe City’s 457 Deferred Compensation Plan is a way for you to save for retirement. Contributions are deducted on a pre-tax basis from your paycheck. You have a choice of several different investment options in which to invest your contributions. When you leave City employment there are numerous options as to how and when to receive distributions. Contributions and earnings are taxable when paid out of the plan. Call 727-893-7045 for more information and instructions on how to enroll.

HIPAA -

The Health Insurance Portability and Accountability Act (‘HIPAA’) includes privacy standards for handling “protected health information,” prohibiting insurance carriers from discussing health information with third parties without approval of the member. If you have issues with the insurance carrier, other than enrollment or deductions, contact United’s Member Services at 1-800-377-5154. If the issue cannot be resolved, call 893-7911 to speak with our UHC on-site representative. The City's HIPAA Privacy Policies and Procedures can be found on the Intranet under Benefit News. Questions regarding the City’s HIPAA Policy can be directed to the HIPAA Privacy Officer at 727.893.7372.

CONTACT INFORMATIONThe Florida Relay Service is a link for individuals who are deaf, hard of hearing, deaf/blind or have speech disabilities. Florida Relay Service uses specialized equipment to communicate with others using standard telephone equipment. Dial 711, toll free, and a relay operator will answer your call.

Contact information and links to the carrier web sites are below. Plan information and links can also be found in the Benefits section on the City’s Intranet.

• For Health Plan questions contact: On-site United Representative located in MSC at 727-893-7911 or UnitedHealthcare Customer Service at 1-800-377-5154 or visit myuhc.com

• After April 1, 2017, for Dental Plan questions contact Humana at 1-800-979-4760 or

visit humana.com

• For Vision Plan questions contact: Humana 1-877-398-2980 or visit humana.com

• For Supplemental Life Insurance or Accidental Death & Dismemberment policy questions contact: The Standard 1-800-325-5757 or visit standard.com

Mail any required Evidence of Insurability forms to: The Standard Insurance Company Medical Underwriting 900 S.W. Fifth Avenue, Portland, OR 97204

• For Employee Assistance Program (EAP) contact: ComPsych at 1-888-327-5769

(TDD: 1-800-697-0353) or go online atguidanceresources.com. Company Web ID: STPETE

REMEMBER!

OPEN ENROLLMENT IS THE ONLY TIME TO MAKE CHANGES IN YOUR BENEFIT PLANS UNLESS YOU HAVE A QUALIFYING LIFE EVENT.

OPEN ENROLLMENT IS FEBRUARY 27 THROUGH MARCH 10, 2017.

You must make all selections in Oracle Self-Service by March 10, 2017, and you must submit any required documents to the Benefits Division by the March 13, 2017 deadline for enrollment to be effective. Enrollments in Oracle Self-Service may be made from a City computer, a department kiosk or from a non-City computer. Employees now have access to Oracle Self-Service from home (or other than work computers):

• Go to stpete.org/hr

• Choose the Employee Self-Service option on the left side menu

This guide is a summary and is not intended to describe the benefit plans. Benefit plans are governed by the applicable plan documents of each plan and anything in this summary that is inconsistent with the plan documents shall be superseded by and governed by the plan documents as well as the rules and regulations of the City of St. Petersburg. Full plan documents as well as all required notices can be accessed on the City’s Intranet in the ‘Benefits’ section

Benefits Division One Fourth Street North St. Petersburg, FL 33701727-893-7279