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CITY OF ST. PETERSBURGBenefits Gttlde For RetireesEffective April I, 2021No Annual Retiree MeetingDue to Covid-19 Restrictions. ,Please Joinit ual MeetingtingJ in BenefitsB n fit forr a Virtual.Friday,n a March 5, 20212 219 a.m.a.111. tot 11I 1 a.m.111.ToT JoinJ in Zoom11 g111 ID:D: 2882 067 2739 orrDialI by 1 646 876 9923 US.st.petersburg. . '\.WIIIWWW.Slpele. oruThis information will be made available in alternate formats for persons with disabilities upon request.Page 1 of 10

Healthcare Plan Options for RetireesAvailable for Retirees with Medicare PartsUnitedHealthcare CHOICE (EPO)A&BUnitedHealthcare CHOICE PLUS - BASEUnitedHealthcare CHOICE PLUS (PPO)OPTION (PPO)UnitedHealthcare CHOICE HDP WITH HRAHUMANA GOLD (HMO)UnitedHealthcare BASIC HDPHUMANA CHOICE (PPO)MEDICARE Upon Medicare eligibility, (generally Age 65) Medicare automatically becomes the primary payorand the City’s plan becomes secondary, regardless of whether not you enroll in Medicare. Medicare Parts A & B coverage is required for your benefits to properly coordinate. Medicare Part D is not needed when a retiree is covered by UnitedHealthcare or Humana planssince the City’s coverage has pharmacy included which is as good or better than Medicare Part D. If you become eligible for Social Security Disability Benefits, you should enroll in MedicareParts A & B coverage. Once you submit a copy of your Medicare card to the Benefits Divisionyou will be eligible to change your Healthcare plan option.COVERAGE FOR SURVIVING DEPENDENTS If you retired prior to March 1, 1978 – Coverage continues until the end of the period forwhich the surviving dependent receives pension benefits; the City contributes to health coveragepremiums. If you retired from March 1, 1978 - March 31, 1988 Coverage continues for the earlier of a)12 months; or b) the end of the period for which pension benefits are received; the City’scontribution for health coverage continues. COBRA coverage is available for the balance of a36-month period after the date of death at the full cost of the premium plus a 2% administrativefee. (No City contribution). If you retired after April 1, 1988 - COBRA coverage for up to 36 months will be offered at thefull cost of the premium plus a 2% administrative fee. (No City contribution).FREQUENTLY ASKED QUESTIONSWhere can I learn more about Retiree Benefits? Please join us for our Zoom meeting on FridayMarch 5, 2021 9:00am – 11:00. To Join Zoom Meeting go to https://zoom.us/j/2880672239Meeting ID: 288 067 2739. Or Dial 1 646 876 9923 US & enter meeting number 288 067 2739Can I change or drop enrollments? Changes can be made when you or your dependent experiencea qualifying life event OR you want to decrease your coverage. Once you elect to drop coverageyou will NOT have the option to re-enroll in that coverage. Changes are effective the first of themonth following the request and the receipt of required documentation by the Benefits Division.Page 2 of 10

Qualifying life events are, you (or a dependent): turning age 65, being approved for SocialSecurity Disability, marriage, birth of a child, adoption, divorce, loss of benefit coverage,death.How long do I have to report a qualifying life event to the Benefits Division? Retirees have upto 30 days after the qualifying life event contact the Benefits Division and complete the requiredforms and provide certified documentation.What happens if I sign up for an outside supplemental Medicare plan while enrolled in amedical plan offered by the City? Your City medical plan will be cancelled, and you will nothave the option of re-enrolling in the City’s plan.How long does someone turning 65 have to change to a Medicare plan with the City of St.Petersburg? Retirees age 65 and over can make this election at any time. Retirees must be enrolledin Medicare Parts A & B. Enrollment is not retroactive.Can a life insurance/AD&D beneficiary be changed? Retirees can change their life insuranceand/or AD&D beneficiary at any time. A beneficiary change form must be completed and sent tothe Benefits Division; you can request a form by calling 727-893-7819 or download a form atwww.stpete.org/retireebenefits.What is the difference between the Choice Plus and Choice Plus Base Option? The Choice PlusBase Option Plan has a lifetime maximum benefit of 100,000. The Choice Plus Plan has nolifetime maximum.If enrolled in the Choice Plus Base Option, how can I track my lifetime maximum benefit of 100,000? You can check your balance by (1) Calling UHC Customer service at 1-800-396-8810:or (2) Call our UHC rep, Lauren Gibson at 727-893-7911; or (3) Visit the myuhc website atwww.myuhc.comWhat happens if I reach the maximum benefit of 100,000? If you reach the 100,000 lifetimemaximum limit you are ineligible to stay in the Choice Plus Base Option plan and will have aonetime opportunity to enroll in another health plan the City offers.What happens if I am traveling and have an emergency? All plans cover emergency services.Contact the carrier as soon as possible if you have an emergency.What happens if I am on the Humana HMO plan and I move out of the service area? You willnot be able to remain on the plan. You have a onetime opportunity to transfer to the Humana ChoicePPO plan or United Choice Plus Base Option plan.Where can I get bloodwork? Laboratory tests can be completed at a LabCorp or Quest DiagnosticsFacility. Visit labcorp.com or questdiagnostics.com for locations.Where can I register for UnitedHealthcare’s Diabetes Program? You register online athttps://dhp.healthmine.com/#/ or by calling 1-866-944-9001Page 3 of 10

Health and Wellness Center603 7th Street South, Suite 350. St. Petersburg, FL, 33701Hours of operation: Monday – Friday 8:00am to 5:00pmClosed 12:00 – 1:00 for LunchPhone number: (727) 553-7474Dr. Israel Wojnowich and his staff offer primary care services, chronic disease management andepisodic illness treatment along with other services. Benefits of the Wellness Center include: High Quality Health Care provided by a Board-Certified Family Practice PhysicianSecure, Private, HIPAA CompliantEvaluation and Coaching to Minimize Health Risks and Improve Quality of LifeNo Co-pay if eligible and covered by City medical insurance.No Co-pay for Prescriptions dispensed at Center, if eligible and covered by Citymedical insurance.The City of St. Petersburg Health and Wellness Center is open to all Retirees covered underone of the City’s group health plans, and Dependents (age 14 & over) of Retirees who arecovered under one of the City’s group health plans.Wellness PortalThe Wellness Portal is open to all retirees. This web-based tool provides a large amount of healthand wellness information and resources to help you, including online coaching.Go to https://cospwellness.mycernerwellness.com and register.Retiree WebsiteInformation about the City’s benefit programs is now available on the City’s retiree website. Goto www.stpete.org/retireebenefits and enter your retiree ID number to register. Add your emailaddress and you’ll be added to our electronic mailing list. This site contains electronic versionsof plan summaries, forms and other benefit information.Pensioner Self-ServiceThe Self-Service Portal allows retirees to make changes to personal information and accesselectronic information about their retiree benefits. To access, go to http://athena.stpete.org. Formore detailed information, including assistance with logging in to the Self-Service portal, pleasecontact the Pension Division at 727-893-7045.ICMA-RCRetirees who have an account(s) with ICMA-RC may initiate a withdrawal or rollover by accessingtheir account online at www.ICMARC.com or by calling (800)669-7400. It is no longer necessaryto complete a form requiring a signature from the city.Page 4 of 10

Humana Dental PlansRetirees enrolled in the DHMO must select a participating provider. You will need tocontact Humana directly to designate/update your participating provider. Call customerservice at 1-800-979-4760 for participating providers and to request a copy of your card.Group ID#782141Monthly CostSingleTwo PersonFamilyHumana DHMO HS195 17.18 30.05 47.25Humana PPO 27.56 58.42 90.20Humana Vision PlansCall customer service at 1-800-979-4760 for participating providers and to request a copyof your card. Group ID#782141Monthly CostSingleTwo PersonFamilyVision Basic 0.96 1.45 2.42Vision High Option 6.01 11.97 16.01Basic Life and AD&D – Standard Life InsuranceCompany Policy Group Policy #631957Life Insurance is offered by The Standard Life Insurance Company. The amount of yourcoverage amount was determined at the time you retired and cannot be changed. Rates areunchanged for 2021.Monthly Rates, Per 1,000 of CoverageBasic Life 5.366AD&D - Single .023AD&D - Family .035Page 5 of 10

2021 – 2022 Group Health PlansUnitedHealthcare and Humana will continue to administer the City’s group health plans for retirees. See the“Summary of Benefits and Coverage” for more details. There are no changes in benefits for the 2021-2022 planyear.Retiree Group Health Plan Comparison & RatesPlanUHC Choice (EPO)In-Network OnlyUHC Choice Plus (PPO)In-Network *UHC HDP planIn-Network * 750 Individual 1,500 Family0% 300 / 3 days anddeductible 250 co-pay anddeductible 30 - 50co-pay 50 and deductible 750 Individual 1,500 Family10% 300 / 3 days thenco-ins and deductible 250 co-pay anddeductible 30 - 50co-pay 50 and deductible100% Coverage100% CoverageSkilled nursing facility100% coverage anddeductible (Limit: 60 daysper plan year)10% co-ins anddeductible (Limit: 60 daysper plan year)Rehabilitation Services 30 co-pay per visit (limit60 visits each type ofservice, multiple visits perday) 35 co-pay per visit (limit60 visits each type ofservice, multiple visits perday)Outpatient Surgery hospital100% coverage afterdeductible10% co-ins and deductible10% co-insand deductibleAnnual Out of PocketLimit 3,000 individual, 6,000 Family 3,000 individual, 6,000 Family 3,500 individual, 7,000 FamilyNo lifetime maximumbenefitNo lifetime maximumbenefitNo lifetime maximumbenefit 15; 35; 50; 25%Tier 2-4 200/ 400deductible. Accumulatesto Annual Out of Pocket 15; 35; 50; 25%Tier 2-4 200/ 400deductible. Accumulatesto Annual Out of Pocket 15; 35; 50; 25%Tier 2-4 200/ 400deductible. Accumulatesto Annual Out of PocketAnnual DeductiblesCoinsuranceHospitalEmergency RoomPhysician:Urgent Care CenterPreventative CareLifetime MaximumBenefitPrescription DrugCoverage(Tier 1-4) 1,750 Individual 3,500 Family10% 300 / 5 days thenco-ins and deductible 250 co-pay anddeductible 25 - 45co-pay 50 and deductible100%Coverage10 % co-ins anddeductible(Limit: 60 days per planyear) 35 co-pay per visit (limit60 visits each type ofservice, multiple visits perday)*Out of Network Benefits available. See the SBC or SPD for more information. Find the SBCand SPD at www.stpete.org/retireebenefitsPage 6 of 10