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2020Employee Benefits GuideThis guide is intended to provide a review of the many benefits availableto you as an employee of Hillsborough County.Please take the me to become familiar with your benefits. Addi onalinforma on is available on the Employee Benefits page on COIN.Thank you for your service to Hillsborough County.Plan Year January 1, 2020 ‐ December 31, 20205And moreLife & Disability4VisionMedical13Dental2If you have Medicare or will become eligible forMedicare in the next 12 months, a federal law givesyou more choices about your prescrip on drugcoverage. Please refer to the Medicare D no ce inthis benefits guide for more details on page 34.

Introduction and Benefits EligibilityIntroduc onHillsborough County BOCC (HCBOCC) understands that your benefits are important to you and your family. Helping youunderstand the benefits available to you is essen al. This Benefits Guide provides a descrip on of our benefit program.This guide is not an employee/employer contract. It is not intended to cover all provisions of all plans, but rather aquick reference to help answer most of your ques ons. Please see the carrier benefit summaries for more details.Included in this guide are summary explana ons of the benefits, as well as contact informa on for each provider. It isimportant to remember that only those benefit programs for which you are eligible and have enrolled apply to you.We encourage you to review each sec on and to discuss your benefits with your family members. Be sure to pay closea en on to applicable co‐payments and deduc bles, how to file claims, preauthoriza on requirements, par cipa ngnetworks and services that may be limited or not covered (exclusions). We hope this guide will give you an overview ofyour benefits and help you be be er prepared for the enrollment process.Benefits EligibilityEmployeeBenefit eligible employees are provided an opportunity to par cipate in the HCBOCC sponsored benefits program uponini al hire and annually during Open Enrollment. You are eligible for benefits on the first day of the month following 30days of employment if you are a permanent employee regularly scheduled to work 30 or more hours per week.(The wai ng period for disability insurance is 6 months.)Please refer to the following guidelines regarding eligibility and elec on changes.New employees must enroll in their benefits within 30 days of their date of hire.DependentA dependent is defined as a covered employee’s legal spouse, a domes c partner (certain rules apply, see Domes cPartner Benefits Guideline on COIN), or a dependent child of the employee or employee’s spouse. Dependent childrenwill be covered up un l their 26th birthday.A dependent child is defined as: A natural child A step‐child A legally adopted child A child of your domes c partner (certain rules apply) A child placed for adop on Grandchildren up to 18 months of age if the parent is also a covered dependent on the plan A child for whom legal guardianship has been awarded to the covered employee or the employee’s spouse Unmarried children of any age who become mentally or physically disabled before reaching the age limit, and whoare covered under the benefit programs before reaching the age limit. Suppor ng documenta on is required at theme of con nua on beyond limi ng age.Full names and social security numbers for all covered dependents must be added on Oracle Employee Self Serviceunder “Personal Informa on” or Benefits Enrollment.”FL Statute 627.6562 Dependent Coverage: A con nua on of Health insurance coverage is available for over‐agedependents between the ages of 26 to 30. Please contact the Human Resources for more informa on.2

OverviewQualifying EventCoverage elec ons made at Open Enrollment CANNOT be changed un l the next Open Enrollment period. The onlyexcep on to this IRS Sec on 125 Rule is if you experience a “Qualifying Event.” A Qualifying Event allows you to make achange to your benefit elec ons within 30 days of the event.Examples of Qualifying Events include, but not limited to: Marriage Divorce or legal separa on Birth, adop on, or legal custody of a dependent child Involuntary loss/gain of other group insurance coverage Death Eligibility requirements reached for Domes c Partner BenefitsIf you experience a Qualifying Event, contact Human Resources and submit all required documenta on within 30days of the event. Documenta on must be supplied to Human Resources, Benefits Unit via Docusign .YOUR ResponsibilityBefore you enroll, make sure you understand the plans and ask ques ons if you do not. A er you enroll, you shouldalways check your paycheck stub to make sure that the correct amount is being deducted and all of the benefits youelected are included. Print or save your Oracle Benefits Enrollment Confirma on Statement as proof of enrollment.Any correc ons must be made within the first 30 days of enrollment. You should also verify that all beneficiaryinforma on is up to date.3

Medical InsuranceMedical InsuranceEffec ve January 1, 2020 HBOCC will con nue to provide two (2) plan op ons through Cigna. The plans offered are the“Modern Plan”, and the “Tradi onal Plan”.Both plans are open access. This means you do not need to obtain referrals for specialist visits nor are you required toselect a Primary Care Physician (PCP).Both plans have In and Out‐of‐Network benefits. By using In‐network providers, you may have a higher level ofbenefits and lower out‐of‐pocket expenses.MyCigna.comWe encourage you to register on mycigna.com. This site provides you access to your benefits and can help you find outwhat is covered, view recent claim ac vity, find doctors and services and get health advice. On mycigna.com you alsowill be able to see plan premiums as well as get es mates for the cost of certain services using the cost of carees mator. Many of the programs are listed below. Click here for the video.MyCigna Mobile AppYou are busier than ever. Cigna understands that. While they can’t wave a magic‐wand and make all of the frustra ng,me‐consuming aspects of your life go away, they can give you a tool to help make your life easier. And healthier.Download the mobile app from the Apple Store or Google Play and get access to your ID cards, find a doctor near you,look up your claims and account balances all while you are on the go! Click here for the video.TelehealthCigna Telehealth Connec on let’s you get the care you need ‐ including most prescrip ons ‐ for a wide range of minorcondi ons. Now you can connect with a board‐cer fied doctor via video chat or phone, without leaving your home oroffice. When, where and how it works best for you. Use Telehealth to connect with a doctor about acne, allergies,rashes, headaches, sore throats, colds, fevers and more! Register at eitherAmerican Well: amwellforcigna.com 1 (855) 667‐9722 or at MDLive mdliveforcigna.com 1 (888) 726‐3171MyCignaplans.comNeed help choosing a plan? Cigna now offers access to a benefit planning tool to help you with your decisions. Visitmycignaplans.com and enter the following criteria: Username ‐ myhealthhcbocc and Password ‐ cigna. A er logging inyou will see informa on about the plan op ons available to you through the County. You can review how the planswork, the benefit summaries and access frequently asked ques ons. You can also compare medical and prescrip ondrug costs, use the Health Savings Account calculator to see poten al tax savings and check ways on how you can helpcontrol your own healthcare costs. If you want to speak to someone about your medical plan op ons you can also callCigna at (800) 401‐4041.Cigna One GuideThe myCigna app just got be er! With One Guide you can build your own customized health team. Create a personallist of your physicians, den sts and facili es along with their contact informa on for easy access. You can also sign upto receive messages that can guide you to savings and coaching opportuni es. One Guide also helps you keep track ofappointments and reminds you to get your preven ve care. You can also chat with your own Personal Guide at Cigna .Your Personal Guide can help you get answers and make the most out of your Cigna health plans. Click here for moreinforma on on One Guide4

Cigna Modern PlanAdministrator NameCignaType of PlanNetwork AccessHillsborough County Health PlanIn NetworkOut of NetworkHCBOCC Employer HSA Contribu onPer Employee Per Year 750 Single / 1,500 FamilyCalendar Year Deduc bles (CYD)Individual 2,500 5,000Family 5,000 10,00010%30%Individual Medical Out‐Of‐PocketMaximum 4,000 8,000Family Medical Out‐Of‐Pocket Maximum 8,000 16,000Primary Care Physician (PCP) Office Visits10% A er CYD30% A er CYDSpecialist Office Visits10% A er CYD30% A er CYDPreven ve Care VisitsNo Charge30% A er CYDYour Benefit PlanCoinsurance (when applicable)Professional ServicesTelehealth Physician Service10% A er CYDHospital ServicesInpa ent Hospitaliza on10% a er CYD30% A er CYDOutpa ent Hospital10% A er CYD30% A er CYDUrgent Care Center10% A er CYD10% A er CYDEmergency Room10% A er CYD10% A er CYDIndependent Lab/ X‐ray10% A er CYD30% A er CYDMRI, MRA, CT & PET Scans10% A er CYD30% A er CYDGeneric10% A er CYD30% A er CYDPreferred Brand10% A er CYD30% A er CYDNon‐Preferred Brand10% A er CYD30% A er CYDSelf Administered injectables10% A er CYD30% A er CYDCigna Now Retail Pharmacy (90‐day supply)10% A er CYD30% A er CYDMail Order Pharmacy (90‐day supply)10% A er CYDNot CoveredPharmacy Out‐Of‐Pocket MaximumN/A ‐ Included in medical out‐of‐pocket maximumPharmacy5

Cigna Traditional PlanAdministrator NameCignaType of PlanNetwork AccessHillsborough County Health PlanIn NetworkOut of NetworkIndividual 1,000 2,000Family 2,000 4,00010%30%Individual Medical Out‐Of‐PocketMaximum 3,000 7,000Family Medical Out‐Of‐Pocket Maximum 6,000 14,000Primary Care Physician (PCP) Office Visits 35 Copay30% A er CYDSpecialist Office Visits 50 Copay30% A er CYDPreven ve Care VisitsNo Charge30% A er CYDCalendar Year Deduc bles (CYD)Your Benefit PlanCoinsurance (when applicable)Professional ServicesTelehealth Physician Service 20 CopayHospital ServicesInpa ent Hospitaliza on10% a er CYD30% A er CYDOutpa ent Hospital10% a er CYD30% A er CYDUrgent Care Center 75 Copay30% 300 300Maximum of 75 Copay30% A er CYDMaximum of 300 Copay (per scan)30% A er CYDGeneric 15 Copay30% A er CopayPreferred Brand 40 Copay30% A er CopayNon‐Preferred Brand 60 Copay30% A er Copay25%30%Cigna Now Retail Pharmacy (90‐day supply) 30/ 80/ 120/25%Not CoveredMail Order Pharmacy (90‐day supply) 20/ 60/ 90/25%Not CoveredEmergency RoomIndependent Lab/ X‐rayMRI, MRA, CT & PET ScansPharmacySelf Administered Injectables & SpecialtyMedica onsPharmacy Out‐Of‐Pocket Maximum 2,500 Individual/ 5,000 Family6