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Retiree - Miami-Dade County Public Schools

Retiree Medical & Flexible Benefits Guide Improving Our Wellness Together 20. M-DCPS. 12. For assistance in English, please call Para ayuda en Espa ol, llame a Si'w ta bezwen yon moun ki pale Krey l ki pou ede'w, tanpri rele nan nimewo Important Phone Numbers and Hours of Operation ENROLLMENT ASSISTANCE OTHER IMPORTANT NUMBERS Legal Plans For assistance in completing your Miami-Dade County Public Schools ARAG . enrollment form, you may visit us at: The Office of Risk and Benefits Management Customer Care Office of Risk and Benefits Management Monday through Friday from 8:00 - Mon - Fri, 8 - 8 ET. 1501 NE 2nd Avenue Suite 335 4:30 ET Monday through Friday , , , from 8:00 - 4:30 ET , Access Code: 10287mds , SeniorAdvocatetm Plan Miami-Dade County Public Schools ARAG Eldercare Program HEALTHCARE PROVIDERS Office of Retirement Mon - Fri, 8 - 8 ET.

3 www.aescools.net Table of Contents 4 Retiree Open Enrollment Facts 7 Open Enrollment Information for New Retirees 8 Payment Method & Cancellation Frequently Asked Questions

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Transcription of Retiree - Miami-Dade County Public Schools

1 Retiree Medical & Flexible Benefits Guide Improving Our Wellness Together 20. M-DCPS. 12. For assistance in English, please call Para ayuda en Espa ol, llame a Si'w ta bezwen yon moun ki pale Krey l ki pou ede'w, tanpri rele nan nimewo Important Phone Numbers and Hours of Operation ENROLLMENT ASSISTANCE OTHER IMPORTANT NUMBERS Legal Plans For assistance in completing your Miami-Dade County Public Schools ARAG . enrollment form, you may visit us at: The Office of Risk and Benefits Management Customer Care Office of Risk and Benefits Management Monday through Friday from 8:00 - Mon - Fri, 8 - 8 ET. 1501 NE 2nd Avenue Suite 335 4:30 ET Monday through Friday , , , from 8:00 - 4:30 ET , Access Code: 10287mds , SeniorAdvocatetm Plan Miami-Dade County Public Schools ARAG Eldercare Program HEALTHCARE PROVIDERS Office of Retirement Mon - Fri, 8 - 8 ET.

2 Under 65 Healthcare Plans Monday through Friday from 8:00 - Cigna Healthcare 4:30 ET , Access Code: 24-hours/7 days a week 10287mds State of Florida Retirement Division US Legal Monday through Friday from 8:00 - Family Defender 4:30 ET Customer Service Over 65 Healthcare Plans Humana or Humana Customer Service Available 24/7. (TTY: 711). FLEXPLAN PROVIDERS Hours of service for questions protector/mdcps before enrollment: Dental Plans 8 8 , Monday Friday SafeGuard MetLife DHMO Plans Senior Protector Customer Service/Claims Customer Service Hours of service for all other questions: Mon - Thur, 8 - 8 (All Zones) Seven days a week from 8 to 8 Fri, 8 - 5 (All Zones) Available 24/7. Our automated phone system may answer your call after 6 , and on Saturdays, protector/mdcps Sundays, and some holidays; leave a message and we'll call back by the end of MetLife Indemnity Plans Customer Service/Claims Identity Theft Plan the next business day Mon - Thur, 8 - 8 (All Zones) ID Watchdog, Inc.

3 Fri, 8 - 5 (All Zones) Customer Service HumanaFirst 24 Hour Nurse Advice Line (TTY: 711) Mon - Fri, 8 - 6 (MST). 24 hours a day, seven days a week If you have questions about symptoms you're experiencing but aren't sure if Life Insurance Hospital Indemnity Coverage you need to see your doctor, call the MetLife Group Life Claims Life Insurance Co. of North America HumanaFirst Nurse Advice Line. Customer Service (A Cigna Company). Customer Service/Claims MEDICARE Mon - Fri, 8 - 8 ET. Mon - Fri, 7 - 10 ET. or , , option #2. 24 hours/ 7 days a week. TTY: Vision Plan Voluntary Life Insurance UnitedHealthcare Vision and Accidental Death and Social Security Customer Service Dismemberment (AD&D). Mon - Fri, 8 - 11 ET. MetLife Voluntary Life Claims TTY: Sat 9 - 6:30 ET. Customer Service Mon - Fri, 8 - 8 ET. , option #2. 2. Table of Contents 4 Retiree Open Enrollment Facts Flexible Benefits 7 Open Enrollment Information for 81 How to Check Your Flexible New Retirees Retiree Benefits 8 Payment Method & Cancellation Dental Plans frequently asked Questions 82 MetLife Dental Comparison Chart 9 Changing Your Benefits During 83 SafeGuard Standard DHMO Plan the Plan Year SGC-1033.

4 11 Dependent Eligibility 89 SafeGuard High DHMO Plan 13 Dependent Eligibility Documentation SGC-1034. Requirements 98 MetLife Indemnity Dental 14 Domestic Partner Eligibility Comparison Chart Documentation Requirements 15 Affidavit of Domestic Partnership Vision Plan 16 Adult Child Notice 102 UnitedHealthcare Vision Plan Healthcare Plans Identity Theft Plan 17 Healthcare Q&A 105 ID Watchdog Identity Theft Plan 19 Cigna Healthcare Plans Effective 1/1/12 - 3/31/12 Legal Plans 20 Summary of Benefits (OAP 10) 107 ARAG Legal Plan 31 Summary of Benefits (OAP20) 114 US Legal Family Defender 40 Cigna Healthcare Plans Effective 4/1/12 - 12/31/12 Senior Legal Plans 41 Summary of Benefits (OAP 10) 112 ARAG SeniorAdvocateTM. 52 Summary of Benefits (OAP20) 116 US Legal Senior Protector 63 Healthcare Benefits Hospital Indemnity Coverage 65 Pre-Certification 119 Life Insurance Company of North 67 Guide to Your Explanation America (LINA).

5 Of Benefits Voluntary Life Insurance 70 Prescription Medication Benefit 121 MetLife Voluntary Life Insurance Over Age 65 Humana Healthcare Plan Summaries Accidental Death and Dismemberment (AD&D). 71 Humana Healthcare 123 MetLife AD&D. 74 Humana Comparison for HMO. 76 Humana Comparison for PPO Retiree Rates & Notices 79 General Limitations and Exclusions of 129 Retiree Rates Medical and Pharmacy Benefits 136 Important Notices 3 Retiree Open Enrollment Facts To Learn More About Your 2012 Benefits log on to : View your online Retiree Benefits Guide at Click on Employee Benefits, then click on Retiree link, then click on the 2012 Retiree Benefits Guide View your Provider Directories View Flexible Benefits Provider links Additional Important Resources If You Are A Continuing Retiree If you do not return an enrollment or cancellation form, your benefits will continue and your FRS deduction or Direct Billing coupon will Benefits Effective January 1, 2012 automatically be adjusted.

6 - March 31, 2012 Changes made during this enrollment will become effective January 1, 2012. Enrollment Facts: You may only select healthcare and flexible benefits if you are This is a changes only enrollment, so if you do not return your currently enrolled in both. enrollment form, your current benefits will continue. Plan design changes and premiums will automatically be adjusted. If you are currently enrolled in healthcare only, you may not select any FlexPlan Benefits. Cigna Healthcare will continue to be the insurance provider for retirees and dependents Under 65 and not Medicare eligible. If you are participating in the Flexible Benefits Plan only, you only need to return an enrollment form if making changes to your flexible Humana Group Medicare will continue to be the provider for retirees benefits selection. Over 65 or Under 65 and Medicare eligible.

7 If you do not return an enrollment form, your current flexible benefits If you are currently having FRS deductions and are not making will continue, plan design and premium changes will automatically any changes for 2012, a new FRS Payroll Authorization form is not be applied. required. If you are currently enrolled in flexible benefits only, you cannot Additionally, current direct pay participants will automatically be enroll in healthcare. sent payment coupons if not making any changes. If you wish to cancel your and/or your dependent(s) healthcare coverage, please complete the enclosed "2012 Benefits Coverage Cancellation Request form" and return it by the deadline. If you cancel your coverage, you will not be allowed to reinstate the healthcare coverage or any flexible benefits with a School Board- sponsored plan at another time.

8 The materials contained in this notebook do not constitute an insurance certificate or policy. The information provided is intended only to assist in the selection of benefits. Final determination of benefits, exact terms and exclusions of coverage for each benefit plan are contained in certificates of insurance issued by the participating insurance companies. Additionally, you can view them by logging onto by clicking on Employee Benefits and then under the Retiree column, click on Certificates. The School Board of Miami-Dade County , Florida reserves the right to amend or to terminate the Plan described in this booklet at any time, subject to the specific restrictions, if any, in the collective bargaining agreement. In the event of any such amendment or termination, your coverage may be modified or discontinued and the School Board assumes no obligation to continue the benefits or coverages described in this booklet.

9 4. Retiree Open Enrollment Facts Open Enrollment Retiree And Dependent(s). Benefits Effective April 1, 2012 - Under 65 And Not December 31, 2012 Medicare Eligible This is a changes only enrollment for retirees currently enrolled in Cigna and not Medicare eligible. Cigna Open Access Plus Plans: The School Board of Miami-Dade County , Florida, is committed to If you do not make any changes to your current benefits, your current providing you and your eligible dependents with the highest quality of benefits will continue. Both plan design and premium changes will benefit selections available. automatically occur. Cigna Open Access Plus (OAP) 10 Employee electing this plan will If you wish to continue your dependent and/or your adult child, you continue to pay a cost-share based on their salary band. do not need to re-enroll your adult child, coverage will automatically continue, and plan design and premiums will automatically be Cigna Open Access Plus (OAP) 20 Remains a free-option, no-cost adjusted.

10 For employee only coverage. The School Board of Miami-Dade County , Florida, is committed to Primary Care Physician co-payment remains at $20 per visit. providing you and your eligible dependents with the highest quality Introduction of the CIgna Care Network (CCN) Specialist, a specialist benefit selections available. designated network that has been identified by Cigna to have demonstrated the best in management of patient treatment. If you and/or your dependent are Medicare eligible and enrolled in Humana, your coverage continues. Cigna Care Network (CCN) Specialist co-pay at $50 per visit. Non CCN Specialist co-pay at $70 per visit. If you do not return an enrollment form, making changes to your current plan or a Cancellation Form, your FRS deduction or Direct Minimal pharmacy co-payment increases, services performed at Billing coupon will automatically be adjusted to reflect the new Cigna Emergency Rooms, Urgent Care Centers and Conventional Centers rates.


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