Office of Human Resources, Montgomery County Government 2021 Open Enrollment Benefits Bonanza
Transcript
Office of Human Resources Montgomery County Government
2021 Open Enrollment Benefits Bonanza
Office of Human Resources Montgomery County Government
What Is Open Enrollmentbull Open Enrollment is the only time of year when employees can make changes to
the following plans for next yearrsquos benefit elections without needing a qualifying life event Medical Prescription Dental Vision Optional Life Healthcare amp Childcare FSAs AFLAC Short Term Disability or Critical Illness
Available to unrepresented and IAFF employees only
Office of Human Resources Montgomery County Government
What Changes Can be Made Changes employees can make during Open Enrollment are
bull Enroll in the benefit plan(s) for the first timebull Adddelete dependent(s)bull Change from one plan to another bull Drop coveragebull Enroll in or increase Optional Life insurance bull (Re)enroll in a Flexible Spending Accountbull Enroll in AFLAC short-term disability or critical illness
Available to unrepresented and IAFF employees only To enroll contact AFLAC directly
Office of Human Resources Montgomery County Government
Open Enrollment Dates2021 Open Enrollment (OE) runs from September 21 ndash October 9 2020
bull All OE changes must be submitted during the OE windowBegins ndash Monday September 21 at 8 am Deadline ndash Friday October 9 at 5 pm
bull OE changes are effective January 1 2021
Office of Human Resources Montgomery County Government
MCG Continues to Make Generous Employer Contributions
bull This graph provides a visual example of the extremely generous employer contributions that MCG makes toward employee insurance premiums
bull These contributions reduce the amount employees pay This is an important part of their total compensation package as an MCG employee
Note The chart above reflects Self only contributions To view charts reflecting Self+1 and Self+Family contributions visitthe Open Enrollment website after September 21 2020
Office of Human Resources Montgomery County Government
New for 2021bull 2021 Open Enrollment will be held virtually this year All of MCGrsquos carriers will be
hosting virtual presentations and QampA sessions See the virtual event tab on the Open Enrollment website for a schedule of virtual events
bull The Health Care FSA annual contribution limit increasing to $2750 The amount you can contribute for 2021 will increase by $50
bull Health Care FSA now allows Over-the-counter expenses without a prescription (ie allergy heartburn or pain relief medications etc)
bull Benefits Bites delivered to your County email weekly via the MCG Employee Connect newsletter Be sure to check the Benefits Bites section for helpful Open Enrollment tips and resources
bull Enhanced Open Enrollment website with new Frequently Asked Questions and a dedicated MCG discount amp resource section
Office of Human Resources Montgomery County Government
Special 2021 Plan Rates AnnouncementCOVID-19 has impacted us in many ways including financially In light of the fact that employees will not be receiving a General Wage Adjustment (GWA) in FY21bull There will be 0 rate increase for these medical plans
CareFirstUnited HealthcareCVS Caremark
bull The Kaiser medical plan costs are decreasing bull The County will pay a large portion of the dental PPO and vision increases but
these increases will also be shared with employees
Office of Human Resources Montgomery County Government
Employee Rate Changes for Calendar Year 2021Plan Per Pay Period Increase
Self Self + 1 FamilyCareFirst High Option POS $000 $000 $000CareFirst Standard Option POS $000 $000 $000Kaiser -$147 -$276 -$435United HealthCare HMO $000 $000 $000CVS Standard Prescription Plan $000 $000 $000CVS High $4$8 Prescription Plan $000 $000 $000CVS High $5$10 Prescription Plan $000 $000 $000CIGNA PPO Dental $041 $094 $134CIGNA DHMO Dental $000 $000 $000EyeMed Vision $009 $014 $020
Office of Human Resources Montgomery County Government
Planning Ahead Minimizing Future Rate IncreasesHere are ways employees can work together with MCG to keep future plan rate increases at a minimumbull Seek out preventive care such as annual exams and age-based screeningsbull Visit in-network doctors via virtual visitsbull Use urgent care facilities for non-emergent services rather than going to the
emergency roombull Choose generic prescription drugsbull Maximize wellness resources through health insurance carriers and MCGrsquos LiveWell
program
Office of Human Resources Montgomery County Government
New for 2021bull All Open Enrollment events held virtually this yearMCGrsquos carriers will be hosting virtual presentations and QampA sessionsOHR Virtual Office Hours
bull Health Care FSA changesAnnual contribution limit increasing to $2750Over-the-counter expenses are permitted without a written prescription Feminine products are now an eligible expense
bull New Open Enrollment Communication MethodsBenefits Bites delivered in the MCG Employee Connect newsletter Enhanced Open Enrollment website
bull Frequently Asked Questionsbull MCG employee discount amp resource section bull Employee self-service (ESS) instructions and demonstrationsbull MCG vendor video presentations
Office of Human Resources Montgomery County Government
Open Enrollment Communications bull 2021 Open Enrollment Guides were mailed to homes on September 11
Employees should receive the guides between September 14 ndash 16
bull Employees are encouraged to check their County email during and after Open EnrollmentOpen Enrollment email series featuring news and remindersMCG Employee Connect newsletter sharing Open Enrollment news in the Benefits Bites
sectionAfter Open Enrollment ends MetLife will email employees who elected or increased
Optional Life to complete a Statement of Health online
bull The Open Enrollment Website is a dedicated resource for all Open Enrollment needsAvailable Monday September 21 at 8 am
Office of Human Resources Montgomery County Government
Itrsquos a New Frontier COVID-19 has changed the way we utilize our plans MCGrsquos health insurance plans offer many value-added services and discounts to provide employees with support This year more than ever it is important to know our resources
bull Virtual doctor visits bull Built-in emotional amp wellness supportbull Disease management bull Lifestyle coachingbull Stress relief appsbull Discounts and more
Please see the 2021 Open Enrollment guide for additional information
Office of Human Resources Montgomery County Government
2021 Open Enrollment ChecklistTake Action Early Follow these steps for a successful Open Enrollment1 Review available resources
bull 2021 Open Enrollment Guide (mailed to homes on September 11th)bull Open Enrollment Websitebull County Email for Important Updates and Follow-Ups bull Benefits Bites Section of the MCG Employee Connect Newsletter
2 Attend a virtual Open Enrollment event3 Attend OHR virtual office hours4 Make changes online amp print Confirmation Statement5 (Re)Enroll in Flexible Spending Accounts (FSAs) and check FSA contribution
amounts
Office of Human Resources Montgomery County Government
Open Enrollment Website Resources Visit the Open Enrollment website for a variety of planning tools amp resources Open Enrollment schedule of virtual events Open Enrollment frequently asked questions 2021 Employee Self-Service (ESS) instruction video amp written instructions Side-by-side plan comparisons Life insurance needs estimator FSA tax savings calculator MCG employee discounts amp resources and more
Office of Human Resources Montgomery County Government
Attend a Virtual Open Enrollment Event bull Insurance Carrier Virtual Presentations and QampA Sessions Visit the Open Enrollment website for full schedule of events
bull Attend OHR Virtual Office Hours Virtual Office Hours SchedulePlease note Virtual Office Hours are held in a public virtual meeting If questions will
reveal any personal PHI (protected health information) such as a chronic medical condition or names of specific prescription drugs employees should direct those questions to OHRrsquos customer service center at 240-773-6471 to place a service request
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Paper Enrollment Form Permitted for Only Two ReasonsThere are only two exceptions permitting the use of paper Open Enrollment forms
bull Technical barriers preventing access to ESS (only in the event of no internet no smartphone or computer) the employee should contact MC311 and place a service request to be mailed a paper enrollment form Call 240-773-OHR1 (240-773-6471) available Monday through Friday 8 am to 5 pm
bull Experiencing a Life Event If an employee has a qualified status change (life event) during Open Enrollment they cannot make changes using the Open Enrollment form or online system Instead they should contact the OHR Health Insurance Team via MC311 to make changes Qualifying life events marriage divorce the birth of a child or the death of spouse or a
dependent aging out
Office of Human Resources Montgomery County Government
Dependent EligibilityEligible dependents for medical prescription dental and vision coverage arebull Spouse
Legally married EligibleDivorced Not Eligible
bull Children (biological legally adopted stepchildren or under your legal custody)Under age 26 EligibleAge 26 and over Not Eligible unless incapable of self support
Proof of eligible dependents is required
Office of Human Resources Montgomery County Government
Proof of Dependent EligibilityEmployees enrolling new dependents during Open Enrollment must upload the necessary dependent documentation in ESS prior to October 9 at 5 pmRequired Documentationbull Spouse Official State Marriage Certificate (certified by appropriate State or County Official)bull Biological Child State Birth Certificate (For newborns OHR will accept hospital discharge papers for first 60 days birth
certificate must then be submitted)bull Adopted Child Copy of Adoption or Placement for Adoption Papers bull Step-Child State Birth Certificate Marriage Certificate and Divorce Decree or Custody Papers bull Disabled Child Medical plan verification of disability prior to age 26 bull Legal Custody Copy of Court Order granting legal custody
Office of Human Resources Montgomery County Government
Marriage Certificate Example Required Documentation (Contd)
Office of Human Resources Montgomery County Government
Benefits Refresher
Office of Human Resources Montgomery County Government
Medical amp Rx
Office of Human Resources Montgomery County Government
Medical Plan OptionsHealth Maintenance Organizations (HMO)bull Kaiser Permanente Signature (HMO)bull United Healthcare Select (HMO)
Point of Service Plans (POS)bull CareFirst BCBS (POS) High Optionbull CareFirst BCBS (POS) Standard Option
Three tiers of coverage Self Self + 1 or Family
Office of Human Resources Montgomery County Government
Medical Benefits at-a-Glance To view full carrier medical summaries visit OHRrsquos Health Insurance Website
Kaiser Permanente HMO + Rx
wwwkporg
United HealthCare Select HMO
wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS)
wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS)
wwwcarefirstcom
Plan Type HMO HMO Point-of-Service Point-of-Service
PCP Required Yes Yes No No
Provider Network Regional (MDDCVA) National National National
Out-of-Network Benefits No No Yes Yes
Referrals Required Yes No No No
Annual Deductible None NoneIn-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Sheet1
Sheet1 (2)
Office of Human Resources Montgomery County Government
Medical Benefits at-a-Glance (contd)
New Employee Orientation Program
Kaiser Permanente HMO + Rx
wwwkporg
United HealthCare Select HMO
wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS)
wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS)
wwwcarefirstcom
Dr Office Visits PCPSpecialist $5 copay $5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits Covered in full $5 copay $10 copay In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care $5 copay $15 copay Covered in full Covered in full
Emergency Room $50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization Covered in full Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
Visit OHRrsquos Health Insurance webpage to view Medical summaries
Sheet1
Sheet1 (2)
Office of Human Resources Montgomery County Government
Prescription Plans Caremarkbull Two Rx Plan OptionsStandardHigh
bull If you elect UHC or CareFirst and want Rx coverage you will need to elect the stand-alone Caremark Rx plan (Kaiser already includes Rx coverage)
bull Maintenance Choice Program available for maintenance drugs significant cost savings ndash 1 copay for each 90-day prescription In order to get the Maintenance pricing you must fil Rx at CVS retail pharmacy Mail order
Office of Human Resources Montgomery County Government
Prescription Drug Plan Comparison High Option $48
Only MCGEOIAFF employees can enroll in this High plan
High Option $510Only FOPNON-REP employees
can enroll in this High plan
Standard Option All employees can enroll in this
Standard plan
Copay $4 Generics$8 Brand Name
$5 Generics$10 Brand Name
$10 Generics$20 PBrand Name
$35 NPBrand NameDeductible na na $50yearMail Order Yes Yes Yes
Maintenance Choice Yes Yes YesCovered Drugs Same Same Same
Visit OHRrsquos Health Insurance Website to view Rx summaries
Office of Human Resources Montgomery County Government
Prescription Drug Cost Comparison Cost
High Option $48Only MCGEOIAFF employees
can enroll in this High plan
High Option $510Only FOPNON-REP employees
can enroll in this High plan
Standard Option All employees can enroll in this
Standard plan
Self Only
Bi-Weekly $11339Monthly $24568Yearly $294814
Bi-Weekly $11100Monthly $24050Yearly $288600
Bi-Weekly $2413Monthly $5258Yearly $62738
Self + 1
Bi-Weekly $20979Monthly $45455Yearly $545454
Bi-Weekly $20536Monthly $44495Yearly $533936
Bi-Weekly $4463Monthly $9670
Yearly $116038
Self + Family
Bi-Weekly $32511Monthly $70441Yearly $845286
Bi-Weekly $31824Monthly $68952Yearly $827424
Bi-Weekly $6916Monthly $14985Yearly $179816
Office of Human Resources Montgomery County Government
Dental
Office of Human Resources Montgomery County Government
Dental Comparison Cigna
For a list of HMO covered services and assigned costs (copays) view the HMO benefit summary
Required to Use An Assigned Provider Yes In-network only Primary Dental Office will be
assigned based on home address
No
Out of Network Benefits Available No Yes
Balance Billing for Covered Services No Yes if you go out-of-network
Referral Required Yes No
Orthodontia Benefits Available Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime) Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person) Unlimited $200000
Deductible (singlefamily) None $50 $ 150 waived for preventive care
Table 1
Office of Human Resources Montgomery County Government
Vision
Office of Human Resources Montgomery County Government
Vision Insurancebull The Countyrsquos Vision carrier is EyeMedbull Benefits payable for exams lenses and contacts (elective or necessary) every
calendar year frames every two calendar yearsbull In-network or out-of-network benefits available bull Enhanced Hearing Benefit through EyeMedrsquos partner Amplifon40 off hearing examDiscounted pricing on thousands of hearing aids including latest technologyOne-year free follow-up care with unlimited appointmentsFree batteries for two years with initial purchase Three-year warranty and loss and damage coverage
Visit OHRrsquos Health Insurance webpage to view vision summary
Office of Human Resources Montgomery County Government
Optional Life amp Dependent Life
Office of Human Resources Montgomery County Government
Optional Life Insurance ADampDbull You may elect Optional Life ADampD coverage for yourself in increments of 1 to 8 times
your basic annual earnings ($1 million maximum)
bull NOTE Coverage is not guaranteed issue for any level You must complete an online Statement of Health no matter what level of coverage you elect Later this fall after Open Enrollment ends you will receive an email from MetLife with a link to complete the Statement of Health online
bull An eligible dependent is defined as 1) your opposite or same sex spouse or 2) your unmarried children under age 26 (natural adopted or stepchildrenfoster children who depend on your support)
Office of Human Resources Montgomery County Government
Optional Life Insurance RatesHow to estimate your Optional Life Insurance bi-weekly rate
Example 40-year-old applying for 2 x salary Salary is $49300
Steps Example Calculate for Yourself
A Find your age-based rate on the rate sheet (left) $ 0037 $_________________
B Choose how much coverage you are applying for
$99000 (2 x salary rounded to the nearest $1000 ) $_________________
C Divide that coverage amount by 100099 ($99000 1000) $_________________
D Multiply A x C for estimated bi-weekly cost$366 ($037 x 99) $_________________
Office of Human Resources Montgomery County Government
Dependent Life InsuranceYou may also purchase Dependent Optional Life insurance forbull Your opposite or same sex spouse bull Your unmarried children under age 26
ndash Natural adoptedndash Stepchildrenfoster childrenNote you do not need to supply marriage certificatesbirth certificates for dependent optional life
You may electbull $2000 Spouse$1000 Childbull $4000 Spouse $2000 Childbull $10000 Spouse $5000 Child
The bi-weekly rate is not based on salary
Office of Human Resources Montgomery County Government
Flexible Spending Accounts
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Visit the Open Enrollment website to watch a recorded FSA presentation from MCGrsquos FSA vendor Benefit Strategies
bull What is an FSA It is an IRS-approved tax-free account that saves onQualified out-of-pocket medical and dependent care expensesFederal and State Income taxSocial Security Tax
bull 3 Account Options Health Care FSA Child Care FSA and Commuter Choice Transit bull FSA accounts are administered through Benefit Strategies bull FSAs are ldquouse-it or lose-itrdquo accounts claims must be incurred during the 2021 plan year (January 1
2021 ndash March 15 2022) and submitted by April 30 2022
IMPORTANT You must re-enroll in an FSA every Open Enrollment if you want to participate in the upcoming plan year
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Why You Should EnrollGive yourself a raise by reducing your taxesbull Elect the annual amount you want to place in your FSA(s) for the upcoming plan year during Open Enrollmentbull That amount is divided by 26 and taken from your biweekly paychecks on a pre-tax basis (21 paychecks for
10-month employees)bull Then use your pre-tax FSA dollars to pay for eligible out-of-pocket health care child-care or transit
expenses
Office of Human Resources Montgomery County Government
Health Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull Claims must be submitted by April 30 of the following yearbull You may elect to contribute up to $2750 Your total annual election amount is available to spend on the first
day of the new plan year bull FSA debit card allows you to pay for expenses at the time of servicebull Examples of IRS qualified eligible expenses
bull Copays (medical prescription dental vision) deductibles and coinsurance amounts over reasonable and customary charge
bull Hearing aids bull Acupuncture bull Orthopedic shoes bull Over-the-counter (OTC) drugs (no longer require doctorrsquos prescription)
Office of Human Resources Montgomery County Government
Child Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull $5000 annual maximum per household ($2500 for married filing separately)bull Funds are available to spend as they are accumulated through payroll deductionsbull Reimbursable expenses
bull day care centersbull elder carebull beforeafter school carebull babysitter fees that allow you and your spouse to work or go to school (no child support payments)
bull Qualifying dependentsbull Children under the age of 13 and are a tax dependent of the employeebull Spouse or tax dependent that is physically or mentally incapable of self-care
bull Must coordinate between filing a tax credit with IRS and your Dependent Care FSA plan
Office of Human Resources Montgomery County Government
Commuter Choice Transit FSAbull $230 per month maximum for MCGEO staff $260 per month maximum for Unrepresented staffbull Applies to employee commuting expenses only (not spouses or dependents)bull Can enroll throughout the year (not limited to Open Enrollment election)bull Eligible expenses include Metro Marc Vanpool Lyft Line Uber Poolbull Debit card ndash may be used for some expenses (not Metro)Metro riders will have to submit claim forms for reimbursement
bull Funds must be used within 180 days of election bull If retiring or leaving the County will need to coordinate use all available funds
Office of Human Resources Montgomery County Government
Using Your FSA FundsHealth Care FSA Your full annual election amount is available on the first day of the plan yearChild Care FSA Your funds are available as they accumulate through payroll deductionsCommuterTransit FSA Your funds are available as they accumulate through payroll deductions
The FSA Debit Card bull Your FSA debit card is the same card for your Health Care Child Care and TransitCommuter FSA accountsbull The card is pre-loaded with your full annual Health Care FSA election amount You can use the card to pay for IRS qualified expenses at
the time of service or when paying a bill Receipt notifications will be mailed to you monthly by Benefit Strategies Your response to receipt notifications is necessary under the provisions of the plan No response my result in the ineligibility of the purchase and as a result your card may be temporarily deactivated
bull If you are enrolled in the Child Care FSA the card can also be used in child-care settings Just remember that the card will only work for an amount that does not exceed the available balance in your Child Care FSA account on that day
bull The card can also be used to pay for your commutertransit expenses however it does not work for WMATA metro Metro riders will have to submit manual claims for reimbursement from your CommuterTransit FSA
bull Cards are re-loaded each year after you make your new annual election Please keep your cards You will only receive a new card if your old card is about to expire
Office of Human Resources Montgomery County Government
AFLAC Voluntary Plans
Office of Human Resources Montgomery County Government
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Short-Term Disabilitybull Provides short-term cash benefits in the event of disabilitybull Monthly benefit amounts available from $500 - $6000 (subject to income requirements)bull Benefit options of 3 6 12 18 or 24 months with a variety of elimination periods
Critical Illness Insurancebull Provides a lump sum cash benefit in the event of critical illnessbull Benefit amounts available in $5000 increments from $10000 - $30000
Participants pay 100 through payroll deduction for Short-Term Disability and Critical Illness Insurance
To ENROLL Text SETAPPTrdquo to 41411orCall 920-420-8861 orEmail susan_mcdanielusAflaccom
Office of Human Resources Montgomery County Government
Carrier Resources amp Cost-Saving Tips
Office of Human Resources Montgomery County Government
Lower Your Out-of-Pocket CostsChoose the plan thatrsquos right for youbull See the medical benefits chart for options bull Stay in network Use the provider search engines on your carrier website or mobile app to find in-network providersSeek preventive carebull Check-ups immunizations and screenings are an important part of staying healthy They can detect or prevent serious diseases and keep you healthyKnow where to go for carebull You have many options of places to go when you need care If your medical condition isnrsquot serious or life threatening you can save money by connecting
with a doctor online through a virtual visit or going to an urgent care center or convenience care clinic instead of a hospital emergency roomReview your prescription drug plan optionsbull Decide which Caremark prescription plan is best for you Note that the Kaiser HMO includes prescription drug coverage Both the Standard and High
Option Caremark plans cover the same prescription drugs but have different copay and deductiblesUse generic and long-term prescriptions bull Opt for lower-cost generic drugs whenever possible bull Ask your doctor to write a 90-day prescription instead of a 30-day prescription to participate in the mail order prescription programTake advantage of tax savings by participating in Flexible Spending Accountsbull Use pre-tax dollars for eligible out of pocket services and items
Office of Human Resources Montgomery County Government
Built-in Wellness Support Take advantage of the free programs available to you through your medical carrier Each of MCGrsquos medical carriers (Kaiser UHC amp CareFirst) offer valuable programs to help you manage your health
Disease Management Programsbull Help manage your chronic condition through personalized coaching support and encouragement and online education materialsEmotional Wellness amp Stress Management Support bull Help manage stress through mobile apps and other self-care resources Maternity Programsbull Support healthy moms and healthy babiesWeight-loss Programs bull Offers telephonic coaching support and web-based tools to help ensure long-term weight managementbull See the next slide for an example of an MCG success storySmoking Cessation Programsbull Supportive coaching to make quitting more successfulDiscounts bull Gym memberships weight loss programs and moreFor more information about the programs available to you please see the Open Enrollment Guide and contact your medical carrier
Office of Human Resources Montgomery County Government
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You GoAll of MCGrsquos health insurance carriers offer a simple-to-use tool that can help make your life easier while yoursquore on the go Download your carrierrsquos Mobile App to help you personalize organize and access your important plan information on your phone or tablet
bull Schedule Virtual Visitsbull Manage and track claimsbull View ID card informationbull Find doctor and compare costs and quality ratingsbull Review your coveragebull Track your account balances and deductiblesbull Access a variety of health and wellness tools
Visit Google Play or the Apple App Store to download your carrierrsquos App
Office of Human Resources Montgomery County Government
Making Changes
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Questions
Office of Human Resources Montgomery County Government
Open Enrollment AssistanceFollow these steps (in this order)1 Review the frequently asked questions (FAQs) on the Open Enrollment website at wwwmontgomerycountymdgovoe
(available beginning September 21) You can enter key words into the interactive search bar to quickly locate the answer to your question
2 Visit the MC311 website at wwwmontgomerycountymdgovmc311 and search key words for your question The search results contain various knowledge-based articles with information related to your search words Simply click on the corresponding link and the detailed answer is revealed
3 Attend one of OHRrsquos Virtual Office Hours via Microsoft Teams Members of OHRs Health Insurance Team will be on hand to address employee questions by video or via the chat box View the schedule and access the sessions through the Open Enrollment website at wwwmontgomerycountymdgovoe (available beginning September 21)
4 If you have tried all the methods above and still have Open Enrollment-related questions please contact OHRs MC311 Customer Service Center at 240-773-6471 (Mon-Fri 8 am - 5 pm) to open a service request A member of the health insurance team will respond to service requests in the order they are received Tip Please provide an email address at the time you place your Service Request This will ensure the fastest response possible
Office of Human Resources Montgomery County Government
Online ResourcesVisit the 2021 Open Enrollment Webpage
wwwmontgomerycountymdgovOE
Visit OHRrsquos WebpagewwwmontgomerycountymdgovHR
Health Insurance active employees
Office of Human Resources Montgomery County Government
Legal InformationThe County reserves the right at any time and for any reason to amend the Program subject to the Countys collective bargainingagreements The County expects to continue the Program but it is the Countys position that there is no implied contract between individual employees and the County to do so
The County may amend the Program prospectively or retroactively to comply with applicable law
In the event of a conflict between this presentation the County Code andor the Summary Description the County Code then the Summary Description will govern
Office of Human Resources Montgomery County Government
Thank YouWe hope you enjoyed learning about 2021 Open Enrollment
~Your OHR Health Insurance Team
2021 Open Enrollment Benefits Bonanza
What Is Open Enrollment
What Changes Can be Made
Open Enrollment Dates
MCG Continues to Make Generous Employer Contributions
New for 2021
Special 2021 Plan Rates Announcement
Employee Rate Changes for Calendar Year 2021
Planning Ahead Minimizing Future Rate Increases
New for 2021
Open Enrollment Communications
Itrsquos a New Frontier
2021 Open Enrollment Checklist
Open Enrollment Website Resources
Attend a Virtual Open Enrollment Event
Make Changes Online
Paper Enrollment Form Permitted for Only Two Reasons
Dependent Eligibility
Proof of Dependent Eligibility
Marriage Certificate Example Required Documentation (Contd)
Benefits Refresher
Medical amp Rx
Medical Plan Options
Medical Benefits at-a-Glance
Medical Benefits at-a-Glance (contd)
Prescription Plans Caremark
Prescription Drug Plan Comparison
Prescription Drug Cost Comparison
Dental
Slide Number 30
Vision
Vision Insurance
Optional Life amp Dependent Life
Optional Life Insurance ADampD
Optional Life Insurance Rates
Dependent Life Insurance
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs)Why You Should Enroll
Health Care FSA
Child Care FSA
Commuter Choice Transit FSA
Using Your FSA Funds
AFLAC Voluntary Plans
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Carrier Resources amp Cost-Saving Tips
Lower Your Out-of-Pocket Costs
Built-in Wellness Support
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You Go
Making Changes
Make Changes Online
Questions
Open Enrollment Assistance
Online Resources
Legal Information
Thank You
Cigna Dental Comparison
DHMO
PPO
CIGNA NETWORK
Care-Access PlusDHMO
Total CIGNA PPOPPO
Required to Use An Assigned Provider
Yes In-network only Primary Dental Office will be assigned based on home address
No
Out of Network Benefits Available
No
Yes
Balance Billing for Covered Services
No
Yes if you go out-of-network
Referral Required
Yes
No
Orthodontia Benefits Available
Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime)
Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person)
Unlimited
$200000
Deductible (singlefamily)
None
$50 $ 150 waived for preventive care
1Claim submission would be required and balance billing may occur when visiting a nonparticipating provider2Deductible does not apply to Class I ndash Diagnostic and Preventive Services
Coverage for dependents would cease on the day which the child turns 26Benefit Maximum and Deductibles are for the period of January 01 through December 31
All services listed on this benefit summary are subject to the contractSchedules of Benefits and current Exclusions and Limitations
Medical Benefits at a Glance
Kaiser Permanente HMO + Rx wwwkporg
United HealthCare Select HMO wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS) wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS) wwwcarefirstcom
Plan Type
HMO
HMO
Point-of-Service
Point-of-Service
PCP Required
Yes
Yes
No
No
Provider Network
Regional (MDDCVA)
National
National
National
Out-of-Network Benefits
No
No
Yes
Yes
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
None
None
In-Network None Out-of-Network 80
In-Network None Out-of-Network 80
Dr Office Visits PCPSpecialist
$5 copay
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits
Covered in full
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care
$5 copay
$15 copay
Covered in full
Covered in full
Emergency Room
$50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization
Covered in full
Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
MCG 2018 Medical Plan Comparison Chart
Kaiser Permanente
United HealthCare
CareFirst POS Standard
CareFirst POS High
Plan Type
HMO
HMO
Point of Service
Point of Service
Provider Network
Regional (MDDCVA)
National
National
National
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
Annual Out-of-Pocket Maximum
None
$1100 per individual up to cap of $3600 for a family
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
Physician Servcies
PCP Office Visits
$5 copay
$5 copay PCP
In-Network $15 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Specialist Office Visits
$5 copay
$10 copay
In-Network $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Annual Physical
Covered in full
$5 copay PCP
In-Network $15 copay Primary Care Physician $30 copay specialist Out-of-Network 80 covered after deductible (limit 1calendar year)
In-Network $15 copay Out-of-Network 80 not subject to deductible (up to age 18)
In-Network $10 copay Out-of-Network 80 not subject to deductible (up to age 18)
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Allergy Testing
$5 copay
$5 copay PCP $10 copay Specialist
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Virtual Visits
Labs X-Rays Diagnostics
Outpatient labs
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient X-Rays
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Major Diagnostics
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Immedate Medical Servcies
Emergency Room
$50 copay waived if admitted to hospital
$25 copay waived if admitted to hospital $15 copay for urgent care
In-Network $35 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
Urgent Care
Hospital Services
Inpatient Hospitalization
Covered in full
Covered in full
In-Network Covered in full after $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Services
Surgery
Covered in full
Inpatient covered in full Outpatient $25 copay
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Hearing Aids
For minor children One hearing aid for each hearing impaired ear once every 36 months
For minor children One hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
Hearing Screening
$5 copay for hearing exam (hearing aids are excluded)
$5 Copay PCP $10 Copay Specialist
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
Home Health Care Services
Covered in full if medically necessary
Covered in full No copayment 60 visit maximum for skilled care services per calendar year
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
Hospice
Covered in full
Covered in full (See coverage booklet for eligibility information)
In-Network Covered in full
In-Network Covered in full
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
In vitro Fertilization
Limited to 3 attempts per live birth Lifetime maximum of $100000
Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
Mammography - Preventive Screening Schedule
Schedule consistent with the current recommendations of the American College of Physicians
Covered in full Age 35-39 one baseline mammogram Age 40-49 one mammogram every two calendar years Age 50+ one mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
Maternity
Covered in full once pregnancy is diagnosed
No copayment applies after the first visit
In-Network first visit 100 after $30 copay other visits 100
In-Network First visit 100 after $10 copay other visits 100
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Maximum Lifetime Benefit
Unlimited maximum
Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
Prescriptions
Kaiser Rx plan (included with Kaiser HMO medical plan) $5 at on-site pharmacies and for mail order $15 at participating pharmacies
No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
Rehabilitation Services
Inpatient Covered in full (unlimited) Outpatient $5 copay outpatient services for physical therapy are limited to up to 30 visits occupational and speech therapy per injury incident or condition are covered for a period not to exceed 90 days
$10 copayvisit 60 combined visits per year (short-term non-chronic conditions only)
In-Network
In-Network
100
100
Skilled Nursing Facility
Covered in full 100 days maximum
Covered in full 60 days per calendar year maximum
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Substance AbuseMental Health
Inpatient Covered in full Outpatient $5 copay
Inpatient Covered in full Outpatient $5 copay
In-Network Inpatient- $150 per admission copay Outpatient- $15 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
In-Network Inpatient- covered in full Outpatient- $10 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
Vision (Routine)
$5 copay for exams 25 discount on lensesframes at Kaiser centers 15 discount off the costs of contact lenses
$25 copay for exam 15-20 discount through participating optical centers
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
53116
Medical Benefits at a Glance
Kaiser Permanente HMO + Rx wwwkporg
United HealthCare Select HMO wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS) wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS) wwwcarefirstcom
Plan Type
HMO
HMO
Point-of-Service
Point-of-Service
PCP Required
Yes
Yes
No
No
Provider Network
Regional (MDDCVA)
National
National
National
Out-of-Network Benefits
No
No
Yes
Yes
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
None
None
In-Network None Out-of-Network 80
In-Network None Out-of-Network 80
Dr Office Visits PCPSpecialist
$5 copay
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits
Covered in full
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care
$5 copay
$15 copay
Covered in full
Covered in full
Emergency Room
$50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization
Covered in full
Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
MCG 2018 Medical Plan Comparison Chart
Kaiser Permanente
United HealthCare
CareFirst POS Standard
CareFirst POS High
Plan Type
HMO
HMO
Point of Service
Point of Service
Provider Network
Regional (MDDCVA)
National
National
National
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
Annual Out-of-Pocket Maximum
None
$1100 per individual up to cap of $3600 for a family
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
Physician Servcies
PCP Office Visits
$5 copay
$5 copay PCP
In-Network $15 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Specialist Office Visits
$5 copay
$10 copay
In-Network $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Annual Physical
Covered in full
$5 copay PCP
In-Network $15 copay Primary Care Physician $30 copay specialist Out-of-Network 80 covered after deductible (limit 1calendar year)
In-Network $15 copay Out-of-Network 80 not subject to deductible (up to age 18)
In-Network $10 copay Out-of-Network 80 not subject to deductible (up to age 18)
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Allergy Testing
$5 copay
$5 copay PCP $10 copay Specialist
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Virtual Visits
Labs X-Rays Diagnostics
Outpatient labs
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient X-Rays
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Major Diagnostics
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Immedate Medical Servcies
Emergency Room
$50 copay waived if admitted to hospital
$25 copay waived if admitted to hospital $15 copay for urgent care
In-Network $35 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
Urgent Care
Hospital Services
Inpatient Hospitalization
Covered in full
Covered in full
In-Network Covered in full after $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Services
Surgery
Covered in full
Inpatient covered in full Outpatient $25 copay
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Hearing Aids
For minor children One hearing aid for each hearing impaired ear once every 36 months
For minor children One hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
Hearing Screening
$5 copay for hearing exam (hearing aids are excluded)
$5 Copay PCP $10 Copay Specialist
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
Home Health Care Services
Covered in full if medically necessary
Covered in full No copayment 60 visit maximum for skilled care services per calendar year
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
Hospice
Covered in full
Covered in full (See coverage booklet for eligibility information)
In-Network Covered in full
In-Network Covered in full
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
In vitro Fertilization
Limited to 3 attempts per live birth Lifetime maximum of $100000
Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
Mammography - Preventive Screening Schedule
Schedule consistent with the current recommendations of the American College of Physicians
Covered in full Age 35-39 one baseline mammogram Age 40-49 one mammogram every two calendar years Age 50+ one mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
Maternity
Covered in full once pregnancy is diagnosed
No copayment applies after the first visit
In-Network first visit 100 after $30 copay other visits 100
In-Network First visit 100 after $10 copay other visits 100
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Maximum Lifetime Benefit
Unlimited maximum
Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
Prescriptions
Kaiser Rx plan (included with Kaiser HMO medical plan) $5 at on-site pharmacies and for mail order $15 at participating pharmacies
No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
Rehabilitation Services
Inpatient Covered in full (unlimited) Outpatient $5 copay outpatient services for physical therapy are limited to up to 30 visits occupational and speech therapy per injury incident or condition are covered for a period not to exceed 90 days
$10 copayvisit 60 combined visits per year (short-term non-chronic conditions only)
In-Network
In-Network
100
100
Skilled Nursing Facility
Covered in full 100 days maximum
Covered in full 60 days per calendar year maximum
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Substance AbuseMental Health
Inpatient Covered in full Outpatient $5 copay
Inpatient Covered in full Outpatient $5 copay
In-Network Inpatient- $150 per admission copay Outpatient- $15 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
In-Network Inpatient- covered in full Outpatient- $10 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
Vision (Routine)
$5 copay for exams 25 discount on lensesframes at Kaiser centers 15 discount off the costs of contact lenses
$25 copay for exam 15-20 discount through participating optical centers
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
53116
Office of Human Resources Montgomery County Government
What Is Open Enrollmentbull Open Enrollment is the only time of year when employees can make changes to
the following plans for next yearrsquos benefit elections without needing a qualifying life event Medical Prescription Dental Vision Optional Life Healthcare amp Childcare FSAs AFLAC Short Term Disability or Critical Illness
Available to unrepresented and IAFF employees only
Office of Human Resources Montgomery County Government
What Changes Can be Made Changes employees can make during Open Enrollment are
bull Enroll in the benefit plan(s) for the first timebull Adddelete dependent(s)bull Change from one plan to another bull Drop coveragebull Enroll in or increase Optional Life insurance bull (Re)enroll in a Flexible Spending Accountbull Enroll in AFLAC short-term disability or critical illness
Available to unrepresented and IAFF employees only To enroll contact AFLAC directly
Office of Human Resources Montgomery County Government
Open Enrollment Dates2021 Open Enrollment (OE) runs from September 21 ndash October 9 2020
bull All OE changes must be submitted during the OE windowBegins ndash Monday September 21 at 8 am Deadline ndash Friday October 9 at 5 pm
bull OE changes are effective January 1 2021
Office of Human Resources Montgomery County Government
MCG Continues to Make Generous Employer Contributions
bull This graph provides a visual example of the extremely generous employer contributions that MCG makes toward employee insurance premiums
bull These contributions reduce the amount employees pay This is an important part of their total compensation package as an MCG employee
Note The chart above reflects Self only contributions To view charts reflecting Self+1 and Self+Family contributions visitthe Open Enrollment website after September 21 2020
Office of Human Resources Montgomery County Government
New for 2021bull 2021 Open Enrollment will be held virtually this year All of MCGrsquos carriers will be
hosting virtual presentations and QampA sessions See the virtual event tab on the Open Enrollment website for a schedule of virtual events
bull The Health Care FSA annual contribution limit increasing to $2750 The amount you can contribute for 2021 will increase by $50
bull Health Care FSA now allows Over-the-counter expenses without a prescription (ie allergy heartburn or pain relief medications etc)
bull Benefits Bites delivered to your County email weekly via the MCG Employee Connect newsletter Be sure to check the Benefits Bites section for helpful Open Enrollment tips and resources
bull Enhanced Open Enrollment website with new Frequently Asked Questions and a dedicated MCG discount amp resource section
Office of Human Resources Montgomery County Government
Special 2021 Plan Rates AnnouncementCOVID-19 has impacted us in many ways including financially In light of the fact that employees will not be receiving a General Wage Adjustment (GWA) in FY21bull There will be 0 rate increase for these medical plans
CareFirstUnited HealthcareCVS Caremark
bull The Kaiser medical plan costs are decreasing bull The County will pay a large portion of the dental PPO and vision increases but
these increases will also be shared with employees
Office of Human Resources Montgomery County Government
Employee Rate Changes for Calendar Year 2021Plan Per Pay Period Increase
Self Self + 1 FamilyCareFirst High Option POS $000 $000 $000CareFirst Standard Option POS $000 $000 $000Kaiser -$147 -$276 -$435United HealthCare HMO $000 $000 $000CVS Standard Prescription Plan $000 $000 $000CVS High $4$8 Prescription Plan $000 $000 $000CVS High $5$10 Prescription Plan $000 $000 $000CIGNA PPO Dental $041 $094 $134CIGNA DHMO Dental $000 $000 $000EyeMed Vision $009 $014 $020
Office of Human Resources Montgomery County Government
Planning Ahead Minimizing Future Rate IncreasesHere are ways employees can work together with MCG to keep future plan rate increases at a minimumbull Seek out preventive care such as annual exams and age-based screeningsbull Visit in-network doctors via virtual visitsbull Use urgent care facilities for non-emergent services rather than going to the
emergency roombull Choose generic prescription drugsbull Maximize wellness resources through health insurance carriers and MCGrsquos LiveWell
program
Office of Human Resources Montgomery County Government
New for 2021bull All Open Enrollment events held virtually this yearMCGrsquos carriers will be hosting virtual presentations and QampA sessionsOHR Virtual Office Hours
bull Health Care FSA changesAnnual contribution limit increasing to $2750Over-the-counter expenses are permitted without a written prescription Feminine products are now an eligible expense
bull New Open Enrollment Communication MethodsBenefits Bites delivered in the MCG Employee Connect newsletter Enhanced Open Enrollment website
bull Frequently Asked Questionsbull MCG employee discount amp resource section bull Employee self-service (ESS) instructions and demonstrationsbull MCG vendor video presentations
Office of Human Resources Montgomery County Government
Open Enrollment Communications bull 2021 Open Enrollment Guides were mailed to homes on September 11
Employees should receive the guides between September 14 ndash 16
bull Employees are encouraged to check their County email during and after Open EnrollmentOpen Enrollment email series featuring news and remindersMCG Employee Connect newsletter sharing Open Enrollment news in the Benefits Bites
sectionAfter Open Enrollment ends MetLife will email employees who elected or increased
Optional Life to complete a Statement of Health online
bull The Open Enrollment Website is a dedicated resource for all Open Enrollment needsAvailable Monday September 21 at 8 am
Office of Human Resources Montgomery County Government
Itrsquos a New Frontier COVID-19 has changed the way we utilize our plans MCGrsquos health insurance plans offer many value-added services and discounts to provide employees with support This year more than ever it is important to know our resources
bull Virtual doctor visits bull Built-in emotional amp wellness supportbull Disease management bull Lifestyle coachingbull Stress relief appsbull Discounts and more
Please see the 2021 Open Enrollment guide for additional information
Office of Human Resources Montgomery County Government
2021 Open Enrollment ChecklistTake Action Early Follow these steps for a successful Open Enrollment1 Review available resources
bull 2021 Open Enrollment Guide (mailed to homes on September 11th)bull Open Enrollment Websitebull County Email for Important Updates and Follow-Ups bull Benefits Bites Section of the MCG Employee Connect Newsletter
2 Attend a virtual Open Enrollment event3 Attend OHR virtual office hours4 Make changes online amp print Confirmation Statement5 (Re)Enroll in Flexible Spending Accounts (FSAs) and check FSA contribution
amounts
Office of Human Resources Montgomery County Government
Open Enrollment Website Resources Visit the Open Enrollment website for a variety of planning tools amp resources Open Enrollment schedule of virtual events Open Enrollment frequently asked questions 2021 Employee Self-Service (ESS) instruction video amp written instructions Side-by-side plan comparisons Life insurance needs estimator FSA tax savings calculator MCG employee discounts amp resources and more
Office of Human Resources Montgomery County Government
Attend a Virtual Open Enrollment Event bull Insurance Carrier Virtual Presentations and QampA Sessions Visit the Open Enrollment website for full schedule of events
bull Attend OHR Virtual Office Hours Virtual Office Hours SchedulePlease note Virtual Office Hours are held in a public virtual meeting If questions will
reveal any personal PHI (protected health information) such as a chronic medical condition or names of specific prescription drugs employees should direct those questions to OHRrsquos customer service center at 240-773-6471 to place a service request
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Paper Enrollment Form Permitted for Only Two ReasonsThere are only two exceptions permitting the use of paper Open Enrollment forms
bull Technical barriers preventing access to ESS (only in the event of no internet no smartphone or computer) the employee should contact MC311 and place a service request to be mailed a paper enrollment form Call 240-773-OHR1 (240-773-6471) available Monday through Friday 8 am to 5 pm
bull Experiencing a Life Event If an employee has a qualified status change (life event) during Open Enrollment they cannot make changes using the Open Enrollment form or online system Instead they should contact the OHR Health Insurance Team via MC311 to make changes Qualifying life events marriage divorce the birth of a child or the death of spouse or a
dependent aging out
Office of Human Resources Montgomery County Government
Dependent EligibilityEligible dependents for medical prescription dental and vision coverage arebull Spouse
Legally married EligibleDivorced Not Eligible
bull Children (biological legally adopted stepchildren or under your legal custody)Under age 26 EligibleAge 26 and over Not Eligible unless incapable of self support
Proof of eligible dependents is required
Office of Human Resources Montgomery County Government
Proof of Dependent EligibilityEmployees enrolling new dependents during Open Enrollment must upload the necessary dependent documentation in ESS prior to October 9 at 5 pmRequired Documentationbull Spouse Official State Marriage Certificate (certified by appropriate State or County Official)bull Biological Child State Birth Certificate (For newborns OHR will accept hospital discharge papers for first 60 days birth
certificate must then be submitted)bull Adopted Child Copy of Adoption or Placement for Adoption Papers bull Step-Child State Birth Certificate Marriage Certificate and Divorce Decree or Custody Papers bull Disabled Child Medical plan verification of disability prior to age 26 bull Legal Custody Copy of Court Order granting legal custody
Office of Human Resources Montgomery County Government
Marriage Certificate Example Required Documentation (Contd)
Office of Human Resources Montgomery County Government
Benefits Refresher
Office of Human Resources Montgomery County Government
Medical amp Rx
Office of Human Resources Montgomery County Government
Medical Plan OptionsHealth Maintenance Organizations (HMO)bull Kaiser Permanente Signature (HMO)bull United Healthcare Select (HMO)
Point of Service Plans (POS)bull CareFirst BCBS (POS) High Optionbull CareFirst BCBS (POS) Standard Option
Three tiers of coverage Self Self + 1 or Family
Office of Human Resources Montgomery County Government
Medical Benefits at-a-Glance To view full carrier medical summaries visit OHRrsquos Health Insurance Website
Kaiser Permanente HMO + Rx
wwwkporg
United HealthCare Select HMO
wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS)
wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS)
wwwcarefirstcom
Plan Type HMO HMO Point-of-Service Point-of-Service
PCP Required Yes Yes No No
Provider Network Regional (MDDCVA) National National National
Out-of-Network Benefits No No Yes Yes
Referrals Required Yes No No No
Annual Deductible None NoneIn-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Sheet1
Sheet1 (2)
Office of Human Resources Montgomery County Government
Medical Benefits at-a-Glance (contd)
New Employee Orientation Program
Kaiser Permanente HMO + Rx
wwwkporg
United HealthCare Select HMO
wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS)
wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS)
wwwcarefirstcom
Dr Office Visits PCPSpecialist $5 copay $5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits Covered in full $5 copay $10 copay In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care $5 copay $15 copay Covered in full Covered in full
Emergency Room $50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization Covered in full Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
Visit OHRrsquos Health Insurance webpage to view Medical summaries
Sheet1
Sheet1 (2)
Office of Human Resources Montgomery County Government
Prescription Plans Caremarkbull Two Rx Plan OptionsStandardHigh
bull If you elect UHC or CareFirst and want Rx coverage you will need to elect the stand-alone Caremark Rx plan (Kaiser already includes Rx coverage)
bull Maintenance Choice Program available for maintenance drugs significant cost savings ndash 1 copay for each 90-day prescription In order to get the Maintenance pricing you must fil Rx at CVS retail pharmacy Mail order
Office of Human Resources Montgomery County Government
Prescription Drug Plan Comparison High Option $48
Only MCGEOIAFF employees can enroll in this High plan
High Option $510Only FOPNON-REP employees
can enroll in this High plan
Standard Option All employees can enroll in this
Standard plan
Copay $4 Generics$8 Brand Name
$5 Generics$10 Brand Name
$10 Generics$20 PBrand Name
$35 NPBrand NameDeductible na na $50yearMail Order Yes Yes Yes
Maintenance Choice Yes Yes YesCovered Drugs Same Same Same
Visit OHRrsquos Health Insurance Website to view Rx summaries
Office of Human Resources Montgomery County Government
Prescription Drug Cost Comparison Cost
High Option $48Only MCGEOIAFF employees
can enroll in this High plan
High Option $510Only FOPNON-REP employees
can enroll in this High plan
Standard Option All employees can enroll in this
Standard plan
Self Only
Bi-Weekly $11339Monthly $24568Yearly $294814
Bi-Weekly $11100Monthly $24050Yearly $288600
Bi-Weekly $2413Monthly $5258Yearly $62738
Self + 1
Bi-Weekly $20979Monthly $45455Yearly $545454
Bi-Weekly $20536Monthly $44495Yearly $533936
Bi-Weekly $4463Monthly $9670
Yearly $116038
Self + Family
Bi-Weekly $32511Monthly $70441Yearly $845286
Bi-Weekly $31824Monthly $68952Yearly $827424
Bi-Weekly $6916Monthly $14985Yearly $179816
Office of Human Resources Montgomery County Government
Dental
Office of Human Resources Montgomery County Government
Dental Comparison Cigna
For a list of HMO covered services and assigned costs (copays) view the HMO benefit summary
Required to Use An Assigned Provider Yes In-network only Primary Dental Office will be
assigned based on home address
No
Out of Network Benefits Available No Yes
Balance Billing for Covered Services No Yes if you go out-of-network
Referral Required Yes No
Orthodontia Benefits Available Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime) Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person) Unlimited $200000
Deductible (singlefamily) None $50 $ 150 waived for preventive care
Table 1
Office of Human Resources Montgomery County Government
Vision
Office of Human Resources Montgomery County Government
Vision Insurancebull The Countyrsquos Vision carrier is EyeMedbull Benefits payable for exams lenses and contacts (elective or necessary) every
calendar year frames every two calendar yearsbull In-network or out-of-network benefits available bull Enhanced Hearing Benefit through EyeMedrsquos partner Amplifon40 off hearing examDiscounted pricing on thousands of hearing aids including latest technologyOne-year free follow-up care with unlimited appointmentsFree batteries for two years with initial purchase Three-year warranty and loss and damage coverage
Visit OHRrsquos Health Insurance webpage to view vision summary
Office of Human Resources Montgomery County Government
Optional Life amp Dependent Life
Office of Human Resources Montgomery County Government
Optional Life Insurance ADampDbull You may elect Optional Life ADampD coverage for yourself in increments of 1 to 8 times
your basic annual earnings ($1 million maximum)
bull NOTE Coverage is not guaranteed issue for any level You must complete an online Statement of Health no matter what level of coverage you elect Later this fall after Open Enrollment ends you will receive an email from MetLife with a link to complete the Statement of Health online
bull An eligible dependent is defined as 1) your opposite or same sex spouse or 2) your unmarried children under age 26 (natural adopted or stepchildrenfoster children who depend on your support)
Office of Human Resources Montgomery County Government
Optional Life Insurance RatesHow to estimate your Optional Life Insurance bi-weekly rate
Example 40-year-old applying for 2 x salary Salary is $49300
Steps Example Calculate for Yourself
A Find your age-based rate on the rate sheet (left) $ 0037 $_________________
B Choose how much coverage you are applying for
$99000 (2 x salary rounded to the nearest $1000 ) $_________________
C Divide that coverage amount by 100099 ($99000 1000) $_________________
D Multiply A x C for estimated bi-weekly cost$366 ($037 x 99) $_________________
Office of Human Resources Montgomery County Government
Dependent Life InsuranceYou may also purchase Dependent Optional Life insurance forbull Your opposite or same sex spouse bull Your unmarried children under age 26
ndash Natural adoptedndash Stepchildrenfoster childrenNote you do not need to supply marriage certificatesbirth certificates for dependent optional life
You may electbull $2000 Spouse$1000 Childbull $4000 Spouse $2000 Childbull $10000 Spouse $5000 Child
The bi-weekly rate is not based on salary
Office of Human Resources Montgomery County Government
Flexible Spending Accounts
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Visit the Open Enrollment website to watch a recorded FSA presentation from MCGrsquos FSA vendor Benefit Strategies
bull What is an FSA It is an IRS-approved tax-free account that saves onQualified out-of-pocket medical and dependent care expensesFederal and State Income taxSocial Security Tax
bull 3 Account Options Health Care FSA Child Care FSA and Commuter Choice Transit bull FSA accounts are administered through Benefit Strategies bull FSAs are ldquouse-it or lose-itrdquo accounts claims must be incurred during the 2021 plan year (January 1
2021 ndash March 15 2022) and submitted by April 30 2022
IMPORTANT You must re-enroll in an FSA every Open Enrollment if you want to participate in the upcoming plan year
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Why You Should EnrollGive yourself a raise by reducing your taxesbull Elect the annual amount you want to place in your FSA(s) for the upcoming plan year during Open Enrollmentbull That amount is divided by 26 and taken from your biweekly paychecks on a pre-tax basis (21 paychecks for
10-month employees)bull Then use your pre-tax FSA dollars to pay for eligible out-of-pocket health care child-care or transit
expenses
Office of Human Resources Montgomery County Government
Health Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull Claims must be submitted by April 30 of the following yearbull You may elect to contribute up to $2750 Your total annual election amount is available to spend on the first
day of the new plan year bull FSA debit card allows you to pay for expenses at the time of servicebull Examples of IRS qualified eligible expenses
bull Copays (medical prescription dental vision) deductibles and coinsurance amounts over reasonable and customary charge
bull Hearing aids bull Acupuncture bull Orthopedic shoes bull Over-the-counter (OTC) drugs (no longer require doctorrsquos prescription)
Office of Human Resources Montgomery County Government
Child Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull $5000 annual maximum per household ($2500 for married filing separately)bull Funds are available to spend as they are accumulated through payroll deductionsbull Reimbursable expenses
bull day care centersbull elder carebull beforeafter school carebull babysitter fees that allow you and your spouse to work or go to school (no child support payments)
bull Qualifying dependentsbull Children under the age of 13 and are a tax dependent of the employeebull Spouse or tax dependent that is physically or mentally incapable of self-care
bull Must coordinate between filing a tax credit with IRS and your Dependent Care FSA plan
Office of Human Resources Montgomery County Government
Commuter Choice Transit FSAbull $230 per month maximum for MCGEO staff $260 per month maximum for Unrepresented staffbull Applies to employee commuting expenses only (not spouses or dependents)bull Can enroll throughout the year (not limited to Open Enrollment election)bull Eligible expenses include Metro Marc Vanpool Lyft Line Uber Poolbull Debit card ndash may be used for some expenses (not Metro)Metro riders will have to submit claim forms for reimbursement
bull Funds must be used within 180 days of election bull If retiring or leaving the County will need to coordinate use all available funds
Office of Human Resources Montgomery County Government
Using Your FSA FundsHealth Care FSA Your full annual election amount is available on the first day of the plan yearChild Care FSA Your funds are available as they accumulate through payroll deductionsCommuterTransit FSA Your funds are available as they accumulate through payroll deductions
The FSA Debit Card bull Your FSA debit card is the same card for your Health Care Child Care and TransitCommuter FSA accountsbull The card is pre-loaded with your full annual Health Care FSA election amount You can use the card to pay for IRS qualified expenses at
the time of service or when paying a bill Receipt notifications will be mailed to you monthly by Benefit Strategies Your response to receipt notifications is necessary under the provisions of the plan No response my result in the ineligibility of the purchase and as a result your card may be temporarily deactivated
bull If you are enrolled in the Child Care FSA the card can also be used in child-care settings Just remember that the card will only work for an amount that does not exceed the available balance in your Child Care FSA account on that day
bull The card can also be used to pay for your commutertransit expenses however it does not work for WMATA metro Metro riders will have to submit manual claims for reimbursement from your CommuterTransit FSA
bull Cards are re-loaded each year after you make your new annual election Please keep your cards You will only receive a new card if your old card is about to expire
Office of Human Resources Montgomery County Government
AFLAC Voluntary Plans
Office of Human Resources Montgomery County Government
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Short-Term Disabilitybull Provides short-term cash benefits in the event of disabilitybull Monthly benefit amounts available from $500 - $6000 (subject to income requirements)bull Benefit options of 3 6 12 18 or 24 months with a variety of elimination periods
Critical Illness Insurancebull Provides a lump sum cash benefit in the event of critical illnessbull Benefit amounts available in $5000 increments from $10000 - $30000
Participants pay 100 through payroll deduction for Short-Term Disability and Critical Illness Insurance
To ENROLL Text SETAPPTrdquo to 41411orCall 920-420-8861 orEmail susan_mcdanielusAflaccom
Office of Human Resources Montgomery County Government
Carrier Resources amp Cost-Saving Tips
Office of Human Resources Montgomery County Government
Lower Your Out-of-Pocket CostsChoose the plan thatrsquos right for youbull See the medical benefits chart for options bull Stay in network Use the provider search engines on your carrier website or mobile app to find in-network providersSeek preventive carebull Check-ups immunizations and screenings are an important part of staying healthy They can detect or prevent serious diseases and keep you healthyKnow where to go for carebull You have many options of places to go when you need care If your medical condition isnrsquot serious or life threatening you can save money by connecting
with a doctor online through a virtual visit or going to an urgent care center or convenience care clinic instead of a hospital emergency roomReview your prescription drug plan optionsbull Decide which Caremark prescription plan is best for you Note that the Kaiser HMO includes prescription drug coverage Both the Standard and High
Option Caremark plans cover the same prescription drugs but have different copay and deductiblesUse generic and long-term prescriptions bull Opt for lower-cost generic drugs whenever possible bull Ask your doctor to write a 90-day prescription instead of a 30-day prescription to participate in the mail order prescription programTake advantage of tax savings by participating in Flexible Spending Accountsbull Use pre-tax dollars for eligible out of pocket services and items
Office of Human Resources Montgomery County Government
Built-in Wellness Support Take advantage of the free programs available to you through your medical carrier Each of MCGrsquos medical carriers (Kaiser UHC amp CareFirst) offer valuable programs to help you manage your health
Disease Management Programsbull Help manage your chronic condition through personalized coaching support and encouragement and online education materialsEmotional Wellness amp Stress Management Support bull Help manage stress through mobile apps and other self-care resources Maternity Programsbull Support healthy moms and healthy babiesWeight-loss Programs bull Offers telephonic coaching support and web-based tools to help ensure long-term weight managementbull See the next slide for an example of an MCG success storySmoking Cessation Programsbull Supportive coaching to make quitting more successfulDiscounts bull Gym memberships weight loss programs and moreFor more information about the programs available to you please see the Open Enrollment Guide and contact your medical carrier
Office of Human Resources Montgomery County Government
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You GoAll of MCGrsquos health insurance carriers offer a simple-to-use tool that can help make your life easier while yoursquore on the go Download your carrierrsquos Mobile App to help you personalize organize and access your important plan information on your phone or tablet
bull Schedule Virtual Visitsbull Manage and track claimsbull View ID card informationbull Find doctor and compare costs and quality ratingsbull Review your coveragebull Track your account balances and deductiblesbull Access a variety of health and wellness tools
Visit Google Play or the Apple App Store to download your carrierrsquos App
Office of Human Resources Montgomery County Government
Making Changes
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Questions
Office of Human Resources Montgomery County Government
Open Enrollment AssistanceFollow these steps (in this order)1 Review the frequently asked questions (FAQs) on the Open Enrollment website at wwwmontgomerycountymdgovoe
(available beginning September 21) You can enter key words into the interactive search bar to quickly locate the answer to your question
2 Visit the MC311 website at wwwmontgomerycountymdgovmc311 and search key words for your question The search results contain various knowledge-based articles with information related to your search words Simply click on the corresponding link and the detailed answer is revealed
3 Attend one of OHRrsquos Virtual Office Hours via Microsoft Teams Members of OHRs Health Insurance Team will be on hand to address employee questions by video or via the chat box View the schedule and access the sessions through the Open Enrollment website at wwwmontgomerycountymdgovoe (available beginning September 21)
4 If you have tried all the methods above and still have Open Enrollment-related questions please contact OHRs MC311 Customer Service Center at 240-773-6471 (Mon-Fri 8 am - 5 pm) to open a service request A member of the health insurance team will respond to service requests in the order they are received Tip Please provide an email address at the time you place your Service Request This will ensure the fastest response possible
Office of Human Resources Montgomery County Government
Online ResourcesVisit the 2021 Open Enrollment Webpage
wwwmontgomerycountymdgovOE
Visit OHRrsquos WebpagewwwmontgomerycountymdgovHR
Health Insurance active employees
Office of Human Resources Montgomery County Government
Legal InformationThe County reserves the right at any time and for any reason to amend the Program subject to the Countys collective bargainingagreements The County expects to continue the Program but it is the Countys position that there is no implied contract between individual employees and the County to do so
The County may amend the Program prospectively or retroactively to comply with applicable law
In the event of a conflict between this presentation the County Code andor the Summary Description the County Code then the Summary Description will govern
Office of Human Resources Montgomery County Government
Thank YouWe hope you enjoyed learning about 2021 Open Enrollment
~Your OHR Health Insurance Team
2021 Open Enrollment Benefits Bonanza
What Is Open Enrollment
What Changes Can be Made
Open Enrollment Dates
MCG Continues to Make Generous Employer Contributions
New for 2021
Special 2021 Plan Rates Announcement
Employee Rate Changes for Calendar Year 2021
Planning Ahead Minimizing Future Rate Increases
New for 2021
Open Enrollment Communications
Itrsquos a New Frontier
2021 Open Enrollment Checklist
Open Enrollment Website Resources
Attend a Virtual Open Enrollment Event
Make Changes Online
Paper Enrollment Form Permitted for Only Two Reasons
Dependent Eligibility
Proof of Dependent Eligibility
Marriage Certificate Example Required Documentation (Contd)
Benefits Refresher
Medical amp Rx
Medical Plan Options
Medical Benefits at-a-Glance
Medical Benefits at-a-Glance (contd)
Prescription Plans Caremark
Prescription Drug Plan Comparison
Prescription Drug Cost Comparison
Dental
Slide Number 30
Vision
Vision Insurance
Optional Life amp Dependent Life
Optional Life Insurance ADampD
Optional Life Insurance Rates
Dependent Life Insurance
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs)Why You Should Enroll
Health Care FSA
Child Care FSA
Commuter Choice Transit FSA
Using Your FSA Funds
AFLAC Voluntary Plans
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Carrier Resources amp Cost-Saving Tips
Lower Your Out-of-Pocket Costs
Built-in Wellness Support
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You Go
Making Changes
Make Changes Online
Questions
Open Enrollment Assistance
Online Resources
Legal Information
Thank You
Cigna Dental Comparison
DHMO
PPO
CIGNA NETWORK
Care-Access PlusDHMO
Total CIGNA PPOPPO
Required to Use An Assigned Provider
Yes In-network only Primary Dental Office will be assigned based on home address
No
Out of Network Benefits Available
No
Yes
Balance Billing for Covered Services
No
Yes if you go out-of-network
Referral Required
Yes
No
Orthodontia Benefits Available
Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime)
Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person)
Unlimited
$200000
Deductible (singlefamily)
None
$50 $ 150 waived for preventive care
1Claim submission would be required and balance billing may occur when visiting a nonparticipating provider2Deductible does not apply to Class I ndash Diagnostic and Preventive Services
Coverage for dependents would cease on the day which the child turns 26Benefit Maximum and Deductibles are for the period of January 01 through December 31
All services listed on this benefit summary are subject to the contractSchedules of Benefits and current Exclusions and Limitations
Medical Benefits at a Glance
Kaiser Permanente HMO + Rx wwwkporg
United HealthCare Select HMO wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS) wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS) wwwcarefirstcom
Plan Type
HMO
HMO
Point-of-Service
Point-of-Service
PCP Required
Yes
Yes
No
No
Provider Network
Regional (MDDCVA)
National
National
National
Out-of-Network Benefits
No
No
Yes
Yes
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
None
None
In-Network None Out-of-Network 80
In-Network None Out-of-Network 80
Dr Office Visits PCPSpecialist
$5 copay
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits
Covered in full
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care
$5 copay
$15 copay
Covered in full
Covered in full
Emergency Room
$50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization
Covered in full
Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
MCG 2018 Medical Plan Comparison Chart
Kaiser Permanente
United HealthCare
CareFirst POS Standard
CareFirst POS High
Plan Type
HMO
HMO
Point of Service
Point of Service
Provider Network
Regional (MDDCVA)
National
National
National
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
Annual Out-of-Pocket Maximum
None
$1100 per individual up to cap of $3600 for a family
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
Physician Servcies
PCP Office Visits
$5 copay
$5 copay PCP
In-Network $15 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Specialist Office Visits
$5 copay
$10 copay
In-Network $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Annual Physical
Covered in full
$5 copay PCP
In-Network $15 copay Primary Care Physician $30 copay specialist Out-of-Network 80 covered after deductible (limit 1calendar year)
In-Network $15 copay Out-of-Network 80 not subject to deductible (up to age 18)
In-Network $10 copay Out-of-Network 80 not subject to deductible (up to age 18)
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Allergy Testing
$5 copay
$5 copay PCP $10 copay Specialist
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Virtual Visits
Labs X-Rays Diagnostics
Outpatient labs
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient X-Rays
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Major Diagnostics
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Immedate Medical Servcies
Emergency Room
$50 copay waived if admitted to hospital
$25 copay waived if admitted to hospital $15 copay for urgent care
In-Network $35 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
Urgent Care
Hospital Services
Inpatient Hospitalization
Covered in full
Covered in full
In-Network Covered in full after $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Services
Surgery
Covered in full
Inpatient covered in full Outpatient $25 copay
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Hearing Aids
For minor children One hearing aid for each hearing impaired ear once every 36 months
For minor children One hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
Hearing Screening
$5 copay for hearing exam (hearing aids are excluded)
$5 Copay PCP $10 Copay Specialist
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
Home Health Care Services
Covered in full if medically necessary
Covered in full No copayment 60 visit maximum for skilled care services per calendar year
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
Hospice
Covered in full
Covered in full (See coverage booklet for eligibility information)
In-Network Covered in full
In-Network Covered in full
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
In vitro Fertilization
Limited to 3 attempts per live birth Lifetime maximum of $100000
Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
Mammography - Preventive Screening Schedule
Schedule consistent with the current recommendations of the American College of Physicians
Covered in full Age 35-39 one baseline mammogram Age 40-49 one mammogram every two calendar years Age 50+ one mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
Maternity
Covered in full once pregnancy is diagnosed
No copayment applies after the first visit
In-Network first visit 100 after $30 copay other visits 100
In-Network First visit 100 after $10 copay other visits 100
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Maximum Lifetime Benefit
Unlimited maximum
Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
Prescriptions
Kaiser Rx plan (included with Kaiser HMO medical plan) $5 at on-site pharmacies and for mail order $15 at participating pharmacies
No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
Rehabilitation Services
Inpatient Covered in full (unlimited) Outpatient $5 copay outpatient services for physical therapy are limited to up to 30 visits occupational and speech therapy per injury incident or condition are covered for a period not to exceed 90 days
$10 copayvisit 60 combined visits per year (short-term non-chronic conditions only)
In-Network
In-Network
100
100
Skilled Nursing Facility
Covered in full 100 days maximum
Covered in full 60 days per calendar year maximum
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Substance AbuseMental Health
Inpatient Covered in full Outpatient $5 copay
Inpatient Covered in full Outpatient $5 copay
In-Network Inpatient- $150 per admission copay Outpatient- $15 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
In-Network Inpatient- covered in full Outpatient- $10 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
Vision (Routine)
$5 copay for exams 25 discount on lensesframes at Kaiser centers 15 discount off the costs of contact lenses
$25 copay for exam 15-20 discount through participating optical centers
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
53116
Medical Benefits at a Glance
Kaiser Permanente HMO + Rx wwwkporg
United HealthCare Select HMO wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS) wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS) wwwcarefirstcom
Plan Type
HMO
HMO
Point-of-Service
Point-of-Service
PCP Required
Yes
Yes
No
No
Provider Network
Regional (MDDCVA)
National
National
National
Out-of-Network Benefits
No
No
Yes
Yes
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
None
None
In-Network None Out-of-Network 80
In-Network None Out-of-Network 80
Dr Office Visits PCPSpecialist
$5 copay
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits
Covered in full
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care
$5 copay
$15 copay
Covered in full
Covered in full
Emergency Room
$50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization
Covered in full
Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
MCG 2018 Medical Plan Comparison Chart
Kaiser Permanente
United HealthCare
CareFirst POS Standard
CareFirst POS High
Plan Type
HMO
HMO
Point of Service
Point of Service
Provider Network
Regional (MDDCVA)
National
National
National
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
Annual Out-of-Pocket Maximum
None
$1100 per individual up to cap of $3600 for a family
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
Physician Servcies
PCP Office Visits
$5 copay
$5 copay PCP
In-Network $15 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Specialist Office Visits
$5 copay
$10 copay
In-Network $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Annual Physical
Covered in full
$5 copay PCP
In-Network $15 copay Primary Care Physician $30 copay specialist Out-of-Network 80 covered after deductible (limit 1calendar year)
In-Network $15 copay Out-of-Network 80 not subject to deductible (up to age 18)
In-Network $10 copay Out-of-Network 80 not subject to deductible (up to age 18)
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Allergy Testing
$5 copay
$5 copay PCP $10 copay Specialist
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Virtual Visits
Labs X-Rays Diagnostics
Outpatient labs
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient X-Rays
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Major Diagnostics
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Immedate Medical Servcies
Emergency Room
$50 copay waived if admitted to hospital
$25 copay waived if admitted to hospital $15 copay for urgent care
In-Network $35 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
Urgent Care
Hospital Services
Inpatient Hospitalization
Covered in full
Covered in full
In-Network Covered in full after $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Services
Surgery
Covered in full
Inpatient covered in full Outpatient $25 copay
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Hearing Aids
For minor children One hearing aid for each hearing impaired ear once every 36 months
For minor children One hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
Hearing Screening
$5 copay for hearing exam (hearing aids are excluded)
$5 Copay PCP $10 Copay Specialist
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
Home Health Care Services
Covered in full if medically necessary
Covered in full No copayment 60 visit maximum for skilled care services per calendar year
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
Hospice
Covered in full
Covered in full (See coverage booklet for eligibility information)
In-Network Covered in full
In-Network Covered in full
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
In vitro Fertilization
Limited to 3 attempts per live birth Lifetime maximum of $100000
Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
Mammography - Preventive Screening Schedule
Schedule consistent with the current recommendations of the American College of Physicians
Covered in full Age 35-39 one baseline mammogram Age 40-49 one mammogram every two calendar years Age 50+ one mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
Maternity
Covered in full once pregnancy is diagnosed
No copayment applies after the first visit
In-Network first visit 100 after $30 copay other visits 100
In-Network First visit 100 after $10 copay other visits 100
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Maximum Lifetime Benefit
Unlimited maximum
Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
Prescriptions
Kaiser Rx plan (included with Kaiser HMO medical plan) $5 at on-site pharmacies and for mail order $15 at participating pharmacies
No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
Rehabilitation Services
Inpatient Covered in full (unlimited) Outpatient $5 copay outpatient services for physical therapy are limited to up to 30 visits occupational and speech therapy per injury incident or condition are covered for a period not to exceed 90 days
$10 copayvisit 60 combined visits per year (short-term non-chronic conditions only)
In-Network
In-Network
100
100
Skilled Nursing Facility
Covered in full 100 days maximum
Covered in full 60 days per calendar year maximum
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Substance AbuseMental Health
Inpatient Covered in full Outpatient $5 copay
Inpatient Covered in full Outpatient $5 copay
In-Network Inpatient- $150 per admission copay Outpatient- $15 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
In-Network Inpatient- covered in full Outpatient- $10 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
Vision (Routine)
$5 copay for exams 25 discount on lensesframes at Kaiser centers 15 discount off the costs of contact lenses
$25 copay for exam 15-20 discount through participating optical centers
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
53116
Office of Human Resources Montgomery County Government
What Changes Can be Made Changes employees can make during Open Enrollment are
bull Enroll in the benefit plan(s) for the first timebull Adddelete dependent(s)bull Change from one plan to another bull Drop coveragebull Enroll in or increase Optional Life insurance bull (Re)enroll in a Flexible Spending Accountbull Enroll in AFLAC short-term disability or critical illness
Available to unrepresented and IAFF employees only To enroll contact AFLAC directly
Office of Human Resources Montgomery County Government
Open Enrollment Dates2021 Open Enrollment (OE) runs from September 21 ndash October 9 2020
bull All OE changes must be submitted during the OE windowBegins ndash Monday September 21 at 8 am Deadline ndash Friday October 9 at 5 pm
bull OE changes are effective January 1 2021
Office of Human Resources Montgomery County Government
MCG Continues to Make Generous Employer Contributions
bull This graph provides a visual example of the extremely generous employer contributions that MCG makes toward employee insurance premiums
bull These contributions reduce the amount employees pay This is an important part of their total compensation package as an MCG employee
Note The chart above reflects Self only contributions To view charts reflecting Self+1 and Self+Family contributions visitthe Open Enrollment website after September 21 2020
Office of Human Resources Montgomery County Government
New for 2021bull 2021 Open Enrollment will be held virtually this year All of MCGrsquos carriers will be
hosting virtual presentations and QampA sessions See the virtual event tab on the Open Enrollment website for a schedule of virtual events
bull The Health Care FSA annual contribution limit increasing to $2750 The amount you can contribute for 2021 will increase by $50
bull Health Care FSA now allows Over-the-counter expenses without a prescription (ie allergy heartburn or pain relief medications etc)
bull Benefits Bites delivered to your County email weekly via the MCG Employee Connect newsletter Be sure to check the Benefits Bites section for helpful Open Enrollment tips and resources
bull Enhanced Open Enrollment website with new Frequently Asked Questions and a dedicated MCG discount amp resource section
Office of Human Resources Montgomery County Government
Special 2021 Plan Rates AnnouncementCOVID-19 has impacted us in many ways including financially In light of the fact that employees will not be receiving a General Wage Adjustment (GWA) in FY21bull There will be 0 rate increase for these medical plans
CareFirstUnited HealthcareCVS Caremark
bull The Kaiser medical plan costs are decreasing bull The County will pay a large portion of the dental PPO and vision increases but
these increases will also be shared with employees
Office of Human Resources Montgomery County Government
Employee Rate Changes for Calendar Year 2021Plan Per Pay Period Increase
Self Self + 1 FamilyCareFirst High Option POS $000 $000 $000CareFirst Standard Option POS $000 $000 $000Kaiser -$147 -$276 -$435United HealthCare HMO $000 $000 $000CVS Standard Prescription Plan $000 $000 $000CVS High $4$8 Prescription Plan $000 $000 $000CVS High $5$10 Prescription Plan $000 $000 $000CIGNA PPO Dental $041 $094 $134CIGNA DHMO Dental $000 $000 $000EyeMed Vision $009 $014 $020
Office of Human Resources Montgomery County Government
Planning Ahead Minimizing Future Rate IncreasesHere are ways employees can work together with MCG to keep future plan rate increases at a minimumbull Seek out preventive care such as annual exams and age-based screeningsbull Visit in-network doctors via virtual visitsbull Use urgent care facilities for non-emergent services rather than going to the
emergency roombull Choose generic prescription drugsbull Maximize wellness resources through health insurance carriers and MCGrsquos LiveWell
program
Office of Human Resources Montgomery County Government
New for 2021bull All Open Enrollment events held virtually this yearMCGrsquos carriers will be hosting virtual presentations and QampA sessionsOHR Virtual Office Hours
bull Health Care FSA changesAnnual contribution limit increasing to $2750Over-the-counter expenses are permitted without a written prescription Feminine products are now an eligible expense
bull New Open Enrollment Communication MethodsBenefits Bites delivered in the MCG Employee Connect newsletter Enhanced Open Enrollment website
bull Frequently Asked Questionsbull MCG employee discount amp resource section bull Employee self-service (ESS) instructions and demonstrationsbull MCG vendor video presentations
Office of Human Resources Montgomery County Government
Open Enrollment Communications bull 2021 Open Enrollment Guides were mailed to homes on September 11
Employees should receive the guides between September 14 ndash 16
bull Employees are encouraged to check their County email during and after Open EnrollmentOpen Enrollment email series featuring news and remindersMCG Employee Connect newsletter sharing Open Enrollment news in the Benefits Bites
sectionAfter Open Enrollment ends MetLife will email employees who elected or increased
Optional Life to complete a Statement of Health online
bull The Open Enrollment Website is a dedicated resource for all Open Enrollment needsAvailable Monday September 21 at 8 am
Office of Human Resources Montgomery County Government
Itrsquos a New Frontier COVID-19 has changed the way we utilize our plans MCGrsquos health insurance plans offer many value-added services and discounts to provide employees with support This year more than ever it is important to know our resources
bull Virtual doctor visits bull Built-in emotional amp wellness supportbull Disease management bull Lifestyle coachingbull Stress relief appsbull Discounts and more
Please see the 2021 Open Enrollment guide for additional information
Office of Human Resources Montgomery County Government
2021 Open Enrollment ChecklistTake Action Early Follow these steps for a successful Open Enrollment1 Review available resources
bull 2021 Open Enrollment Guide (mailed to homes on September 11th)bull Open Enrollment Websitebull County Email for Important Updates and Follow-Ups bull Benefits Bites Section of the MCG Employee Connect Newsletter
2 Attend a virtual Open Enrollment event3 Attend OHR virtual office hours4 Make changes online amp print Confirmation Statement5 (Re)Enroll in Flexible Spending Accounts (FSAs) and check FSA contribution
amounts
Office of Human Resources Montgomery County Government
Open Enrollment Website Resources Visit the Open Enrollment website for a variety of planning tools amp resources Open Enrollment schedule of virtual events Open Enrollment frequently asked questions 2021 Employee Self-Service (ESS) instruction video amp written instructions Side-by-side plan comparisons Life insurance needs estimator FSA tax savings calculator MCG employee discounts amp resources and more
Office of Human Resources Montgomery County Government
Attend a Virtual Open Enrollment Event bull Insurance Carrier Virtual Presentations and QampA Sessions Visit the Open Enrollment website for full schedule of events
bull Attend OHR Virtual Office Hours Virtual Office Hours SchedulePlease note Virtual Office Hours are held in a public virtual meeting If questions will
reveal any personal PHI (protected health information) such as a chronic medical condition or names of specific prescription drugs employees should direct those questions to OHRrsquos customer service center at 240-773-6471 to place a service request
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Paper Enrollment Form Permitted for Only Two ReasonsThere are only two exceptions permitting the use of paper Open Enrollment forms
bull Technical barriers preventing access to ESS (only in the event of no internet no smartphone or computer) the employee should contact MC311 and place a service request to be mailed a paper enrollment form Call 240-773-OHR1 (240-773-6471) available Monday through Friday 8 am to 5 pm
bull Experiencing a Life Event If an employee has a qualified status change (life event) during Open Enrollment they cannot make changes using the Open Enrollment form or online system Instead they should contact the OHR Health Insurance Team via MC311 to make changes Qualifying life events marriage divorce the birth of a child or the death of spouse or a
dependent aging out
Office of Human Resources Montgomery County Government
Dependent EligibilityEligible dependents for medical prescription dental and vision coverage arebull Spouse
Legally married EligibleDivorced Not Eligible
bull Children (biological legally adopted stepchildren or under your legal custody)Under age 26 EligibleAge 26 and over Not Eligible unless incapable of self support
Proof of eligible dependents is required
Office of Human Resources Montgomery County Government
Proof of Dependent EligibilityEmployees enrolling new dependents during Open Enrollment must upload the necessary dependent documentation in ESS prior to October 9 at 5 pmRequired Documentationbull Spouse Official State Marriage Certificate (certified by appropriate State or County Official)bull Biological Child State Birth Certificate (For newborns OHR will accept hospital discharge papers for first 60 days birth
certificate must then be submitted)bull Adopted Child Copy of Adoption or Placement for Adoption Papers bull Step-Child State Birth Certificate Marriage Certificate and Divorce Decree or Custody Papers bull Disabled Child Medical plan verification of disability prior to age 26 bull Legal Custody Copy of Court Order granting legal custody
Office of Human Resources Montgomery County Government
Marriage Certificate Example Required Documentation (Contd)
Office of Human Resources Montgomery County Government
Benefits Refresher
Office of Human Resources Montgomery County Government
Medical amp Rx
Office of Human Resources Montgomery County Government
Medical Plan OptionsHealth Maintenance Organizations (HMO)bull Kaiser Permanente Signature (HMO)bull United Healthcare Select (HMO)
Point of Service Plans (POS)bull CareFirst BCBS (POS) High Optionbull CareFirst BCBS (POS) Standard Option
Three tiers of coverage Self Self + 1 or Family
Office of Human Resources Montgomery County Government
Medical Benefits at-a-Glance To view full carrier medical summaries visit OHRrsquos Health Insurance Website
Kaiser Permanente HMO + Rx
wwwkporg
United HealthCare Select HMO
wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS)
wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS)
wwwcarefirstcom
Plan Type HMO HMO Point-of-Service Point-of-Service
PCP Required Yes Yes No No
Provider Network Regional (MDDCVA) National National National
Out-of-Network Benefits No No Yes Yes
Referrals Required Yes No No No
Annual Deductible None NoneIn-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Sheet1
Sheet1 (2)
Office of Human Resources Montgomery County Government
Medical Benefits at-a-Glance (contd)
New Employee Orientation Program
Kaiser Permanente HMO + Rx
wwwkporg
United HealthCare Select HMO
wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS)
wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS)
wwwcarefirstcom
Dr Office Visits PCPSpecialist $5 copay $5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits Covered in full $5 copay $10 copay In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care $5 copay $15 copay Covered in full Covered in full
Emergency Room $50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization Covered in full Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
Visit OHRrsquos Health Insurance webpage to view Medical summaries
Sheet1
Sheet1 (2)
Office of Human Resources Montgomery County Government
Prescription Plans Caremarkbull Two Rx Plan OptionsStandardHigh
bull If you elect UHC or CareFirst and want Rx coverage you will need to elect the stand-alone Caremark Rx plan (Kaiser already includes Rx coverage)
bull Maintenance Choice Program available for maintenance drugs significant cost savings ndash 1 copay for each 90-day prescription In order to get the Maintenance pricing you must fil Rx at CVS retail pharmacy Mail order
Office of Human Resources Montgomery County Government
Prescription Drug Plan Comparison High Option $48
Only MCGEOIAFF employees can enroll in this High plan
High Option $510Only FOPNON-REP employees
can enroll in this High plan
Standard Option All employees can enroll in this
Standard plan
Copay $4 Generics$8 Brand Name
$5 Generics$10 Brand Name
$10 Generics$20 PBrand Name
$35 NPBrand NameDeductible na na $50yearMail Order Yes Yes Yes
Maintenance Choice Yes Yes YesCovered Drugs Same Same Same
Visit OHRrsquos Health Insurance Website to view Rx summaries
Office of Human Resources Montgomery County Government
Prescription Drug Cost Comparison Cost
High Option $48Only MCGEOIAFF employees
can enroll in this High plan
High Option $510Only FOPNON-REP employees
can enroll in this High plan
Standard Option All employees can enroll in this
Standard plan
Self Only
Bi-Weekly $11339Monthly $24568Yearly $294814
Bi-Weekly $11100Monthly $24050Yearly $288600
Bi-Weekly $2413Monthly $5258Yearly $62738
Self + 1
Bi-Weekly $20979Monthly $45455Yearly $545454
Bi-Weekly $20536Monthly $44495Yearly $533936
Bi-Weekly $4463Monthly $9670
Yearly $116038
Self + Family
Bi-Weekly $32511Monthly $70441Yearly $845286
Bi-Weekly $31824Monthly $68952Yearly $827424
Bi-Weekly $6916Monthly $14985Yearly $179816
Office of Human Resources Montgomery County Government
Dental
Office of Human Resources Montgomery County Government
Dental Comparison Cigna
For a list of HMO covered services and assigned costs (copays) view the HMO benefit summary
Required to Use An Assigned Provider Yes In-network only Primary Dental Office will be
assigned based on home address
No
Out of Network Benefits Available No Yes
Balance Billing for Covered Services No Yes if you go out-of-network
Referral Required Yes No
Orthodontia Benefits Available Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime) Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person) Unlimited $200000
Deductible (singlefamily) None $50 $ 150 waived for preventive care
Table 1
Office of Human Resources Montgomery County Government
Vision
Office of Human Resources Montgomery County Government
Vision Insurancebull The Countyrsquos Vision carrier is EyeMedbull Benefits payable for exams lenses and contacts (elective or necessary) every
calendar year frames every two calendar yearsbull In-network or out-of-network benefits available bull Enhanced Hearing Benefit through EyeMedrsquos partner Amplifon40 off hearing examDiscounted pricing on thousands of hearing aids including latest technologyOne-year free follow-up care with unlimited appointmentsFree batteries for two years with initial purchase Three-year warranty and loss and damage coverage
Visit OHRrsquos Health Insurance webpage to view vision summary
Office of Human Resources Montgomery County Government
Optional Life amp Dependent Life
Office of Human Resources Montgomery County Government
Optional Life Insurance ADampDbull You may elect Optional Life ADampD coverage for yourself in increments of 1 to 8 times
your basic annual earnings ($1 million maximum)
bull NOTE Coverage is not guaranteed issue for any level You must complete an online Statement of Health no matter what level of coverage you elect Later this fall after Open Enrollment ends you will receive an email from MetLife with a link to complete the Statement of Health online
bull An eligible dependent is defined as 1) your opposite or same sex spouse or 2) your unmarried children under age 26 (natural adopted or stepchildrenfoster children who depend on your support)
Office of Human Resources Montgomery County Government
Optional Life Insurance RatesHow to estimate your Optional Life Insurance bi-weekly rate
Example 40-year-old applying for 2 x salary Salary is $49300
Steps Example Calculate for Yourself
A Find your age-based rate on the rate sheet (left) $ 0037 $_________________
B Choose how much coverage you are applying for
$99000 (2 x salary rounded to the nearest $1000 ) $_________________
C Divide that coverage amount by 100099 ($99000 1000) $_________________
D Multiply A x C for estimated bi-weekly cost$366 ($037 x 99) $_________________
Office of Human Resources Montgomery County Government
Dependent Life InsuranceYou may also purchase Dependent Optional Life insurance forbull Your opposite or same sex spouse bull Your unmarried children under age 26
ndash Natural adoptedndash Stepchildrenfoster childrenNote you do not need to supply marriage certificatesbirth certificates for dependent optional life
You may electbull $2000 Spouse$1000 Childbull $4000 Spouse $2000 Childbull $10000 Spouse $5000 Child
The bi-weekly rate is not based on salary
Office of Human Resources Montgomery County Government
Flexible Spending Accounts
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Visit the Open Enrollment website to watch a recorded FSA presentation from MCGrsquos FSA vendor Benefit Strategies
bull What is an FSA It is an IRS-approved tax-free account that saves onQualified out-of-pocket medical and dependent care expensesFederal and State Income taxSocial Security Tax
bull 3 Account Options Health Care FSA Child Care FSA and Commuter Choice Transit bull FSA accounts are administered through Benefit Strategies bull FSAs are ldquouse-it or lose-itrdquo accounts claims must be incurred during the 2021 plan year (January 1
2021 ndash March 15 2022) and submitted by April 30 2022
IMPORTANT You must re-enroll in an FSA every Open Enrollment if you want to participate in the upcoming plan year
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Why You Should EnrollGive yourself a raise by reducing your taxesbull Elect the annual amount you want to place in your FSA(s) for the upcoming plan year during Open Enrollmentbull That amount is divided by 26 and taken from your biweekly paychecks on a pre-tax basis (21 paychecks for
10-month employees)bull Then use your pre-tax FSA dollars to pay for eligible out-of-pocket health care child-care or transit
expenses
Office of Human Resources Montgomery County Government
Health Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull Claims must be submitted by April 30 of the following yearbull You may elect to contribute up to $2750 Your total annual election amount is available to spend on the first
day of the new plan year bull FSA debit card allows you to pay for expenses at the time of servicebull Examples of IRS qualified eligible expenses
bull Copays (medical prescription dental vision) deductibles and coinsurance amounts over reasonable and customary charge
bull Hearing aids bull Acupuncture bull Orthopedic shoes bull Over-the-counter (OTC) drugs (no longer require doctorrsquos prescription)
Office of Human Resources Montgomery County Government
Child Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull $5000 annual maximum per household ($2500 for married filing separately)bull Funds are available to spend as they are accumulated through payroll deductionsbull Reimbursable expenses
bull day care centersbull elder carebull beforeafter school carebull babysitter fees that allow you and your spouse to work or go to school (no child support payments)
bull Qualifying dependentsbull Children under the age of 13 and are a tax dependent of the employeebull Spouse or tax dependent that is physically or mentally incapable of self-care
bull Must coordinate between filing a tax credit with IRS and your Dependent Care FSA plan
Office of Human Resources Montgomery County Government
Commuter Choice Transit FSAbull $230 per month maximum for MCGEO staff $260 per month maximum for Unrepresented staffbull Applies to employee commuting expenses only (not spouses or dependents)bull Can enroll throughout the year (not limited to Open Enrollment election)bull Eligible expenses include Metro Marc Vanpool Lyft Line Uber Poolbull Debit card ndash may be used for some expenses (not Metro)Metro riders will have to submit claim forms for reimbursement
bull Funds must be used within 180 days of election bull If retiring or leaving the County will need to coordinate use all available funds
Office of Human Resources Montgomery County Government
Using Your FSA FundsHealth Care FSA Your full annual election amount is available on the first day of the plan yearChild Care FSA Your funds are available as they accumulate through payroll deductionsCommuterTransit FSA Your funds are available as they accumulate through payroll deductions
The FSA Debit Card bull Your FSA debit card is the same card for your Health Care Child Care and TransitCommuter FSA accountsbull The card is pre-loaded with your full annual Health Care FSA election amount You can use the card to pay for IRS qualified expenses at
the time of service or when paying a bill Receipt notifications will be mailed to you monthly by Benefit Strategies Your response to receipt notifications is necessary under the provisions of the plan No response my result in the ineligibility of the purchase and as a result your card may be temporarily deactivated
bull If you are enrolled in the Child Care FSA the card can also be used in child-care settings Just remember that the card will only work for an amount that does not exceed the available balance in your Child Care FSA account on that day
bull The card can also be used to pay for your commutertransit expenses however it does not work for WMATA metro Metro riders will have to submit manual claims for reimbursement from your CommuterTransit FSA
bull Cards are re-loaded each year after you make your new annual election Please keep your cards You will only receive a new card if your old card is about to expire
Office of Human Resources Montgomery County Government
AFLAC Voluntary Plans
Office of Human Resources Montgomery County Government
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Short-Term Disabilitybull Provides short-term cash benefits in the event of disabilitybull Monthly benefit amounts available from $500 - $6000 (subject to income requirements)bull Benefit options of 3 6 12 18 or 24 months with a variety of elimination periods
Critical Illness Insurancebull Provides a lump sum cash benefit in the event of critical illnessbull Benefit amounts available in $5000 increments from $10000 - $30000
Participants pay 100 through payroll deduction for Short-Term Disability and Critical Illness Insurance
To ENROLL Text SETAPPTrdquo to 41411orCall 920-420-8861 orEmail susan_mcdanielusAflaccom
Office of Human Resources Montgomery County Government
Carrier Resources amp Cost-Saving Tips
Office of Human Resources Montgomery County Government
Lower Your Out-of-Pocket CostsChoose the plan thatrsquos right for youbull See the medical benefits chart for options bull Stay in network Use the provider search engines on your carrier website or mobile app to find in-network providersSeek preventive carebull Check-ups immunizations and screenings are an important part of staying healthy They can detect or prevent serious diseases and keep you healthyKnow where to go for carebull You have many options of places to go when you need care If your medical condition isnrsquot serious or life threatening you can save money by connecting
with a doctor online through a virtual visit or going to an urgent care center or convenience care clinic instead of a hospital emergency roomReview your prescription drug plan optionsbull Decide which Caremark prescription plan is best for you Note that the Kaiser HMO includes prescription drug coverage Both the Standard and High
Option Caremark plans cover the same prescription drugs but have different copay and deductiblesUse generic and long-term prescriptions bull Opt for lower-cost generic drugs whenever possible bull Ask your doctor to write a 90-day prescription instead of a 30-day prescription to participate in the mail order prescription programTake advantage of tax savings by participating in Flexible Spending Accountsbull Use pre-tax dollars for eligible out of pocket services and items
Office of Human Resources Montgomery County Government
Built-in Wellness Support Take advantage of the free programs available to you through your medical carrier Each of MCGrsquos medical carriers (Kaiser UHC amp CareFirst) offer valuable programs to help you manage your health
Disease Management Programsbull Help manage your chronic condition through personalized coaching support and encouragement and online education materialsEmotional Wellness amp Stress Management Support bull Help manage stress through mobile apps and other self-care resources Maternity Programsbull Support healthy moms and healthy babiesWeight-loss Programs bull Offers telephonic coaching support and web-based tools to help ensure long-term weight managementbull See the next slide for an example of an MCG success storySmoking Cessation Programsbull Supportive coaching to make quitting more successfulDiscounts bull Gym memberships weight loss programs and moreFor more information about the programs available to you please see the Open Enrollment Guide and contact your medical carrier
Office of Human Resources Montgomery County Government
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You GoAll of MCGrsquos health insurance carriers offer a simple-to-use tool that can help make your life easier while yoursquore on the go Download your carrierrsquos Mobile App to help you personalize organize and access your important plan information on your phone or tablet
bull Schedule Virtual Visitsbull Manage and track claimsbull View ID card informationbull Find doctor and compare costs and quality ratingsbull Review your coveragebull Track your account balances and deductiblesbull Access a variety of health and wellness tools
Visit Google Play or the Apple App Store to download your carrierrsquos App
Office of Human Resources Montgomery County Government
Making Changes
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Questions
Office of Human Resources Montgomery County Government
Open Enrollment AssistanceFollow these steps (in this order)1 Review the frequently asked questions (FAQs) on the Open Enrollment website at wwwmontgomerycountymdgovoe
(available beginning September 21) You can enter key words into the interactive search bar to quickly locate the answer to your question
2 Visit the MC311 website at wwwmontgomerycountymdgovmc311 and search key words for your question The search results contain various knowledge-based articles with information related to your search words Simply click on the corresponding link and the detailed answer is revealed
3 Attend one of OHRrsquos Virtual Office Hours via Microsoft Teams Members of OHRs Health Insurance Team will be on hand to address employee questions by video or via the chat box View the schedule and access the sessions through the Open Enrollment website at wwwmontgomerycountymdgovoe (available beginning September 21)
4 If you have tried all the methods above and still have Open Enrollment-related questions please contact OHRs MC311 Customer Service Center at 240-773-6471 (Mon-Fri 8 am - 5 pm) to open a service request A member of the health insurance team will respond to service requests in the order they are received Tip Please provide an email address at the time you place your Service Request This will ensure the fastest response possible
Office of Human Resources Montgomery County Government
Online ResourcesVisit the 2021 Open Enrollment Webpage
wwwmontgomerycountymdgovOE
Visit OHRrsquos WebpagewwwmontgomerycountymdgovHR
Health Insurance active employees
Office of Human Resources Montgomery County Government
Legal InformationThe County reserves the right at any time and for any reason to amend the Program subject to the Countys collective bargainingagreements The County expects to continue the Program but it is the Countys position that there is no implied contract between individual employees and the County to do so
The County may amend the Program prospectively or retroactively to comply with applicable law
In the event of a conflict between this presentation the County Code andor the Summary Description the County Code then the Summary Description will govern
Office of Human Resources Montgomery County Government
Thank YouWe hope you enjoyed learning about 2021 Open Enrollment
~Your OHR Health Insurance Team
2021 Open Enrollment Benefits Bonanza
What Is Open Enrollment
What Changes Can be Made
Open Enrollment Dates
MCG Continues to Make Generous Employer Contributions
New for 2021
Special 2021 Plan Rates Announcement
Employee Rate Changes for Calendar Year 2021
Planning Ahead Minimizing Future Rate Increases
New for 2021
Open Enrollment Communications
Itrsquos a New Frontier
2021 Open Enrollment Checklist
Open Enrollment Website Resources
Attend a Virtual Open Enrollment Event
Make Changes Online
Paper Enrollment Form Permitted for Only Two Reasons
Dependent Eligibility
Proof of Dependent Eligibility
Marriage Certificate Example Required Documentation (Contd)
Benefits Refresher
Medical amp Rx
Medical Plan Options
Medical Benefits at-a-Glance
Medical Benefits at-a-Glance (contd)
Prescription Plans Caremark
Prescription Drug Plan Comparison
Prescription Drug Cost Comparison
Dental
Slide Number 30
Vision
Vision Insurance
Optional Life amp Dependent Life
Optional Life Insurance ADampD
Optional Life Insurance Rates
Dependent Life Insurance
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs)Why You Should Enroll
Health Care FSA
Child Care FSA
Commuter Choice Transit FSA
Using Your FSA Funds
AFLAC Voluntary Plans
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Carrier Resources amp Cost-Saving Tips
Lower Your Out-of-Pocket Costs
Built-in Wellness Support
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You Go
Making Changes
Make Changes Online
Questions
Open Enrollment Assistance
Online Resources
Legal Information
Thank You
Cigna Dental Comparison
DHMO
PPO
CIGNA NETWORK
Care-Access PlusDHMO
Total CIGNA PPOPPO
Required to Use An Assigned Provider
Yes In-network only Primary Dental Office will be assigned based on home address
No
Out of Network Benefits Available
No
Yes
Balance Billing for Covered Services
No
Yes if you go out-of-network
Referral Required
Yes
No
Orthodontia Benefits Available
Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime)
Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person)
Unlimited
$200000
Deductible (singlefamily)
None
$50 $ 150 waived for preventive care
1Claim submission would be required and balance billing may occur when visiting a nonparticipating provider2Deductible does not apply to Class I ndash Diagnostic and Preventive Services
Coverage for dependents would cease on the day which the child turns 26Benefit Maximum and Deductibles are for the period of January 01 through December 31
All services listed on this benefit summary are subject to the contractSchedules of Benefits and current Exclusions and Limitations
Medical Benefits at a Glance
Kaiser Permanente HMO + Rx wwwkporg
United HealthCare Select HMO wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS) wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS) wwwcarefirstcom
Plan Type
HMO
HMO
Point-of-Service
Point-of-Service
PCP Required
Yes
Yes
No
No
Provider Network
Regional (MDDCVA)
National
National
National
Out-of-Network Benefits
No
No
Yes
Yes
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
None
None
In-Network None Out-of-Network 80
In-Network None Out-of-Network 80
Dr Office Visits PCPSpecialist
$5 copay
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits
Covered in full
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care
$5 copay
$15 copay
Covered in full
Covered in full
Emergency Room
$50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization
Covered in full
Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
MCG 2018 Medical Plan Comparison Chart
Kaiser Permanente
United HealthCare
CareFirst POS Standard
CareFirst POS High
Plan Type
HMO
HMO
Point of Service
Point of Service
Provider Network
Regional (MDDCVA)
National
National
National
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
Annual Out-of-Pocket Maximum
None
$1100 per individual up to cap of $3600 for a family
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
Physician Servcies
PCP Office Visits
$5 copay
$5 copay PCP
In-Network $15 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Specialist Office Visits
$5 copay
$10 copay
In-Network $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Annual Physical
Covered in full
$5 copay PCP
In-Network $15 copay Primary Care Physician $30 copay specialist Out-of-Network 80 covered after deductible (limit 1calendar year)
In-Network $15 copay Out-of-Network 80 not subject to deductible (up to age 18)
In-Network $10 copay Out-of-Network 80 not subject to deductible (up to age 18)
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Allergy Testing
$5 copay
$5 copay PCP $10 copay Specialist
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Virtual Visits
Labs X-Rays Diagnostics
Outpatient labs
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient X-Rays
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Major Diagnostics
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Immedate Medical Servcies
Emergency Room
$50 copay waived if admitted to hospital
$25 copay waived if admitted to hospital $15 copay for urgent care
In-Network $35 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
Urgent Care
Hospital Services
Inpatient Hospitalization
Covered in full
Covered in full
In-Network Covered in full after $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Services
Surgery
Covered in full
Inpatient covered in full Outpatient $25 copay
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Hearing Aids
For minor children One hearing aid for each hearing impaired ear once every 36 months
For minor children One hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
Hearing Screening
$5 copay for hearing exam (hearing aids are excluded)
$5 Copay PCP $10 Copay Specialist
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
Home Health Care Services
Covered in full if medically necessary
Covered in full No copayment 60 visit maximum for skilled care services per calendar year
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
Hospice
Covered in full
Covered in full (See coverage booklet for eligibility information)
In-Network Covered in full
In-Network Covered in full
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
In vitro Fertilization
Limited to 3 attempts per live birth Lifetime maximum of $100000
Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
Mammography - Preventive Screening Schedule
Schedule consistent with the current recommendations of the American College of Physicians
Covered in full Age 35-39 one baseline mammogram Age 40-49 one mammogram every two calendar years Age 50+ one mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
Maternity
Covered in full once pregnancy is diagnosed
No copayment applies after the first visit
In-Network first visit 100 after $30 copay other visits 100
In-Network First visit 100 after $10 copay other visits 100
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Maximum Lifetime Benefit
Unlimited maximum
Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
Prescriptions
Kaiser Rx plan (included with Kaiser HMO medical plan) $5 at on-site pharmacies and for mail order $15 at participating pharmacies
No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
Rehabilitation Services
Inpatient Covered in full (unlimited) Outpatient $5 copay outpatient services for physical therapy are limited to up to 30 visits occupational and speech therapy per injury incident or condition are covered for a period not to exceed 90 days
$10 copayvisit 60 combined visits per year (short-term non-chronic conditions only)
In-Network
In-Network
100
100
Skilled Nursing Facility
Covered in full 100 days maximum
Covered in full 60 days per calendar year maximum
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Substance AbuseMental Health
Inpatient Covered in full Outpatient $5 copay
Inpatient Covered in full Outpatient $5 copay
In-Network Inpatient- $150 per admission copay Outpatient- $15 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
In-Network Inpatient- covered in full Outpatient- $10 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
Vision (Routine)
$5 copay for exams 25 discount on lensesframes at Kaiser centers 15 discount off the costs of contact lenses
$25 copay for exam 15-20 discount through participating optical centers
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
53116
Medical Benefits at a Glance
Kaiser Permanente HMO + Rx wwwkporg
United HealthCare Select HMO wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS) wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS) wwwcarefirstcom
Plan Type
HMO
HMO
Point-of-Service
Point-of-Service
PCP Required
Yes
Yes
No
No
Provider Network
Regional (MDDCVA)
National
National
National
Out-of-Network Benefits
No
No
Yes
Yes
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
None
None
In-Network None Out-of-Network 80
In-Network None Out-of-Network 80
Dr Office Visits PCPSpecialist
$5 copay
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits
Covered in full
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care
$5 copay
$15 copay
Covered in full
Covered in full
Emergency Room
$50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization
Covered in full
Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
MCG 2018 Medical Plan Comparison Chart
Kaiser Permanente
United HealthCare
CareFirst POS Standard
CareFirst POS High
Plan Type
HMO
HMO
Point of Service
Point of Service
Provider Network
Regional (MDDCVA)
National
National
National
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
Annual Out-of-Pocket Maximum
None
$1100 per individual up to cap of $3600 for a family
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
Physician Servcies
PCP Office Visits
$5 copay
$5 copay PCP
In-Network $15 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Specialist Office Visits
$5 copay
$10 copay
In-Network $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Annual Physical
Covered in full
$5 copay PCP
In-Network $15 copay Primary Care Physician $30 copay specialist Out-of-Network 80 covered after deductible (limit 1calendar year)
In-Network $15 copay Out-of-Network 80 not subject to deductible (up to age 18)
In-Network $10 copay Out-of-Network 80 not subject to deductible (up to age 18)
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Allergy Testing
$5 copay
$5 copay PCP $10 copay Specialist
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Virtual Visits
Labs X-Rays Diagnostics
Outpatient labs
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient X-Rays
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Major Diagnostics
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Immedate Medical Servcies
Emergency Room
$50 copay waived if admitted to hospital
$25 copay waived if admitted to hospital $15 copay for urgent care
In-Network $35 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
Urgent Care
Hospital Services
Inpatient Hospitalization
Covered in full
Covered in full
In-Network Covered in full after $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Services
Surgery
Covered in full
Inpatient covered in full Outpatient $25 copay
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Hearing Aids
For minor children One hearing aid for each hearing impaired ear once every 36 months
For minor children One hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
Hearing Screening
$5 copay for hearing exam (hearing aids are excluded)
$5 Copay PCP $10 Copay Specialist
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
Home Health Care Services
Covered in full if medically necessary
Covered in full No copayment 60 visit maximum for skilled care services per calendar year
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
Hospice
Covered in full
Covered in full (See coverage booklet for eligibility information)
In-Network Covered in full
In-Network Covered in full
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
In vitro Fertilization
Limited to 3 attempts per live birth Lifetime maximum of $100000
Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
Mammography - Preventive Screening Schedule
Schedule consistent with the current recommendations of the American College of Physicians
Covered in full Age 35-39 one baseline mammogram Age 40-49 one mammogram every two calendar years Age 50+ one mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
Maternity
Covered in full once pregnancy is diagnosed
No copayment applies after the first visit
In-Network first visit 100 after $30 copay other visits 100
In-Network First visit 100 after $10 copay other visits 100
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Maximum Lifetime Benefit
Unlimited maximum
Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
Prescriptions
Kaiser Rx plan (included with Kaiser HMO medical plan) $5 at on-site pharmacies and for mail order $15 at participating pharmacies
No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
Rehabilitation Services
Inpatient Covered in full (unlimited) Outpatient $5 copay outpatient services for physical therapy are limited to up to 30 visits occupational and speech therapy per injury incident or condition are covered for a period not to exceed 90 days
$10 copayvisit 60 combined visits per year (short-term non-chronic conditions only)
In-Network
In-Network
100
100
Skilled Nursing Facility
Covered in full 100 days maximum
Covered in full 60 days per calendar year maximum
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Substance AbuseMental Health
Inpatient Covered in full Outpatient $5 copay
Inpatient Covered in full Outpatient $5 copay
In-Network Inpatient- $150 per admission copay Outpatient- $15 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
In-Network Inpatient- covered in full Outpatient- $10 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
Vision (Routine)
$5 copay for exams 25 discount on lensesframes at Kaiser centers 15 discount off the costs of contact lenses
$25 copay for exam 15-20 discount through participating optical centers
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
53116
Office of Human Resources Montgomery County Government
Open Enrollment Dates2021 Open Enrollment (OE) runs from September 21 ndash October 9 2020
bull All OE changes must be submitted during the OE windowBegins ndash Monday September 21 at 8 am Deadline ndash Friday October 9 at 5 pm
bull OE changes are effective January 1 2021
Office of Human Resources Montgomery County Government
MCG Continues to Make Generous Employer Contributions
bull This graph provides a visual example of the extremely generous employer contributions that MCG makes toward employee insurance premiums
bull These contributions reduce the amount employees pay This is an important part of their total compensation package as an MCG employee
Note The chart above reflects Self only contributions To view charts reflecting Self+1 and Self+Family contributions visitthe Open Enrollment website after September 21 2020
Office of Human Resources Montgomery County Government
New for 2021bull 2021 Open Enrollment will be held virtually this year All of MCGrsquos carriers will be
hosting virtual presentations and QampA sessions See the virtual event tab on the Open Enrollment website for a schedule of virtual events
bull The Health Care FSA annual contribution limit increasing to $2750 The amount you can contribute for 2021 will increase by $50
bull Health Care FSA now allows Over-the-counter expenses without a prescription (ie allergy heartburn or pain relief medications etc)
bull Benefits Bites delivered to your County email weekly via the MCG Employee Connect newsletter Be sure to check the Benefits Bites section for helpful Open Enrollment tips and resources
bull Enhanced Open Enrollment website with new Frequently Asked Questions and a dedicated MCG discount amp resource section
Office of Human Resources Montgomery County Government
Special 2021 Plan Rates AnnouncementCOVID-19 has impacted us in many ways including financially In light of the fact that employees will not be receiving a General Wage Adjustment (GWA) in FY21bull There will be 0 rate increase for these medical plans
CareFirstUnited HealthcareCVS Caremark
bull The Kaiser medical plan costs are decreasing bull The County will pay a large portion of the dental PPO and vision increases but
these increases will also be shared with employees
Office of Human Resources Montgomery County Government
Employee Rate Changes for Calendar Year 2021Plan Per Pay Period Increase
Self Self + 1 FamilyCareFirst High Option POS $000 $000 $000CareFirst Standard Option POS $000 $000 $000Kaiser -$147 -$276 -$435United HealthCare HMO $000 $000 $000CVS Standard Prescription Plan $000 $000 $000CVS High $4$8 Prescription Plan $000 $000 $000CVS High $5$10 Prescription Plan $000 $000 $000CIGNA PPO Dental $041 $094 $134CIGNA DHMO Dental $000 $000 $000EyeMed Vision $009 $014 $020
Office of Human Resources Montgomery County Government
Planning Ahead Minimizing Future Rate IncreasesHere are ways employees can work together with MCG to keep future plan rate increases at a minimumbull Seek out preventive care such as annual exams and age-based screeningsbull Visit in-network doctors via virtual visitsbull Use urgent care facilities for non-emergent services rather than going to the
emergency roombull Choose generic prescription drugsbull Maximize wellness resources through health insurance carriers and MCGrsquos LiveWell
program
Office of Human Resources Montgomery County Government
New for 2021bull All Open Enrollment events held virtually this yearMCGrsquos carriers will be hosting virtual presentations and QampA sessionsOHR Virtual Office Hours
bull Health Care FSA changesAnnual contribution limit increasing to $2750Over-the-counter expenses are permitted without a written prescription Feminine products are now an eligible expense
bull New Open Enrollment Communication MethodsBenefits Bites delivered in the MCG Employee Connect newsletter Enhanced Open Enrollment website
bull Frequently Asked Questionsbull MCG employee discount amp resource section bull Employee self-service (ESS) instructions and demonstrationsbull MCG vendor video presentations
Office of Human Resources Montgomery County Government
Open Enrollment Communications bull 2021 Open Enrollment Guides were mailed to homes on September 11
Employees should receive the guides between September 14 ndash 16
bull Employees are encouraged to check their County email during and after Open EnrollmentOpen Enrollment email series featuring news and remindersMCG Employee Connect newsletter sharing Open Enrollment news in the Benefits Bites
sectionAfter Open Enrollment ends MetLife will email employees who elected or increased
Optional Life to complete a Statement of Health online
bull The Open Enrollment Website is a dedicated resource for all Open Enrollment needsAvailable Monday September 21 at 8 am
Office of Human Resources Montgomery County Government
Itrsquos a New Frontier COVID-19 has changed the way we utilize our plans MCGrsquos health insurance plans offer many value-added services and discounts to provide employees with support This year more than ever it is important to know our resources
bull Virtual doctor visits bull Built-in emotional amp wellness supportbull Disease management bull Lifestyle coachingbull Stress relief appsbull Discounts and more
Please see the 2021 Open Enrollment guide for additional information
Office of Human Resources Montgomery County Government
2021 Open Enrollment ChecklistTake Action Early Follow these steps for a successful Open Enrollment1 Review available resources
bull 2021 Open Enrollment Guide (mailed to homes on September 11th)bull Open Enrollment Websitebull County Email for Important Updates and Follow-Ups bull Benefits Bites Section of the MCG Employee Connect Newsletter
2 Attend a virtual Open Enrollment event3 Attend OHR virtual office hours4 Make changes online amp print Confirmation Statement5 (Re)Enroll in Flexible Spending Accounts (FSAs) and check FSA contribution
amounts
Office of Human Resources Montgomery County Government
Open Enrollment Website Resources Visit the Open Enrollment website for a variety of planning tools amp resources Open Enrollment schedule of virtual events Open Enrollment frequently asked questions 2021 Employee Self-Service (ESS) instruction video amp written instructions Side-by-side plan comparisons Life insurance needs estimator FSA tax savings calculator MCG employee discounts amp resources and more
Office of Human Resources Montgomery County Government
Attend a Virtual Open Enrollment Event bull Insurance Carrier Virtual Presentations and QampA Sessions Visit the Open Enrollment website for full schedule of events
bull Attend OHR Virtual Office Hours Virtual Office Hours SchedulePlease note Virtual Office Hours are held in a public virtual meeting If questions will
reveal any personal PHI (protected health information) such as a chronic medical condition or names of specific prescription drugs employees should direct those questions to OHRrsquos customer service center at 240-773-6471 to place a service request
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Paper Enrollment Form Permitted for Only Two ReasonsThere are only two exceptions permitting the use of paper Open Enrollment forms
bull Technical barriers preventing access to ESS (only in the event of no internet no smartphone or computer) the employee should contact MC311 and place a service request to be mailed a paper enrollment form Call 240-773-OHR1 (240-773-6471) available Monday through Friday 8 am to 5 pm
bull Experiencing a Life Event If an employee has a qualified status change (life event) during Open Enrollment they cannot make changes using the Open Enrollment form or online system Instead they should contact the OHR Health Insurance Team via MC311 to make changes Qualifying life events marriage divorce the birth of a child or the death of spouse or a
dependent aging out
Office of Human Resources Montgomery County Government
Dependent EligibilityEligible dependents for medical prescription dental and vision coverage arebull Spouse
Legally married EligibleDivorced Not Eligible
bull Children (biological legally adopted stepchildren or under your legal custody)Under age 26 EligibleAge 26 and over Not Eligible unless incapable of self support
Proof of eligible dependents is required
Office of Human Resources Montgomery County Government
Proof of Dependent EligibilityEmployees enrolling new dependents during Open Enrollment must upload the necessary dependent documentation in ESS prior to October 9 at 5 pmRequired Documentationbull Spouse Official State Marriage Certificate (certified by appropriate State or County Official)bull Biological Child State Birth Certificate (For newborns OHR will accept hospital discharge papers for first 60 days birth
certificate must then be submitted)bull Adopted Child Copy of Adoption or Placement for Adoption Papers bull Step-Child State Birth Certificate Marriage Certificate and Divorce Decree or Custody Papers bull Disabled Child Medical plan verification of disability prior to age 26 bull Legal Custody Copy of Court Order granting legal custody
Office of Human Resources Montgomery County Government
Marriage Certificate Example Required Documentation (Contd)
Office of Human Resources Montgomery County Government
Benefits Refresher
Office of Human Resources Montgomery County Government
Medical amp Rx
Office of Human Resources Montgomery County Government
Medical Plan OptionsHealth Maintenance Organizations (HMO)bull Kaiser Permanente Signature (HMO)bull United Healthcare Select (HMO)
Point of Service Plans (POS)bull CareFirst BCBS (POS) High Optionbull CareFirst BCBS (POS) Standard Option
Three tiers of coverage Self Self + 1 or Family
Office of Human Resources Montgomery County Government
Medical Benefits at-a-Glance To view full carrier medical summaries visit OHRrsquos Health Insurance Website
Kaiser Permanente HMO + Rx
wwwkporg
United HealthCare Select HMO
wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS)
wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS)
wwwcarefirstcom
Plan Type HMO HMO Point-of-Service Point-of-Service
PCP Required Yes Yes No No
Provider Network Regional (MDDCVA) National National National
Out-of-Network Benefits No No Yes Yes
Referrals Required Yes No No No
Annual Deductible None NoneIn-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Sheet1
Sheet1 (2)
Office of Human Resources Montgomery County Government
Medical Benefits at-a-Glance (contd)
New Employee Orientation Program
Kaiser Permanente HMO + Rx
wwwkporg
United HealthCare Select HMO
wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS)
wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS)
wwwcarefirstcom
Dr Office Visits PCPSpecialist $5 copay $5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits Covered in full $5 copay $10 copay In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care $5 copay $15 copay Covered in full Covered in full
Emergency Room $50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization Covered in full Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
Visit OHRrsquos Health Insurance webpage to view Medical summaries
Sheet1
Sheet1 (2)
Office of Human Resources Montgomery County Government
Prescription Plans Caremarkbull Two Rx Plan OptionsStandardHigh
bull If you elect UHC or CareFirst and want Rx coverage you will need to elect the stand-alone Caremark Rx plan (Kaiser already includes Rx coverage)
bull Maintenance Choice Program available for maintenance drugs significant cost savings ndash 1 copay for each 90-day prescription In order to get the Maintenance pricing you must fil Rx at CVS retail pharmacy Mail order
Office of Human Resources Montgomery County Government
Prescription Drug Plan Comparison High Option $48
Only MCGEOIAFF employees can enroll in this High plan
High Option $510Only FOPNON-REP employees
can enroll in this High plan
Standard Option All employees can enroll in this
Standard plan
Copay $4 Generics$8 Brand Name
$5 Generics$10 Brand Name
$10 Generics$20 PBrand Name
$35 NPBrand NameDeductible na na $50yearMail Order Yes Yes Yes
Maintenance Choice Yes Yes YesCovered Drugs Same Same Same
Visit OHRrsquos Health Insurance Website to view Rx summaries
Office of Human Resources Montgomery County Government
Prescription Drug Cost Comparison Cost
High Option $48Only MCGEOIAFF employees
can enroll in this High plan
High Option $510Only FOPNON-REP employees
can enroll in this High plan
Standard Option All employees can enroll in this
Standard plan
Self Only
Bi-Weekly $11339Monthly $24568Yearly $294814
Bi-Weekly $11100Monthly $24050Yearly $288600
Bi-Weekly $2413Monthly $5258Yearly $62738
Self + 1
Bi-Weekly $20979Monthly $45455Yearly $545454
Bi-Weekly $20536Monthly $44495Yearly $533936
Bi-Weekly $4463Monthly $9670
Yearly $116038
Self + Family
Bi-Weekly $32511Monthly $70441Yearly $845286
Bi-Weekly $31824Monthly $68952Yearly $827424
Bi-Weekly $6916Monthly $14985Yearly $179816
Office of Human Resources Montgomery County Government
Dental
Office of Human Resources Montgomery County Government
Dental Comparison Cigna
For a list of HMO covered services and assigned costs (copays) view the HMO benefit summary
Required to Use An Assigned Provider Yes In-network only Primary Dental Office will be
assigned based on home address
No
Out of Network Benefits Available No Yes
Balance Billing for Covered Services No Yes if you go out-of-network
Referral Required Yes No
Orthodontia Benefits Available Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime) Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person) Unlimited $200000
Deductible (singlefamily) None $50 $ 150 waived for preventive care
Table 1
Office of Human Resources Montgomery County Government
Vision
Office of Human Resources Montgomery County Government
Vision Insurancebull The Countyrsquos Vision carrier is EyeMedbull Benefits payable for exams lenses and contacts (elective or necessary) every
calendar year frames every two calendar yearsbull In-network or out-of-network benefits available bull Enhanced Hearing Benefit through EyeMedrsquos partner Amplifon40 off hearing examDiscounted pricing on thousands of hearing aids including latest technologyOne-year free follow-up care with unlimited appointmentsFree batteries for two years with initial purchase Three-year warranty and loss and damage coverage
Visit OHRrsquos Health Insurance webpage to view vision summary
Office of Human Resources Montgomery County Government
Optional Life amp Dependent Life
Office of Human Resources Montgomery County Government
Optional Life Insurance ADampDbull You may elect Optional Life ADampD coverage for yourself in increments of 1 to 8 times
your basic annual earnings ($1 million maximum)
bull NOTE Coverage is not guaranteed issue for any level You must complete an online Statement of Health no matter what level of coverage you elect Later this fall after Open Enrollment ends you will receive an email from MetLife with a link to complete the Statement of Health online
bull An eligible dependent is defined as 1) your opposite or same sex spouse or 2) your unmarried children under age 26 (natural adopted or stepchildrenfoster children who depend on your support)
Office of Human Resources Montgomery County Government
Optional Life Insurance RatesHow to estimate your Optional Life Insurance bi-weekly rate
Example 40-year-old applying for 2 x salary Salary is $49300
Steps Example Calculate for Yourself
A Find your age-based rate on the rate sheet (left) $ 0037 $_________________
B Choose how much coverage you are applying for
$99000 (2 x salary rounded to the nearest $1000 ) $_________________
C Divide that coverage amount by 100099 ($99000 1000) $_________________
D Multiply A x C for estimated bi-weekly cost$366 ($037 x 99) $_________________
Office of Human Resources Montgomery County Government
Dependent Life InsuranceYou may also purchase Dependent Optional Life insurance forbull Your opposite or same sex spouse bull Your unmarried children under age 26
ndash Natural adoptedndash Stepchildrenfoster childrenNote you do not need to supply marriage certificatesbirth certificates for dependent optional life
You may electbull $2000 Spouse$1000 Childbull $4000 Spouse $2000 Childbull $10000 Spouse $5000 Child
The bi-weekly rate is not based on salary
Office of Human Resources Montgomery County Government
Flexible Spending Accounts
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Visit the Open Enrollment website to watch a recorded FSA presentation from MCGrsquos FSA vendor Benefit Strategies
bull What is an FSA It is an IRS-approved tax-free account that saves onQualified out-of-pocket medical and dependent care expensesFederal and State Income taxSocial Security Tax
bull 3 Account Options Health Care FSA Child Care FSA and Commuter Choice Transit bull FSA accounts are administered through Benefit Strategies bull FSAs are ldquouse-it or lose-itrdquo accounts claims must be incurred during the 2021 plan year (January 1
2021 ndash March 15 2022) and submitted by April 30 2022
IMPORTANT You must re-enroll in an FSA every Open Enrollment if you want to participate in the upcoming plan year
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Why You Should EnrollGive yourself a raise by reducing your taxesbull Elect the annual amount you want to place in your FSA(s) for the upcoming plan year during Open Enrollmentbull That amount is divided by 26 and taken from your biweekly paychecks on a pre-tax basis (21 paychecks for
10-month employees)bull Then use your pre-tax FSA dollars to pay for eligible out-of-pocket health care child-care or transit
expenses
Office of Human Resources Montgomery County Government
Health Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull Claims must be submitted by April 30 of the following yearbull You may elect to contribute up to $2750 Your total annual election amount is available to spend on the first
day of the new plan year bull FSA debit card allows you to pay for expenses at the time of servicebull Examples of IRS qualified eligible expenses
bull Copays (medical prescription dental vision) deductibles and coinsurance amounts over reasonable and customary charge
bull Hearing aids bull Acupuncture bull Orthopedic shoes bull Over-the-counter (OTC) drugs (no longer require doctorrsquos prescription)
Office of Human Resources Montgomery County Government
Child Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull $5000 annual maximum per household ($2500 for married filing separately)bull Funds are available to spend as they are accumulated through payroll deductionsbull Reimbursable expenses
bull day care centersbull elder carebull beforeafter school carebull babysitter fees that allow you and your spouse to work or go to school (no child support payments)
bull Qualifying dependentsbull Children under the age of 13 and are a tax dependent of the employeebull Spouse or tax dependent that is physically or mentally incapable of self-care
bull Must coordinate between filing a tax credit with IRS and your Dependent Care FSA plan
Office of Human Resources Montgomery County Government
Commuter Choice Transit FSAbull $230 per month maximum for MCGEO staff $260 per month maximum for Unrepresented staffbull Applies to employee commuting expenses only (not spouses or dependents)bull Can enroll throughout the year (not limited to Open Enrollment election)bull Eligible expenses include Metro Marc Vanpool Lyft Line Uber Poolbull Debit card ndash may be used for some expenses (not Metro)Metro riders will have to submit claim forms for reimbursement
bull Funds must be used within 180 days of election bull If retiring or leaving the County will need to coordinate use all available funds
Office of Human Resources Montgomery County Government
Using Your FSA FundsHealth Care FSA Your full annual election amount is available on the first day of the plan yearChild Care FSA Your funds are available as they accumulate through payroll deductionsCommuterTransit FSA Your funds are available as they accumulate through payroll deductions
The FSA Debit Card bull Your FSA debit card is the same card for your Health Care Child Care and TransitCommuter FSA accountsbull The card is pre-loaded with your full annual Health Care FSA election amount You can use the card to pay for IRS qualified expenses at
the time of service or when paying a bill Receipt notifications will be mailed to you monthly by Benefit Strategies Your response to receipt notifications is necessary under the provisions of the plan No response my result in the ineligibility of the purchase and as a result your card may be temporarily deactivated
bull If you are enrolled in the Child Care FSA the card can also be used in child-care settings Just remember that the card will only work for an amount that does not exceed the available balance in your Child Care FSA account on that day
bull The card can also be used to pay for your commutertransit expenses however it does not work for WMATA metro Metro riders will have to submit manual claims for reimbursement from your CommuterTransit FSA
bull Cards are re-loaded each year after you make your new annual election Please keep your cards You will only receive a new card if your old card is about to expire
Office of Human Resources Montgomery County Government
AFLAC Voluntary Plans
Office of Human Resources Montgomery County Government
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Short-Term Disabilitybull Provides short-term cash benefits in the event of disabilitybull Monthly benefit amounts available from $500 - $6000 (subject to income requirements)bull Benefit options of 3 6 12 18 or 24 months with a variety of elimination periods
Critical Illness Insurancebull Provides a lump sum cash benefit in the event of critical illnessbull Benefit amounts available in $5000 increments from $10000 - $30000
Participants pay 100 through payroll deduction for Short-Term Disability and Critical Illness Insurance
To ENROLL Text SETAPPTrdquo to 41411orCall 920-420-8861 orEmail susan_mcdanielusAflaccom
Office of Human Resources Montgomery County Government
Carrier Resources amp Cost-Saving Tips
Office of Human Resources Montgomery County Government
Lower Your Out-of-Pocket CostsChoose the plan thatrsquos right for youbull See the medical benefits chart for options bull Stay in network Use the provider search engines on your carrier website or mobile app to find in-network providersSeek preventive carebull Check-ups immunizations and screenings are an important part of staying healthy They can detect or prevent serious diseases and keep you healthyKnow where to go for carebull You have many options of places to go when you need care If your medical condition isnrsquot serious or life threatening you can save money by connecting
with a doctor online through a virtual visit or going to an urgent care center or convenience care clinic instead of a hospital emergency roomReview your prescription drug plan optionsbull Decide which Caremark prescription plan is best for you Note that the Kaiser HMO includes prescription drug coverage Both the Standard and High
Option Caremark plans cover the same prescription drugs but have different copay and deductiblesUse generic and long-term prescriptions bull Opt for lower-cost generic drugs whenever possible bull Ask your doctor to write a 90-day prescription instead of a 30-day prescription to participate in the mail order prescription programTake advantage of tax savings by participating in Flexible Spending Accountsbull Use pre-tax dollars for eligible out of pocket services and items
Office of Human Resources Montgomery County Government
Built-in Wellness Support Take advantage of the free programs available to you through your medical carrier Each of MCGrsquos medical carriers (Kaiser UHC amp CareFirst) offer valuable programs to help you manage your health
Disease Management Programsbull Help manage your chronic condition through personalized coaching support and encouragement and online education materialsEmotional Wellness amp Stress Management Support bull Help manage stress through mobile apps and other self-care resources Maternity Programsbull Support healthy moms and healthy babiesWeight-loss Programs bull Offers telephonic coaching support and web-based tools to help ensure long-term weight managementbull See the next slide for an example of an MCG success storySmoking Cessation Programsbull Supportive coaching to make quitting more successfulDiscounts bull Gym memberships weight loss programs and moreFor more information about the programs available to you please see the Open Enrollment Guide and contact your medical carrier
Office of Human Resources Montgomery County Government
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You GoAll of MCGrsquos health insurance carriers offer a simple-to-use tool that can help make your life easier while yoursquore on the go Download your carrierrsquos Mobile App to help you personalize organize and access your important plan information on your phone or tablet
bull Schedule Virtual Visitsbull Manage and track claimsbull View ID card informationbull Find doctor and compare costs and quality ratingsbull Review your coveragebull Track your account balances and deductiblesbull Access a variety of health and wellness tools
Visit Google Play or the Apple App Store to download your carrierrsquos App
Office of Human Resources Montgomery County Government
Making Changes
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Questions
Office of Human Resources Montgomery County Government
Open Enrollment AssistanceFollow these steps (in this order)1 Review the frequently asked questions (FAQs) on the Open Enrollment website at wwwmontgomerycountymdgovoe
(available beginning September 21) You can enter key words into the interactive search bar to quickly locate the answer to your question
2 Visit the MC311 website at wwwmontgomerycountymdgovmc311 and search key words for your question The search results contain various knowledge-based articles with information related to your search words Simply click on the corresponding link and the detailed answer is revealed
3 Attend one of OHRrsquos Virtual Office Hours via Microsoft Teams Members of OHRs Health Insurance Team will be on hand to address employee questions by video or via the chat box View the schedule and access the sessions through the Open Enrollment website at wwwmontgomerycountymdgovoe (available beginning September 21)
4 If you have tried all the methods above and still have Open Enrollment-related questions please contact OHRs MC311 Customer Service Center at 240-773-6471 (Mon-Fri 8 am - 5 pm) to open a service request A member of the health insurance team will respond to service requests in the order they are received Tip Please provide an email address at the time you place your Service Request This will ensure the fastest response possible
Office of Human Resources Montgomery County Government
Online ResourcesVisit the 2021 Open Enrollment Webpage
wwwmontgomerycountymdgovOE
Visit OHRrsquos WebpagewwwmontgomerycountymdgovHR
Health Insurance active employees
Office of Human Resources Montgomery County Government
Legal InformationThe County reserves the right at any time and for any reason to amend the Program subject to the Countys collective bargainingagreements The County expects to continue the Program but it is the Countys position that there is no implied contract between individual employees and the County to do so
The County may amend the Program prospectively or retroactively to comply with applicable law
In the event of a conflict between this presentation the County Code andor the Summary Description the County Code then the Summary Description will govern
Office of Human Resources Montgomery County Government
Thank YouWe hope you enjoyed learning about 2021 Open Enrollment
~Your OHR Health Insurance Team
2021 Open Enrollment Benefits Bonanza
What Is Open Enrollment
What Changes Can be Made
Open Enrollment Dates
MCG Continues to Make Generous Employer Contributions
New for 2021
Special 2021 Plan Rates Announcement
Employee Rate Changes for Calendar Year 2021
Planning Ahead Minimizing Future Rate Increases
New for 2021
Open Enrollment Communications
Itrsquos a New Frontier
2021 Open Enrollment Checklist
Open Enrollment Website Resources
Attend a Virtual Open Enrollment Event
Make Changes Online
Paper Enrollment Form Permitted for Only Two Reasons
Dependent Eligibility
Proof of Dependent Eligibility
Marriage Certificate Example Required Documentation (Contd)
Benefits Refresher
Medical amp Rx
Medical Plan Options
Medical Benefits at-a-Glance
Medical Benefits at-a-Glance (contd)
Prescription Plans Caremark
Prescription Drug Plan Comparison
Prescription Drug Cost Comparison
Dental
Slide Number 30
Vision
Vision Insurance
Optional Life amp Dependent Life
Optional Life Insurance ADampD
Optional Life Insurance Rates
Dependent Life Insurance
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs)Why You Should Enroll
Health Care FSA
Child Care FSA
Commuter Choice Transit FSA
Using Your FSA Funds
AFLAC Voluntary Plans
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Carrier Resources amp Cost-Saving Tips
Lower Your Out-of-Pocket Costs
Built-in Wellness Support
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You Go
Making Changes
Make Changes Online
Questions
Open Enrollment Assistance
Online Resources
Legal Information
Thank You
Cigna Dental Comparison
DHMO
PPO
CIGNA NETWORK
Care-Access PlusDHMO
Total CIGNA PPOPPO
Required to Use An Assigned Provider
Yes In-network only Primary Dental Office will be assigned based on home address
No
Out of Network Benefits Available
No
Yes
Balance Billing for Covered Services
No
Yes if you go out-of-network
Referral Required
Yes
No
Orthodontia Benefits Available
Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime)
Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person)
Unlimited
$200000
Deductible (singlefamily)
None
$50 $ 150 waived for preventive care
1Claim submission would be required and balance billing may occur when visiting a nonparticipating provider2Deductible does not apply to Class I ndash Diagnostic and Preventive Services
Coverage for dependents would cease on the day which the child turns 26Benefit Maximum and Deductibles are for the period of January 01 through December 31
All services listed on this benefit summary are subject to the contractSchedules of Benefits and current Exclusions and Limitations
Medical Benefits at a Glance
Kaiser Permanente HMO + Rx wwwkporg
United HealthCare Select HMO wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS) wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS) wwwcarefirstcom
Plan Type
HMO
HMO
Point-of-Service
Point-of-Service
PCP Required
Yes
Yes
No
No
Provider Network
Regional (MDDCVA)
National
National
National
Out-of-Network Benefits
No
No
Yes
Yes
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
None
None
In-Network None Out-of-Network 80
In-Network None Out-of-Network 80
Dr Office Visits PCPSpecialist
$5 copay
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits
Covered in full
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care
$5 copay
$15 copay
Covered in full
Covered in full
Emergency Room
$50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization
Covered in full
Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
MCG 2018 Medical Plan Comparison Chart
Kaiser Permanente
United HealthCare
CareFirst POS Standard
CareFirst POS High
Plan Type
HMO
HMO
Point of Service
Point of Service
Provider Network
Regional (MDDCVA)
National
National
National
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
Annual Out-of-Pocket Maximum
None
$1100 per individual up to cap of $3600 for a family
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
Physician Servcies
PCP Office Visits
$5 copay
$5 copay PCP
In-Network $15 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Specialist Office Visits
$5 copay
$10 copay
In-Network $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Annual Physical
Covered in full
$5 copay PCP
In-Network $15 copay Primary Care Physician $30 copay specialist Out-of-Network 80 covered after deductible (limit 1calendar year)
In-Network $15 copay Out-of-Network 80 not subject to deductible (up to age 18)
In-Network $10 copay Out-of-Network 80 not subject to deductible (up to age 18)
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Allergy Testing
$5 copay
$5 copay PCP $10 copay Specialist
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Virtual Visits
Labs X-Rays Diagnostics
Outpatient labs
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient X-Rays
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Major Diagnostics
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Immedate Medical Servcies
Emergency Room
$50 copay waived if admitted to hospital
$25 copay waived if admitted to hospital $15 copay for urgent care
In-Network $35 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
Urgent Care
Hospital Services
Inpatient Hospitalization
Covered in full
Covered in full
In-Network Covered in full after $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Services
Surgery
Covered in full
Inpatient covered in full Outpatient $25 copay
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Hearing Aids
For minor children One hearing aid for each hearing impaired ear once every 36 months
For minor children One hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
Hearing Screening
$5 copay for hearing exam (hearing aids are excluded)
$5 Copay PCP $10 Copay Specialist
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
Home Health Care Services
Covered in full if medically necessary
Covered in full No copayment 60 visit maximum for skilled care services per calendar year
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
Hospice
Covered in full
Covered in full (See coverage booklet for eligibility information)
In-Network Covered in full
In-Network Covered in full
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
In vitro Fertilization
Limited to 3 attempts per live birth Lifetime maximum of $100000
Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
Mammography - Preventive Screening Schedule
Schedule consistent with the current recommendations of the American College of Physicians
Covered in full Age 35-39 one baseline mammogram Age 40-49 one mammogram every two calendar years Age 50+ one mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
Maternity
Covered in full once pregnancy is diagnosed
No copayment applies after the first visit
In-Network first visit 100 after $30 copay other visits 100
In-Network First visit 100 after $10 copay other visits 100
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Maximum Lifetime Benefit
Unlimited maximum
Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
Prescriptions
Kaiser Rx plan (included with Kaiser HMO medical plan) $5 at on-site pharmacies and for mail order $15 at participating pharmacies
No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
Rehabilitation Services
Inpatient Covered in full (unlimited) Outpatient $5 copay outpatient services for physical therapy are limited to up to 30 visits occupational and speech therapy per injury incident or condition are covered for a period not to exceed 90 days
$10 copayvisit 60 combined visits per year (short-term non-chronic conditions only)
In-Network
In-Network
100
100
Skilled Nursing Facility
Covered in full 100 days maximum
Covered in full 60 days per calendar year maximum
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Substance AbuseMental Health
Inpatient Covered in full Outpatient $5 copay
Inpatient Covered in full Outpatient $5 copay
In-Network Inpatient- $150 per admission copay Outpatient- $15 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
In-Network Inpatient- covered in full Outpatient- $10 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
Vision (Routine)
$5 copay for exams 25 discount on lensesframes at Kaiser centers 15 discount off the costs of contact lenses
$25 copay for exam 15-20 discount through participating optical centers
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
53116
Medical Benefits at a Glance
Kaiser Permanente HMO + Rx wwwkporg
United HealthCare Select HMO wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS) wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS) wwwcarefirstcom
Plan Type
HMO
HMO
Point-of-Service
Point-of-Service
PCP Required
Yes
Yes
No
No
Provider Network
Regional (MDDCVA)
National
National
National
Out-of-Network Benefits
No
No
Yes
Yes
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
None
None
In-Network None Out-of-Network 80
In-Network None Out-of-Network 80
Dr Office Visits PCPSpecialist
$5 copay
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits
Covered in full
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care
$5 copay
$15 copay
Covered in full
Covered in full
Emergency Room
$50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization
Covered in full
Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
MCG 2018 Medical Plan Comparison Chart
Kaiser Permanente
United HealthCare
CareFirst POS Standard
CareFirst POS High
Plan Type
HMO
HMO
Point of Service
Point of Service
Provider Network
Regional (MDDCVA)
National
National
National
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
Annual Out-of-Pocket Maximum
None
$1100 per individual up to cap of $3600 for a family
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
Physician Servcies
PCP Office Visits
$5 copay
$5 copay PCP
In-Network $15 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Specialist Office Visits
$5 copay
$10 copay
In-Network $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Annual Physical
Covered in full
$5 copay PCP
In-Network $15 copay Primary Care Physician $30 copay specialist Out-of-Network 80 covered after deductible (limit 1calendar year)
In-Network $15 copay Out-of-Network 80 not subject to deductible (up to age 18)
In-Network $10 copay Out-of-Network 80 not subject to deductible (up to age 18)
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Allergy Testing
$5 copay
$5 copay PCP $10 copay Specialist
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Virtual Visits
Labs X-Rays Diagnostics
Outpatient labs
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient X-Rays
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Major Diagnostics
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Immedate Medical Servcies
Emergency Room
$50 copay waived if admitted to hospital
$25 copay waived if admitted to hospital $15 copay for urgent care
In-Network $35 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
Urgent Care
Hospital Services
Inpatient Hospitalization
Covered in full
Covered in full
In-Network Covered in full after $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Services
Surgery
Covered in full
Inpatient covered in full Outpatient $25 copay
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Hearing Aids
For minor children One hearing aid for each hearing impaired ear once every 36 months
For minor children One hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
Hearing Screening
$5 copay for hearing exam (hearing aids are excluded)
$5 Copay PCP $10 Copay Specialist
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
Home Health Care Services
Covered in full if medically necessary
Covered in full No copayment 60 visit maximum for skilled care services per calendar year
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
Hospice
Covered in full
Covered in full (See coverage booklet for eligibility information)
In-Network Covered in full
In-Network Covered in full
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
In vitro Fertilization
Limited to 3 attempts per live birth Lifetime maximum of $100000
Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
Mammography - Preventive Screening Schedule
Schedule consistent with the current recommendations of the American College of Physicians
Covered in full Age 35-39 one baseline mammogram Age 40-49 one mammogram every two calendar years Age 50+ one mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
Maternity
Covered in full once pregnancy is diagnosed
No copayment applies after the first visit
In-Network first visit 100 after $30 copay other visits 100
In-Network First visit 100 after $10 copay other visits 100
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Maximum Lifetime Benefit
Unlimited maximum
Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
Prescriptions
Kaiser Rx plan (included with Kaiser HMO medical plan) $5 at on-site pharmacies and for mail order $15 at participating pharmacies
No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
Rehabilitation Services
Inpatient Covered in full (unlimited) Outpatient $5 copay outpatient services for physical therapy are limited to up to 30 visits occupational and speech therapy per injury incident or condition are covered for a period not to exceed 90 days
$10 copayvisit 60 combined visits per year (short-term non-chronic conditions only)
In-Network
In-Network
100
100
Skilled Nursing Facility
Covered in full 100 days maximum
Covered in full 60 days per calendar year maximum
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Substance AbuseMental Health
Inpatient Covered in full Outpatient $5 copay
Inpatient Covered in full Outpatient $5 copay
In-Network Inpatient- $150 per admission copay Outpatient- $15 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
In-Network Inpatient- covered in full Outpatient- $10 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
Vision (Routine)
$5 copay for exams 25 discount on lensesframes at Kaiser centers 15 discount off the costs of contact lenses
$25 copay for exam 15-20 discount through participating optical centers
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
53116
Office of Human Resources Montgomery County Government
MCG Continues to Make Generous Employer Contributions
bull This graph provides a visual example of the extremely generous employer contributions that MCG makes toward employee insurance premiums
bull These contributions reduce the amount employees pay This is an important part of their total compensation package as an MCG employee
Note The chart above reflects Self only contributions To view charts reflecting Self+1 and Self+Family contributions visitthe Open Enrollment website after September 21 2020
Office of Human Resources Montgomery County Government
New for 2021bull 2021 Open Enrollment will be held virtually this year All of MCGrsquos carriers will be
hosting virtual presentations and QampA sessions See the virtual event tab on the Open Enrollment website for a schedule of virtual events
bull The Health Care FSA annual contribution limit increasing to $2750 The amount you can contribute for 2021 will increase by $50
bull Health Care FSA now allows Over-the-counter expenses without a prescription (ie allergy heartburn or pain relief medications etc)
bull Benefits Bites delivered to your County email weekly via the MCG Employee Connect newsletter Be sure to check the Benefits Bites section for helpful Open Enrollment tips and resources
bull Enhanced Open Enrollment website with new Frequently Asked Questions and a dedicated MCG discount amp resource section
Office of Human Resources Montgomery County Government
Special 2021 Plan Rates AnnouncementCOVID-19 has impacted us in many ways including financially In light of the fact that employees will not be receiving a General Wage Adjustment (GWA) in FY21bull There will be 0 rate increase for these medical plans
CareFirstUnited HealthcareCVS Caremark
bull The Kaiser medical plan costs are decreasing bull The County will pay a large portion of the dental PPO and vision increases but
these increases will also be shared with employees
Office of Human Resources Montgomery County Government
Employee Rate Changes for Calendar Year 2021Plan Per Pay Period Increase
Self Self + 1 FamilyCareFirst High Option POS $000 $000 $000CareFirst Standard Option POS $000 $000 $000Kaiser -$147 -$276 -$435United HealthCare HMO $000 $000 $000CVS Standard Prescription Plan $000 $000 $000CVS High $4$8 Prescription Plan $000 $000 $000CVS High $5$10 Prescription Plan $000 $000 $000CIGNA PPO Dental $041 $094 $134CIGNA DHMO Dental $000 $000 $000EyeMed Vision $009 $014 $020
Office of Human Resources Montgomery County Government
Planning Ahead Minimizing Future Rate IncreasesHere are ways employees can work together with MCG to keep future plan rate increases at a minimumbull Seek out preventive care such as annual exams and age-based screeningsbull Visit in-network doctors via virtual visitsbull Use urgent care facilities for non-emergent services rather than going to the
emergency roombull Choose generic prescription drugsbull Maximize wellness resources through health insurance carriers and MCGrsquos LiveWell
program
Office of Human Resources Montgomery County Government
New for 2021bull All Open Enrollment events held virtually this yearMCGrsquos carriers will be hosting virtual presentations and QampA sessionsOHR Virtual Office Hours
bull Health Care FSA changesAnnual contribution limit increasing to $2750Over-the-counter expenses are permitted without a written prescription Feminine products are now an eligible expense
bull New Open Enrollment Communication MethodsBenefits Bites delivered in the MCG Employee Connect newsletter Enhanced Open Enrollment website
bull Frequently Asked Questionsbull MCG employee discount amp resource section bull Employee self-service (ESS) instructions and demonstrationsbull MCG vendor video presentations
Office of Human Resources Montgomery County Government
Open Enrollment Communications bull 2021 Open Enrollment Guides were mailed to homes on September 11
Employees should receive the guides between September 14 ndash 16
bull Employees are encouraged to check their County email during and after Open EnrollmentOpen Enrollment email series featuring news and remindersMCG Employee Connect newsletter sharing Open Enrollment news in the Benefits Bites
sectionAfter Open Enrollment ends MetLife will email employees who elected or increased
Optional Life to complete a Statement of Health online
bull The Open Enrollment Website is a dedicated resource for all Open Enrollment needsAvailable Monday September 21 at 8 am
Office of Human Resources Montgomery County Government
Itrsquos a New Frontier COVID-19 has changed the way we utilize our plans MCGrsquos health insurance plans offer many value-added services and discounts to provide employees with support This year more than ever it is important to know our resources
bull Virtual doctor visits bull Built-in emotional amp wellness supportbull Disease management bull Lifestyle coachingbull Stress relief appsbull Discounts and more
Please see the 2021 Open Enrollment guide for additional information
Office of Human Resources Montgomery County Government
2021 Open Enrollment ChecklistTake Action Early Follow these steps for a successful Open Enrollment1 Review available resources
bull 2021 Open Enrollment Guide (mailed to homes on September 11th)bull Open Enrollment Websitebull County Email for Important Updates and Follow-Ups bull Benefits Bites Section of the MCG Employee Connect Newsletter
2 Attend a virtual Open Enrollment event3 Attend OHR virtual office hours4 Make changes online amp print Confirmation Statement5 (Re)Enroll in Flexible Spending Accounts (FSAs) and check FSA contribution
amounts
Office of Human Resources Montgomery County Government
Open Enrollment Website Resources Visit the Open Enrollment website for a variety of planning tools amp resources Open Enrollment schedule of virtual events Open Enrollment frequently asked questions 2021 Employee Self-Service (ESS) instruction video amp written instructions Side-by-side plan comparisons Life insurance needs estimator FSA tax savings calculator MCG employee discounts amp resources and more
Office of Human Resources Montgomery County Government
Attend a Virtual Open Enrollment Event bull Insurance Carrier Virtual Presentations and QampA Sessions Visit the Open Enrollment website for full schedule of events
bull Attend OHR Virtual Office Hours Virtual Office Hours SchedulePlease note Virtual Office Hours are held in a public virtual meeting If questions will
reveal any personal PHI (protected health information) such as a chronic medical condition or names of specific prescription drugs employees should direct those questions to OHRrsquos customer service center at 240-773-6471 to place a service request
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Paper Enrollment Form Permitted for Only Two ReasonsThere are only two exceptions permitting the use of paper Open Enrollment forms
bull Technical barriers preventing access to ESS (only in the event of no internet no smartphone or computer) the employee should contact MC311 and place a service request to be mailed a paper enrollment form Call 240-773-OHR1 (240-773-6471) available Monday through Friday 8 am to 5 pm
bull Experiencing a Life Event If an employee has a qualified status change (life event) during Open Enrollment they cannot make changes using the Open Enrollment form or online system Instead they should contact the OHR Health Insurance Team via MC311 to make changes Qualifying life events marriage divorce the birth of a child or the death of spouse or a
dependent aging out
Office of Human Resources Montgomery County Government
Dependent EligibilityEligible dependents for medical prescription dental and vision coverage arebull Spouse
Legally married EligibleDivorced Not Eligible
bull Children (biological legally adopted stepchildren or under your legal custody)Under age 26 EligibleAge 26 and over Not Eligible unless incapable of self support
Proof of eligible dependents is required
Office of Human Resources Montgomery County Government
Proof of Dependent EligibilityEmployees enrolling new dependents during Open Enrollment must upload the necessary dependent documentation in ESS prior to October 9 at 5 pmRequired Documentationbull Spouse Official State Marriage Certificate (certified by appropriate State or County Official)bull Biological Child State Birth Certificate (For newborns OHR will accept hospital discharge papers for first 60 days birth
certificate must then be submitted)bull Adopted Child Copy of Adoption or Placement for Adoption Papers bull Step-Child State Birth Certificate Marriage Certificate and Divorce Decree or Custody Papers bull Disabled Child Medical plan verification of disability prior to age 26 bull Legal Custody Copy of Court Order granting legal custody
Office of Human Resources Montgomery County Government
Marriage Certificate Example Required Documentation (Contd)
Office of Human Resources Montgomery County Government
Benefits Refresher
Office of Human Resources Montgomery County Government
Medical amp Rx
Office of Human Resources Montgomery County Government
Medical Plan OptionsHealth Maintenance Organizations (HMO)bull Kaiser Permanente Signature (HMO)bull United Healthcare Select (HMO)
Point of Service Plans (POS)bull CareFirst BCBS (POS) High Optionbull CareFirst BCBS (POS) Standard Option
Three tiers of coverage Self Self + 1 or Family
Office of Human Resources Montgomery County Government
Medical Benefits at-a-Glance To view full carrier medical summaries visit OHRrsquos Health Insurance Website
Kaiser Permanente HMO + Rx
wwwkporg
United HealthCare Select HMO
wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS)
wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS)
wwwcarefirstcom
Plan Type HMO HMO Point-of-Service Point-of-Service
PCP Required Yes Yes No No
Provider Network Regional (MDDCVA) National National National
Out-of-Network Benefits No No Yes Yes
Referrals Required Yes No No No
Annual Deductible None NoneIn-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Sheet1
Sheet1 (2)
Office of Human Resources Montgomery County Government
Medical Benefits at-a-Glance (contd)
New Employee Orientation Program
Kaiser Permanente HMO + Rx
wwwkporg
United HealthCare Select HMO
wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS)
wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS)
wwwcarefirstcom
Dr Office Visits PCPSpecialist $5 copay $5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits Covered in full $5 copay $10 copay In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care $5 copay $15 copay Covered in full Covered in full
Emergency Room $50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization Covered in full Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
Visit OHRrsquos Health Insurance webpage to view Medical summaries
Sheet1
Sheet1 (2)
Office of Human Resources Montgomery County Government
Prescription Plans Caremarkbull Two Rx Plan OptionsStandardHigh
bull If you elect UHC or CareFirst and want Rx coverage you will need to elect the stand-alone Caremark Rx plan (Kaiser already includes Rx coverage)
bull Maintenance Choice Program available for maintenance drugs significant cost savings ndash 1 copay for each 90-day prescription In order to get the Maintenance pricing you must fil Rx at CVS retail pharmacy Mail order
Office of Human Resources Montgomery County Government
Prescription Drug Plan Comparison High Option $48
Only MCGEOIAFF employees can enroll in this High plan
High Option $510Only FOPNON-REP employees
can enroll in this High plan
Standard Option All employees can enroll in this
Standard plan
Copay $4 Generics$8 Brand Name
$5 Generics$10 Brand Name
$10 Generics$20 PBrand Name
$35 NPBrand NameDeductible na na $50yearMail Order Yes Yes Yes
Maintenance Choice Yes Yes YesCovered Drugs Same Same Same
Visit OHRrsquos Health Insurance Website to view Rx summaries
Office of Human Resources Montgomery County Government
Prescription Drug Cost Comparison Cost
High Option $48Only MCGEOIAFF employees
can enroll in this High plan
High Option $510Only FOPNON-REP employees
can enroll in this High plan
Standard Option All employees can enroll in this
Standard plan
Self Only
Bi-Weekly $11339Monthly $24568Yearly $294814
Bi-Weekly $11100Monthly $24050Yearly $288600
Bi-Weekly $2413Monthly $5258Yearly $62738
Self + 1
Bi-Weekly $20979Monthly $45455Yearly $545454
Bi-Weekly $20536Monthly $44495Yearly $533936
Bi-Weekly $4463Monthly $9670
Yearly $116038
Self + Family
Bi-Weekly $32511Monthly $70441Yearly $845286
Bi-Weekly $31824Monthly $68952Yearly $827424
Bi-Weekly $6916Monthly $14985Yearly $179816
Office of Human Resources Montgomery County Government
Dental
Office of Human Resources Montgomery County Government
Dental Comparison Cigna
For a list of HMO covered services and assigned costs (copays) view the HMO benefit summary
Required to Use An Assigned Provider Yes In-network only Primary Dental Office will be
assigned based on home address
No
Out of Network Benefits Available No Yes
Balance Billing for Covered Services No Yes if you go out-of-network
Referral Required Yes No
Orthodontia Benefits Available Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime) Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person) Unlimited $200000
Deductible (singlefamily) None $50 $ 150 waived for preventive care
Table 1
Office of Human Resources Montgomery County Government
Vision
Office of Human Resources Montgomery County Government
Vision Insurancebull The Countyrsquos Vision carrier is EyeMedbull Benefits payable for exams lenses and contacts (elective or necessary) every
calendar year frames every two calendar yearsbull In-network or out-of-network benefits available bull Enhanced Hearing Benefit through EyeMedrsquos partner Amplifon40 off hearing examDiscounted pricing on thousands of hearing aids including latest technologyOne-year free follow-up care with unlimited appointmentsFree batteries for two years with initial purchase Three-year warranty and loss and damage coverage
Visit OHRrsquos Health Insurance webpage to view vision summary
Office of Human Resources Montgomery County Government
Optional Life amp Dependent Life
Office of Human Resources Montgomery County Government
Optional Life Insurance ADampDbull You may elect Optional Life ADampD coverage for yourself in increments of 1 to 8 times
your basic annual earnings ($1 million maximum)
bull NOTE Coverage is not guaranteed issue for any level You must complete an online Statement of Health no matter what level of coverage you elect Later this fall after Open Enrollment ends you will receive an email from MetLife with a link to complete the Statement of Health online
bull An eligible dependent is defined as 1) your opposite or same sex spouse or 2) your unmarried children under age 26 (natural adopted or stepchildrenfoster children who depend on your support)
Office of Human Resources Montgomery County Government
Optional Life Insurance RatesHow to estimate your Optional Life Insurance bi-weekly rate
Example 40-year-old applying for 2 x salary Salary is $49300
Steps Example Calculate for Yourself
A Find your age-based rate on the rate sheet (left) $ 0037 $_________________
B Choose how much coverage you are applying for
$99000 (2 x salary rounded to the nearest $1000 ) $_________________
C Divide that coverage amount by 100099 ($99000 1000) $_________________
D Multiply A x C for estimated bi-weekly cost$366 ($037 x 99) $_________________
Office of Human Resources Montgomery County Government
Dependent Life InsuranceYou may also purchase Dependent Optional Life insurance forbull Your opposite or same sex spouse bull Your unmarried children under age 26
ndash Natural adoptedndash Stepchildrenfoster childrenNote you do not need to supply marriage certificatesbirth certificates for dependent optional life
You may electbull $2000 Spouse$1000 Childbull $4000 Spouse $2000 Childbull $10000 Spouse $5000 Child
The bi-weekly rate is not based on salary
Office of Human Resources Montgomery County Government
Flexible Spending Accounts
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Visit the Open Enrollment website to watch a recorded FSA presentation from MCGrsquos FSA vendor Benefit Strategies
bull What is an FSA It is an IRS-approved tax-free account that saves onQualified out-of-pocket medical and dependent care expensesFederal and State Income taxSocial Security Tax
bull 3 Account Options Health Care FSA Child Care FSA and Commuter Choice Transit bull FSA accounts are administered through Benefit Strategies bull FSAs are ldquouse-it or lose-itrdquo accounts claims must be incurred during the 2021 plan year (January 1
2021 ndash March 15 2022) and submitted by April 30 2022
IMPORTANT You must re-enroll in an FSA every Open Enrollment if you want to participate in the upcoming plan year
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Why You Should EnrollGive yourself a raise by reducing your taxesbull Elect the annual amount you want to place in your FSA(s) for the upcoming plan year during Open Enrollmentbull That amount is divided by 26 and taken from your biweekly paychecks on a pre-tax basis (21 paychecks for
10-month employees)bull Then use your pre-tax FSA dollars to pay for eligible out-of-pocket health care child-care or transit
expenses
Office of Human Resources Montgomery County Government
Health Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull Claims must be submitted by April 30 of the following yearbull You may elect to contribute up to $2750 Your total annual election amount is available to spend on the first
day of the new plan year bull FSA debit card allows you to pay for expenses at the time of servicebull Examples of IRS qualified eligible expenses
bull Copays (medical prescription dental vision) deductibles and coinsurance amounts over reasonable and customary charge
bull Hearing aids bull Acupuncture bull Orthopedic shoes bull Over-the-counter (OTC) drugs (no longer require doctorrsquos prescription)
Office of Human Resources Montgomery County Government
Child Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull $5000 annual maximum per household ($2500 for married filing separately)bull Funds are available to spend as they are accumulated through payroll deductionsbull Reimbursable expenses
bull day care centersbull elder carebull beforeafter school carebull babysitter fees that allow you and your spouse to work or go to school (no child support payments)
bull Qualifying dependentsbull Children under the age of 13 and are a tax dependent of the employeebull Spouse or tax dependent that is physically or mentally incapable of self-care
bull Must coordinate between filing a tax credit with IRS and your Dependent Care FSA plan
Office of Human Resources Montgomery County Government
Commuter Choice Transit FSAbull $230 per month maximum for MCGEO staff $260 per month maximum for Unrepresented staffbull Applies to employee commuting expenses only (not spouses or dependents)bull Can enroll throughout the year (not limited to Open Enrollment election)bull Eligible expenses include Metro Marc Vanpool Lyft Line Uber Poolbull Debit card ndash may be used for some expenses (not Metro)Metro riders will have to submit claim forms for reimbursement
bull Funds must be used within 180 days of election bull If retiring or leaving the County will need to coordinate use all available funds
Office of Human Resources Montgomery County Government
Using Your FSA FundsHealth Care FSA Your full annual election amount is available on the first day of the plan yearChild Care FSA Your funds are available as they accumulate through payroll deductionsCommuterTransit FSA Your funds are available as they accumulate through payroll deductions
The FSA Debit Card bull Your FSA debit card is the same card for your Health Care Child Care and TransitCommuter FSA accountsbull The card is pre-loaded with your full annual Health Care FSA election amount You can use the card to pay for IRS qualified expenses at
the time of service or when paying a bill Receipt notifications will be mailed to you monthly by Benefit Strategies Your response to receipt notifications is necessary under the provisions of the plan No response my result in the ineligibility of the purchase and as a result your card may be temporarily deactivated
bull If you are enrolled in the Child Care FSA the card can also be used in child-care settings Just remember that the card will only work for an amount that does not exceed the available balance in your Child Care FSA account on that day
bull The card can also be used to pay for your commutertransit expenses however it does not work for WMATA metro Metro riders will have to submit manual claims for reimbursement from your CommuterTransit FSA
bull Cards are re-loaded each year after you make your new annual election Please keep your cards You will only receive a new card if your old card is about to expire
Office of Human Resources Montgomery County Government
AFLAC Voluntary Plans
Office of Human Resources Montgomery County Government
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Short-Term Disabilitybull Provides short-term cash benefits in the event of disabilitybull Monthly benefit amounts available from $500 - $6000 (subject to income requirements)bull Benefit options of 3 6 12 18 or 24 months with a variety of elimination periods
Critical Illness Insurancebull Provides a lump sum cash benefit in the event of critical illnessbull Benefit amounts available in $5000 increments from $10000 - $30000
Participants pay 100 through payroll deduction for Short-Term Disability and Critical Illness Insurance
To ENROLL Text SETAPPTrdquo to 41411orCall 920-420-8861 orEmail susan_mcdanielusAflaccom
Office of Human Resources Montgomery County Government
Carrier Resources amp Cost-Saving Tips
Office of Human Resources Montgomery County Government
Lower Your Out-of-Pocket CostsChoose the plan thatrsquos right for youbull See the medical benefits chart for options bull Stay in network Use the provider search engines on your carrier website or mobile app to find in-network providersSeek preventive carebull Check-ups immunizations and screenings are an important part of staying healthy They can detect or prevent serious diseases and keep you healthyKnow where to go for carebull You have many options of places to go when you need care If your medical condition isnrsquot serious or life threatening you can save money by connecting
with a doctor online through a virtual visit or going to an urgent care center or convenience care clinic instead of a hospital emergency roomReview your prescription drug plan optionsbull Decide which Caremark prescription plan is best for you Note that the Kaiser HMO includes prescription drug coverage Both the Standard and High
Option Caremark plans cover the same prescription drugs but have different copay and deductiblesUse generic and long-term prescriptions bull Opt for lower-cost generic drugs whenever possible bull Ask your doctor to write a 90-day prescription instead of a 30-day prescription to participate in the mail order prescription programTake advantage of tax savings by participating in Flexible Spending Accountsbull Use pre-tax dollars for eligible out of pocket services and items
Office of Human Resources Montgomery County Government
Built-in Wellness Support Take advantage of the free programs available to you through your medical carrier Each of MCGrsquos medical carriers (Kaiser UHC amp CareFirst) offer valuable programs to help you manage your health
Disease Management Programsbull Help manage your chronic condition through personalized coaching support and encouragement and online education materialsEmotional Wellness amp Stress Management Support bull Help manage stress through mobile apps and other self-care resources Maternity Programsbull Support healthy moms and healthy babiesWeight-loss Programs bull Offers telephonic coaching support and web-based tools to help ensure long-term weight managementbull See the next slide for an example of an MCG success storySmoking Cessation Programsbull Supportive coaching to make quitting more successfulDiscounts bull Gym memberships weight loss programs and moreFor more information about the programs available to you please see the Open Enrollment Guide and contact your medical carrier
Office of Human Resources Montgomery County Government
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You GoAll of MCGrsquos health insurance carriers offer a simple-to-use tool that can help make your life easier while yoursquore on the go Download your carrierrsquos Mobile App to help you personalize organize and access your important plan information on your phone or tablet
bull Schedule Virtual Visitsbull Manage and track claimsbull View ID card informationbull Find doctor and compare costs and quality ratingsbull Review your coveragebull Track your account balances and deductiblesbull Access a variety of health and wellness tools
Visit Google Play or the Apple App Store to download your carrierrsquos App
Office of Human Resources Montgomery County Government
Making Changes
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Questions
Office of Human Resources Montgomery County Government
Open Enrollment AssistanceFollow these steps (in this order)1 Review the frequently asked questions (FAQs) on the Open Enrollment website at wwwmontgomerycountymdgovoe
(available beginning September 21) You can enter key words into the interactive search bar to quickly locate the answer to your question
2 Visit the MC311 website at wwwmontgomerycountymdgovmc311 and search key words for your question The search results contain various knowledge-based articles with information related to your search words Simply click on the corresponding link and the detailed answer is revealed
3 Attend one of OHRrsquos Virtual Office Hours via Microsoft Teams Members of OHRs Health Insurance Team will be on hand to address employee questions by video or via the chat box View the schedule and access the sessions through the Open Enrollment website at wwwmontgomerycountymdgovoe (available beginning September 21)
4 If you have tried all the methods above and still have Open Enrollment-related questions please contact OHRs MC311 Customer Service Center at 240-773-6471 (Mon-Fri 8 am - 5 pm) to open a service request A member of the health insurance team will respond to service requests in the order they are received Tip Please provide an email address at the time you place your Service Request This will ensure the fastest response possible
Office of Human Resources Montgomery County Government
Online ResourcesVisit the 2021 Open Enrollment Webpage
wwwmontgomerycountymdgovOE
Visit OHRrsquos WebpagewwwmontgomerycountymdgovHR
Health Insurance active employees
Office of Human Resources Montgomery County Government
Legal InformationThe County reserves the right at any time and for any reason to amend the Program subject to the Countys collective bargainingagreements The County expects to continue the Program but it is the Countys position that there is no implied contract between individual employees and the County to do so
The County may amend the Program prospectively or retroactively to comply with applicable law
In the event of a conflict between this presentation the County Code andor the Summary Description the County Code then the Summary Description will govern
Office of Human Resources Montgomery County Government
Thank YouWe hope you enjoyed learning about 2021 Open Enrollment
~Your OHR Health Insurance Team
2021 Open Enrollment Benefits Bonanza
What Is Open Enrollment
What Changes Can be Made
Open Enrollment Dates
MCG Continues to Make Generous Employer Contributions
New for 2021
Special 2021 Plan Rates Announcement
Employee Rate Changes for Calendar Year 2021
Planning Ahead Minimizing Future Rate Increases
New for 2021
Open Enrollment Communications
Itrsquos a New Frontier
2021 Open Enrollment Checklist
Open Enrollment Website Resources
Attend a Virtual Open Enrollment Event
Make Changes Online
Paper Enrollment Form Permitted for Only Two Reasons
Dependent Eligibility
Proof of Dependent Eligibility
Marriage Certificate Example Required Documentation (Contd)
Benefits Refresher
Medical amp Rx
Medical Plan Options
Medical Benefits at-a-Glance
Medical Benefits at-a-Glance (contd)
Prescription Plans Caremark
Prescription Drug Plan Comparison
Prescription Drug Cost Comparison
Dental
Slide Number 30
Vision
Vision Insurance
Optional Life amp Dependent Life
Optional Life Insurance ADampD
Optional Life Insurance Rates
Dependent Life Insurance
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs)Why You Should Enroll
Health Care FSA
Child Care FSA
Commuter Choice Transit FSA
Using Your FSA Funds
AFLAC Voluntary Plans
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Carrier Resources amp Cost-Saving Tips
Lower Your Out-of-Pocket Costs
Built-in Wellness Support
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You Go
Making Changes
Make Changes Online
Questions
Open Enrollment Assistance
Online Resources
Legal Information
Thank You
Cigna Dental Comparison
DHMO
PPO
CIGNA NETWORK
Care-Access PlusDHMO
Total CIGNA PPOPPO
Required to Use An Assigned Provider
Yes In-network only Primary Dental Office will be assigned based on home address
No
Out of Network Benefits Available
No
Yes
Balance Billing for Covered Services
No
Yes if you go out-of-network
Referral Required
Yes
No
Orthodontia Benefits Available
Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime)
Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person)
Unlimited
$200000
Deductible (singlefamily)
None
$50 $ 150 waived for preventive care
1Claim submission would be required and balance billing may occur when visiting a nonparticipating provider2Deductible does not apply to Class I ndash Diagnostic and Preventive Services
Coverage for dependents would cease on the day which the child turns 26Benefit Maximum and Deductibles are for the period of January 01 through December 31
All services listed on this benefit summary are subject to the contractSchedules of Benefits and current Exclusions and Limitations
Medical Benefits at a Glance
Kaiser Permanente HMO + Rx wwwkporg
United HealthCare Select HMO wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS) wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS) wwwcarefirstcom
Plan Type
HMO
HMO
Point-of-Service
Point-of-Service
PCP Required
Yes
Yes
No
No
Provider Network
Regional (MDDCVA)
National
National
National
Out-of-Network Benefits
No
No
Yes
Yes
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
None
None
In-Network None Out-of-Network 80
In-Network None Out-of-Network 80
Dr Office Visits PCPSpecialist
$5 copay
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits
Covered in full
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care
$5 copay
$15 copay
Covered in full
Covered in full
Emergency Room
$50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization
Covered in full
Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
MCG 2018 Medical Plan Comparison Chart
Kaiser Permanente
United HealthCare
CareFirst POS Standard
CareFirst POS High
Plan Type
HMO
HMO
Point of Service
Point of Service
Provider Network
Regional (MDDCVA)
National
National
National
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
Annual Out-of-Pocket Maximum
None
$1100 per individual up to cap of $3600 for a family
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
Physician Servcies
PCP Office Visits
$5 copay
$5 copay PCP
In-Network $15 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Specialist Office Visits
$5 copay
$10 copay
In-Network $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Annual Physical
Covered in full
$5 copay PCP
In-Network $15 copay Primary Care Physician $30 copay specialist Out-of-Network 80 covered after deductible (limit 1calendar year)
In-Network $15 copay Out-of-Network 80 not subject to deductible (up to age 18)
In-Network $10 copay Out-of-Network 80 not subject to deductible (up to age 18)
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Allergy Testing
$5 copay
$5 copay PCP $10 copay Specialist
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Virtual Visits
Labs X-Rays Diagnostics
Outpatient labs
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient X-Rays
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Major Diagnostics
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Immedate Medical Servcies
Emergency Room
$50 copay waived if admitted to hospital
$25 copay waived if admitted to hospital $15 copay for urgent care
In-Network $35 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
Urgent Care
Hospital Services
Inpatient Hospitalization
Covered in full
Covered in full
In-Network Covered in full after $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Services
Surgery
Covered in full
Inpatient covered in full Outpatient $25 copay
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Hearing Aids
For minor children One hearing aid for each hearing impaired ear once every 36 months
For minor children One hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
Hearing Screening
$5 copay for hearing exam (hearing aids are excluded)
$5 Copay PCP $10 Copay Specialist
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
Home Health Care Services
Covered in full if medically necessary
Covered in full No copayment 60 visit maximum for skilled care services per calendar year
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
Hospice
Covered in full
Covered in full (See coverage booklet for eligibility information)
In-Network Covered in full
In-Network Covered in full
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
In vitro Fertilization
Limited to 3 attempts per live birth Lifetime maximum of $100000
Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
Mammography - Preventive Screening Schedule
Schedule consistent with the current recommendations of the American College of Physicians
Covered in full Age 35-39 one baseline mammogram Age 40-49 one mammogram every two calendar years Age 50+ one mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
Maternity
Covered in full once pregnancy is diagnosed
No copayment applies after the first visit
In-Network first visit 100 after $30 copay other visits 100
In-Network First visit 100 after $10 copay other visits 100
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Maximum Lifetime Benefit
Unlimited maximum
Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
Prescriptions
Kaiser Rx plan (included with Kaiser HMO medical plan) $5 at on-site pharmacies and for mail order $15 at participating pharmacies
No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
Rehabilitation Services
Inpatient Covered in full (unlimited) Outpatient $5 copay outpatient services for physical therapy are limited to up to 30 visits occupational and speech therapy per injury incident or condition are covered for a period not to exceed 90 days
$10 copayvisit 60 combined visits per year (short-term non-chronic conditions only)
In-Network
In-Network
100
100
Skilled Nursing Facility
Covered in full 100 days maximum
Covered in full 60 days per calendar year maximum
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Substance AbuseMental Health
Inpatient Covered in full Outpatient $5 copay
Inpatient Covered in full Outpatient $5 copay
In-Network Inpatient- $150 per admission copay Outpatient- $15 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
In-Network Inpatient- covered in full Outpatient- $10 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
Vision (Routine)
$5 copay for exams 25 discount on lensesframes at Kaiser centers 15 discount off the costs of contact lenses
$25 copay for exam 15-20 discount through participating optical centers
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
53116
Medical Benefits at a Glance
Kaiser Permanente HMO + Rx wwwkporg
United HealthCare Select HMO wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS) wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS) wwwcarefirstcom
Plan Type
HMO
HMO
Point-of-Service
Point-of-Service
PCP Required
Yes
Yes
No
No
Provider Network
Regional (MDDCVA)
National
National
National
Out-of-Network Benefits
No
No
Yes
Yes
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
None
None
In-Network None Out-of-Network 80
In-Network None Out-of-Network 80
Dr Office Visits PCPSpecialist
$5 copay
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits
Covered in full
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care
$5 copay
$15 copay
Covered in full
Covered in full
Emergency Room
$50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization
Covered in full
Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
MCG 2018 Medical Plan Comparison Chart
Kaiser Permanente
United HealthCare
CareFirst POS Standard
CareFirst POS High
Plan Type
HMO
HMO
Point of Service
Point of Service
Provider Network
Regional (MDDCVA)
National
National
National
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
Annual Out-of-Pocket Maximum
None
$1100 per individual up to cap of $3600 for a family
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
Physician Servcies
PCP Office Visits
$5 copay
$5 copay PCP
In-Network $15 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Specialist Office Visits
$5 copay
$10 copay
In-Network $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Annual Physical
Covered in full
$5 copay PCP
In-Network $15 copay Primary Care Physician $30 copay specialist Out-of-Network 80 covered after deductible (limit 1calendar year)
In-Network $15 copay Out-of-Network 80 not subject to deductible (up to age 18)
In-Network $10 copay Out-of-Network 80 not subject to deductible (up to age 18)
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Allergy Testing
$5 copay
$5 copay PCP $10 copay Specialist
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Virtual Visits
Labs X-Rays Diagnostics
Outpatient labs
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient X-Rays
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Major Diagnostics
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Immedate Medical Servcies
Emergency Room
$50 copay waived if admitted to hospital
$25 copay waived if admitted to hospital $15 copay for urgent care
In-Network $35 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
Urgent Care
Hospital Services
Inpatient Hospitalization
Covered in full
Covered in full
In-Network Covered in full after $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Services
Surgery
Covered in full
Inpatient covered in full Outpatient $25 copay
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Hearing Aids
For minor children One hearing aid for each hearing impaired ear once every 36 months
For minor children One hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
Hearing Screening
$5 copay for hearing exam (hearing aids are excluded)
$5 Copay PCP $10 Copay Specialist
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
Home Health Care Services
Covered in full if medically necessary
Covered in full No copayment 60 visit maximum for skilled care services per calendar year
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
Hospice
Covered in full
Covered in full (See coverage booklet for eligibility information)
In-Network Covered in full
In-Network Covered in full
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
In vitro Fertilization
Limited to 3 attempts per live birth Lifetime maximum of $100000
Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
Mammography - Preventive Screening Schedule
Schedule consistent with the current recommendations of the American College of Physicians
Covered in full Age 35-39 one baseline mammogram Age 40-49 one mammogram every two calendar years Age 50+ one mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
Maternity
Covered in full once pregnancy is diagnosed
No copayment applies after the first visit
In-Network first visit 100 after $30 copay other visits 100
In-Network First visit 100 after $10 copay other visits 100
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Maximum Lifetime Benefit
Unlimited maximum
Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
Prescriptions
Kaiser Rx plan (included with Kaiser HMO medical plan) $5 at on-site pharmacies and for mail order $15 at participating pharmacies
No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
Rehabilitation Services
Inpatient Covered in full (unlimited) Outpatient $5 copay outpatient services for physical therapy are limited to up to 30 visits occupational and speech therapy per injury incident or condition are covered for a period not to exceed 90 days
$10 copayvisit 60 combined visits per year (short-term non-chronic conditions only)
In-Network
In-Network
100
100
Skilled Nursing Facility
Covered in full 100 days maximum
Covered in full 60 days per calendar year maximum
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Substance AbuseMental Health
Inpatient Covered in full Outpatient $5 copay
Inpatient Covered in full Outpatient $5 copay
In-Network Inpatient- $150 per admission copay Outpatient- $15 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
In-Network Inpatient- covered in full Outpatient- $10 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
Vision (Routine)
$5 copay for exams 25 discount on lensesframes at Kaiser centers 15 discount off the costs of contact lenses
$25 copay for exam 15-20 discount through participating optical centers
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
53116
Office of Human Resources Montgomery County Government
New for 2021bull 2021 Open Enrollment will be held virtually this year All of MCGrsquos carriers will be
hosting virtual presentations and QampA sessions See the virtual event tab on the Open Enrollment website for a schedule of virtual events
bull The Health Care FSA annual contribution limit increasing to $2750 The amount you can contribute for 2021 will increase by $50
bull Health Care FSA now allows Over-the-counter expenses without a prescription (ie allergy heartburn or pain relief medications etc)
bull Benefits Bites delivered to your County email weekly via the MCG Employee Connect newsletter Be sure to check the Benefits Bites section for helpful Open Enrollment tips and resources
bull Enhanced Open Enrollment website with new Frequently Asked Questions and a dedicated MCG discount amp resource section
Office of Human Resources Montgomery County Government
Special 2021 Plan Rates AnnouncementCOVID-19 has impacted us in many ways including financially In light of the fact that employees will not be receiving a General Wage Adjustment (GWA) in FY21bull There will be 0 rate increase for these medical plans
CareFirstUnited HealthcareCVS Caremark
bull The Kaiser medical plan costs are decreasing bull The County will pay a large portion of the dental PPO and vision increases but
these increases will also be shared with employees
Office of Human Resources Montgomery County Government
Employee Rate Changes for Calendar Year 2021Plan Per Pay Period Increase
Self Self + 1 FamilyCareFirst High Option POS $000 $000 $000CareFirst Standard Option POS $000 $000 $000Kaiser -$147 -$276 -$435United HealthCare HMO $000 $000 $000CVS Standard Prescription Plan $000 $000 $000CVS High $4$8 Prescription Plan $000 $000 $000CVS High $5$10 Prescription Plan $000 $000 $000CIGNA PPO Dental $041 $094 $134CIGNA DHMO Dental $000 $000 $000EyeMed Vision $009 $014 $020
Office of Human Resources Montgomery County Government
Planning Ahead Minimizing Future Rate IncreasesHere are ways employees can work together with MCG to keep future plan rate increases at a minimumbull Seek out preventive care such as annual exams and age-based screeningsbull Visit in-network doctors via virtual visitsbull Use urgent care facilities for non-emergent services rather than going to the
emergency roombull Choose generic prescription drugsbull Maximize wellness resources through health insurance carriers and MCGrsquos LiveWell
program
Office of Human Resources Montgomery County Government
New for 2021bull All Open Enrollment events held virtually this yearMCGrsquos carriers will be hosting virtual presentations and QampA sessionsOHR Virtual Office Hours
bull Health Care FSA changesAnnual contribution limit increasing to $2750Over-the-counter expenses are permitted without a written prescription Feminine products are now an eligible expense
bull New Open Enrollment Communication MethodsBenefits Bites delivered in the MCG Employee Connect newsletter Enhanced Open Enrollment website
bull Frequently Asked Questionsbull MCG employee discount amp resource section bull Employee self-service (ESS) instructions and demonstrationsbull MCG vendor video presentations
Office of Human Resources Montgomery County Government
Open Enrollment Communications bull 2021 Open Enrollment Guides were mailed to homes on September 11
Employees should receive the guides between September 14 ndash 16
bull Employees are encouraged to check their County email during and after Open EnrollmentOpen Enrollment email series featuring news and remindersMCG Employee Connect newsletter sharing Open Enrollment news in the Benefits Bites
sectionAfter Open Enrollment ends MetLife will email employees who elected or increased
Optional Life to complete a Statement of Health online
bull The Open Enrollment Website is a dedicated resource for all Open Enrollment needsAvailable Monday September 21 at 8 am
Office of Human Resources Montgomery County Government
Itrsquos a New Frontier COVID-19 has changed the way we utilize our plans MCGrsquos health insurance plans offer many value-added services and discounts to provide employees with support This year more than ever it is important to know our resources
bull Virtual doctor visits bull Built-in emotional amp wellness supportbull Disease management bull Lifestyle coachingbull Stress relief appsbull Discounts and more
Please see the 2021 Open Enrollment guide for additional information
Office of Human Resources Montgomery County Government
2021 Open Enrollment ChecklistTake Action Early Follow these steps for a successful Open Enrollment1 Review available resources
bull 2021 Open Enrollment Guide (mailed to homes on September 11th)bull Open Enrollment Websitebull County Email for Important Updates and Follow-Ups bull Benefits Bites Section of the MCG Employee Connect Newsletter
2 Attend a virtual Open Enrollment event3 Attend OHR virtual office hours4 Make changes online amp print Confirmation Statement5 (Re)Enroll in Flexible Spending Accounts (FSAs) and check FSA contribution
amounts
Office of Human Resources Montgomery County Government
Open Enrollment Website Resources Visit the Open Enrollment website for a variety of planning tools amp resources Open Enrollment schedule of virtual events Open Enrollment frequently asked questions 2021 Employee Self-Service (ESS) instruction video amp written instructions Side-by-side plan comparisons Life insurance needs estimator FSA tax savings calculator MCG employee discounts amp resources and more
Office of Human Resources Montgomery County Government
Attend a Virtual Open Enrollment Event bull Insurance Carrier Virtual Presentations and QampA Sessions Visit the Open Enrollment website for full schedule of events
bull Attend OHR Virtual Office Hours Virtual Office Hours SchedulePlease note Virtual Office Hours are held in a public virtual meeting If questions will
reveal any personal PHI (protected health information) such as a chronic medical condition or names of specific prescription drugs employees should direct those questions to OHRrsquos customer service center at 240-773-6471 to place a service request
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Paper Enrollment Form Permitted for Only Two ReasonsThere are only two exceptions permitting the use of paper Open Enrollment forms
bull Technical barriers preventing access to ESS (only in the event of no internet no smartphone or computer) the employee should contact MC311 and place a service request to be mailed a paper enrollment form Call 240-773-OHR1 (240-773-6471) available Monday through Friday 8 am to 5 pm
bull Experiencing a Life Event If an employee has a qualified status change (life event) during Open Enrollment they cannot make changes using the Open Enrollment form or online system Instead they should contact the OHR Health Insurance Team via MC311 to make changes Qualifying life events marriage divorce the birth of a child or the death of spouse or a
dependent aging out
Office of Human Resources Montgomery County Government
Dependent EligibilityEligible dependents for medical prescription dental and vision coverage arebull Spouse
Legally married EligibleDivorced Not Eligible
bull Children (biological legally adopted stepchildren or under your legal custody)Under age 26 EligibleAge 26 and over Not Eligible unless incapable of self support
Proof of eligible dependents is required
Office of Human Resources Montgomery County Government
Proof of Dependent EligibilityEmployees enrolling new dependents during Open Enrollment must upload the necessary dependent documentation in ESS prior to October 9 at 5 pmRequired Documentationbull Spouse Official State Marriage Certificate (certified by appropriate State or County Official)bull Biological Child State Birth Certificate (For newborns OHR will accept hospital discharge papers for first 60 days birth
certificate must then be submitted)bull Adopted Child Copy of Adoption or Placement for Adoption Papers bull Step-Child State Birth Certificate Marriage Certificate and Divorce Decree or Custody Papers bull Disabled Child Medical plan verification of disability prior to age 26 bull Legal Custody Copy of Court Order granting legal custody
Office of Human Resources Montgomery County Government
Marriage Certificate Example Required Documentation (Contd)
Office of Human Resources Montgomery County Government
Benefits Refresher
Office of Human Resources Montgomery County Government
Medical amp Rx
Office of Human Resources Montgomery County Government
Medical Plan OptionsHealth Maintenance Organizations (HMO)bull Kaiser Permanente Signature (HMO)bull United Healthcare Select (HMO)
Point of Service Plans (POS)bull CareFirst BCBS (POS) High Optionbull CareFirst BCBS (POS) Standard Option
Three tiers of coverage Self Self + 1 or Family
Office of Human Resources Montgomery County Government
Medical Benefits at-a-Glance To view full carrier medical summaries visit OHRrsquos Health Insurance Website
Kaiser Permanente HMO + Rx
wwwkporg
United HealthCare Select HMO
wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS)
wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS)
wwwcarefirstcom
Plan Type HMO HMO Point-of-Service Point-of-Service
PCP Required Yes Yes No No
Provider Network Regional (MDDCVA) National National National
Out-of-Network Benefits No No Yes Yes
Referrals Required Yes No No No
Annual Deductible None NoneIn-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Sheet1
Sheet1 (2)
Office of Human Resources Montgomery County Government
Medical Benefits at-a-Glance (contd)
New Employee Orientation Program
Kaiser Permanente HMO + Rx
wwwkporg
United HealthCare Select HMO
wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS)
wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS)
wwwcarefirstcom
Dr Office Visits PCPSpecialist $5 copay $5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits Covered in full $5 copay $10 copay In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care $5 copay $15 copay Covered in full Covered in full
Emergency Room $50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization Covered in full Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
Visit OHRrsquos Health Insurance webpage to view Medical summaries
Sheet1
Sheet1 (2)
Office of Human Resources Montgomery County Government
Prescription Plans Caremarkbull Two Rx Plan OptionsStandardHigh
bull If you elect UHC or CareFirst and want Rx coverage you will need to elect the stand-alone Caremark Rx plan (Kaiser already includes Rx coverage)
bull Maintenance Choice Program available for maintenance drugs significant cost savings ndash 1 copay for each 90-day prescription In order to get the Maintenance pricing you must fil Rx at CVS retail pharmacy Mail order
Office of Human Resources Montgomery County Government
Prescription Drug Plan Comparison High Option $48
Only MCGEOIAFF employees can enroll in this High plan
High Option $510Only FOPNON-REP employees
can enroll in this High plan
Standard Option All employees can enroll in this
Standard plan
Copay $4 Generics$8 Brand Name
$5 Generics$10 Brand Name
$10 Generics$20 PBrand Name
$35 NPBrand NameDeductible na na $50yearMail Order Yes Yes Yes
Maintenance Choice Yes Yes YesCovered Drugs Same Same Same
Visit OHRrsquos Health Insurance Website to view Rx summaries
Office of Human Resources Montgomery County Government
Prescription Drug Cost Comparison Cost
High Option $48Only MCGEOIAFF employees
can enroll in this High plan
High Option $510Only FOPNON-REP employees
can enroll in this High plan
Standard Option All employees can enroll in this
Standard plan
Self Only
Bi-Weekly $11339Monthly $24568Yearly $294814
Bi-Weekly $11100Monthly $24050Yearly $288600
Bi-Weekly $2413Monthly $5258Yearly $62738
Self + 1
Bi-Weekly $20979Monthly $45455Yearly $545454
Bi-Weekly $20536Monthly $44495Yearly $533936
Bi-Weekly $4463Monthly $9670
Yearly $116038
Self + Family
Bi-Weekly $32511Monthly $70441Yearly $845286
Bi-Weekly $31824Monthly $68952Yearly $827424
Bi-Weekly $6916Monthly $14985Yearly $179816
Office of Human Resources Montgomery County Government
Dental
Office of Human Resources Montgomery County Government
Dental Comparison Cigna
For a list of HMO covered services and assigned costs (copays) view the HMO benefit summary
Required to Use An Assigned Provider Yes In-network only Primary Dental Office will be
assigned based on home address
No
Out of Network Benefits Available No Yes
Balance Billing for Covered Services No Yes if you go out-of-network
Referral Required Yes No
Orthodontia Benefits Available Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime) Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person) Unlimited $200000
Deductible (singlefamily) None $50 $ 150 waived for preventive care
Table 1
Office of Human Resources Montgomery County Government
Vision
Office of Human Resources Montgomery County Government
Vision Insurancebull The Countyrsquos Vision carrier is EyeMedbull Benefits payable for exams lenses and contacts (elective or necessary) every
calendar year frames every two calendar yearsbull In-network or out-of-network benefits available bull Enhanced Hearing Benefit through EyeMedrsquos partner Amplifon40 off hearing examDiscounted pricing on thousands of hearing aids including latest technologyOne-year free follow-up care with unlimited appointmentsFree batteries for two years with initial purchase Three-year warranty and loss and damage coverage
Visit OHRrsquos Health Insurance webpage to view vision summary
Office of Human Resources Montgomery County Government
Optional Life amp Dependent Life
Office of Human Resources Montgomery County Government
Optional Life Insurance ADampDbull You may elect Optional Life ADampD coverage for yourself in increments of 1 to 8 times
your basic annual earnings ($1 million maximum)
bull NOTE Coverage is not guaranteed issue for any level You must complete an online Statement of Health no matter what level of coverage you elect Later this fall after Open Enrollment ends you will receive an email from MetLife with a link to complete the Statement of Health online
bull An eligible dependent is defined as 1) your opposite or same sex spouse or 2) your unmarried children under age 26 (natural adopted or stepchildrenfoster children who depend on your support)
Office of Human Resources Montgomery County Government
Optional Life Insurance RatesHow to estimate your Optional Life Insurance bi-weekly rate
Example 40-year-old applying for 2 x salary Salary is $49300
Steps Example Calculate for Yourself
A Find your age-based rate on the rate sheet (left) $ 0037 $_________________
B Choose how much coverage you are applying for
$99000 (2 x salary rounded to the nearest $1000 ) $_________________
C Divide that coverage amount by 100099 ($99000 1000) $_________________
D Multiply A x C for estimated bi-weekly cost$366 ($037 x 99) $_________________
Office of Human Resources Montgomery County Government
Dependent Life InsuranceYou may also purchase Dependent Optional Life insurance forbull Your opposite or same sex spouse bull Your unmarried children under age 26
ndash Natural adoptedndash Stepchildrenfoster childrenNote you do not need to supply marriage certificatesbirth certificates for dependent optional life
You may electbull $2000 Spouse$1000 Childbull $4000 Spouse $2000 Childbull $10000 Spouse $5000 Child
The bi-weekly rate is not based on salary
Office of Human Resources Montgomery County Government
Flexible Spending Accounts
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Visit the Open Enrollment website to watch a recorded FSA presentation from MCGrsquos FSA vendor Benefit Strategies
bull What is an FSA It is an IRS-approved tax-free account that saves onQualified out-of-pocket medical and dependent care expensesFederal and State Income taxSocial Security Tax
bull 3 Account Options Health Care FSA Child Care FSA and Commuter Choice Transit bull FSA accounts are administered through Benefit Strategies bull FSAs are ldquouse-it or lose-itrdquo accounts claims must be incurred during the 2021 plan year (January 1
2021 ndash March 15 2022) and submitted by April 30 2022
IMPORTANT You must re-enroll in an FSA every Open Enrollment if you want to participate in the upcoming plan year
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Why You Should EnrollGive yourself a raise by reducing your taxesbull Elect the annual amount you want to place in your FSA(s) for the upcoming plan year during Open Enrollmentbull That amount is divided by 26 and taken from your biweekly paychecks on a pre-tax basis (21 paychecks for
10-month employees)bull Then use your pre-tax FSA dollars to pay for eligible out-of-pocket health care child-care or transit
expenses
Office of Human Resources Montgomery County Government
Health Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull Claims must be submitted by April 30 of the following yearbull You may elect to contribute up to $2750 Your total annual election amount is available to spend on the first
day of the new plan year bull FSA debit card allows you to pay for expenses at the time of servicebull Examples of IRS qualified eligible expenses
bull Copays (medical prescription dental vision) deductibles and coinsurance amounts over reasonable and customary charge
bull Hearing aids bull Acupuncture bull Orthopedic shoes bull Over-the-counter (OTC) drugs (no longer require doctorrsquos prescription)
Office of Human Resources Montgomery County Government
Child Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull $5000 annual maximum per household ($2500 for married filing separately)bull Funds are available to spend as they are accumulated through payroll deductionsbull Reimbursable expenses
bull day care centersbull elder carebull beforeafter school carebull babysitter fees that allow you and your spouse to work or go to school (no child support payments)
bull Qualifying dependentsbull Children under the age of 13 and are a tax dependent of the employeebull Spouse or tax dependent that is physically or mentally incapable of self-care
bull Must coordinate between filing a tax credit with IRS and your Dependent Care FSA plan
Office of Human Resources Montgomery County Government
Commuter Choice Transit FSAbull $230 per month maximum for MCGEO staff $260 per month maximum for Unrepresented staffbull Applies to employee commuting expenses only (not spouses or dependents)bull Can enroll throughout the year (not limited to Open Enrollment election)bull Eligible expenses include Metro Marc Vanpool Lyft Line Uber Poolbull Debit card ndash may be used for some expenses (not Metro)Metro riders will have to submit claim forms for reimbursement
bull Funds must be used within 180 days of election bull If retiring or leaving the County will need to coordinate use all available funds
Office of Human Resources Montgomery County Government
Using Your FSA FundsHealth Care FSA Your full annual election amount is available on the first day of the plan yearChild Care FSA Your funds are available as they accumulate through payroll deductionsCommuterTransit FSA Your funds are available as they accumulate through payroll deductions
The FSA Debit Card bull Your FSA debit card is the same card for your Health Care Child Care and TransitCommuter FSA accountsbull The card is pre-loaded with your full annual Health Care FSA election amount You can use the card to pay for IRS qualified expenses at
the time of service or when paying a bill Receipt notifications will be mailed to you monthly by Benefit Strategies Your response to receipt notifications is necessary under the provisions of the plan No response my result in the ineligibility of the purchase and as a result your card may be temporarily deactivated
bull If you are enrolled in the Child Care FSA the card can also be used in child-care settings Just remember that the card will only work for an amount that does not exceed the available balance in your Child Care FSA account on that day
bull The card can also be used to pay for your commutertransit expenses however it does not work for WMATA metro Metro riders will have to submit manual claims for reimbursement from your CommuterTransit FSA
bull Cards are re-loaded each year after you make your new annual election Please keep your cards You will only receive a new card if your old card is about to expire
Office of Human Resources Montgomery County Government
AFLAC Voluntary Plans
Office of Human Resources Montgomery County Government
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Short-Term Disabilitybull Provides short-term cash benefits in the event of disabilitybull Monthly benefit amounts available from $500 - $6000 (subject to income requirements)bull Benefit options of 3 6 12 18 or 24 months with a variety of elimination periods
Critical Illness Insurancebull Provides a lump sum cash benefit in the event of critical illnessbull Benefit amounts available in $5000 increments from $10000 - $30000
Participants pay 100 through payroll deduction for Short-Term Disability and Critical Illness Insurance
To ENROLL Text SETAPPTrdquo to 41411orCall 920-420-8861 orEmail susan_mcdanielusAflaccom
Office of Human Resources Montgomery County Government
Carrier Resources amp Cost-Saving Tips
Office of Human Resources Montgomery County Government
Lower Your Out-of-Pocket CostsChoose the plan thatrsquos right for youbull See the medical benefits chart for options bull Stay in network Use the provider search engines on your carrier website or mobile app to find in-network providersSeek preventive carebull Check-ups immunizations and screenings are an important part of staying healthy They can detect or prevent serious diseases and keep you healthyKnow where to go for carebull You have many options of places to go when you need care If your medical condition isnrsquot serious or life threatening you can save money by connecting
with a doctor online through a virtual visit or going to an urgent care center or convenience care clinic instead of a hospital emergency roomReview your prescription drug plan optionsbull Decide which Caremark prescription plan is best for you Note that the Kaiser HMO includes prescription drug coverage Both the Standard and High
Option Caremark plans cover the same prescription drugs but have different copay and deductiblesUse generic and long-term prescriptions bull Opt for lower-cost generic drugs whenever possible bull Ask your doctor to write a 90-day prescription instead of a 30-day prescription to participate in the mail order prescription programTake advantage of tax savings by participating in Flexible Spending Accountsbull Use pre-tax dollars for eligible out of pocket services and items
Office of Human Resources Montgomery County Government
Built-in Wellness Support Take advantage of the free programs available to you through your medical carrier Each of MCGrsquos medical carriers (Kaiser UHC amp CareFirst) offer valuable programs to help you manage your health
Disease Management Programsbull Help manage your chronic condition through personalized coaching support and encouragement and online education materialsEmotional Wellness amp Stress Management Support bull Help manage stress through mobile apps and other self-care resources Maternity Programsbull Support healthy moms and healthy babiesWeight-loss Programs bull Offers telephonic coaching support and web-based tools to help ensure long-term weight managementbull See the next slide for an example of an MCG success storySmoking Cessation Programsbull Supportive coaching to make quitting more successfulDiscounts bull Gym memberships weight loss programs and moreFor more information about the programs available to you please see the Open Enrollment Guide and contact your medical carrier
Office of Human Resources Montgomery County Government
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You GoAll of MCGrsquos health insurance carriers offer a simple-to-use tool that can help make your life easier while yoursquore on the go Download your carrierrsquos Mobile App to help you personalize organize and access your important plan information on your phone or tablet
bull Schedule Virtual Visitsbull Manage and track claimsbull View ID card informationbull Find doctor and compare costs and quality ratingsbull Review your coveragebull Track your account balances and deductiblesbull Access a variety of health and wellness tools
Visit Google Play or the Apple App Store to download your carrierrsquos App
Office of Human Resources Montgomery County Government
Making Changes
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Questions
Office of Human Resources Montgomery County Government
Open Enrollment AssistanceFollow these steps (in this order)1 Review the frequently asked questions (FAQs) on the Open Enrollment website at wwwmontgomerycountymdgovoe
(available beginning September 21) You can enter key words into the interactive search bar to quickly locate the answer to your question
2 Visit the MC311 website at wwwmontgomerycountymdgovmc311 and search key words for your question The search results contain various knowledge-based articles with information related to your search words Simply click on the corresponding link and the detailed answer is revealed
3 Attend one of OHRrsquos Virtual Office Hours via Microsoft Teams Members of OHRs Health Insurance Team will be on hand to address employee questions by video or via the chat box View the schedule and access the sessions through the Open Enrollment website at wwwmontgomerycountymdgovoe (available beginning September 21)
4 If you have tried all the methods above and still have Open Enrollment-related questions please contact OHRs MC311 Customer Service Center at 240-773-6471 (Mon-Fri 8 am - 5 pm) to open a service request A member of the health insurance team will respond to service requests in the order they are received Tip Please provide an email address at the time you place your Service Request This will ensure the fastest response possible
Office of Human Resources Montgomery County Government
Online ResourcesVisit the 2021 Open Enrollment Webpage
wwwmontgomerycountymdgovOE
Visit OHRrsquos WebpagewwwmontgomerycountymdgovHR
Health Insurance active employees
Office of Human Resources Montgomery County Government
Legal InformationThe County reserves the right at any time and for any reason to amend the Program subject to the Countys collective bargainingagreements The County expects to continue the Program but it is the Countys position that there is no implied contract between individual employees and the County to do so
The County may amend the Program prospectively or retroactively to comply with applicable law
In the event of a conflict between this presentation the County Code andor the Summary Description the County Code then the Summary Description will govern
Office of Human Resources Montgomery County Government
Thank YouWe hope you enjoyed learning about 2021 Open Enrollment
~Your OHR Health Insurance Team
2021 Open Enrollment Benefits Bonanza
What Is Open Enrollment
What Changes Can be Made
Open Enrollment Dates
MCG Continues to Make Generous Employer Contributions
New for 2021
Special 2021 Plan Rates Announcement
Employee Rate Changes for Calendar Year 2021
Planning Ahead Minimizing Future Rate Increases
New for 2021
Open Enrollment Communications
Itrsquos a New Frontier
2021 Open Enrollment Checklist
Open Enrollment Website Resources
Attend a Virtual Open Enrollment Event
Make Changes Online
Paper Enrollment Form Permitted for Only Two Reasons
Dependent Eligibility
Proof of Dependent Eligibility
Marriage Certificate Example Required Documentation (Contd)
Benefits Refresher
Medical amp Rx
Medical Plan Options
Medical Benefits at-a-Glance
Medical Benefits at-a-Glance (contd)
Prescription Plans Caremark
Prescription Drug Plan Comparison
Prescription Drug Cost Comparison
Dental
Slide Number 30
Vision
Vision Insurance
Optional Life amp Dependent Life
Optional Life Insurance ADampD
Optional Life Insurance Rates
Dependent Life Insurance
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs)Why You Should Enroll
Health Care FSA
Child Care FSA
Commuter Choice Transit FSA
Using Your FSA Funds
AFLAC Voluntary Plans
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Carrier Resources amp Cost-Saving Tips
Lower Your Out-of-Pocket Costs
Built-in Wellness Support
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You Go
Making Changes
Make Changes Online
Questions
Open Enrollment Assistance
Online Resources
Legal Information
Thank You
Cigna Dental Comparison
DHMO
PPO
CIGNA NETWORK
Care-Access PlusDHMO
Total CIGNA PPOPPO
Required to Use An Assigned Provider
Yes In-network only Primary Dental Office will be assigned based on home address
No
Out of Network Benefits Available
No
Yes
Balance Billing for Covered Services
No
Yes if you go out-of-network
Referral Required
Yes
No
Orthodontia Benefits Available
Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime)
Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person)
Unlimited
$200000
Deductible (singlefamily)
None
$50 $ 150 waived for preventive care
1Claim submission would be required and balance billing may occur when visiting a nonparticipating provider2Deductible does not apply to Class I ndash Diagnostic and Preventive Services
Coverage for dependents would cease on the day which the child turns 26Benefit Maximum and Deductibles are for the period of January 01 through December 31
All services listed on this benefit summary are subject to the contractSchedules of Benefits and current Exclusions and Limitations
Medical Benefits at a Glance
Kaiser Permanente HMO + Rx wwwkporg
United HealthCare Select HMO wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS) wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS) wwwcarefirstcom
Plan Type
HMO
HMO
Point-of-Service
Point-of-Service
PCP Required
Yes
Yes
No
No
Provider Network
Regional (MDDCVA)
National
National
National
Out-of-Network Benefits
No
No
Yes
Yes
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
None
None
In-Network None Out-of-Network 80
In-Network None Out-of-Network 80
Dr Office Visits PCPSpecialist
$5 copay
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits
Covered in full
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care
$5 copay
$15 copay
Covered in full
Covered in full
Emergency Room
$50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization
Covered in full
Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
MCG 2018 Medical Plan Comparison Chart
Kaiser Permanente
United HealthCare
CareFirst POS Standard
CareFirst POS High
Plan Type
HMO
HMO
Point of Service
Point of Service
Provider Network
Regional (MDDCVA)
National
National
National
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
Annual Out-of-Pocket Maximum
None
$1100 per individual up to cap of $3600 for a family
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
Physician Servcies
PCP Office Visits
$5 copay
$5 copay PCP
In-Network $15 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Specialist Office Visits
$5 copay
$10 copay
In-Network $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Annual Physical
Covered in full
$5 copay PCP
In-Network $15 copay Primary Care Physician $30 copay specialist Out-of-Network 80 covered after deductible (limit 1calendar year)
In-Network $15 copay Out-of-Network 80 not subject to deductible (up to age 18)
In-Network $10 copay Out-of-Network 80 not subject to deductible (up to age 18)
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Allergy Testing
$5 copay
$5 copay PCP $10 copay Specialist
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Virtual Visits
Labs X-Rays Diagnostics
Outpatient labs
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient X-Rays
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Major Diagnostics
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Immedate Medical Servcies
Emergency Room
$50 copay waived if admitted to hospital
$25 copay waived if admitted to hospital $15 copay for urgent care
In-Network $35 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
Urgent Care
Hospital Services
Inpatient Hospitalization
Covered in full
Covered in full
In-Network Covered in full after $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Services
Surgery
Covered in full
Inpatient covered in full Outpatient $25 copay
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Hearing Aids
For minor children One hearing aid for each hearing impaired ear once every 36 months
For minor children One hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
Hearing Screening
$5 copay for hearing exam (hearing aids are excluded)
$5 Copay PCP $10 Copay Specialist
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
Home Health Care Services
Covered in full if medically necessary
Covered in full No copayment 60 visit maximum for skilled care services per calendar year
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
Hospice
Covered in full
Covered in full (See coverage booklet for eligibility information)
In-Network Covered in full
In-Network Covered in full
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
In vitro Fertilization
Limited to 3 attempts per live birth Lifetime maximum of $100000
Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
Mammography - Preventive Screening Schedule
Schedule consistent with the current recommendations of the American College of Physicians
Covered in full Age 35-39 one baseline mammogram Age 40-49 one mammogram every two calendar years Age 50+ one mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
Maternity
Covered in full once pregnancy is diagnosed
No copayment applies after the first visit
In-Network first visit 100 after $30 copay other visits 100
In-Network First visit 100 after $10 copay other visits 100
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Maximum Lifetime Benefit
Unlimited maximum
Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
Prescriptions
Kaiser Rx plan (included with Kaiser HMO medical plan) $5 at on-site pharmacies and for mail order $15 at participating pharmacies
No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
Rehabilitation Services
Inpatient Covered in full (unlimited) Outpatient $5 copay outpatient services for physical therapy are limited to up to 30 visits occupational and speech therapy per injury incident or condition are covered for a period not to exceed 90 days
$10 copayvisit 60 combined visits per year (short-term non-chronic conditions only)
In-Network
In-Network
100
100
Skilled Nursing Facility
Covered in full 100 days maximum
Covered in full 60 days per calendar year maximum
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Substance AbuseMental Health
Inpatient Covered in full Outpatient $5 copay
Inpatient Covered in full Outpatient $5 copay
In-Network Inpatient- $150 per admission copay Outpatient- $15 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
In-Network Inpatient- covered in full Outpatient- $10 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
Vision (Routine)
$5 copay for exams 25 discount on lensesframes at Kaiser centers 15 discount off the costs of contact lenses
$25 copay for exam 15-20 discount through participating optical centers
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
53116
Medical Benefits at a Glance
Kaiser Permanente HMO + Rx wwwkporg
United HealthCare Select HMO wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS) wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS) wwwcarefirstcom
Plan Type
HMO
HMO
Point-of-Service
Point-of-Service
PCP Required
Yes
Yes
No
No
Provider Network
Regional (MDDCVA)
National
National
National
Out-of-Network Benefits
No
No
Yes
Yes
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
None
None
In-Network None Out-of-Network 80
In-Network None Out-of-Network 80
Dr Office Visits PCPSpecialist
$5 copay
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits
Covered in full
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care
$5 copay
$15 copay
Covered in full
Covered in full
Emergency Room
$50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization
Covered in full
Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
MCG 2018 Medical Plan Comparison Chart
Kaiser Permanente
United HealthCare
CareFirst POS Standard
CareFirst POS High
Plan Type
HMO
HMO
Point of Service
Point of Service
Provider Network
Regional (MDDCVA)
National
National
National
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
Annual Out-of-Pocket Maximum
None
$1100 per individual up to cap of $3600 for a family
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
Physician Servcies
PCP Office Visits
$5 copay
$5 copay PCP
In-Network $15 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Specialist Office Visits
$5 copay
$10 copay
In-Network $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Annual Physical
Covered in full
$5 copay PCP
In-Network $15 copay Primary Care Physician $30 copay specialist Out-of-Network 80 covered after deductible (limit 1calendar year)
In-Network $15 copay Out-of-Network 80 not subject to deductible (up to age 18)
In-Network $10 copay Out-of-Network 80 not subject to deductible (up to age 18)
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Allergy Testing
$5 copay
$5 copay PCP $10 copay Specialist
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Virtual Visits
Labs X-Rays Diagnostics
Outpatient labs
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient X-Rays
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Major Diagnostics
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Immedate Medical Servcies
Emergency Room
$50 copay waived if admitted to hospital
$25 copay waived if admitted to hospital $15 copay for urgent care
In-Network $35 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
Urgent Care
Hospital Services
Inpatient Hospitalization
Covered in full
Covered in full
In-Network Covered in full after $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Services
Surgery
Covered in full
Inpatient covered in full Outpatient $25 copay
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Hearing Aids
For minor children One hearing aid for each hearing impaired ear once every 36 months
For minor children One hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
Hearing Screening
$5 copay for hearing exam (hearing aids are excluded)
$5 Copay PCP $10 Copay Specialist
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
Home Health Care Services
Covered in full if medically necessary
Covered in full No copayment 60 visit maximum for skilled care services per calendar year
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
Hospice
Covered in full
Covered in full (See coverage booklet for eligibility information)
In-Network Covered in full
In-Network Covered in full
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
In vitro Fertilization
Limited to 3 attempts per live birth Lifetime maximum of $100000
Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
Mammography - Preventive Screening Schedule
Schedule consistent with the current recommendations of the American College of Physicians
Covered in full Age 35-39 one baseline mammogram Age 40-49 one mammogram every two calendar years Age 50+ one mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
Maternity
Covered in full once pregnancy is diagnosed
No copayment applies after the first visit
In-Network first visit 100 after $30 copay other visits 100
In-Network First visit 100 after $10 copay other visits 100
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Maximum Lifetime Benefit
Unlimited maximum
Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
Prescriptions
Kaiser Rx plan (included with Kaiser HMO medical plan) $5 at on-site pharmacies and for mail order $15 at participating pharmacies
No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
Rehabilitation Services
Inpatient Covered in full (unlimited) Outpatient $5 copay outpatient services for physical therapy are limited to up to 30 visits occupational and speech therapy per injury incident or condition are covered for a period not to exceed 90 days
$10 copayvisit 60 combined visits per year (short-term non-chronic conditions only)
In-Network
In-Network
100
100
Skilled Nursing Facility
Covered in full 100 days maximum
Covered in full 60 days per calendar year maximum
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Substance AbuseMental Health
Inpatient Covered in full Outpatient $5 copay
Inpatient Covered in full Outpatient $5 copay
In-Network Inpatient- $150 per admission copay Outpatient- $15 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
In-Network Inpatient- covered in full Outpatient- $10 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
Vision (Routine)
$5 copay for exams 25 discount on lensesframes at Kaiser centers 15 discount off the costs of contact lenses
$25 copay for exam 15-20 discount through participating optical centers
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
53116
Office of Human Resources Montgomery County Government
Special 2021 Plan Rates AnnouncementCOVID-19 has impacted us in many ways including financially In light of the fact that employees will not be receiving a General Wage Adjustment (GWA) in FY21bull There will be 0 rate increase for these medical plans
CareFirstUnited HealthcareCVS Caremark
bull The Kaiser medical plan costs are decreasing bull The County will pay a large portion of the dental PPO and vision increases but
these increases will also be shared with employees
Office of Human Resources Montgomery County Government
Employee Rate Changes for Calendar Year 2021Plan Per Pay Period Increase
Self Self + 1 FamilyCareFirst High Option POS $000 $000 $000CareFirst Standard Option POS $000 $000 $000Kaiser -$147 -$276 -$435United HealthCare HMO $000 $000 $000CVS Standard Prescription Plan $000 $000 $000CVS High $4$8 Prescription Plan $000 $000 $000CVS High $5$10 Prescription Plan $000 $000 $000CIGNA PPO Dental $041 $094 $134CIGNA DHMO Dental $000 $000 $000EyeMed Vision $009 $014 $020
Office of Human Resources Montgomery County Government
Planning Ahead Minimizing Future Rate IncreasesHere are ways employees can work together with MCG to keep future plan rate increases at a minimumbull Seek out preventive care such as annual exams and age-based screeningsbull Visit in-network doctors via virtual visitsbull Use urgent care facilities for non-emergent services rather than going to the
emergency roombull Choose generic prescription drugsbull Maximize wellness resources through health insurance carriers and MCGrsquos LiveWell
program
Office of Human Resources Montgomery County Government
New for 2021bull All Open Enrollment events held virtually this yearMCGrsquos carriers will be hosting virtual presentations and QampA sessionsOHR Virtual Office Hours
bull Health Care FSA changesAnnual contribution limit increasing to $2750Over-the-counter expenses are permitted without a written prescription Feminine products are now an eligible expense
bull New Open Enrollment Communication MethodsBenefits Bites delivered in the MCG Employee Connect newsletter Enhanced Open Enrollment website
bull Frequently Asked Questionsbull MCG employee discount amp resource section bull Employee self-service (ESS) instructions and demonstrationsbull MCG vendor video presentations
Office of Human Resources Montgomery County Government
Open Enrollment Communications bull 2021 Open Enrollment Guides were mailed to homes on September 11
Employees should receive the guides between September 14 ndash 16
bull Employees are encouraged to check their County email during and after Open EnrollmentOpen Enrollment email series featuring news and remindersMCG Employee Connect newsletter sharing Open Enrollment news in the Benefits Bites
sectionAfter Open Enrollment ends MetLife will email employees who elected or increased
Optional Life to complete a Statement of Health online
bull The Open Enrollment Website is a dedicated resource for all Open Enrollment needsAvailable Monday September 21 at 8 am
Office of Human Resources Montgomery County Government
Itrsquos a New Frontier COVID-19 has changed the way we utilize our plans MCGrsquos health insurance plans offer many value-added services and discounts to provide employees with support This year more than ever it is important to know our resources
bull Virtual doctor visits bull Built-in emotional amp wellness supportbull Disease management bull Lifestyle coachingbull Stress relief appsbull Discounts and more
Please see the 2021 Open Enrollment guide for additional information
Office of Human Resources Montgomery County Government
2021 Open Enrollment ChecklistTake Action Early Follow these steps for a successful Open Enrollment1 Review available resources
bull 2021 Open Enrollment Guide (mailed to homes on September 11th)bull Open Enrollment Websitebull County Email for Important Updates and Follow-Ups bull Benefits Bites Section of the MCG Employee Connect Newsletter
2 Attend a virtual Open Enrollment event3 Attend OHR virtual office hours4 Make changes online amp print Confirmation Statement5 (Re)Enroll in Flexible Spending Accounts (FSAs) and check FSA contribution
amounts
Office of Human Resources Montgomery County Government
Open Enrollment Website Resources Visit the Open Enrollment website for a variety of planning tools amp resources Open Enrollment schedule of virtual events Open Enrollment frequently asked questions 2021 Employee Self-Service (ESS) instruction video amp written instructions Side-by-side plan comparisons Life insurance needs estimator FSA tax savings calculator MCG employee discounts amp resources and more
Office of Human Resources Montgomery County Government
Attend a Virtual Open Enrollment Event bull Insurance Carrier Virtual Presentations and QampA Sessions Visit the Open Enrollment website for full schedule of events
bull Attend OHR Virtual Office Hours Virtual Office Hours SchedulePlease note Virtual Office Hours are held in a public virtual meeting If questions will
reveal any personal PHI (protected health information) such as a chronic medical condition or names of specific prescription drugs employees should direct those questions to OHRrsquos customer service center at 240-773-6471 to place a service request
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Paper Enrollment Form Permitted for Only Two ReasonsThere are only two exceptions permitting the use of paper Open Enrollment forms
bull Technical barriers preventing access to ESS (only in the event of no internet no smartphone or computer) the employee should contact MC311 and place a service request to be mailed a paper enrollment form Call 240-773-OHR1 (240-773-6471) available Monday through Friday 8 am to 5 pm
bull Experiencing a Life Event If an employee has a qualified status change (life event) during Open Enrollment they cannot make changes using the Open Enrollment form or online system Instead they should contact the OHR Health Insurance Team via MC311 to make changes Qualifying life events marriage divorce the birth of a child or the death of spouse or a
dependent aging out
Office of Human Resources Montgomery County Government
Dependent EligibilityEligible dependents for medical prescription dental and vision coverage arebull Spouse
Legally married EligibleDivorced Not Eligible
bull Children (biological legally adopted stepchildren or under your legal custody)Under age 26 EligibleAge 26 and over Not Eligible unless incapable of self support
Proof of eligible dependents is required
Office of Human Resources Montgomery County Government
Proof of Dependent EligibilityEmployees enrolling new dependents during Open Enrollment must upload the necessary dependent documentation in ESS prior to October 9 at 5 pmRequired Documentationbull Spouse Official State Marriage Certificate (certified by appropriate State or County Official)bull Biological Child State Birth Certificate (For newborns OHR will accept hospital discharge papers for first 60 days birth
certificate must then be submitted)bull Adopted Child Copy of Adoption or Placement for Adoption Papers bull Step-Child State Birth Certificate Marriage Certificate and Divorce Decree or Custody Papers bull Disabled Child Medical plan verification of disability prior to age 26 bull Legal Custody Copy of Court Order granting legal custody
Office of Human Resources Montgomery County Government
Marriage Certificate Example Required Documentation (Contd)
Office of Human Resources Montgomery County Government
Benefits Refresher
Office of Human Resources Montgomery County Government
Medical amp Rx
Office of Human Resources Montgomery County Government
Medical Plan OptionsHealth Maintenance Organizations (HMO)bull Kaiser Permanente Signature (HMO)bull United Healthcare Select (HMO)
Point of Service Plans (POS)bull CareFirst BCBS (POS) High Optionbull CareFirst BCBS (POS) Standard Option
Three tiers of coverage Self Self + 1 or Family
Office of Human Resources Montgomery County Government
Medical Benefits at-a-Glance To view full carrier medical summaries visit OHRrsquos Health Insurance Website
Kaiser Permanente HMO + Rx
wwwkporg
United HealthCare Select HMO
wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS)
wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS)
wwwcarefirstcom
Plan Type HMO HMO Point-of-Service Point-of-Service
PCP Required Yes Yes No No
Provider Network Regional (MDDCVA) National National National
Out-of-Network Benefits No No Yes Yes
Referrals Required Yes No No No
Annual Deductible None NoneIn-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Sheet1
Sheet1 (2)
Office of Human Resources Montgomery County Government
Medical Benefits at-a-Glance (contd)
New Employee Orientation Program
Kaiser Permanente HMO + Rx
wwwkporg
United HealthCare Select HMO
wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS)
wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS)
wwwcarefirstcom
Dr Office Visits PCPSpecialist $5 copay $5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits Covered in full $5 copay $10 copay In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care $5 copay $15 copay Covered in full Covered in full
Emergency Room $50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization Covered in full Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
Visit OHRrsquos Health Insurance webpage to view Medical summaries
Sheet1
Sheet1 (2)
Office of Human Resources Montgomery County Government
Prescription Plans Caremarkbull Two Rx Plan OptionsStandardHigh
bull If you elect UHC or CareFirst and want Rx coverage you will need to elect the stand-alone Caremark Rx plan (Kaiser already includes Rx coverage)
bull Maintenance Choice Program available for maintenance drugs significant cost savings ndash 1 copay for each 90-day prescription In order to get the Maintenance pricing you must fil Rx at CVS retail pharmacy Mail order
Office of Human Resources Montgomery County Government
Prescription Drug Plan Comparison High Option $48
Only MCGEOIAFF employees can enroll in this High plan
High Option $510Only FOPNON-REP employees
can enroll in this High plan
Standard Option All employees can enroll in this
Standard plan
Copay $4 Generics$8 Brand Name
$5 Generics$10 Brand Name
$10 Generics$20 PBrand Name
$35 NPBrand NameDeductible na na $50yearMail Order Yes Yes Yes
Maintenance Choice Yes Yes YesCovered Drugs Same Same Same
Visit OHRrsquos Health Insurance Website to view Rx summaries
Office of Human Resources Montgomery County Government
Prescription Drug Cost Comparison Cost
High Option $48Only MCGEOIAFF employees
can enroll in this High plan
High Option $510Only FOPNON-REP employees
can enroll in this High plan
Standard Option All employees can enroll in this
Standard plan
Self Only
Bi-Weekly $11339Monthly $24568Yearly $294814
Bi-Weekly $11100Monthly $24050Yearly $288600
Bi-Weekly $2413Monthly $5258Yearly $62738
Self + 1
Bi-Weekly $20979Monthly $45455Yearly $545454
Bi-Weekly $20536Monthly $44495Yearly $533936
Bi-Weekly $4463Monthly $9670
Yearly $116038
Self + Family
Bi-Weekly $32511Monthly $70441Yearly $845286
Bi-Weekly $31824Monthly $68952Yearly $827424
Bi-Weekly $6916Monthly $14985Yearly $179816
Office of Human Resources Montgomery County Government
Dental
Office of Human Resources Montgomery County Government
Dental Comparison Cigna
For a list of HMO covered services and assigned costs (copays) view the HMO benefit summary
Required to Use An Assigned Provider Yes In-network only Primary Dental Office will be
assigned based on home address
No
Out of Network Benefits Available No Yes
Balance Billing for Covered Services No Yes if you go out-of-network
Referral Required Yes No
Orthodontia Benefits Available Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime) Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person) Unlimited $200000
Deductible (singlefamily) None $50 $ 150 waived for preventive care
Table 1
Office of Human Resources Montgomery County Government
Vision
Office of Human Resources Montgomery County Government
Vision Insurancebull The Countyrsquos Vision carrier is EyeMedbull Benefits payable for exams lenses and contacts (elective or necessary) every
calendar year frames every two calendar yearsbull In-network or out-of-network benefits available bull Enhanced Hearing Benefit through EyeMedrsquos partner Amplifon40 off hearing examDiscounted pricing on thousands of hearing aids including latest technologyOne-year free follow-up care with unlimited appointmentsFree batteries for two years with initial purchase Three-year warranty and loss and damage coverage
Visit OHRrsquos Health Insurance webpage to view vision summary
Office of Human Resources Montgomery County Government
Optional Life amp Dependent Life
Office of Human Resources Montgomery County Government
Optional Life Insurance ADampDbull You may elect Optional Life ADampD coverage for yourself in increments of 1 to 8 times
your basic annual earnings ($1 million maximum)
bull NOTE Coverage is not guaranteed issue for any level You must complete an online Statement of Health no matter what level of coverage you elect Later this fall after Open Enrollment ends you will receive an email from MetLife with a link to complete the Statement of Health online
bull An eligible dependent is defined as 1) your opposite or same sex spouse or 2) your unmarried children under age 26 (natural adopted or stepchildrenfoster children who depend on your support)
Office of Human Resources Montgomery County Government
Optional Life Insurance RatesHow to estimate your Optional Life Insurance bi-weekly rate
Example 40-year-old applying for 2 x salary Salary is $49300
Steps Example Calculate for Yourself
A Find your age-based rate on the rate sheet (left) $ 0037 $_________________
B Choose how much coverage you are applying for
$99000 (2 x salary rounded to the nearest $1000 ) $_________________
C Divide that coverage amount by 100099 ($99000 1000) $_________________
D Multiply A x C for estimated bi-weekly cost$366 ($037 x 99) $_________________
Office of Human Resources Montgomery County Government
Dependent Life InsuranceYou may also purchase Dependent Optional Life insurance forbull Your opposite or same sex spouse bull Your unmarried children under age 26
ndash Natural adoptedndash Stepchildrenfoster childrenNote you do not need to supply marriage certificatesbirth certificates for dependent optional life
You may electbull $2000 Spouse$1000 Childbull $4000 Spouse $2000 Childbull $10000 Spouse $5000 Child
The bi-weekly rate is not based on salary
Office of Human Resources Montgomery County Government
Flexible Spending Accounts
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Visit the Open Enrollment website to watch a recorded FSA presentation from MCGrsquos FSA vendor Benefit Strategies
bull What is an FSA It is an IRS-approved tax-free account that saves onQualified out-of-pocket medical and dependent care expensesFederal and State Income taxSocial Security Tax
bull 3 Account Options Health Care FSA Child Care FSA and Commuter Choice Transit bull FSA accounts are administered through Benefit Strategies bull FSAs are ldquouse-it or lose-itrdquo accounts claims must be incurred during the 2021 plan year (January 1
2021 ndash March 15 2022) and submitted by April 30 2022
IMPORTANT You must re-enroll in an FSA every Open Enrollment if you want to participate in the upcoming plan year
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Why You Should EnrollGive yourself a raise by reducing your taxesbull Elect the annual amount you want to place in your FSA(s) for the upcoming plan year during Open Enrollmentbull That amount is divided by 26 and taken from your biweekly paychecks on a pre-tax basis (21 paychecks for
10-month employees)bull Then use your pre-tax FSA dollars to pay for eligible out-of-pocket health care child-care or transit
expenses
Office of Human Resources Montgomery County Government
Health Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull Claims must be submitted by April 30 of the following yearbull You may elect to contribute up to $2750 Your total annual election amount is available to spend on the first
day of the new plan year bull FSA debit card allows you to pay for expenses at the time of servicebull Examples of IRS qualified eligible expenses
bull Copays (medical prescription dental vision) deductibles and coinsurance amounts over reasonable and customary charge
bull Hearing aids bull Acupuncture bull Orthopedic shoes bull Over-the-counter (OTC) drugs (no longer require doctorrsquos prescription)
Office of Human Resources Montgomery County Government
Child Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull $5000 annual maximum per household ($2500 for married filing separately)bull Funds are available to spend as they are accumulated through payroll deductionsbull Reimbursable expenses
bull day care centersbull elder carebull beforeafter school carebull babysitter fees that allow you and your spouse to work or go to school (no child support payments)
bull Qualifying dependentsbull Children under the age of 13 and are a tax dependent of the employeebull Spouse or tax dependent that is physically or mentally incapable of self-care
bull Must coordinate between filing a tax credit with IRS and your Dependent Care FSA plan
Office of Human Resources Montgomery County Government
Commuter Choice Transit FSAbull $230 per month maximum for MCGEO staff $260 per month maximum for Unrepresented staffbull Applies to employee commuting expenses only (not spouses or dependents)bull Can enroll throughout the year (not limited to Open Enrollment election)bull Eligible expenses include Metro Marc Vanpool Lyft Line Uber Poolbull Debit card ndash may be used for some expenses (not Metro)Metro riders will have to submit claim forms for reimbursement
bull Funds must be used within 180 days of election bull If retiring or leaving the County will need to coordinate use all available funds
Office of Human Resources Montgomery County Government
Using Your FSA FundsHealth Care FSA Your full annual election amount is available on the first day of the plan yearChild Care FSA Your funds are available as they accumulate through payroll deductionsCommuterTransit FSA Your funds are available as they accumulate through payroll deductions
The FSA Debit Card bull Your FSA debit card is the same card for your Health Care Child Care and TransitCommuter FSA accountsbull The card is pre-loaded with your full annual Health Care FSA election amount You can use the card to pay for IRS qualified expenses at
the time of service or when paying a bill Receipt notifications will be mailed to you monthly by Benefit Strategies Your response to receipt notifications is necessary under the provisions of the plan No response my result in the ineligibility of the purchase and as a result your card may be temporarily deactivated
bull If you are enrolled in the Child Care FSA the card can also be used in child-care settings Just remember that the card will only work for an amount that does not exceed the available balance in your Child Care FSA account on that day
bull The card can also be used to pay for your commutertransit expenses however it does not work for WMATA metro Metro riders will have to submit manual claims for reimbursement from your CommuterTransit FSA
bull Cards are re-loaded each year after you make your new annual election Please keep your cards You will only receive a new card if your old card is about to expire
Office of Human Resources Montgomery County Government
AFLAC Voluntary Plans
Office of Human Resources Montgomery County Government
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Short-Term Disabilitybull Provides short-term cash benefits in the event of disabilitybull Monthly benefit amounts available from $500 - $6000 (subject to income requirements)bull Benefit options of 3 6 12 18 or 24 months with a variety of elimination periods
Critical Illness Insurancebull Provides a lump sum cash benefit in the event of critical illnessbull Benefit amounts available in $5000 increments from $10000 - $30000
Participants pay 100 through payroll deduction for Short-Term Disability and Critical Illness Insurance
To ENROLL Text SETAPPTrdquo to 41411orCall 920-420-8861 orEmail susan_mcdanielusAflaccom
Office of Human Resources Montgomery County Government
Carrier Resources amp Cost-Saving Tips
Office of Human Resources Montgomery County Government
Lower Your Out-of-Pocket CostsChoose the plan thatrsquos right for youbull See the medical benefits chart for options bull Stay in network Use the provider search engines on your carrier website or mobile app to find in-network providersSeek preventive carebull Check-ups immunizations and screenings are an important part of staying healthy They can detect or prevent serious diseases and keep you healthyKnow where to go for carebull You have many options of places to go when you need care If your medical condition isnrsquot serious or life threatening you can save money by connecting
with a doctor online through a virtual visit or going to an urgent care center or convenience care clinic instead of a hospital emergency roomReview your prescription drug plan optionsbull Decide which Caremark prescription plan is best for you Note that the Kaiser HMO includes prescription drug coverage Both the Standard and High
Option Caremark plans cover the same prescription drugs but have different copay and deductiblesUse generic and long-term prescriptions bull Opt for lower-cost generic drugs whenever possible bull Ask your doctor to write a 90-day prescription instead of a 30-day prescription to participate in the mail order prescription programTake advantage of tax savings by participating in Flexible Spending Accountsbull Use pre-tax dollars for eligible out of pocket services and items
Office of Human Resources Montgomery County Government
Built-in Wellness Support Take advantage of the free programs available to you through your medical carrier Each of MCGrsquos medical carriers (Kaiser UHC amp CareFirst) offer valuable programs to help you manage your health
Disease Management Programsbull Help manage your chronic condition through personalized coaching support and encouragement and online education materialsEmotional Wellness amp Stress Management Support bull Help manage stress through mobile apps and other self-care resources Maternity Programsbull Support healthy moms and healthy babiesWeight-loss Programs bull Offers telephonic coaching support and web-based tools to help ensure long-term weight managementbull See the next slide for an example of an MCG success storySmoking Cessation Programsbull Supportive coaching to make quitting more successfulDiscounts bull Gym memberships weight loss programs and moreFor more information about the programs available to you please see the Open Enrollment Guide and contact your medical carrier
Office of Human Resources Montgomery County Government
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You GoAll of MCGrsquos health insurance carriers offer a simple-to-use tool that can help make your life easier while yoursquore on the go Download your carrierrsquos Mobile App to help you personalize organize and access your important plan information on your phone or tablet
bull Schedule Virtual Visitsbull Manage and track claimsbull View ID card informationbull Find doctor and compare costs and quality ratingsbull Review your coveragebull Track your account balances and deductiblesbull Access a variety of health and wellness tools
Visit Google Play or the Apple App Store to download your carrierrsquos App
Office of Human Resources Montgomery County Government
Making Changes
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Questions
Office of Human Resources Montgomery County Government
Open Enrollment AssistanceFollow these steps (in this order)1 Review the frequently asked questions (FAQs) on the Open Enrollment website at wwwmontgomerycountymdgovoe
(available beginning September 21) You can enter key words into the interactive search bar to quickly locate the answer to your question
2 Visit the MC311 website at wwwmontgomerycountymdgovmc311 and search key words for your question The search results contain various knowledge-based articles with information related to your search words Simply click on the corresponding link and the detailed answer is revealed
3 Attend one of OHRrsquos Virtual Office Hours via Microsoft Teams Members of OHRs Health Insurance Team will be on hand to address employee questions by video or via the chat box View the schedule and access the sessions through the Open Enrollment website at wwwmontgomerycountymdgovoe (available beginning September 21)
4 If you have tried all the methods above and still have Open Enrollment-related questions please contact OHRs MC311 Customer Service Center at 240-773-6471 (Mon-Fri 8 am - 5 pm) to open a service request A member of the health insurance team will respond to service requests in the order they are received Tip Please provide an email address at the time you place your Service Request This will ensure the fastest response possible
Office of Human Resources Montgomery County Government
Online ResourcesVisit the 2021 Open Enrollment Webpage
wwwmontgomerycountymdgovOE
Visit OHRrsquos WebpagewwwmontgomerycountymdgovHR
Health Insurance active employees
Office of Human Resources Montgomery County Government
Legal InformationThe County reserves the right at any time and for any reason to amend the Program subject to the Countys collective bargainingagreements The County expects to continue the Program but it is the Countys position that there is no implied contract between individual employees and the County to do so
The County may amend the Program prospectively or retroactively to comply with applicable law
In the event of a conflict between this presentation the County Code andor the Summary Description the County Code then the Summary Description will govern
Office of Human Resources Montgomery County Government
Thank YouWe hope you enjoyed learning about 2021 Open Enrollment
~Your OHR Health Insurance Team
2021 Open Enrollment Benefits Bonanza
What Is Open Enrollment
What Changes Can be Made
Open Enrollment Dates
MCG Continues to Make Generous Employer Contributions
New for 2021
Special 2021 Plan Rates Announcement
Employee Rate Changes for Calendar Year 2021
Planning Ahead Minimizing Future Rate Increases
New for 2021
Open Enrollment Communications
Itrsquos a New Frontier
2021 Open Enrollment Checklist
Open Enrollment Website Resources
Attend a Virtual Open Enrollment Event
Make Changes Online
Paper Enrollment Form Permitted for Only Two Reasons
Dependent Eligibility
Proof of Dependent Eligibility
Marriage Certificate Example Required Documentation (Contd)
Benefits Refresher
Medical amp Rx
Medical Plan Options
Medical Benefits at-a-Glance
Medical Benefits at-a-Glance (contd)
Prescription Plans Caremark
Prescription Drug Plan Comparison
Prescription Drug Cost Comparison
Dental
Slide Number 30
Vision
Vision Insurance
Optional Life amp Dependent Life
Optional Life Insurance ADampD
Optional Life Insurance Rates
Dependent Life Insurance
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs)Why You Should Enroll
Health Care FSA
Child Care FSA
Commuter Choice Transit FSA
Using Your FSA Funds
AFLAC Voluntary Plans
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Carrier Resources amp Cost-Saving Tips
Lower Your Out-of-Pocket Costs
Built-in Wellness Support
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You Go
Making Changes
Make Changes Online
Questions
Open Enrollment Assistance
Online Resources
Legal Information
Thank You
Cigna Dental Comparison
DHMO
PPO
CIGNA NETWORK
Care-Access PlusDHMO
Total CIGNA PPOPPO
Required to Use An Assigned Provider
Yes In-network only Primary Dental Office will be assigned based on home address
No
Out of Network Benefits Available
No
Yes
Balance Billing for Covered Services
No
Yes if you go out-of-network
Referral Required
Yes
No
Orthodontia Benefits Available
Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime)
Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person)
Unlimited
$200000
Deductible (singlefamily)
None
$50 $ 150 waived for preventive care
1Claim submission would be required and balance billing may occur when visiting a nonparticipating provider2Deductible does not apply to Class I ndash Diagnostic and Preventive Services
Coverage for dependents would cease on the day which the child turns 26Benefit Maximum and Deductibles are for the period of January 01 through December 31
All services listed on this benefit summary are subject to the contractSchedules of Benefits and current Exclusions and Limitations
Medical Benefits at a Glance
Kaiser Permanente HMO + Rx wwwkporg
United HealthCare Select HMO wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS) wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS) wwwcarefirstcom
Plan Type
HMO
HMO
Point-of-Service
Point-of-Service
PCP Required
Yes
Yes
No
No
Provider Network
Regional (MDDCVA)
National
National
National
Out-of-Network Benefits
No
No
Yes
Yes
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
None
None
In-Network None Out-of-Network 80
In-Network None Out-of-Network 80
Dr Office Visits PCPSpecialist
$5 copay
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits
Covered in full
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care
$5 copay
$15 copay
Covered in full
Covered in full
Emergency Room
$50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization
Covered in full
Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
MCG 2018 Medical Plan Comparison Chart
Kaiser Permanente
United HealthCare
CareFirst POS Standard
CareFirst POS High
Plan Type
HMO
HMO
Point of Service
Point of Service
Provider Network
Regional (MDDCVA)
National
National
National
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
Annual Out-of-Pocket Maximum
None
$1100 per individual up to cap of $3600 for a family
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
Physician Servcies
PCP Office Visits
$5 copay
$5 copay PCP
In-Network $15 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Specialist Office Visits
$5 copay
$10 copay
In-Network $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Annual Physical
Covered in full
$5 copay PCP
In-Network $15 copay Primary Care Physician $30 copay specialist Out-of-Network 80 covered after deductible (limit 1calendar year)
In-Network $15 copay Out-of-Network 80 not subject to deductible (up to age 18)
In-Network $10 copay Out-of-Network 80 not subject to deductible (up to age 18)
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Allergy Testing
$5 copay
$5 copay PCP $10 copay Specialist
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Virtual Visits
Labs X-Rays Diagnostics
Outpatient labs
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient X-Rays
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Major Diagnostics
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Immedate Medical Servcies
Emergency Room
$50 copay waived if admitted to hospital
$25 copay waived if admitted to hospital $15 copay for urgent care
In-Network $35 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
Urgent Care
Hospital Services
Inpatient Hospitalization
Covered in full
Covered in full
In-Network Covered in full after $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Services
Surgery
Covered in full
Inpatient covered in full Outpatient $25 copay
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Hearing Aids
For minor children One hearing aid for each hearing impaired ear once every 36 months
For minor children One hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
Hearing Screening
$5 copay for hearing exam (hearing aids are excluded)
$5 Copay PCP $10 Copay Specialist
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
Home Health Care Services
Covered in full if medically necessary
Covered in full No copayment 60 visit maximum for skilled care services per calendar year
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
Hospice
Covered in full
Covered in full (See coverage booklet for eligibility information)
In-Network Covered in full
In-Network Covered in full
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
In vitro Fertilization
Limited to 3 attempts per live birth Lifetime maximum of $100000
Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
Mammography - Preventive Screening Schedule
Schedule consistent with the current recommendations of the American College of Physicians
Covered in full Age 35-39 one baseline mammogram Age 40-49 one mammogram every two calendar years Age 50+ one mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
Maternity
Covered in full once pregnancy is diagnosed
No copayment applies after the first visit
In-Network first visit 100 after $30 copay other visits 100
In-Network First visit 100 after $10 copay other visits 100
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Maximum Lifetime Benefit
Unlimited maximum
Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
Prescriptions
Kaiser Rx plan (included with Kaiser HMO medical plan) $5 at on-site pharmacies and for mail order $15 at participating pharmacies
No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
Rehabilitation Services
Inpatient Covered in full (unlimited) Outpatient $5 copay outpatient services for physical therapy are limited to up to 30 visits occupational and speech therapy per injury incident or condition are covered for a period not to exceed 90 days
$10 copayvisit 60 combined visits per year (short-term non-chronic conditions only)
In-Network
In-Network
100
100
Skilled Nursing Facility
Covered in full 100 days maximum
Covered in full 60 days per calendar year maximum
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Substance AbuseMental Health
Inpatient Covered in full Outpatient $5 copay
Inpatient Covered in full Outpatient $5 copay
In-Network Inpatient- $150 per admission copay Outpatient- $15 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
In-Network Inpatient- covered in full Outpatient- $10 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
Vision (Routine)
$5 copay for exams 25 discount on lensesframes at Kaiser centers 15 discount off the costs of contact lenses
$25 copay for exam 15-20 discount through participating optical centers
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
53116
Medical Benefits at a Glance
Kaiser Permanente HMO + Rx wwwkporg
United HealthCare Select HMO wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS) wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS) wwwcarefirstcom
Plan Type
HMO
HMO
Point-of-Service
Point-of-Service
PCP Required
Yes
Yes
No
No
Provider Network
Regional (MDDCVA)
National
National
National
Out-of-Network Benefits
No
No
Yes
Yes
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
None
None
In-Network None Out-of-Network 80
In-Network None Out-of-Network 80
Dr Office Visits PCPSpecialist
$5 copay
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits
Covered in full
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care
$5 copay
$15 copay
Covered in full
Covered in full
Emergency Room
$50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization
Covered in full
Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
MCG 2018 Medical Plan Comparison Chart
Kaiser Permanente
United HealthCare
CareFirst POS Standard
CareFirst POS High
Plan Type
HMO
HMO
Point of Service
Point of Service
Provider Network
Regional (MDDCVA)
National
National
National
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
Annual Out-of-Pocket Maximum
None
$1100 per individual up to cap of $3600 for a family
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
Physician Servcies
PCP Office Visits
$5 copay
$5 copay PCP
In-Network $15 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Specialist Office Visits
$5 copay
$10 copay
In-Network $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Annual Physical
Covered in full
$5 copay PCP
In-Network $15 copay Primary Care Physician $30 copay specialist Out-of-Network 80 covered after deductible (limit 1calendar year)
In-Network $15 copay Out-of-Network 80 not subject to deductible (up to age 18)
In-Network $10 copay Out-of-Network 80 not subject to deductible (up to age 18)
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Allergy Testing
$5 copay
$5 copay PCP $10 copay Specialist
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Virtual Visits
Labs X-Rays Diagnostics
Outpatient labs
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient X-Rays
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Major Diagnostics
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Immedate Medical Servcies
Emergency Room
$50 copay waived if admitted to hospital
$25 copay waived if admitted to hospital $15 copay for urgent care
In-Network $35 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
Urgent Care
Hospital Services
Inpatient Hospitalization
Covered in full
Covered in full
In-Network Covered in full after $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Services
Surgery
Covered in full
Inpatient covered in full Outpatient $25 copay
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Hearing Aids
For minor children One hearing aid for each hearing impaired ear once every 36 months
For minor children One hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
Hearing Screening
$5 copay for hearing exam (hearing aids are excluded)
$5 Copay PCP $10 Copay Specialist
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
Home Health Care Services
Covered in full if medically necessary
Covered in full No copayment 60 visit maximum for skilled care services per calendar year
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
Hospice
Covered in full
Covered in full (See coverage booklet for eligibility information)
In-Network Covered in full
In-Network Covered in full
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
In vitro Fertilization
Limited to 3 attempts per live birth Lifetime maximum of $100000
Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
Mammography - Preventive Screening Schedule
Schedule consistent with the current recommendations of the American College of Physicians
Covered in full Age 35-39 one baseline mammogram Age 40-49 one mammogram every two calendar years Age 50+ one mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
Maternity
Covered in full once pregnancy is diagnosed
No copayment applies after the first visit
In-Network first visit 100 after $30 copay other visits 100
In-Network First visit 100 after $10 copay other visits 100
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Maximum Lifetime Benefit
Unlimited maximum
Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
Prescriptions
Kaiser Rx plan (included with Kaiser HMO medical plan) $5 at on-site pharmacies and for mail order $15 at participating pharmacies
No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
Rehabilitation Services
Inpatient Covered in full (unlimited) Outpatient $5 copay outpatient services for physical therapy are limited to up to 30 visits occupational and speech therapy per injury incident or condition are covered for a period not to exceed 90 days
$10 copayvisit 60 combined visits per year (short-term non-chronic conditions only)
In-Network
In-Network
100
100
Skilled Nursing Facility
Covered in full 100 days maximum
Covered in full 60 days per calendar year maximum
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Substance AbuseMental Health
Inpatient Covered in full Outpatient $5 copay
Inpatient Covered in full Outpatient $5 copay
In-Network Inpatient- $150 per admission copay Outpatient- $15 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
In-Network Inpatient- covered in full Outpatient- $10 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
Vision (Routine)
$5 copay for exams 25 discount on lensesframes at Kaiser centers 15 discount off the costs of contact lenses
$25 copay for exam 15-20 discount through participating optical centers
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
53116
Office of Human Resources Montgomery County Government
Employee Rate Changes for Calendar Year 2021Plan Per Pay Period Increase
Self Self + 1 FamilyCareFirst High Option POS $000 $000 $000CareFirst Standard Option POS $000 $000 $000Kaiser -$147 -$276 -$435United HealthCare HMO $000 $000 $000CVS Standard Prescription Plan $000 $000 $000CVS High $4$8 Prescription Plan $000 $000 $000CVS High $5$10 Prescription Plan $000 $000 $000CIGNA PPO Dental $041 $094 $134CIGNA DHMO Dental $000 $000 $000EyeMed Vision $009 $014 $020
Office of Human Resources Montgomery County Government
Planning Ahead Minimizing Future Rate IncreasesHere are ways employees can work together with MCG to keep future plan rate increases at a minimumbull Seek out preventive care such as annual exams and age-based screeningsbull Visit in-network doctors via virtual visitsbull Use urgent care facilities for non-emergent services rather than going to the
emergency roombull Choose generic prescription drugsbull Maximize wellness resources through health insurance carriers and MCGrsquos LiveWell
program
Office of Human Resources Montgomery County Government
New for 2021bull All Open Enrollment events held virtually this yearMCGrsquos carriers will be hosting virtual presentations and QampA sessionsOHR Virtual Office Hours
bull Health Care FSA changesAnnual contribution limit increasing to $2750Over-the-counter expenses are permitted without a written prescription Feminine products are now an eligible expense
bull New Open Enrollment Communication MethodsBenefits Bites delivered in the MCG Employee Connect newsletter Enhanced Open Enrollment website
bull Frequently Asked Questionsbull MCG employee discount amp resource section bull Employee self-service (ESS) instructions and demonstrationsbull MCG vendor video presentations
Office of Human Resources Montgomery County Government
Open Enrollment Communications bull 2021 Open Enrollment Guides were mailed to homes on September 11
Employees should receive the guides between September 14 ndash 16
bull Employees are encouraged to check their County email during and after Open EnrollmentOpen Enrollment email series featuring news and remindersMCG Employee Connect newsletter sharing Open Enrollment news in the Benefits Bites
sectionAfter Open Enrollment ends MetLife will email employees who elected or increased
Optional Life to complete a Statement of Health online
bull The Open Enrollment Website is a dedicated resource for all Open Enrollment needsAvailable Monday September 21 at 8 am
Office of Human Resources Montgomery County Government
Itrsquos a New Frontier COVID-19 has changed the way we utilize our plans MCGrsquos health insurance plans offer many value-added services and discounts to provide employees with support This year more than ever it is important to know our resources
bull Virtual doctor visits bull Built-in emotional amp wellness supportbull Disease management bull Lifestyle coachingbull Stress relief appsbull Discounts and more
Please see the 2021 Open Enrollment guide for additional information
Office of Human Resources Montgomery County Government
2021 Open Enrollment ChecklistTake Action Early Follow these steps for a successful Open Enrollment1 Review available resources
bull 2021 Open Enrollment Guide (mailed to homes on September 11th)bull Open Enrollment Websitebull County Email for Important Updates and Follow-Ups bull Benefits Bites Section of the MCG Employee Connect Newsletter
2 Attend a virtual Open Enrollment event3 Attend OHR virtual office hours4 Make changes online amp print Confirmation Statement5 (Re)Enroll in Flexible Spending Accounts (FSAs) and check FSA contribution
amounts
Office of Human Resources Montgomery County Government
Open Enrollment Website Resources Visit the Open Enrollment website for a variety of planning tools amp resources Open Enrollment schedule of virtual events Open Enrollment frequently asked questions 2021 Employee Self-Service (ESS) instruction video amp written instructions Side-by-side plan comparisons Life insurance needs estimator FSA tax savings calculator MCG employee discounts amp resources and more
Office of Human Resources Montgomery County Government
Attend a Virtual Open Enrollment Event bull Insurance Carrier Virtual Presentations and QampA Sessions Visit the Open Enrollment website for full schedule of events
bull Attend OHR Virtual Office Hours Virtual Office Hours SchedulePlease note Virtual Office Hours are held in a public virtual meeting If questions will
reveal any personal PHI (protected health information) such as a chronic medical condition or names of specific prescription drugs employees should direct those questions to OHRrsquos customer service center at 240-773-6471 to place a service request
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Paper Enrollment Form Permitted for Only Two ReasonsThere are only two exceptions permitting the use of paper Open Enrollment forms
bull Technical barriers preventing access to ESS (only in the event of no internet no smartphone or computer) the employee should contact MC311 and place a service request to be mailed a paper enrollment form Call 240-773-OHR1 (240-773-6471) available Monday through Friday 8 am to 5 pm
bull Experiencing a Life Event If an employee has a qualified status change (life event) during Open Enrollment they cannot make changes using the Open Enrollment form or online system Instead they should contact the OHR Health Insurance Team via MC311 to make changes Qualifying life events marriage divorce the birth of a child or the death of spouse or a
dependent aging out
Office of Human Resources Montgomery County Government
Dependent EligibilityEligible dependents for medical prescription dental and vision coverage arebull Spouse
Legally married EligibleDivorced Not Eligible
bull Children (biological legally adopted stepchildren or under your legal custody)Under age 26 EligibleAge 26 and over Not Eligible unless incapable of self support
Proof of eligible dependents is required
Office of Human Resources Montgomery County Government
Proof of Dependent EligibilityEmployees enrolling new dependents during Open Enrollment must upload the necessary dependent documentation in ESS prior to October 9 at 5 pmRequired Documentationbull Spouse Official State Marriage Certificate (certified by appropriate State or County Official)bull Biological Child State Birth Certificate (For newborns OHR will accept hospital discharge papers for first 60 days birth
certificate must then be submitted)bull Adopted Child Copy of Adoption or Placement for Adoption Papers bull Step-Child State Birth Certificate Marriage Certificate and Divorce Decree or Custody Papers bull Disabled Child Medical plan verification of disability prior to age 26 bull Legal Custody Copy of Court Order granting legal custody
Office of Human Resources Montgomery County Government
Marriage Certificate Example Required Documentation (Contd)
Office of Human Resources Montgomery County Government
Benefits Refresher
Office of Human Resources Montgomery County Government
Medical amp Rx
Office of Human Resources Montgomery County Government
Medical Plan OptionsHealth Maintenance Organizations (HMO)bull Kaiser Permanente Signature (HMO)bull United Healthcare Select (HMO)
Point of Service Plans (POS)bull CareFirst BCBS (POS) High Optionbull CareFirst BCBS (POS) Standard Option
Three tiers of coverage Self Self + 1 or Family
Office of Human Resources Montgomery County Government
Medical Benefits at-a-Glance To view full carrier medical summaries visit OHRrsquos Health Insurance Website
Kaiser Permanente HMO + Rx
wwwkporg
United HealthCare Select HMO
wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS)
wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS)
wwwcarefirstcom
Plan Type HMO HMO Point-of-Service Point-of-Service
PCP Required Yes Yes No No
Provider Network Regional (MDDCVA) National National National
Out-of-Network Benefits No No Yes Yes
Referrals Required Yes No No No
Annual Deductible None NoneIn-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Sheet1
Sheet1 (2)
Office of Human Resources Montgomery County Government
Medical Benefits at-a-Glance (contd)
New Employee Orientation Program
Kaiser Permanente HMO + Rx
wwwkporg
United HealthCare Select HMO
wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS)
wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS)
wwwcarefirstcom
Dr Office Visits PCPSpecialist $5 copay $5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits Covered in full $5 copay $10 copay In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care $5 copay $15 copay Covered in full Covered in full
Emergency Room $50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization Covered in full Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
Visit OHRrsquos Health Insurance webpage to view Medical summaries
Sheet1
Sheet1 (2)
Office of Human Resources Montgomery County Government
Prescription Plans Caremarkbull Two Rx Plan OptionsStandardHigh
bull If you elect UHC or CareFirst and want Rx coverage you will need to elect the stand-alone Caremark Rx plan (Kaiser already includes Rx coverage)
bull Maintenance Choice Program available for maintenance drugs significant cost savings ndash 1 copay for each 90-day prescription In order to get the Maintenance pricing you must fil Rx at CVS retail pharmacy Mail order
Office of Human Resources Montgomery County Government
Prescription Drug Plan Comparison High Option $48
Only MCGEOIAFF employees can enroll in this High plan
High Option $510Only FOPNON-REP employees
can enroll in this High plan
Standard Option All employees can enroll in this
Standard plan
Copay $4 Generics$8 Brand Name
$5 Generics$10 Brand Name
$10 Generics$20 PBrand Name
$35 NPBrand NameDeductible na na $50yearMail Order Yes Yes Yes
Maintenance Choice Yes Yes YesCovered Drugs Same Same Same
Visit OHRrsquos Health Insurance Website to view Rx summaries
Office of Human Resources Montgomery County Government
Prescription Drug Cost Comparison Cost
High Option $48Only MCGEOIAFF employees
can enroll in this High plan
High Option $510Only FOPNON-REP employees
can enroll in this High plan
Standard Option All employees can enroll in this
Standard plan
Self Only
Bi-Weekly $11339Monthly $24568Yearly $294814
Bi-Weekly $11100Monthly $24050Yearly $288600
Bi-Weekly $2413Monthly $5258Yearly $62738
Self + 1
Bi-Weekly $20979Monthly $45455Yearly $545454
Bi-Weekly $20536Monthly $44495Yearly $533936
Bi-Weekly $4463Monthly $9670
Yearly $116038
Self + Family
Bi-Weekly $32511Monthly $70441Yearly $845286
Bi-Weekly $31824Monthly $68952Yearly $827424
Bi-Weekly $6916Monthly $14985Yearly $179816
Office of Human Resources Montgomery County Government
Dental
Office of Human Resources Montgomery County Government
Dental Comparison Cigna
For a list of HMO covered services and assigned costs (copays) view the HMO benefit summary
Required to Use An Assigned Provider Yes In-network only Primary Dental Office will be
assigned based on home address
No
Out of Network Benefits Available No Yes
Balance Billing for Covered Services No Yes if you go out-of-network
Referral Required Yes No
Orthodontia Benefits Available Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime) Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person) Unlimited $200000
Deductible (singlefamily) None $50 $ 150 waived for preventive care
Table 1
Office of Human Resources Montgomery County Government
Vision
Office of Human Resources Montgomery County Government
Vision Insurancebull The Countyrsquos Vision carrier is EyeMedbull Benefits payable for exams lenses and contacts (elective or necessary) every
calendar year frames every two calendar yearsbull In-network or out-of-network benefits available bull Enhanced Hearing Benefit through EyeMedrsquos partner Amplifon40 off hearing examDiscounted pricing on thousands of hearing aids including latest technologyOne-year free follow-up care with unlimited appointmentsFree batteries for two years with initial purchase Three-year warranty and loss and damage coverage
Visit OHRrsquos Health Insurance webpage to view vision summary
Office of Human Resources Montgomery County Government
Optional Life amp Dependent Life
Office of Human Resources Montgomery County Government
Optional Life Insurance ADampDbull You may elect Optional Life ADampD coverage for yourself in increments of 1 to 8 times
your basic annual earnings ($1 million maximum)
bull NOTE Coverage is not guaranteed issue for any level You must complete an online Statement of Health no matter what level of coverage you elect Later this fall after Open Enrollment ends you will receive an email from MetLife with a link to complete the Statement of Health online
bull An eligible dependent is defined as 1) your opposite or same sex spouse or 2) your unmarried children under age 26 (natural adopted or stepchildrenfoster children who depend on your support)
Office of Human Resources Montgomery County Government
Optional Life Insurance RatesHow to estimate your Optional Life Insurance bi-weekly rate
Example 40-year-old applying for 2 x salary Salary is $49300
Steps Example Calculate for Yourself
A Find your age-based rate on the rate sheet (left) $ 0037 $_________________
B Choose how much coverage you are applying for
$99000 (2 x salary rounded to the nearest $1000 ) $_________________
C Divide that coverage amount by 100099 ($99000 1000) $_________________
D Multiply A x C for estimated bi-weekly cost$366 ($037 x 99) $_________________
Office of Human Resources Montgomery County Government
Dependent Life InsuranceYou may also purchase Dependent Optional Life insurance forbull Your opposite or same sex spouse bull Your unmarried children under age 26
ndash Natural adoptedndash Stepchildrenfoster childrenNote you do not need to supply marriage certificatesbirth certificates for dependent optional life
You may electbull $2000 Spouse$1000 Childbull $4000 Spouse $2000 Childbull $10000 Spouse $5000 Child
The bi-weekly rate is not based on salary
Office of Human Resources Montgomery County Government
Flexible Spending Accounts
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Visit the Open Enrollment website to watch a recorded FSA presentation from MCGrsquos FSA vendor Benefit Strategies
bull What is an FSA It is an IRS-approved tax-free account that saves onQualified out-of-pocket medical and dependent care expensesFederal and State Income taxSocial Security Tax
bull 3 Account Options Health Care FSA Child Care FSA and Commuter Choice Transit bull FSA accounts are administered through Benefit Strategies bull FSAs are ldquouse-it or lose-itrdquo accounts claims must be incurred during the 2021 plan year (January 1
2021 ndash March 15 2022) and submitted by April 30 2022
IMPORTANT You must re-enroll in an FSA every Open Enrollment if you want to participate in the upcoming plan year
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Why You Should EnrollGive yourself a raise by reducing your taxesbull Elect the annual amount you want to place in your FSA(s) for the upcoming plan year during Open Enrollmentbull That amount is divided by 26 and taken from your biweekly paychecks on a pre-tax basis (21 paychecks for
10-month employees)bull Then use your pre-tax FSA dollars to pay for eligible out-of-pocket health care child-care or transit
expenses
Office of Human Resources Montgomery County Government
Health Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull Claims must be submitted by April 30 of the following yearbull You may elect to contribute up to $2750 Your total annual election amount is available to spend on the first
day of the new plan year bull FSA debit card allows you to pay for expenses at the time of servicebull Examples of IRS qualified eligible expenses
bull Copays (medical prescription dental vision) deductibles and coinsurance amounts over reasonable and customary charge
bull Hearing aids bull Acupuncture bull Orthopedic shoes bull Over-the-counter (OTC) drugs (no longer require doctorrsquos prescription)
Office of Human Resources Montgomery County Government
Child Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull $5000 annual maximum per household ($2500 for married filing separately)bull Funds are available to spend as they are accumulated through payroll deductionsbull Reimbursable expenses
bull day care centersbull elder carebull beforeafter school carebull babysitter fees that allow you and your spouse to work or go to school (no child support payments)
bull Qualifying dependentsbull Children under the age of 13 and are a tax dependent of the employeebull Spouse or tax dependent that is physically or mentally incapable of self-care
bull Must coordinate between filing a tax credit with IRS and your Dependent Care FSA plan
Office of Human Resources Montgomery County Government
Commuter Choice Transit FSAbull $230 per month maximum for MCGEO staff $260 per month maximum for Unrepresented staffbull Applies to employee commuting expenses only (not spouses or dependents)bull Can enroll throughout the year (not limited to Open Enrollment election)bull Eligible expenses include Metro Marc Vanpool Lyft Line Uber Poolbull Debit card ndash may be used for some expenses (not Metro)Metro riders will have to submit claim forms for reimbursement
bull Funds must be used within 180 days of election bull If retiring or leaving the County will need to coordinate use all available funds
Office of Human Resources Montgomery County Government
Using Your FSA FundsHealth Care FSA Your full annual election amount is available on the first day of the plan yearChild Care FSA Your funds are available as they accumulate through payroll deductionsCommuterTransit FSA Your funds are available as they accumulate through payroll deductions
The FSA Debit Card bull Your FSA debit card is the same card for your Health Care Child Care and TransitCommuter FSA accountsbull The card is pre-loaded with your full annual Health Care FSA election amount You can use the card to pay for IRS qualified expenses at
the time of service or when paying a bill Receipt notifications will be mailed to you monthly by Benefit Strategies Your response to receipt notifications is necessary under the provisions of the plan No response my result in the ineligibility of the purchase and as a result your card may be temporarily deactivated
bull If you are enrolled in the Child Care FSA the card can also be used in child-care settings Just remember that the card will only work for an amount that does not exceed the available balance in your Child Care FSA account on that day
bull The card can also be used to pay for your commutertransit expenses however it does not work for WMATA metro Metro riders will have to submit manual claims for reimbursement from your CommuterTransit FSA
bull Cards are re-loaded each year after you make your new annual election Please keep your cards You will only receive a new card if your old card is about to expire
Office of Human Resources Montgomery County Government
AFLAC Voluntary Plans
Office of Human Resources Montgomery County Government
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Short-Term Disabilitybull Provides short-term cash benefits in the event of disabilitybull Monthly benefit amounts available from $500 - $6000 (subject to income requirements)bull Benefit options of 3 6 12 18 or 24 months with a variety of elimination periods
Critical Illness Insurancebull Provides a lump sum cash benefit in the event of critical illnessbull Benefit amounts available in $5000 increments from $10000 - $30000
Participants pay 100 through payroll deduction for Short-Term Disability and Critical Illness Insurance
To ENROLL Text SETAPPTrdquo to 41411orCall 920-420-8861 orEmail susan_mcdanielusAflaccom
Office of Human Resources Montgomery County Government
Carrier Resources amp Cost-Saving Tips
Office of Human Resources Montgomery County Government
Lower Your Out-of-Pocket CostsChoose the plan thatrsquos right for youbull See the medical benefits chart for options bull Stay in network Use the provider search engines on your carrier website or mobile app to find in-network providersSeek preventive carebull Check-ups immunizations and screenings are an important part of staying healthy They can detect or prevent serious diseases and keep you healthyKnow where to go for carebull You have many options of places to go when you need care If your medical condition isnrsquot serious or life threatening you can save money by connecting
with a doctor online through a virtual visit or going to an urgent care center or convenience care clinic instead of a hospital emergency roomReview your prescription drug plan optionsbull Decide which Caremark prescription plan is best for you Note that the Kaiser HMO includes prescription drug coverage Both the Standard and High
Option Caremark plans cover the same prescription drugs but have different copay and deductiblesUse generic and long-term prescriptions bull Opt for lower-cost generic drugs whenever possible bull Ask your doctor to write a 90-day prescription instead of a 30-day prescription to participate in the mail order prescription programTake advantage of tax savings by participating in Flexible Spending Accountsbull Use pre-tax dollars for eligible out of pocket services and items
Office of Human Resources Montgomery County Government
Built-in Wellness Support Take advantage of the free programs available to you through your medical carrier Each of MCGrsquos medical carriers (Kaiser UHC amp CareFirst) offer valuable programs to help you manage your health
Disease Management Programsbull Help manage your chronic condition through personalized coaching support and encouragement and online education materialsEmotional Wellness amp Stress Management Support bull Help manage stress through mobile apps and other self-care resources Maternity Programsbull Support healthy moms and healthy babiesWeight-loss Programs bull Offers telephonic coaching support and web-based tools to help ensure long-term weight managementbull See the next slide for an example of an MCG success storySmoking Cessation Programsbull Supportive coaching to make quitting more successfulDiscounts bull Gym memberships weight loss programs and moreFor more information about the programs available to you please see the Open Enrollment Guide and contact your medical carrier
Office of Human Resources Montgomery County Government
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You GoAll of MCGrsquos health insurance carriers offer a simple-to-use tool that can help make your life easier while yoursquore on the go Download your carrierrsquos Mobile App to help you personalize organize and access your important plan information on your phone or tablet
bull Schedule Virtual Visitsbull Manage and track claimsbull View ID card informationbull Find doctor and compare costs and quality ratingsbull Review your coveragebull Track your account balances and deductiblesbull Access a variety of health and wellness tools
Visit Google Play or the Apple App Store to download your carrierrsquos App
Office of Human Resources Montgomery County Government
Making Changes
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Questions
Office of Human Resources Montgomery County Government
Open Enrollment AssistanceFollow these steps (in this order)1 Review the frequently asked questions (FAQs) on the Open Enrollment website at wwwmontgomerycountymdgovoe
(available beginning September 21) You can enter key words into the interactive search bar to quickly locate the answer to your question
2 Visit the MC311 website at wwwmontgomerycountymdgovmc311 and search key words for your question The search results contain various knowledge-based articles with information related to your search words Simply click on the corresponding link and the detailed answer is revealed
3 Attend one of OHRrsquos Virtual Office Hours via Microsoft Teams Members of OHRs Health Insurance Team will be on hand to address employee questions by video or via the chat box View the schedule and access the sessions through the Open Enrollment website at wwwmontgomerycountymdgovoe (available beginning September 21)
4 If you have tried all the methods above and still have Open Enrollment-related questions please contact OHRs MC311 Customer Service Center at 240-773-6471 (Mon-Fri 8 am - 5 pm) to open a service request A member of the health insurance team will respond to service requests in the order they are received Tip Please provide an email address at the time you place your Service Request This will ensure the fastest response possible
Office of Human Resources Montgomery County Government
Online ResourcesVisit the 2021 Open Enrollment Webpage
wwwmontgomerycountymdgovOE
Visit OHRrsquos WebpagewwwmontgomerycountymdgovHR
Health Insurance active employees
Office of Human Resources Montgomery County Government
Legal InformationThe County reserves the right at any time and for any reason to amend the Program subject to the Countys collective bargainingagreements The County expects to continue the Program but it is the Countys position that there is no implied contract between individual employees and the County to do so
The County may amend the Program prospectively or retroactively to comply with applicable law
In the event of a conflict between this presentation the County Code andor the Summary Description the County Code then the Summary Description will govern
Office of Human Resources Montgomery County Government
Thank YouWe hope you enjoyed learning about 2021 Open Enrollment
~Your OHR Health Insurance Team
2021 Open Enrollment Benefits Bonanza
What Is Open Enrollment
What Changes Can be Made
Open Enrollment Dates
MCG Continues to Make Generous Employer Contributions
New for 2021
Special 2021 Plan Rates Announcement
Employee Rate Changes for Calendar Year 2021
Planning Ahead Minimizing Future Rate Increases
New for 2021
Open Enrollment Communications
Itrsquos a New Frontier
2021 Open Enrollment Checklist
Open Enrollment Website Resources
Attend a Virtual Open Enrollment Event
Make Changes Online
Paper Enrollment Form Permitted for Only Two Reasons
Dependent Eligibility
Proof of Dependent Eligibility
Marriage Certificate Example Required Documentation (Contd)
Benefits Refresher
Medical amp Rx
Medical Plan Options
Medical Benefits at-a-Glance
Medical Benefits at-a-Glance (contd)
Prescription Plans Caremark
Prescription Drug Plan Comparison
Prescription Drug Cost Comparison
Dental
Slide Number 30
Vision
Vision Insurance
Optional Life amp Dependent Life
Optional Life Insurance ADampD
Optional Life Insurance Rates
Dependent Life Insurance
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs)Why You Should Enroll
Health Care FSA
Child Care FSA
Commuter Choice Transit FSA
Using Your FSA Funds
AFLAC Voluntary Plans
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Carrier Resources amp Cost-Saving Tips
Lower Your Out-of-Pocket Costs
Built-in Wellness Support
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You Go
Making Changes
Make Changes Online
Questions
Open Enrollment Assistance
Online Resources
Legal Information
Thank You
Cigna Dental Comparison
DHMO
PPO
CIGNA NETWORK
Care-Access PlusDHMO
Total CIGNA PPOPPO
Required to Use An Assigned Provider
Yes In-network only Primary Dental Office will be assigned based on home address
No
Out of Network Benefits Available
No
Yes
Balance Billing for Covered Services
No
Yes if you go out-of-network
Referral Required
Yes
No
Orthodontia Benefits Available
Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime)
Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person)
Unlimited
$200000
Deductible (singlefamily)
None
$50 $ 150 waived for preventive care
1Claim submission would be required and balance billing may occur when visiting a nonparticipating provider2Deductible does not apply to Class I ndash Diagnostic and Preventive Services
Coverage for dependents would cease on the day which the child turns 26Benefit Maximum and Deductibles are for the period of January 01 through December 31
All services listed on this benefit summary are subject to the contractSchedules of Benefits and current Exclusions and Limitations
Medical Benefits at a Glance
Kaiser Permanente HMO + Rx wwwkporg
United HealthCare Select HMO wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS) wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS) wwwcarefirstcom
Plan Type
HMO
HMO
Point-of-Service
Point-of-Service
PCP Required
Yes
Yes
No
No
Provider Network
Regional (MDDCVA)
National
National
National
Out-of-Network Benefits
No
No
Yes
Yes
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
None
None
In-Network None Out-of-Network 80
In-Network None Out-of-Network 80
Dr Office Visits PCPSpecialist
$5 copay
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits
Covered in full
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care
$5 copay
$15 copay
Covered in full
Covered in full
Emergency Room
$50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization
Covered in full
Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
MCG 2018 Medical Plan Comparison Chart
Kaiser Permanente
United HealthCare
CareFirst POS Standard
CareFirst POS High
Plan Type
HMO
HMO
Point of Service
Point of Service
Provider Network
Regional (MDDCVA)
National
National
National
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
Annual Out-of-Pocket Maximum
None
$1100 per individual up to cap of $3600 for a family
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
Physician Servcies
PCP Office Visits
$5 copay
$5 copay PCP
In-Network $15 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Specialist Office Visits
$5 copay
$10 copay
In-Network $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Annual Physical
Covered in full
$5 copay PCP
In-Network $15 copay Primary Care Physician $30 copay specialist Out-of-Network 80 covered after deductible (limit 1calendar year)
In-Network $15 copay Out-of-Network 80 not subject to deductible (up to age 18)
In-Network $10 copay Out-of-Network 80 not subject to deductible (up to age 18)
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Allergy Testing
$5 copay
$5 copay PCP $10 copay Specialist
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Virtual Visits
Labs X-Rays Diagnostics
Outpatient labs
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient X-Rays
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Major Diagnostics
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Immedate Medical Servcies
Emergency Room
$50 copay waived if admitted to hospital
$25 copay waived if admitted to hospital $15 copay for urgent care
In-Network $35 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
Urgent Care
Hospital Services
Inpatient Hospitalization
Covered in full
Covered in full
In-Network Covered in full after $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Services
Surgery
Covered in full
Inpatient covered in full Outpatient $25 copay
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Hearing Aids
For minor children One hearing aid for each hearing impaired ear once every 36 months
For minor children One hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
Hearing Screening
$5 copay for hearing exam (hearing aids are excluded)
$5 Copay PCP $10 Copay Specialist
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
Home Health Care Services
Covered in full if medically necessary
Covered in full No copayment 60 visit maximum for skilled care services per calendar year
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
Hospice
Covered in full
Covered in full (See coverage booklet for eligibility information)
In-Network Covered in full
In-Network Covered in full
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
In vitro Fertilization
Limited to 3 attempts per live birth Lifetime maximum of $100000
Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
Mammography - Preventive Screening Schedule
Schedule consistent with the current recommendations of the American College of Physicians
Covered in full Age 35-39 one baseline mammogram Age 40-49 one mammogram every two calendar years Age 50+ one mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
Maternity
Covered in full once pregnancy is diagnosed
No copayment applies after the first visit
In-Network first visit 100 after $30 copay other visits 100
In-Network First visit 100 after $10 copay other visits 100
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Maximum Lifetime Benefit
Unlimited maximum
Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
Prescriptions
Kaiser Rx plan (included with Kaiser HMO medical plan) $5 at on-site pharmacies and for mail order $15 at participating pharmacies
No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
Rehabilitation Services
Inpatient Covered in full (unlimited) Outpatient $5 copay outpatient services for physical therapy are limited to up to 30 visits occupational and speech therapy per injury incident or condition are covered for a period not to exceed 90 days
$10 copayvisit 60 combined visits per year (short-term non-chronic conditions only)
In-Network
In-Network
100
100
Skilled Nursing Facility
Covered in full 100 days maximum
Covered in full 60 days per calendar year maximum
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Substance AbuseMental Health
Inpatient Covered in full Outpatient $5 copay
Inpatient Covered in full Outpatient $5 copay
In-Network Inpatient- $150 per admission copay Outpatient- $15 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
In-Network Inpatient- covered in full Outpatient- $10 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
Vision (Routine)
$5 copay for exams 25 discount on lensesframes at Kaiser centers 15 discount off the costs of contact lenses
$25 copay for exam 15-20 discount through participating optical centers
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
53116
Medical Benefits at a Glance
Kaiser Permanente HMO + Rx wwwkporg
United HealthCare Select HMO wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS) wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS) wwwcarefirstcom
Plan Type
HMO
HMO
Point-of-Service
Point-of-Service
PCP Required
Yes
Yes
No
No
Provider Network
Regional (MDDCVA)
National
National
National
Out-of-Network Benefits
No
No
Yes
Yes
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
None
None
In-Network None Out-of-Network 80
In-Network None Out-of-Network 80
Dr Office Visits PCPSpecialist
$5 copay
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits
Covered in full
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care
$5 copay
$15 copay
Covered in full
Covered in full
Emergency Room
$50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization
Covered in full
Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
MCG 2018 Medical Plan Comparison Chart
Kaiser Permanente
United HealthCare
CareFirst POS Standard
CareFirst POS High
Plan Type
HMO
HMO
Point of Service
Point of Service
Provider Network
Regional (MDDCVA)
National
National
National
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
Annual Out-of-Pocket Maximum
None
$1100 per individual up to cap of $3600 for a family
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
Physician Servcies
PCP Office Visits
$5 copay
$5 copay PCP
In-Network $15 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Specialist Office Visits
$5 copay
$10 copay
In-Network $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Annual Physical
Covered in full
$5 copay PCP
In-Network $15 copay Primary Care Physician $30 copay specialist Out-of-Network 80 covered after deductible (limit 1calendar year)
In-Network $15 copay Out-of-Network 80 not subject to deductible (up to age 18)
In-Network $10 copay Out-of-Network 80 not subject to deductible (up to age 18)
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Allergy Testing
$5 copay
$5 copay PCP $10 copay Specialist
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Virtual Visits
Labs X-Rays Diagnostics
Outpatient labs
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient X-Rays
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Major Diagnostics
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Immedate Medical Servcies
Emergency Room
$50 copay waived if admitted to hospital
$25 copay waived if admitted to hospital $15 copay for urgent care
In-Network $35 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
Urgent Care
Hospital Services
Inpatient Hospitalization
Covered in full
Covered in full
In-Network Covered in full after $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Services
Surgery
Covered in full
Inpatient covered in full Outpatient $25 copay
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Hearing Aids
For minor children One hearing aid for each hearing impaired ear once every 36 months
For minor children One hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
Hearing Screening
$5 copay for hearing exam (hearing aids are excluded)
$5 Copay PCP $10 Copay Specialist
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
Home Health Care Services
Covered in full if medically necessary
Covered in full No copayment 60 visit maximum for skilled care services per calendar year
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
Hospice
Covered in full
Covered in full (See coverage booklet for eligibility information)
In-Network Covered in full
In-Network Covered in full
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
In vitro Fertilization
Limited to 3 attempts per live birth Lifetime maximum of $100000
Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
Mammography - Preventive Screening Schedule
Schedule consistent with the current recommendations of the American College of Physicians
Covered in full Age 35-39 one baseline mammogram Age 40-49 one mammogram every two calendar years Age 50+ one mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
Maternity
Covered in full once pregnancy is diagnosed
No copayment applies after the first visit
In-Network first visit 100 after $30 copay other visits 100
In-Network First visit 100 after $10 copay other visits 100
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Maximum Lifetime Benefit
Unlimited maximum
Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
Prescriptions
Kaiser Rx plan (included with Kaiser HMO medical plan) $5 at on-site pharmacies and for mail order $15 at participating pharmacies
No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
Rehabilitation Services
Inpatient Covered in full (unlimited) Outpatient $5 copay outpatient services for physical therapy are limited to up to 30 visits occupational and speech therapy per injury incident or condition are covered for a period not to exceed 90 days
$10 copayvisit 60 combined visits per year (short-term non-chronic conditions only)
In-Network
In-Network
100
100
Skilled Nursing Facility
Covered in full 100 days maximum
Covered in full 60 days per calendar year maximum
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Substance AbuseMental Health
Inpatient Covered in full Outpatient $5 copay
Inpatient Covered in full Outpatient $5 copay
In-Network Inpatient- $150 per admission copay Outpatient- $15 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
In-Network Inpatient- covered in full Outpatient- $10 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
Vision (Routine)
$5 copay for exams 25 discount on lensesframes at Kaiser centers 15 discount off the costs of contact lenses
$25 copay for exam 15-20 discount through participating optical centers
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
53116
Office of Human Resources Montgomery County Government
Planning Ahead Minimizing Future Rate IncreasesHere are ways employees can work together with MCG to keep future plan rate increases at a minimumbull Seek out preventive care such as annual exams and age-based screeningsbull Visit in-network doctors via virtual visitsbull Use urgent care facilities for non-emergent services rather than going to the
emergency roombull Choose generic prescription drugsbull Maximize wellness resources through health insurance carriers and MCGrsquos LiveWell
program
Office of Human Resources Montgomery County Government
New for 2021bull All Open Enrollment events held virtually this yearMCGrsquos carriers will be hosting virtual presentations and QampA sessionsOHR Virtual Office Hours
bull Health Care FSA changesAnnual contribution limit increasing to $2750Over-the-counter expenses are permitted without a written prescription Feminine products are now an eligible expense
bull New Open Enrollment Communication MethodsBenefits Bites delivered in the MCG Employee Connect newsletter Enhanced Open Enrollment website
bull Frequently Asked Questionsbull MCG employee discount amp resource section bull Employee self-service (ESS) instructions and demonstrationsbull MCG vendor video presentations
Office of Human Resources Montgomery County Government
Open Enrollment Communications bull 2021 Open Enrollment Guides were mailed to homes on September 11
Employees should receive the guides between September 14 ndash 16
bull Employees are encouraged to check their County email during and after Open EnrollmentOpen Enrollment email series featuring news and remindersMCG Employee Connect newsletter sharing Open Enrollment news in the Benefits Bites
sectionAfter Open Enrollment ends MetLife will email employees who elected or increased
Optional Life to complete a Statement of Health online
bull The Open Enrollment Website is a dedicated resource for all Open Enrollment needsAvailable Monday September 21 at 8 am
Office of Human Resources Montgomery County Government
Itrsquos a New Frontier COVID-19 has changed the way we utilize our plans MCGrsquos health insurance plans offer many value-added services and discounts to provide employees with support This year more than ever it is important to know our resources
bull Virtual doctor visits bull Built-in emotional amp wellness supportbull Disease management bull Lifestyle coachingbull Stress relief appsbull Discounts and more
Please see the 2021 Open Enrollment guide for additional information
Office of Human Resources Montgomery County Government
2021 Open Enrollment ChecklistTake Action Early Follow these steps for a successful Open Enrollment1 Review available resources
bull 2021 Open Enrollment Guide (mailed to homes on September 11th)bull Open Enrollment Websitebull County Email for Important Updates and Follow-Ups bull Benefits Bites Section of the MCG Employee Connect Newsletter
2 Attend a virtual Open Enrollment event3 Attend OHR virtual office hours4 Make changes online amp print Confirmation Statement5 (Re)Enroll in Flexible Spending Accounts (FSAs) and check FSA contribution
amounts
Office of Human Resources Montgomery County Government
Open Enrollment Website Resources Visit the Open Enrollment website for a variety of planning tools amp resources Open Enrollment schedule of virtual events Open Enrollment frequently asked questions 2021 Employee Self-Service (ESS) instruction video amp written instructions Side-by-side plan comparisons Life insurance needs estimator FSA tax savings calculator MCG employee discounts amp resources and more
Office of Human Resources Montgomery County Government
Attend a Virtual Open Enrollment Event bull Insurance Carrier Virtual Presentations and QampA Sessions Visit the Open Enrollment website for full schedule of events
bull Attend OHR Virtual Office Hours Virtual Office Hours SchedulePlease note Virtual Office Hours are held in a public virtual meeting If questions will
reveal any personal PHI (protected health information) such as a chronic medical condition or names of specific prescription drugs employees should direct those questions to OHRrsquos customer service center at 240-773-6471 to place a service request
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Paper Enrollment Form Permitted for Only Two ReasonsThere are only two exceptions permitting the use of paper Open Enrollment forms
bull Technical barriers preventing access to ESS (only in the event of no internet no smartphone or computer) the employee should contact MC311 and place a service request to be mailed a paper enrollment form Call 240-773-OHR1 (240-773-6471) available Monday through Friday 8 am to 5 pm
bull Experiencing a Life Event If an employee has a qualified status change (life event) during Open Enrollment they cannot make changes using the Open Enrollment form or online system Instead they should contact the OHR Health Insurance Team via MC311 to make changes Qualifying life events marriage divorce the birth of a child or the death of spouse or a
dependent aging out
Office of Human Resources Montgomery County Government
Dependent EligibilityEligible dependents for medical prescription dental and vision coverage arebull Spouse
Legally married EligibleDivorced Not Eligible
bull Children (biological legally adopted stepchildren or under your legal custody)Under age 26 EligibleAge 26 and over Not Eligible unless incapable of self support
Proof of eligible dependents is required
Office of Human Resources Montgomery County Government
Proof of Dependent EligibilityEmployees enrolling new dependents during Open Enrollment must upload the necessary dependent documentation in ESS prior to October 9 at 5 pmRequired Documentationbull Spouse Official State Marriage Certificate (certified by appropriate State or County Official)bull Biological Child State Birth Certificate (For newborns OHR will accept hospital discharge papers for first 60 days birth
certificate must then be submitted)bull Adopted Child Copy of Adoption or Placement for Adoption Papers bull Step-Child State Birth Certificate Marriage Certificate and Divorce Decree or Custody Papers bull Disabled Child Medical plan verification of disability prior to age 26 bull Legal Custody Copy of Court Order granting legal custody
Office of Human Resources Montgomery County Government
Marriage Certificate Example Required Documentation (Contd)
Office of Human Resources Montgomery County Government
Benefits Refresher
Office of Human Resources Montgomery County Government
Medical amp Rx
Office of Human Resources Montgomery County Government
Medical Plan OptionsHealth Maintenance Organizations (HMO)bull Kaiser Permanente Signature (HMO)bull United Healthcare Select (HMO)
Point of Service Plans (POS)bull CareFirst BCBS (POS) High Optionbull CareFirst BCBS (POS) Standard Option
Three tiers of coverage Self Self + 1 or Family
Office of Human Resources Montgomery County Government
Medical Benefits at-a-Glance To view full carrier medical summaries visit OHRrsquos Health Insurance Website
Kaiser Permanente HMO + Rx
wwwkporg
United HealthCare Select HMO
wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS)
wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS)
wwwcarefirstcom
Plan Type HMO HMO Point-of-Service Point-of-Service
PCP Required Yes Yes No No
Provider Network Regional (MDDCVA) National National National
Out-of-Network Benefits No No Yes Yes
Referrals Required Yes No No No
Annual Deductible None NoneIn-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Sheet1
Sheet1 (2)
Office of Human Resources Montgomery County Government
Medical Benefits at-a-Glance (contd)
New Employee Orientation Program
Kaiser Permanente HMO + Rx
wwwkporg
United HealthCare Select HMO
wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS)
wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS)
wwwcarefirstcom
Dr Office Visits PCPSpecialist $5 copay $5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits Covered in full $5 copay $10 copay In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care $5 copay $15 copay Covered in full Covered in full
Emergency Room $50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization Covered in full Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
Visit OHRrsquos Health Insurance webpage to view Medical summaries
Sheet1
Sheet1 (2)
Office of Human Resources Montgomery County Government
Prescription Plans Caremarkbull Two Rx Plan OptionsStandardHigh
bull If you elect UHC or CareFirst and want Rx coverage you will need to elect the stand-alone Caremark Rx plan (Kaiser already includes Rx coverage)
bull Maintenance Choice Program available for maintenance drugs significant cost savings ndash 1 copay for each 90-day prescription In order to get the Maintenance pricing you must fil Rx at CVS retail pharmacy Mail order
Office of Human Resources Montgomery County Government
Prescription Drug Plan Comparison High Option $48
Only MCGEOIAFF employees can enroll in this High plan
High Option $510Only FOPNON-REP employees
can enroll in this High plan
Standard Option All employees can enroll in this
Standard plan
Copay $4 Generics$8 Brand Name
$5 Generics$10 Brand Name
$10 Generics$20 PBrand Name
$35 NPBrand NameDeductible na na $50yearMail Order Yes Yes Yes
Maintenance Choice Yes Yes YesCovered Drugs Same Same Same
Visit OHRrsquos Health Insurance Website to view Rx summaries
Office of Human Resources Montgomery County Government
Prescription Drug Cost Comparison Cost
High Option $48Only MCGEOIAFF employees
can enroll in this High plan
High Option $510Only FOPNON-REP employees
can enroll in this High plan
Standard Option All employees can enroll in this
Standard plan
Self Only
Bi-Weekly $11339Monthly $24568Yearly $294814
Bi-Weekly $11100Monthly $24050Yearly $288600
Bi-Weekly $2413Monthly $5258Yearly $62738
Self + 1
Bi-Weekly $20979Monthly $45455Yearly $545454
Bi-Weekly $20536Monthly $44495Yearly $533936
Bi-Weekly $4463Monthly $9670
Yearly $116038
Self + Family
Bi-Weekly $32511Monthly $70441Yearly $845286
Bi-Weekly $31824Monthly $68952Yearly $827424
Bi-Weekly $6916Monthly $14985Yearly $179816
Office of Human Resources Montgomery County Government
Dental
Office of Human Resources Montgomery County Government
Dental Comparison Cigna
For a list of HMO covered services and assigned costs (copays) view the HMO benefit summary
Required to Use An Assigned Provider Yes In-network only Primary Dental Office will be
assigned based on home address
No
Out of Network Benefits Available No Yes
Balance Billing for Covered Services No Yes if you go out-of-network
Referral Required Yes No
Orthodontia Benefits Available Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime) Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person) Unlimited $200000
Deductible (singlefamily) None $50 $ 150 waived for preventive care
Table 1
Office of Human Resources Montgomery County Government
Vision
Office of Human Resources Montgomery County Government
Vision Insurancebull The Countyrsquos Vision carrier is EyeMedbull Benefits payable for exams lenses and contacts (elective or necessary) every
calendar year frames every two calendar yearsbull In-network or out-of-network benefits available bull Enhanced Hearing Benefit through EyeMedrsquos partner Amplifon40 off hearing examDiscounted pricing on thousands of hearing aids including latest technologyOne-year free follow-up care with unlimited appointmentsFree batteries for two years with initial purchase Three-year warranty and loss and damage coverage
Visit OHRrsquos Health Insurance webpage to view vision summary
Office of Human Resources Montgomery County Government
Optional Life amp Dependent Life
Office of Human Resources Montgomery County Government
Optional Life Insurance ADampDbull You may elect Optional Life ADampD coverage for yourself in increments of 1 to 8 times
your basic annual earnings ($1 million maximum)
bull NOTE Coverage is not guaranteed issue for any level You must complete an online Statement of Health no matter what level of coverage you elect Later this fall after Open Enrollment ends you will receive an email from MetLife with a link to complete the Statement of Health online
bull An eligible dependent is defined as 1) your opposite or same sex spouse or 2) your unmarried children under age 26 (natural adopted or stepchildrenfoster children who depend on your support)
Office of Human Resources Montgomery County Government
Optional Life Insurance RatesHow to estimate your Optional Life Insurance bi-weekly rate
Example 40-year-old applying for 2 x salary Salary is $49300
Steps Example Calculate for Yourself
A Find your age-based rate on the rate sheet (left) $ 0037 $_________________
B Choose how much coverage you are applying for
$99000 (2 x salary rounded to the nearest $1000 ) $_________________
C Divide that coverage amount by 100099 ($99000 1000) $_________________
D Multiply A x C for estimated bi-weekly cost$366 ($037 x 99) $_________________
Office of Human Resources Montgomery County Government
Dependent Life InsuranceYou may also purchase Dependent Optional Life insurance forbull Your opposite or same sex spouse bull Your unmarried children under age 26
ndash Natural adoptedndash Stepchildrenfoster childrenNote you do not need to supply marriage certificatesbirth certificates for dependent optional life
You may electbull $2000 Spouse$1000 Childbull $4000 Spouse $2000 Childbull $10000 Spouse $5000 Child
The bi-weekly rate is not based on salary
Office of Human Resources Montgomery County Government
Flexible Spending Accounts
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Visit the Open Enrollment website to watch a recorded FSA presentation from MCGrsquos FSA vendor Benefit Strategies
bull What is an FSA It is an IRS-approved tax-free account that saves onQualified out-of-pocket medical and dependent care expensesFederal and State Income taxSocial Security Tax
bull 3 Account Options Health Care FSA Child Care FSA and Commuter Choice Transit bull FSA accounts are administered through Benefit Strategies bull FSAs are ldquouse-it or lose-itrdquo accounts claims must be incurred during the 2021 plan year (January 1
2021 ndash March 15 2022) and submitted by April 30 2022
IMPORTANT You must re-enroll in an FSA every Open Enrollment if you want to participate in the upcoming plan year
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Why You Should EnrollGive yourself a raise by reducing your taxesbull Elect the annual amount you want to place in your FSA(s) for the upcoming plan year during Open Enrollmentbull That amount is divided by 26 and taken from your biweekly paychecks on a pre-tax basis (21 paychecks for
10-month employees)bull Then use your pre-tax FSA dollars to pay for eligible out-of-pocket health care child-care or transit
expenses
Office of Human Resources Montgomery County Government
Health Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull Claims must be submitted by April 30 of the following yearbull You may elect to contribute up to $2750 Your total annual election amount is available to spend on the first
day of the new plan year bull FSA debit card allows you to pay for expenses at the time of servicebull Examples of IRS qualified eligible expenses
bull Copays (medical prescription dental vision) deductibles and coinsurance amounts over reasonable and customary charge
bull Hearing aids bull Acupuncture bull Orthopedic shoes bull Over-the-counter (OTC) drugs (no longer require doctorrsquos prescription)
Office of Human Resources Montgomery County Government
Child Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull $5000 annual maximum per household ($2500 for married filing separately)bull Funds are available to spend as they are accumulated through payroll deductionsbull Reimbursable expenses
bull day care centersbull elder carebull beforeafter school carebull babysitter fees that allow you and your spouse to work or go to school (no child support payments)
bull Qualifying dependentsbull Children under the age of 13 and are a tax dependent of the employeebull Spouse or tax dependent that is physically or mentally incapable of self-care
bull Must coordinate between filing a tax credit with IRS and your Dependent Care FSA plan
Office of Human Resources Montgomery County Government
Commuter Choice Transit FSAbull $230 per month maximum for MCGEO staff $260 per month maximum for Unrepresented staffbull Applies to employee commuting expenses only (not spouses or dependents)bull Can enroll throughout the year (not limited to Open Enrollment election)bull Eligible expenses include Metro Marc Vanpool Lyft Line Uber Poolbull Debit card ndash may be used for some expenses (not Metro)Metro riders will have to submit claim forms for reimbursement
bull Funds must be used within 180 days of election bull If retiring or leaving the County will need to coordinate use all available funds
Office of Human Resources Montgomery County Government
Using Your FSA FundsHealth Care FSA Your full annual election amount is available on the first day of the plan yearChild Care FSA Your funds are available as they accumulate through payroll deductionsCommuterTransit FSA Your funds are available as they accumulate through payroll deductions
The FSA Debit Card bull Your FSA debit card is the same card for your Health Care Child Care and TransitCommuter FSA accountsbull The card is pre-loaded with your full annual Health Care FSA election amount You can use the card to pay for IRS qualified expenses at
the time of service or when paying a bill Receipt notifications will be mailed to you monthly by Benefit Strategies Your response to receipt notifications is necessary under the provisions of the plan No response my result in the ineligibility of the purchase and as a result your card may be temporarily deactivated
bull If you are enrolled in the Child Care FSA the card can also be used in child-care settings Just remember that the card will only work for an amount that does not exceed the available balance in your Child Care FSA account on that day
bull The card can also be used to pay for your commutertransit expenses however it does not work for WMATA metro Metro riders will have to submit manual claims for reimbursement from your CommuterTransit FSA
bull Cards are re-loaded each year after you make your new annual election Please keep your cards You will only receive a new card if your old card is about to expire
Office of Human Resources Montgomery County Government
AFLAC Voluntary Plans
Office of Human Resources Montgomery County Government
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Short-Term Disabilitybull Provides short-term cash benefits in the event of disabilitybull Monthly benefit amounts available from $500 - $6000 (subject to income requirements)bull Benefit options of 3 6 12 18 or 24 months with a variety of elimination periods
Critical Illness Insurancebull Provides a lump sum cash benefit in the event of critical illnessbull Benefit amounts available in $5000 increments from $10000 - $30000
Participants pay 100 through payroll deduction for Short-Term Disability and Critical Illness Insurance
To ENROLL Text SETAPPTrdquo to 41411orCall 920-420-8861 orEmail susan_mcdanielusAflaccom
Office of Human Resources Montgomery County Government
Carrier Resources amp Cost-Saving Tips
Office of Human Resources Montgomery County Government
Lower Your Out-of-Pocket CostsChoose the plan thatrsquos right for youbull See the medical benefits chart for options bull Stay in network Use the provider search engines on your carrier website or mobile app to find in-network providersSeek preventive carebull Check-ups immunizations and screenings are an important part of staying healthy They can detect or prevent serious diseases and keep you healthyKnow where to go for carebull You have many options of places to go when you need care If your medical condition isnrsquot serious or life threatening you can save money by connecting
with a doctor online through a virtual visit or going to an urgent care center or convenience care clinic instead of a hospital emergency roomReview your prescription drug plan optionsbull Decide which Caremark prescription plan is best for you Note that the Kaiser HMO includes prescription drug coverage Both the Standard and High
Option Caremark plans cover the same prescription drugs but have different copay and deductiblesUse generic and long-term prescriptions bull Opt for lower-cost generic drugs whenever possible bull Ask your doctor to write a 90-day prescription instead of a 30-day prescription to participate in the mail order prescription programTake advantage of tax savings by participating in Flexible Spending Accountsbull Use pre-tax dollars for eligible out of pocket services and items
Office of Human Resources Montgomery County Government
Built-in Wellness Support Take advantage of the free programs available to you through your medical carrier Each of MCGrsquos medical carriers (Kaiser UHC amp CareFirst) offer valuable programs to help you manage your health
Disease Management Programsbull Help manage your chronic condition through personalized coaching support and encouragement and online education materialsEmotional Wellness amp Stress Management Support bull Help manage stress through mobile apps and other self-care resources Maternity Programsbull Support healthy moms and healthy babiesWeight-loss Programs bull Offers telephonic coaching support and web-based tools to help ensure long-term weight managementbull See the next slide for an example of an MCG success storySmoking Cessation Programsbull Supportive coaching to make quitting more successfulDiscounts bull Gym memberships weight loss programs and moreFor more information about the programs available to you please see the Open Enrollment Guide and contact your medical carrier
Office of Human Resources Montgomery County Government
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You GoAll of MCGrsquos health insurance carriers offer a simple-to-use tool that can help make your life easier while yoursquore on the go Download your carrierrsquos Mobile App to help you personalize organize and access your important plan information on your phone or tablet
bull Schedule Virtual Visitsbull Manage and track claimsbull View ID card informationbull Find doctor and compare costs and quality ratingsbull Review your coveragebull Track your account balances and deductiblesbull Access a variety of health and wellness tools
Visit Google Play or the Apple App Store to download your carrierrsquos App
Office of Human Resources Montgomery County Government
Making Changes
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Questions
Office of Human Resources Montgomery County Government
Open Enrollment AssistanceFollow these steps (in this order)1 Review the frequently asked questions (FAQs) on the Open Enrollment website at wwwmontgomerycountymdgovoe
(available beginning September 21) You can enter key words into the interactive search bar to quickly locate the answer to your question
2 Visit the MC311 website at wwwmontgomerycountymdgovmc311 and search key words for your question The search results contain various knowledge-based articles with information related to your search words Simply click on the corresponding link and the detailed answer is revealed
3 Attend one of OHRrsquos Virtual Office Hours via Microsoft Teams Members of OHRs Health Insurance Team will be on hand to address employee questions by video or via the chat box View the schedule and access the sessions through the Open Enrollment website at wwwmontgomerycountymdgovoe (available beginning September 21)
4 If you have tried all the methods above and still have Open Enrollment-related questions please contact OHRs MC311 Customer Service Center at 240-773-6471 (Mon-Fri 8 am - 5 pm) to open a service request A member of the health insurance team will respond to service requests in the order they are received Tip Please provide an email address at the time you place your Service Request This will ensure the fastest response possible
Office of Human Resources Montgomery County Government
Online ResourcesVisit the 2021 Open Enrollment Webpage
wwwmontgomerycountymdgovOE
Visit OHRrsquos WebpagewwwmontgomerycountymdgovHR
Health Insurance active employees
Office of Human Resources Montgomery County Government
Legal InformationThe County reserves the right at any time and for any reason to amend the Program subject to the Countys collective bargainingagreements The County expects to continue the Program but it is the Countys position that there is no implied contract between individual employees and the County to do so
The County may amend the Program prospectively or retroactively to comply with applicable law
In the event of a conflict between this presentation the County Code andor the Summary Description the County Code then the Summary Description will govern
Office of Human Resources Montgomery County Government
Thank YouWe hope you enjoyed learning about 2021 Open Enrollment
~Your OHR Health Insurance Team
2021 Open Enrollment Benefits Bonanza
What Is Open Enrollment
What Changes Can be Made
Open Enrollment Dates
MCG Continues to Make Generous Employer Contributions
New for 2021
Special 2021 Plan Rates Announcement
Employee Rate Changes for Calendar Year 2021
Planning Ahead Minimizing Future Rate Increases
New for 2021
Open Enrollment Communications
Itrsquos a New Frontier
2021 Open Enrollment Checklist
Open Enrollment Website Resources
Attend a Virtual Open Enrollment Event
Make Changes Online
Paper Enrollment Form Permitted for Only Two Reasons
Dependent Eligibility
Proof of Dependent Eligibility
Marriage Certificate Example Required Documentation (Contd)
Benefits Refresher
Medical amp Rx
Medical Plan Options
Medical Benefits at-a-Glance
Medical Benefits at-a-Glance (contd)
Prescription Plans Caremark
Prescription Drug Plan Comparison
Prescription Drug Cost Comparison
Dental
Slide Number 30
Vision
Vision Insurance
Optional Life amp Dependent Life
Optional Life Insurance ADampD
Optional Life Insurance Rates
Dependent Life Insurance
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs)Why You Should Enroll
Health Care FSA
Child Care FSA
Commuter Choice Transit FSA
Using Your FSA Funds
AFLAC Voluntary Plans
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Carrier Resources amp Cost-Saving Tips
Lower Your Out-of-Pocket Costs
Built-in Wellness Support
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You Go
Making Changes
Make Changes Online
Questions
Open Enrollment Assistance
Online Resources
Legal Information
Thank You
Cigna Dental Comparison
DHMO
PPO
CIGNA NETWORK
Care-Access PlusDHMO
Total CIGNA PPOPPO
Required to Use An Assigned Provider
Yes In-network only Primary Dental Office will be assigned based on home address
No
Out of Network Benefits Available
No
Yes
Balance Billing for Covered Services
No
Yes if you go out-of-network
Referral Required
Yes
No
Orthodontia Benefits Available
Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime)
Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person)
Unlimited
$200000
Deductible (singlefamily)
None
$50 $ 150 waived for preventive care
1Claim submission would be required and balance billing may occur when visiting a nonparticipating provider2Deductible does not apply to Class I ndash Diagnostic and Preventive Services
Coverage for dependents would cease on the day which the child turns 26Benefit Maximum and Deductibles are for the period of January 01 through December 31
All services listed on this benefit summary are subject to the contractSchedules of Benefits and current Exclusions and Limitations
Medical Benefits at a Glance
Kaiser Permanente HMO + Rx wwwkporg
United HealthCare Select HMO wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS) wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS) wwwcarefirstcom
Plan Type
HMO
HMO
Point-of-Service
Point-of-Service
PCP Required
Yes
Yes
No
No
Provider Network
Regional (MDDCVA)
National
National
National
Out-of-Network Benefits
No
No
Yes
Yes
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
None
None
In-Network None Out-of-Network 80
In-Network None Out-of-Network 80
Dr Office Visits PCPSpecialist
$5 copay
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits
Covered in full
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care
$5 copay
$15 copay
Covered in full
Covered in full
Emergency Room
$50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization
Covered in full
Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
MCG 2018 Medical Plan Comparison Chart
Kaiser Permanente
United HealthCare
CareFirst POS Standard
CareFirst POS High
Plan Type
HMO
HMO
Point of Service
Point of Service
Provider Network
Regional (MDDCVA)
National
National
National
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
Annual Out-of-Pocket Maximum
None
$1100 per individual up to cap of $3600 for a family
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
Physician Servcies
PCP Office Visits
$5 copay
$5 copay PCP
In-Network $15 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Specialist Office Visits
$5 copay
$10 copay
In-Network $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Annual Physical
Covered in full
$5 copay PCP
In-Network $15 copay Primary Care Physician $30 copay specialist Out-of-Network 80 covered after deductible (limit 1calendar year)
In-Network $15 copay Out-of-Network 80 not subject to deductible (up to age 18)
In-Network $10 copay Out-of-Network 80 not subject to deductible (up to age 18)
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Allergy Testing
$5 copay
$5 copay PCP $10 copay Specialist
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Virtual Visits
Labs X-Rays Diagnostics
Outpatient labs
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient X-Rays
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Major Diagnostics
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Immedate Medical Servcies
Emergency Room
$50 copay waived if admitted to hospital
$25 copay waived if admitted to hospital $15 copay for urgent care
In-Network $35 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
Urgent Care
Hospital Services
Inpatient Hospitalization
Covered in full
Covered in full
In-Network Covered in full after $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Services
Surgery
Covered in full
Inpatient covered in full Outpatient $25 copay
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Hearing Aids
For minor children One hearing aid for each hearing impaired ear once every 36 months
For minor children One hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
Hearing Screening
$5 copay for hearing exam (hearing aids are excluded)
$5 Copay PCP $10 Copay Specialist
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
Home Health Care Services
Covered in full if medically necessary
Covered in full No copayment 60 visit maximum for skilled care services per calendar year
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
Hospice
Covered in full
Covered in full (See coverage booklet for eligibility information)
In-Network Covered in full
In-Network Covered in full
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
In vitro Fertilization
Limited to 3 attempts per live birth Lifetime maximum of $100000
Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
Mammography - Preventive Screening Schedule
Schedule consistent with the current recommendations of the American College of Physicians
Covered in full Age 35-39 one baseline mammogram Age 40-49 one mammogram every two calendar years Age 50+ one mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
Maternity
Covered in full once pregnancy is diagnosed
No copayment applies after the first visit
In-Network first visit 100 after $30 copay other visits 100
In-Network First visit 100 after $10 copay other visits 100
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Maximum Lifetime Benefit
Unlimited maximum
Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
Prescriptions
Kaiser Rx plan (included with Kaiser HMO medical plan) $5 at on-site pharmacies and for mail order $15 at participating pharmacies
No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
Rehabilitation Services
Inpatient Covered in full (unlimited) Outpatient $5 copay outpatient services for physical therapy are limited to up to 30 visits occupational and speech therapy per injury incident or condition are covered for a period not to exceed 90 days
$10 copayvisit 60 combined visits per year (short-term non-chronic conditions only)
In-Network
In-Network
100
100
Skilled Nursing Facility
Covered in full 100 days maximum
Covered in full 60 days per calendar year maximum
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Substance AbuseMental Health
Inpatient Covered in full Outpatient $5 copay
Inpatient Covered in full Outpatient $5 copay
In-Network Inpatient- $150 per admission copay Outpatient- $15 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
In-Network Inpatient- covered in full Outpatient- $10 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
Vision (Routine)
$5 copay for exams 25 discount on lensesframes at Kaiser centers 15 discount off the costs of contact lenses
$25 copay for exam 15-20 discount through participating optical centers
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
53116
Medical Benefits at a Glance
Kaiser Permanente HMO + Rx wwwkporg
United HealthCare Select HMO wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS) wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS) wwwcarefirstcom
Plan Type
HMO
HMO
Point-of-Service
Point-of-Service
PCP Required
Yes
Yes
No
No
Provider Network
Regional (MDDCVA)
National
National
National
Out-of-Network Benefits
No
No
Yes
Yes
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
None
None
In-Network None Out-of-Network 80
In-Network None Out-of-Network 80
Dr Office Visits PCPSpecialist
$5 copay
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits
Covered in full
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care
$5 copay
$15 copay
Covered in full
Covered in full
Emergency Room
$50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization
Covered in full
Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
MCG 2018 Medical Plan Comparison Chart
Kaiser Permanente
United HealthCare
CareFirst POS Standard
CareFirst POS High
Plan Type
HMO
HMO
Point of Service
Point of Service
Provider Network
Regional (MDDCVA)
National
National
National
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
Annual Out-of-Pocket Maximum
None
$1100 per individual up to cap of $3600 for a family
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
Physician Servcies
PCP Office Visits
$5 copay
$5 copay PCP
In-Network $15 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Specialist Office Visits
$5 copay
$10 copay
In-Network $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Annual Physical
Covered in full
$5 copay PCP
In-Network $15 copay Primary Care Physician $30 copay specialist Out-of-Network 80 covered after deductible (limit 1calendar year)
In-Network $15 copay Out-of-Network 80 not subject to deductible (up to age 18)
In-Network $10 copay Out-of-Network 80 not subject to deductible (up to age 18)
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Allergy Testing
$5 copay
$5 copay PCP $10 copay Specialist
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Virtual Visits
Labs X-Rays Diagnostics
Outpatient labs
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient X-Rays
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Major Diagnostics
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Immedate Medical Servcies
Emergency Room
$50 copay waived if admitted to hospital
$25 copay waived if admitted to hospital $15 copay for urgent care
In-Network $35 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
Urgent Care
Hospital Services
Inpatient Hospitalization
Covered in full
Covered in full
In-Network Covered in full after $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Services
Surgery
Covered in full
Inpatient covered in full Outpatient $25 copay
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Hearing Aids
For minor children One hearing aid for each hearing impaired ear once every 36 months
For minor children One hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
Hearing Screening
$5 copay for hearing exam (hearing aids are excluded)
$5 Copay PCP $10 Copay Specialist
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
Home Health Care Services
Covered in full if medically necessary
Covered in full No copayment 60 visit maximum for skilled care services per calendar year
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
Hospice
Covered in full
Covered in full (See coverage booklet for eligibility information)
In-Network Covered in full
In-Network Covered in full
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
In vitro Fertilization
Limited to 3 attempts per live birth Lifetime maximum of $100000
Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
Mammography - Preventive Screening Schedule
Schedule consistent with the current recommendations of the American College of Physicians
Covered in full Age 35-39 one baseline mammogram Age 40-49 one mammogram every two calendar years Age 50+ one mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
Maternity
Covered in full once pregnancy is diagnosed
No copayment applies after the first visit
In-Network first visit 100 after $30 copay other visits 100
In-Network First visit 100 after $10 copay other visits 100
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Maximum Lifetime Benefit
Unlimited maximum
Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
Prescriptions
Kaiser Rx plan (included with Kaiser HMO medical plan) $5 at on-site pharmacies and for mail order $15 at participating pharmacies
No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
Rehabilitation Services
Inpatient Covered in full (unlimited) Outpatient $5 copay outpatient services for physical therapy are limited to up to 30 visits occupational and speech therapy per injury incident or condition are covered for a period not to exceed 90 days
$10 copayvisit 60 combined visits per year (short-term non-chronic conditions only)
In-Network
In-Network
100
100
Skilled Nursing Facility
Covered in full 100 days maximum
Covered in full 60 days per calendar year maximum
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Substance AbuseMental Health
Inpatient Covered in full Outpatient $5 copay
Inpatient Covered in full Outpatient $5 copay
In-Network Inpatient- $150 per admission copay Outpatient- $15 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
In-Network Inpatient- covered in full Outpatient- $10 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
Vision (Routine)
$5 copay for exams 25 discount on lensesframes at Kaiser centers 15 discount off the costs of contact lenses
$25 copay for exam 15-20 discount through participating optical centers
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
53116
Office of Human Resources Montgomery County Government
New for 2021bull All Open Enrollment events held virtually this yearMCGrsquos carriers will be hosting virtual presentations and QampA sessionsOHR Virtual Office Hours
bull Health Care FSA changesAnnual contribution limit increasing to $2750Over-the-counter expenses are permitted without a written prescription Feminine products are now an eligible expense
bull New Open Enrollment Communication MethodsBenefits Bites delivered in the MCG Employee Connect newsletter Enhanced Open Enrollment website
bull Frequently Asked Questionsbull MCG employee discount amp resource section bull Employee self-service (ESS) instructions and demonstrationsbull MCG vendor video presentations
Office of Human Resources Montgomery County Government
Open Enrollment Communications bull 2021 Open Enrollment Guides were mailed to homes on September 11
Employees should receive the guides between September 14 ndash 16
bull Employees are encouraged to check their County email during and after Open EnrollmentOpen Enrollment email series featuring news and remindersMCG Employee Connect newsletter sharing Open Enrollment news in the Benefits Bites
sectionAfter Open Enrollment ends MetLife will email employees who elected or increased
Optional Life to complete a Statement of Health online
bull The Open Enrollment Website is a dedicated resource for all Open Enrollment needsAvailable Monday September 21 at 8 am
Office of Human Resources Montgomery County Government
Itrsquos a New Frontier COVID-19 has changed the way we utilize our plans MCGrsquos health insurance plans offer many value-added services and discounts to provide employees with support This year more than ever it is important to know our resources
bull Virtual doctor visits bull Built-in emotional amp wellness supportbull Disease management bull Lifestyle coachingbull Stress relief appsbull Discounts and more
Please see the 2021 Open Enrollment guide for additional information
Office of Human Resources Montgomery County Government
2021 Open Enrollment ChecklistTake Action Early Follow these steps for a successful Open Enrollment1 Review available resources
bull 2021 Open Enrollment Guide (mailed to homes on September 11th)bull Open Enrollment Websitebull County Email for Important Updates and Follow-Ups bull Benefits Bites Section of the MCG Employee Connect Newsletter
2 Attend a virtual Open Enrollment event3 Attend OHR virtual office hours4 Make changes online amp print Confirmation Statement5 (Re)Enroll in Flexible Spending Accounts (FSAs) and check FSA contribution
amounts
Office of Human Resources Montgomery County Government
Open Enrollment Website Resources Visit the Open Enrollment website for a variety of planning tools amp resources Open Enrollment schedule of virtual events Open Enrollment frequently asked questions 2021 Employee Self-Service (ESS) instruction video amp written instructions Side-by-side plan comparisons Life insurance needs estimator FSA tax savings calculator MCG employee discounts amp resources and more
Office of Human Resources Montgomery County Government
Attend a Virtual Open Enrollment Event bull Insurance Carrier Virtual Presentations and QampA Sessions Visit the Open Enrollment website for full schedule of events
bull Attend OHR Virtual Office Hours Virtual Office Hours SchedulePlease note Virtual Office Hours are held in a public virtual meeting If questions will
reveal any personal PHI (protected health information) such as a chronic medical condition or names of specific prescription drugs employees should direct those questions to OHRrsquos customer service center at 240-773-6471 to place a service request
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Paper Enrollment Form Permitted for Only Two ReasonsThere are only two exceptions permitting the use of paper Open Enrollment forms
bull Technical barriers preventing access to ESS (only in the event of no internet no smartphone or computer) the employee should contact MC311 and place a service request to be mailed a paper enrollment form Call 240-773-OHR1 (240-773-6471) available Monday through Friday 8 am to 5 pm
bull Experiencing a Life Event If an employee has a qualified status change (life event) during Open Enrollment they cannot make changes using the Open Enrollment form or online system Instead they should contact the OHR Health Insurance Team via MC311 to make changes Qualifying life events marriage divorce the birth of a child or the death of spouse or a
dependent aging out
Office of Human Resources Montgomery County Government
Dependent EligibilityEligible dependents for medical prescription dental and vision coverage arebull Spouse
Legally married EligibleDivorced Not Eligible
bull Children (biological legally adopted stepchildren or under your legal custody)Under age 26 EligibleAge 26 and over Not Eligible unless incapable of self support
Proof of eligible dependents is required
Office of Human Resources Montgomery County Government
Proof of Dependent EligibilityEmployees enrolling new dependents during Open Enrollment must upload the necessary dependent documentation in ESS prior to October 9 at 5 pmRequired Documentationbull Spouse Official State Marriage Certificate (certified by appropriate State or County Official)bull Biological Child State Birth Certificate (For newborns OHR will accept hospital discharge papers for first 60 days birth
certificate must then be submitted)bull Adopted Child Copy of Adoption or Placement for Adoption Papers bull Step-Child State Birth Certificate Marriage Certificate and Divorce Decree or Custody Papers bull Disabled Child Medical plan verification of disability prior to age 26 bull Legal Custody Copy of Court Order granting legal custody
Office of Human Resources Montgomery County Government
Marriage Certificate Example Required Documentation (Contd)
Office of Human Resources Montgomery County Government
Benefits Refresher
Office of Human Resources Montgomery County Government
Medical amp Rx
Office of Human Resources Montgomery County Government
Medical Plan OptionsHealth Maintenance Organizations (HMO)bull Kaiser Permanente Signature (HMO)bull United Healthcare Select (HMO)
Point of Service Plans (POS)bull CareFirst BCBS (POS) High Optionbull CareFirst BCBS (POS) Standard Option
Three tiers of coverage Self Self + 1 or Family
Office of Human Resources Montgomery County Government
Medical Benefits at-a-Glance To view full carrier medical summaries visit OHRrsquos Health Insurance Website
Kaiser Permanente HMO + Rx
wwwkporg
United HealthCare Select HMO
wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS)
wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS)
wwwcarefirstcom
Plan Type HMO HMO Point-of-Service Point-of-Service
PCP Required Yes Yes No No
Provider Network Regional (MDDCVA) National National National
Out-of-Network Benefits No No Yes Yes
Referrals Required Yes No No No
Annual Deductible None NoneIn-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Sheet1
Sheet1 (2)
Office of Human Resources Montgomery County Government
Medical Benefits at-a-Glance (contd)
New Employee Orientation Program
Kaiser Permanente HMO + Rx
wwwkporg
United HealthCare Select HMO
wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS)
wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS)
wwwcarefirstcom
Dr Office Visits PCPSpecialist $5 copay $5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits Covered in full $5 copay $10 copay In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care $5 copay $15 copay Covered in full Covered in full
Emergency Room $50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization Covered in full Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
Visit OHRrsquos Health Insurance webpage to view Medical summaries
Sheet1
Sheet1 (2)
Office of Human Resources Montgomery County Government
Prescription Plans Caremarkbull Two Rx Plan OptionsStandardHigh
bull If you elect UHC or CareFirst and want Rx coverage you will need to elect the stand-alone Caremark Rx plan (Kaiser already includes Rx coverage)
bull Maintenance Choice Program available for maintenance drugs significant cost savings ndash 1 copay for each 90-day prescription In order to get the Maintenance pricing you must fil Rx at CVS retail pharmacy Mail order
Office of Human Resources Montgomery County Government
Prescription Drug Plan Comparison High Option $48
Only MCGEOIAFF employees can enroll in this High plan
High Option $510Only FOPNON-REP employees
can enroll in this High plan
Standard Option All employees can enroll in this
Standard plan
Copay $4 Generics$8 Brand Name
$5 Generics$10 Brand Name
$10 Generics$20 PBrand Name
$35 NPBrand NameDeductible na na $50yearMail Order Yes Yes Yes
Maintenance Choice Yes Yes YesCovered Drugs Same Same Same
Visit OHRrsquos Health Insurance Website to view Rx summaries
Office of Human Resources Montgomery County Government
Prescription Drug Cost Comparison Cost
High Option $48Only MCGEOIAFF employees
can enroll in this High plan
High Option $510Only FOPNON-REP employees
can enroll in this High plan
Standard Option All employees can enroll in this
Standard plan
Self Only
Bi-Weekly $11339Monthly $24568Yearly $294814
Bi-Weekly $11100Monthly $24050Yearly $288600
Bi-Weekly $2413Monthly $5258Yearly $62738
Self + 1
Bi-Weekly $20979Monthly $45455Yearly $545454
Bi-Weekly $20536Monthly $44495Yearly $533936
Bi-Weekly $4463Monthly $9670
Yearly $116038
Self + Family
Bi-Weekly $32511Monthly $70441Yearly $845286
Bi-Weekly $31824Monthly $68952Yearly $827424
Bi-Weekly $6916Monthly $14985Yearly $179816
Office of Human Resources Montgomery County Government
Dental
Office of Human Resources Montgomery County Government
Dental Comparison Cigna
For a list of HMO covered services and assigned costs (copays) view the HMO benefit summary
Required to Use An Assigned Provider Yes In-network only Primary Dental Office will be
assigned based on home address
No
Out of Network Benefits Available No Yes
Balance Billing for Covered Services No Yes if you go out-of-network
Referral Required Yes No
Orthodontia Benefits Available Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime) Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person) Unlimited $200000
Deductible (singlefamily) None $50 $ 150 waived for preventive care
Table 1
Office of Human Resources Montgomery County Government
Vision
Office of Human Resources Montgomery County Government
Vision Insurancebull The Countyrsquos Vision carrier is EyeMedbull Benefits payable for exams lenses and contacts (elective or necessary) every
calendar year frames every two calendar yearsbull In-network or out-of-network benefits available bull Enhanced Hearing Benefit through EyeMedrsquos partner Amplifon40 off hearing examDiscounted pricing on thousands of hearing aids including latest technologyOne-year free follow-up care with unlimited appointmentsFree batteries for two years with initial purchase Three-year warranty and loss and damage coverage
Visit OHRrsquos Health Insurance webpage to view vision summary
Office of Human Resources Montgomery County Government
Optional Life amp Dependent Life
Office of Human Resources Montgomery County Government
Optional Life Insurance ADampDbull You may elect Optional Life ADampD coverage for yourself in increments of 1 to 8 times
your basic annual earnings ($1 million maximum)
bull NOTE Coverage is not guaranteed issue for any level You must complete an online Statement of Health no matter what level of coverage you elect Later this fall after Open Enrollment ends you will receive an email from MetLife with a link to complete the Statement of Health online
bull An eligible dependent is defined as 1) your opposite or same sex spouse or 2) your unmarried children under age 26 (natural adopted or stepchildrenfoster children who depend on your support)
Office of Human Resources Montgomery County Government
Optional Life Insurance RatesHow to estimate your Optional Life Insurance bi-weekly rate
Example 40-year-old applying for 2 x salary Salary is $49300
Steps Example Calculate for Yourself
A Find your age-based rate on the rate sheet (left) $ 0037 $_________________
B Choose how much coverage you are applying for
$99000 (2 x salary rounded to the nearest $1000 ) $_________________
C Divide that coverage amount by 100099 ($99000 1000) $_________________
D Multiply A x C for estimated bi-weekly cost$366 ($037 x 99) $_________________
Office of Human Resources Montgomery County Government
Dependent Life InsuranceYou may also purchase Dependent Optional Life insurance forbull Your opposite or same sex spouse bull Your unmarried children under age 26
ndash Natural adoptedndash Stepchildrenfoster childrenNote you do not need to supply marriage certificatesbirth certificates for dependent optional life
You may electbull $2000 Spouse$1000 Childbull $4000 Spouse $2000 Childbull $10000 Spouse $5000 Child
The bi-weekly rate is not based on salary
Office of Human Resources Montgomery County Government
Flexible Spending Accounts
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Visit the Open Enrollment website to watch a recorded FSA presentation from MCGrsquos FSA vendor Benefit Strategies
bull What is an FSA It is an IRS-approved tax-free account that saves onQualified out-of-pocket medical and dependent care expensesFederal and State Income taxSocial Security Tax
bull 3 Account Options Health Care FSA Child Care FSA and Commuter Choice Transit bull FSA accounts are administered through Benefit Strategies bull FSAs are ldquouse-it or lose-itrdquo accounts claims must be incurred during the 2021 plan year (January 1
2021 ndash March 15 2022) and submitted by April 30 2022
IMPORTANT You must re-enroll in an FSA every Open Enrollment if you want to participate in the upcoming plan year
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Why You Should EnrollGive yourself a raise by reducing your taxesbull Elect the annual amount you want to place in your FSA(s) for the upcoming plan year during Open Enrollmentbull That amount is divided by 26 and taken from your biweekly paychecks on a pre-tax basis (21 paychecks for
10-month employees)bull Then use your pre-tax FSA dollars to pay for eligible out-of-pocket health care child-care or transit
expenses
Office of Human Resources Montgomery County Government
Health Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull Claims must be submitted by April 30 of the following yearbull You may elect to contribute up to $2750 Your total annual election amount is available to spend on the first
day of the new plan year bull FSA debit card allows you to pay for expenses at the time of servicebull Examples of IRS qualified eligible expenses
bull Copays (medical prescription dental vision) deductibles and coinsurance amounts over reasonable and customary charge
bull Hearing aids bull Acupuncture bull Orthopedic shoes bull Over-the-counter (OTC) drugs (no longer require doctorrsquos prescription)
Office of Human Resources Montgomery County Government
Child Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull $5000 annual maximum per household ($2500 for married filing separately)bull Funds are available to spend as they are accumulated through payroll deductionsbull Reimbursable expenses
bull day care centersbull elder carebull beforeafter school carebull babysitter fees that allow you and your spouse to work or go to school (no child support payments)
bull Qualifying dependentsbull Children under the age of 13 and are a tax dependent of the employeebull Spouse or tax dependent that is physically or mentally incapable of self-care
bull Must coordinate between filing a tax credit with IRS and your Dependent Care FSA plan
Office of Human Resources Montgomery County Government
Commuter Choice Transit FSAbull $230 per month maximum for MCGEO staff $260 per month maximum for Unrepresented staffbull Applies to employee commuting expenses only (not spouses or dependents)bull Can enroll throughout the year (not limited to Open Enrollment election)bull Eligible expenses include Metro Marc Vanpool Lyft Line Uber Poolbull Debit card ndash may be used for some expenses (not Metro)Metro riders will have to submit claim forms for reimbursement
bull Funds must be used within 180 days of election bull If retiring or leaving the County will need to coordinate use all available funds
Office of Human Resources Montgomery County Government
Using Your FSA FundsHealth Care FSA Your full annual election amount is available on the first day of the plan yearChild Care FSA Your funds are available as they accumulate through payroll deductionsCommuterTransit FSA Your funds are available as they accumulate through payroll deductions
The FSA Debit Card bull Your FSA debit card is the same card for your Health Care Child Care and TransitCommuter FSA accountsbull The card is pre-loaded with your full annual Health Care FSA election amount You can use the card to pay for IRS qualified expenses at
the time of service or when paying a bill Receipt notifications will be mailed to you monthly by Benefit Strategies Your response to receipt notifications is necessary under the provisions of the plan No response my result in the ineligibility of the purchase and as a result your card may be temporarily deactivated
bull If you are enrolled in the Child Care FSA the card can also be used in child-care settings Just remember that the card will only work for an amount that does not exceed the available balance in your Child Care FSA account on that day
bull The card can also be used to pay for your commutertransit expenses however it does not work for WMATA metro Metro riders will have to submit manual claims for reimbursement from your CommuterTransit FSA
bull Cards are re-loaded each year after you make your new annual election Please keep your cards You will only receive a new card if your old card is about to expire
Office of Human Resources Montgomery County Government
AFLAC Voluntary Plans
Office of Human Resources Montgomery County Government
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Short-Term Disabilitybull Provides short-term cash benefits in the event of disabilitybull Monthly benefit amounts available from $500 - $6000 (subject to income requirements)bull Benefit options of 3 6 12 18 or 24 months with a variety of elimination periods
Critical Illness Insurancebull Provides a lump sum cash benefit in the event of critical illnessbull Benefit amounts available in $5000 increments from $10000 - $30000
Participants pay 100 through payroll deduction for Short-Term Disability and Critical Illness Insurance
To ENROLL Text SETAPPTrdquo to 41411orCall 920-420-8861 orEmail susan_mcdanielusAflaccom
Office of Human Resources Montgomery County Government
Carrier Resources amp Cost-Saving Tips
Office of Human Resources Montgomery County Government
Lower Your Out-of-Pocket CostsChoose the plan thatrsquos right for youbull See the medical benefits chart for options bull Stay in network Use the provider search engines on your carrier website or mobile app to find in-network providersSeek preventive carebull Check-ups immunizations and screenings are an important part of staying healthy They can detect or prevent serious diseases and keep you healthyKnow where to go for carebull You have many options of places to go when you need care If your medical condition isnrsquot serious or life threatening you can save money by connecting
with a doctor online through a virtual visit or going to an urgent care center or convenience care clinic instead of a hospital emergency roomReview your prescription drug plan optionsbull Decide which Caremark prescription plan is best for you Note that the Kaiser HMO includes prescription drug coverage Both the Standard and High
Option Caremark plans cover the same prescription drugs but have different copay and deductiblesUse generic and long-term prescriptions bull Opt for lower-cost generic drugs whenever possible bull Ask your doctor to write a 90-day prescription instead of a 30-day prescription to participate in the mail order prescription programTake advantage of tax savings by participating in Flexible Spending Accountsbull Use pre-tax dollars for eligible out of pocket services and items
Office of Human Resources Montgomery County Government
Built-in Wellness Support Take advantage of the free programs available to you through your medical carrier Each of MCGrsquos medical carriers (Kaiser UHC amp CareFirst) offer valuable programs to help you manage your health
Disease Management Programsbull Help manage your chronic condition through personalized coaching support and encouragement and online education materialsEmotional Wellness amp Stress Management Support bull Help manage stress through mobile apps and other self-care resources Maternity Programsbull Support healthy moms and healthy babiesWeight-loss Programs bull Offers telephonic coaching support and web-based tools to help ensure long-term weight managementbull See the next slide for an example of an MCG success storySmoking Cessation Programsbull Supportive coaching to make quitting more successfulDiscounts bull Gym memberships weight loss programs and moreFor more information about the programs available to you please see the Open Enrollment Guide and contact your medical carrier
Office of Human Resources Montgomery County Government
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You GoAll of MCGrsquos health insurance carriers offer a simple-to-use tool that can help make your life easier while yoursquore on the go Download your carrierrsquos Mobile App to help you personalize organize and access your important plan information on your phone or tablet
bull Schedule Virtual Visitsbull Manage and track claimsbull View ID card informationbull Find doctor and compare costs and quality ratingsbull Review your coveragebull Track your account balances and deductiblesbull Access a variety of health and wellness tools
Visit Google Play or the Apple App Store to download your carrierrsquos App
Office of Human Resources Montgomery County Government
Making Changes
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Questions
Office of Human Resources Montgomery County Government
Open Enrollment AssistanceFollow these steps (in this order)1 Review the frequently asked questions (FAQs) on the Open Enrollment website at wwwmontgomerycountymdgovoe
(available beginning September 21) You can enter key words into the interactive search bar to quickly locate the answer to your question
2 Visit the MC311 website at wwwmontgomerycountymdgovmc311 and search key words for your question The search results contain various knowledge-based articles with information related to your search words Simply click on the corresponding link and the detailed answer is revealed
3 Attend one of OHRrsquos Virtual Office Hours via Microsoft Teams Members of OHRs Health Insurance Team will be on hand to address employee questions by video or via the chat box View the schedule and access the sessions through the Open Enrollment website at wwwmontgomerycountymdgovoe (available beginning September 21)
4 If you have tried all the methods above and still have Open Enrollment-related questions please contact OHRs MC311 Customer Service Center at 240-773-6471 (Mon-Fri 8 am - 5 pm) to open a service request A member of the health insurance team will respond to service requests in the order they are received Tip Please provide an email address at the time you place your Service Request This will ensure the fastest response possible
Office of Human Resources Montgomery County Government
Online ResourcesVisit the 2021 Open Enrollment Webpage
wwwmontgomerycountymdgovOE
Visit OHRrsquos WebpagewwwmontgomerycountymdgovHR
Health Insurance active employees
Office of Human Resources Montgomery County Government
Legal InformationThe County reserves the right at any time and for any reason to amend the Program subject to the Countys collective bargainingagreements The County expects to continue the Program but it is the Countys position that there is no implied contract between individual employees and the County to do so
The County may amend the Program prospectively or retroactively to comply with applicable law
In the event of a conflict between this presentation the County Code andor the Summary Description the County Code then the Summary Description will govern
Office of Human Resources Montgomery County Government
Thank YouWe hope you enjoyed learning about 2021 Open Enrollment
~Your OHR Health Insurance Team
2021 Open Enrollment Benefits Bonanza
What Is Open Enrollment
What Changes Can be Made
Open Enrollment Dates
MCG Continues to Make Generous Employer Contributions
New for 2021
Special 2021 Plan Rates Announcement
Employee Rate Changes for Calendar Year 2021
Planning Ahead Minimizing Future Rate Increases
New for 2021
Open Enrollment Communications
Itrsquos a New Frontier
2021 Open Enrollment Checklist
Open Enrollment Website Resources
Attend a Virtual Open Enrollment Event
Make Changes Online
Paper Enrollment Form Permitted for Only Two Reasons
Dependent Eligibility
Proof of Dependent Eligibility
Marriage Certificate Example Required Documentation (Contd)
Benefits Refresher
Medical amp Rx
Medical Plan Options
Medical Benefits at-a-Glance
Medical Benefits at-a-Glance (contd)
Prescription Plans Caremark
Prescription Drug Plan Comparison
Prescription Drug Cost Comparison
Dental
Slide Number 30
Vision
Vision Insurance
Optional Life amp Dependent Life
Optional Life Insurance ADampD
Optional Life Insurance Rates
Dependent Life Insurance
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs)Why You Should Enroll
Health Care FSA
Child Care FSA
Commuter Choice Transit FSA
Using Your FSA Funds
AFLAC Voluntary Plans
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Carrier Resources amp Cost-Saving Tips
Lower Your Out-of-Pocket Costs
Built-in Wellness Support
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You Go
Making Changes
Make Changes Online
Questions
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Legal Information
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Cigna Dental Comparison
DHMO
PPO
CIGNA NETWORK
Care-Access PlusDHMO
Total CIGNA PPOPPO
Required to Use An Assigned Provider
Yes In-network only Primary Dental Office will be assigned based on home address
No
Out of Network Benefits Available
No
Yes
Balance Billing for Covered Services
No
Yes if you go out-of-network
Referral Required
Yes
No
Orthodontia Benefits Available
Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime)
Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person)
Unlimited
$200000
Deductible (singlefamily)
None
$50 $ 150 waived for preventive care
1Claim submission would be required and balance billing may occur when visiting a nonparticipating provider2Deductible does not apply to Class I ndash Diagnostic and Preventive Services
Coverage for dependents would cease on the day which the child turns 26Benefit Maximum and Deductibles are for the period of January 01 through December 31
All services listed on this benefit summary are subject to the contractSchedules of Benefits and current Exclusions and Limitations
Medical Benefits at a Glance
Kaiser Permanente HMO + Rx wwwkporg
United HealthCare Select HMO wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS) wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS) wwwcarefirstcom
Plan Type
HMO
HMO
Point-of-Service
Point-of-Service
PCP Required
Yes
Yes
No
No
Provider Network
Regional (MDDCVA)
National
National
National
Out-of-Network Benefits
No
No
Yes
Yes
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
None
None
In-Network None Out-of-Network 80
In-Network None Out-of-Network 80
Dr Office Visits PCPSpecialist
$5 copay
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits
Covered in full
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care
$5 copay
$15 copay
Covered in full
Covered in full
Emergency Room
$50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization
Covered in full
Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
MCG 2018 Medical Plan Comparison Chart
Kaiser Permanente
United HealthCare
CareFirst POS Standard
CareFirst POS High
Plan Type
HMO
HMO
Point of Service
Point of Service
Provider Network
Regional (MDDCVA)
National
National
National
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
Annual Out-of-Pocket Maximum
None
$1100 per individual up to cap of $3600 for a family
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
Physician Servcies
PCP Office Visits
$5 copay
$5 copay PCP
In-Network $15 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Specialist Office Visits
$5 copay
$10 copay
In-Network $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Annual Physical
Covered in full
$5 copay PCP
In-Network $15 copay Primary Care Physician $30 copay specialist Out-of-Network 80 covered after deductible (limit 1calendar year)
In-Network $15 copay Out-of-Network 80 not subject to deductible (up to age 18)
In-Network $10 copay Out-of-Network 80 not subject to deductible (up to age 18)
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Allergy Testing
$5 copay
$5 copay PCP $10 copay Specialist
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Virtual Visits
Labs X-Rays Diagnostics
Outpatient labs
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient X-Rays
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Major Diagnostics
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Immedate Medical Servcies
Emergency Room
$50 copay waived if admitted to hospital
$25 copay waived if admitted to hospital $15 copay for urgent care
In-Network $35 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
Urgent Care
Hospital Services
Inpatient Hospitalization
Covered in full
Covered in full
In-Network Covered in full after $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Services
Surgery
Covered in full
Inpatient covered in full Outpatient $25 copay
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Hearing Aids
For minor children One hearing aid for each hearing impaired ear once every 36 months
For minor children One hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
Hearing Screening
$5 copay for hearing exam (hearing aids are excluded)
$5 Copay PCP $10 Copay Specialist
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
Home Health Care Services
Covered in full if medically necessary
Covered in full No copayment 60 visit maximum for skilled care services per calendar year
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
Hospice
Covered in full
Covered in full (See coverage booklet for eligibility information)
In-Network Covered in full
In-Network Covered in full
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
In vitro Fertilization
Limited to 3 attempts per live birth Lifetime maximum of $100000
Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
Mammography - Preventive Screening Schedule
Schedule consistent with the current recommendations of the American College of Physicians
Covered in full Age 35-39 one baseline mammogram Age 40-49 one mammogram every two calendar years Age 50+ one mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
Maternity
Covered in full once pregnancy is diagnosed
No copayment applies after the first visit
In-Network first visit 100 after $30 copay other visits 100
In-Network First visit 100 after $10 copay other visits 100
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Maximum Lifetime Benefit
Unlimited maximum
Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
Prescriptions
Kaiser Rx plan (included with Kaiser HMO medical plan) $5 at on-site pharmacies and for mail order $15 at participating pharmacies
No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
Rehabilitation Services
Inpatient Covered in full (unlimited) Outpatient $5 copay outpatient services for physical therapy are limited to up to 30 visits occupational and speech therapy per injury incident or condition are covered for a period not to exceed 90 days
$10 copayvisit 60 combined visits per year (short-term non-chronic conditions only)
In-Network
In-Network
100
100
Skilled Nursing Facility
Covered in full 100 days maximum
Covered in full 60 days per calendar year maximum
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Substance AbuseMental Health
Inpatient Covered in full Outpatient $5 copay
Inpatient Covered in full Outpatient $5 copay
In-Network Inpatient- $150 per admission copay Outpatient- $15 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
In-Network Inpatient- covered in full Outpatient- $10 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
Vision (Routine)
$5 copay for exams 25 discount on lensesframes at Kaiser centers 15 discount off the costs of contact lenses
$25 copay for exam 15-20 discount through participating optical centers
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
53116
Medical Benefits at a Glance
Kaiser Permanente HMO + Rx wwwkporg
United HealthCare Select HMO wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS) wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS) wwwcarefirstcom
Plan Type
HMO
HMO
Point-of-Service
Point-of-Service
PCP Required
Yes
Yes
No
No
Provider Network
Regional (MDDCVA)
National
National
National
Out-of-Network Benefits
No
No
Yes
Yes
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
None
None
In-Network None Out-of-Network 80
In-Network None Out-of-Network 80
Dr Office Visits PCPSpecialist
$5 copay
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits
Covered in full
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care
$5 copay
$15 copay
Covered in full
Covered in full
Emergency Room
$50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization
Covered in full
Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
MCG 2018 Medical Plan Comparison Chart
Kaiser Permanente
United HealthCare
CareFirst POS Standard
CareFirst POS High
Plan Type
HMO
HMO
Point of Service
Point of Service
Provider Network
Regional (MDDCVA)
National
National
National
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
Annual Out-of-Pocket Maximum
None
$1100 per individual up to cap of $3600 for a family
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
Physician Servcies
PCP Office Visits
$5 copay
$5 copay PCP
In-Network $15 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Specialist Office Visits
$5 copay
$10 copay
In-Network $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Annual Physical
Covered in full
$5 copay PCP
In-Network $15 copay Primary Care Physician $30 copay specialist Out-of-Network 80 covered after deductible (limit 1calendar year)
In-Network $15 copay Out-of-Network 80 not subject to deductible (up to age 18)
In-Network $10 copay Out-of-Network 80 not subject to deductible (up to age 18)
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Allergy Testing
$5 copay
$5 copay PCP $10 copay Specialist
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Virtual Visits
Labs X-Rays Diagnostics
Outpatient labs
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient X-Rays
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Major Diagnostics
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Immedate Medical Servcies
Emergency Room
$50 copay waived if admitted to hospital
$25 copay waived if admitted to hospital $15 copay for urgent care
In-Network $35 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
Urgent Care
Hospital Services
Inpatient Hospitalization
Covered in full
Covered in full
In-Network Covered in full after $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Services
Surgery
Covered in full
Inpatient covered in full Outpatient $25 copay
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Hearing Aids
For minor children One hearing aid for each hearing impaired ear once every 36 months
For minor children One hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
Hearing Screening
$5 copay for hearing exam (hearing aids are excluded)
$5 Copay PCP $10 Copay Specialist
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
Home Health Care Services
Covered in full if medically necessary
Covered in full No copayment 60 visit maximum for skilled care services per calendar year
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
Hospice
Covered in full
Covered in full (See coverage booklet for eligibility information)
In-Network Covered in full
In-Network Covered in full
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
In vitro Fertilization
Limited to 3 attempts per live birth Lifetime maximum of $100000
Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
Mammography - Preventive Screening Schedule
Schedule consistent with the current recommendations of the American College of Physicians
Covered in full Age 35-39 one baseline mammogram Age 40-49 one mammogram every two calendar years Age 50+ one mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
Maternity
Covered in full once pregnancy is diagnosed
No copayment applies after the first visit
In-Network first visit 100 after $30 copay other visits 100
In-Network First visit 100 after $10 copay other visits 100
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Maximum Lifetime Benefit
Unlimited maximum
Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
Prescriptions
Kaiser Rx plan (included with Kaiser HMO medical plan) $5 at on-site pharmacies and for mail order $15 at participating pharmacies
No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
Rehabilitation Services
Inpatient Covered in full (unlimited) Outpatient $5 copay outpatient services for physical therapy are limited to up to 30 visits occupational and speech therapy per injury incident or condition are covered for a period not to exceed 90 days
$10 copayvisit 60 combined visits per year (short-term non-chronic conditions only)
In-Network
In-Network
100
100
Skilled Nursing Facility
Covered in full 100 days maximum
Covered in full 60 days per calendar year maximum
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Substance AbuseMental Health
Inpatient Covered in full Outpatient $5 copay
Inpatient Covered in full Outpatient $5 copay
In-Network Inpatient- $150 per admission copay Outpatient- $15 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
In-Network Inpatient- covered in full Outpatient- $10 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
Vision (Routine)
$5 copay for exams 25 discount on lensesframes at Kaiser centers 15 discount off the costs of contact lenses
$25 copay for exam 15-20 discount through participating optical centers
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
53116
Office of Human Resources Montgomery County Government
Open Enrollment Communications bull 2021 Open Enrollment Guides were mailed to homes on September 11
Employees should receive the guides between September 14 ndash 16
bull Employees are encouraged to check their County email during and after Open EnrollmentOpen Enrollment email series featuring news and remindersMCG Employee Connect newsletter sharing Open Enrollment news in the Benefits Bites
sectionAfter Open Enrollment ends MetLife will email employees who elected or increased
Optional Life to complete a Statement of Health online
bull The Open Enrollment Website is a dedicated resource for all Open Enrollment needsAvailable Monday September 21 at 8 am
Office of Human Resources Montgomery County Government
Itrsquos a New Frontier COVID-19 has changed the way we utilize our plans MCGrsquos health insurance plans offer many value-added services and discounts to provide employees with support This year more than ever it is important to know our resources
bull Virtual doctor visits bull Built-in emotional amp wellness supportbull Disease management bull Lifestyle coachingbull Stress relief appsbull Discounts and more
Please see the 2021 Open Enrollment guide for additional information
Office of Human Resources Montgomery County Government
2021 Open Enrollment ChecklistTake Action Early Follow these steps for a successful Open Enrollment1 Review available resources
bull 2021 Open Enrollment Guide (mailed to homes on September 11th)bull Open Enrollment Websitebull County Email for Important Updates and Follow-Ups bull Benefits Bites Section of the MCG Employee Connect Newsletter
2 Attend a virtual Open Enrollment event3 Attend OHR virtual office hours4 Make changes online amp print Confirmation Statement5 (Re)Enroll in Flexible Spending Accounts (FSAs) and check FSA contribution
amounts
Office of Human Resources Montgomery County Government
Open Enrollment Website Resources Visit the Open Enrollment website for a variety of planning tools amp resources Open Enrollment schedule of virtual events Open Enrollment frequently asked questions 2021 Employee Self-Service (ESS) instruction video amp written instructions Side-by-side plan comparisons Life insurance needs estimator FSA tax savings calculator MCG employee discounts amp resources and more
Office of Human Resources Montgomery County Government
Attend a Virtual Open Enrollment Event bull Insurance Carrier Virtual Presentations and QampA Sessions Visit the Open Enrollment website for full schedule of events
bull Attend OHR Virtual Office Hours Virtual Office Hours SchedulePlease note Virtual Office Hours are held in a public virtual meeting If questions will
reveal any personal PHI (protected health information) such as a chronic medical condition or names of specific prescription drugs employees should direct those questions to OHRrsquos customer service center at 240-773-6471 to place a service request
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Paper Enrollment Form Permitted for Only Two ReasonsThere are only two exceptions permitting the use of paper Open Enrollment forms
bull Technical barriers preventing access to ESS (only in the event of no internet no smartphone or computer) the employee should contact MC311 and place a service request to be mailed a paper enrollment form Call 240-773-OHR1 (240-773-6471) available Monday through Friday 8 am to 5 pm
bull Experiencing a Life Event If an employee has a qualified status change (life event) during Open Enrollment they cannot make changes using the Open Enrollment form or online system Instead they should contact the OHR Health Insurance Team via MC311 to make changes Qualifying life events marriage divorce the birth of a child or the death of spouse or a
dependent aging out
Office of Human Resources Montgomery County Government
Dependent EligibilityEligible dependents for medical prescription dental and vision coverage arebull Spouse
Legally married EligibleDivorced Not Eligible
bull Children (biological legally adopted stepchildren or under your legal custody)Under age 26 EligibleAge 26 and over Not Eligible unless incapable of self support
Proof of eligible dependents is required
Office of Human Resources Montgomery County Government
Proof of Dependent EligibilityEmployees enrolling new dependents during Open Enrollment must upload the necessary dependent documentation in ESS prior to October 9 at 5 pmRequired Documentationbull Spouse Official State Marriage Certificate (certified by appropriate State or County Official)bull Biological Child State Birth Certificate (For newborns OHR will accept hospital discharge papers for first 60 days birth
certificate must then be submitted)bull Adopted Child Copy of Adoption or Placement for Adoption Papers bull Step-Child State Birth Certificate Marriage Certificate and Divorce Decree or Custody Papers bull Disabled Child Medical plan verification of disability prior to age 26 bull Legal Custody Copy of Court Order granting legal custody
Office of Human Resources Montgomery County Government
Marriage Certificate Example Required Documentation (Contd)
Office of Human Resources Montgomery County Government
Benefits Refresher
Office of Human Resources Montgomery County Government
Medical amp Rx
Office of Human Resources Montgomery County Government
Medical Plan OptionsHealth Maintenance Organizations (HMO)bull Kaiser Permanente Signature (HMO)bull United Healthcare Select (HMO)
Point of Service Plans (POS)bull CareFirst BCBS (POS) High Optionbull CareFirst BCBS (POS) Standard Option
Three tiers of coverage Self Self + 1 or Family
Office of Human Resources Montgomery County Government
Medical Benefits at-a-Glance To view full carrier medical summaries visit OHRrsquos Health Insurance Website
Kaiser Permanente HMO + Rx
wwwkporg
United HealthCare Select HMO
wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS)
wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS)
wwwcarefirstcom
Plan Type HMO HMO Point-of-Service Point-of-Service
PCP Required Yes Yes No No
Provider Network Regional (MDDCVA) National National National
Out-of-Network Benefits No No Yes Yes
Referrals Required Yes No No No
Annual Deductible None NoneIn-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Sheet1
Sheet1 (2)
Office of Human Resources Montgomery County Government
Medical Benefits at-a-Glance (contd)
New Employee Orientation Program
Kaiser Permanente HMO + Rx
wwwkporg
United HealthCare Select HMO
wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS)
wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS)
wwwcarefirstcom
Dr Office Visits PCPSpecialist $5 copay $5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits Covered in full $5 copay $10 copay In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care $5 copay $15 copay Covered in full Covered in full
Emergency Room $50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization Covered in full Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
Visit OHRrsquos Health Insurance webpage to view Medical summaries
Sheet1
Sheet1 (2)
Office of Human Resources Montgomery County Government
Prescription Plans Caremarkbull Two Rx Plan OptionsStandardHigh
bull If you elect UHC or CareFirst and want Rx coverage you will need to elect the stand-alone Caremark Rx plan (Kaiser already includes Rx coverage)
bull Maintenance Choice Program available for maintenance drugs significant cost savings ndash 1 copay for each 90-day prescription In order to get the Maintenance pricing you must fil Rx at CVS retail pharmacy Mail order
Office of Human Resources Montgomery County Government
Prescription Drug Plan Comparison High Option $48
Only MCGEOIAFF employees can enroll in this High plan
High Option $510Only FOPNON-REP employees
can enroll in this High plan
Standard Option All employees can enroll in this
Standard plan
Copay $4 Generics$8 Brand Name
$5 Generics$10 Brand Name
$10 Generics$20 PBrand Name
$35 NPBrand NameDeductible na na $50yearMail Order Yes Yes Yes
Maintenance Choice Yes Yes YesCovered Drugs Same Same Same
Visit OHRrsquos Health Insurance Website to view Rx summaries
Office of Human Resources Montgomery County Government
Prescription Drug Cost Comparison Cost
High Option $48Only MCGEOIAFF employees
can enroll in this High plan
High Option $510Only FOPNON-REP employees
can enroll in this High plan
Standard Option All employees can enroll in this
Standard plan
Self Only
Bi-Weekly $11339Monthly $24568Yearly $294814
Bi-Weekly $11100Monthly $24050Yearly $288600
Bi-Weekly $2413Monthly $5258Yearly $62738
Self + 1
Bi-Weekly $20979Monthly $45455Yearly $545454
Bi-Weekly $20536Monthly $44495Yearly $533936
Bi-Weekly $4463Monthly $9670
Yearly $116038
Self + Family
Bi-Weekly $32511Monthly $70441Yearly $845286
Bi-Weekly $31824Monthly $68952Yearly $827424
Bi-Weekly $6916Monthly $14985Yearly $179816
Office of Human Resources Montgomery County Government
Dental
Office of Human Resources Montgomery County Government
Dental Comparison Cigna
For a list of HMO covered services and assigned costs (copays) view the HMO benefit summary
Required to Use An Assigned Provider Yes In-network only Primary Dental Office will be
assigned based on home address
No
Out of Network Benefits Available No Yes
Balance Billing for Covered Services No Yes if you go out-of-network
Referral Required Yes No
Orthodontia Benefits Available Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime) Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person) Unlimited $200000
Deductible (singlefamily) None $50 $ 150 waived for preventive care
Table 1
Office of Human Resources Montgomery County Government
Vision
Office of Human Resources Montgomery County Government
Vision Insurancebull The Countyrsquos Vision carrier is EyeMedbull Benefits payable for exams lenses and contacts (elective or necessary) every
calendar year frames every two calendar yearsbull In-network or out-of-network benefits available bull Enhanced Hearing Benefit through EyeMedrsquos partner Amplifon40 off hearing examDiscounted pricing on thousands of hearing aids including latest technologyOne-year free follow-up care with unlimited appointmentsFree batteries for two years with initial purchase Three-year warranty and loss and damage coverage
Visit OHRrsquos Health Insurance webpage to view vision summary
Office of Human Resources Montgomery County Government
Optional Life amp Dependent Life
Office of Human Resources Montgomery County Government
Optional Life Insurance ADampDbull You may elect Optional Life ADampD coverage for yourself in increments of 1 to 8 times
your basic annual earnings ($1 million maximum)
bull NOTE Coverage is not guaranteed issue for any level You must complete an online Statement of Health no matter what level of coverage you elect Later this fall after Open Enrollment ends you will receive an email from MetLife with a link to complete the Statement of Health online
bull An eligible dependent is defined as 1) your opposite or same sex spouse or 2) your unmarried children under age 26 (natural adopted or stepchildrenfoster children who depend on your support)
Office of Human Resources Montgomery County Government
Optional Life Insurance RatesHow to estimate your Optional Life Insurance bi-weekly rate
Example 40-year-old applying for 2 x salary Salary is $49300
Steps Example Calculate for Yourself
A Find your age-based rate on the rate sheet (left) $ 0037 $_________________
B Choose how much coverage you are applying for
$99000 (2 x salary rounded to the nearest $1000 ) $_________________
C Divide that coverage amount by 100099 ($99000 1000) $_________________
D Multiply A x C for estimated bi-weekly cost$366 ($037 x 99) $_________________
Office of Human Resources Montgomery County Government
Dependent Life InsuranceYou may also purchase Dependent Optional Life insurance forbull Your opposite or same sex spouse bull Your unmarried children under age 26
ndash Natural adoptedndash Stepchildrenfoster childrenNote you do not need to supply marriage certificatesbirth certificates for dependent optional life
You may electbull $2000 Spouse$1000 Childbull $4000 Spouse $2000 Childbull $10000 Spouse $5000 Child
The bi-weekly rate is not based on salary
Office of Human Resources Montgomery County Government
Flexible Spending Accounts
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Visit the Open Enrollment website to watch a recorded FSA presentation from MCGrsquos FSA vendor Benefit Strategies
bull What is an FSA It is an IRS-approved tax-free account that saves onQualified out-of-pocket medical and dependent care expensesFederal and State Income taxSocial Security Tax
bull 3 Account Options Health Care FSA Child Care FSA and Commuter Choice Transit bull FSA accounts are administered through Benefit Strategies bull FSAs are ldquouse-it or lose-itrdquo accounts claims must be incurred during the 2021 plan year (January 1
2021 ndash March 15 2022) and submitted by April 30 2022
IMPORTANT You must re-enroll in an FSA every Open Enrollment if you want to participate in the upcoming plan year
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Why You Should EnrollGive yourself a raise by reducing your taxesbull Elect the annual amount you want to place in your FSA(s) for the upcoming plan year during Open Enrollmentbull That amount is divided by 26 and taken from your biweekly paychecks on a pre-tax basis (21 paychecks for
10-month employees)bull Then use your pre-tax FSA dollars to pay for eligible out-of-pocket health care child-care or transit
expenses
Office of Human Resources Montgomery County Government
Health Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull Claims must be submitted by April 30 of the following yearbull You may elect to contribute up to $2750 Your total annual election amount is available to spend on the first
day of the new plan year bull FSA debit card allows you to pay for expenses at the time of servicebull Examples of IRS qualified eligible expenses
bull Copays (medical prescription dental vision) deductibles and coinsurance amounts over reasonable and customary charge
bull Hearing aids bull Acupuncture bull Orthopedic shoes bull Over-the-counter (OTC) drugs (no longer require doctorrsquos prescription)
Office of Human Resources Montgomery County Government
Child Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull $5000 annual maximum per household ($2500 for married filing separately)bull Funds are available to spend as they are accumulated through payroll deductionsbull Reimbursable expenses
bull day care centersbull elder carebull beforeafter school carebull babysitter fees that allow you and your spouse to work or go to school (no child support payments)
bull Qualifying dependentsbull Children under the age of 13 and are a tax dependent of the employeebull Spouse or tax dependent that is physically or mentally incapable of self-care
bull Must coordinate between filing a tax credit with IRS and your Dependent Care FSA plan
Office of Human Resources Montgomery County Government
Commuter Choice Transit FSAbull $230 per month maximum for MCGEO staff $260 per month maximum for Unrepresented staffbull Applies to employee commuting expenses only (not spouses or dependents)bull Can enroll throughout the year (not limited to Open Enrollment election)bull Eligible expenses include Metro Marc Vanpool Lyft Line Uber Poolbull Debit card ndash may be used for some expenses (not Metro)Metro riders will have to submit claim forms for reimbursement
bull Funds must be used within 180 days of election bull If retiring or leaving the County will need to coordinate use all available funds
Office of Human Resources Montgomery County Government
Using Your FSA FundsHealth Care FSA Your full annual election amount is available on the first day of the plan yearChild Care FSA Your funds are available as they accumulate through payroll deductionsCommuterTransit FSA Your funds are available as they accumulate through payroll deductions
The FSA Debit Card bull Your FSA debit card is the same card for your Health Care Child Care and TransitCommuter FSA accountsbull The card is pre-loaded with your full annual Health Care FSA election amount You can use the card to pay for IRS qualified expenses at
the time of service or when paying a bill Receipt notifications will be mailed to you monthly by Benefit Strategies Your response to receipt notifications is necessary under the provisions of the plan No response my result in the ineligibility of the purchase and as a result your card may be temporarily deactivated
bull If you are enrolled in the Child Care FSA the card can also be used in child-care settings Just remember that the card will only work for an amount that does not exceed the available balance in your Child Care FSA account on that day
bull The card can also be used to pay for your commutertransit expenses however it does not work for WMATA metro Metro riders will have to submit manual claims for reimbursement from your CommuterTransit FSA
bull Cards are re-loaded each year after you make your new annual election Please keep your cards You will only receive a new card if your old card is about to expire
Office of Human Resources Montgomery County Government
AFLAC Voluntary Plans
Office of Human Resources Montgomery County Government
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Short-Term Disabilitybull Provides short-term cash benefits in the event of disabilitybull Monthly benefit amounts available from $500 - $6000 (subject to income requirements)bull Benefit options of 3 6 12 18 or 24 months with a variety of elimination periods
Critical Illness Insurancebull Provides a lump sum cash benefit in the event of critical illnessbull Benefit amounts available in $5000 increments from $10000 - $30000
Participants pay 100 through payroll deduction for Short-Term Disability and Critical Illness Insurance
To ENROLL Text SETAPPTrdquo to 41411orCall 920-420-8861 orEmail susan_mcdanielusAflaccom
Office of Human Resources Montgomery County Government
Carrier Resources amp Cost-Saving Tips
Office of Human Resources Montgomery County Government
Lower Your Out-of-Pocket CostsChoose the plan thatrsquos right for youbull See the medical benefits chart for options bull Stay in network Use the provider search engines on your carrier website or mobile app to find in-network providersSeek preventive carebull Check-ups immunizations and screenings are an important part of staying healthy They can detect or prevent serious diseases and keep you healthyKnow where to go for carebull You have many options of places to go when you need care If your medical condition isnrsquot serious or life threatening you can save money by connecting
with a doctor online through a virtual visit or going to an urgent care center or convenience care clinic instead of a hospital emergency roomReview your prescription drug plan optionsbull Decide which Caremark prescription plan is best for you Note that the Kaiser HMO includes prescription drug coverage Both the Standard and High
Option Caremark plans cover the same prescription drugs but have different copay and deductiblesUse generic and long-term prescriptions bull Opt for lower-cost generic drugs whenever possible bull Ask your doctor to write a 90-day prescription instead of a 30-day prescription to participate in the mail order prescription programTake advantage of tax savings by participating in Flexible Spending Accountsbull Use pre-tax dollars for eligible out of pocket services and items
Office of Human Resources Montgomery County Government
Built-in Wellness Support Take advantage of the free programs available to you through your medical carrier Each of MCGrsquos medical carriers (Kaiser UHC amp CareFirst) offer valuable programs to help you manage your health
Disease Management Programsbull Help manage your chronic condition through personalized coaching support and encouragement and online education materialsEmotional Wellness amp Stress Management Support bull Help manage stress through mobile apps and other self-care resources Maternity Programsbull Support healthy moms and healthy babiesWeight-loss Programs bull Offers telephonic coaching support and web-based tools to help ensure long-term weight managementbull See the next slide for an example of an MCG success storySmoking Cessation Programsbull Supportive coaching to make quitting more successfulDiscounts bull Gym memberships weight loss programs and moreFor more information about the programs available to you please see the Open Enrollment Guide and contact your medical carrier
Office of Human Resources Montgomery County Government
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You GoAll of MCGrsquos health insurance carriers offer a simple-to-use tool that can help make your life easier while yoursquore on the go Download your carrierrsquos Mobile App to help you personalize organize and access your important plan information on your phone or tablet
bull Schedule Virtual Visitsbull Manage and track claimsbull View ID card informationbull Find doctor and compare costs and quality ratingsbull Review your coveragebull Track your account balances and deductiblesbull Access a variety of health and wellness tools
Visit Google Play or the Apple App Store to download your carrierrsquos App
Office of Human Resources Montgomery County Government
Making Changes
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Questions
Office of Human Resources Montgomery County Government
Open Enrollment AssistanceFollow these steps (in this order)1 Review the frequently asked questions (FAQs) on the Open Enrollment website at wwwmontgomerycountymdgovoe
(available beginning September 21) You can enter key words into the interactive search bar to quickly locate the answer to your question
2 Visit the MC311 website at wwwmontgomerycountymdgovmc311 and search key words for your question The search results contain various knowledge-based articles with information related to your search words Simply click on the corresponding link and the detailed answer is revealed
3 Attend one of OHRrsquos Virtual Office Hours via Microsoft Teams Members of OHRs Health Insurance Team will be on hand to address employee questions by video or via the chat box View the schedule and access the sessions through the Open Enrollment website at wwwmontgomerycountymdgovoe (available beginning September 21)
4 If you have tried all the methods above and still have Open Enrollment-related questions please contact OHRs MC311 Customer Service Center at 240-773-6471 (Mon-Fri 8 am - 5 pm) to open a service request A member of the health insurance team will respond to service requests in the order they are received Tip Please provide an email address at the time you place your Service Request This will ensure the fastest response possible
Office of Human Resources Montgomery County Government
Online ResourcesVisit the 2021 Open Enrollment Webpage
wwwmontgomerycountymdgovOE
Visit OHRrsquos WebpagewwwmontgomerycountymdgovHR
Health Insurance active employees
Office of Human Resources Montgomery County Government
Legal InformationThe County reserves the right at any time and for any reason to amend the Program subject to the Countys collective bargainingagreements The County expects to continue the Program but it is the Countys position that there is no implied contract between individual employees and the County to do so
The County may amend the Program prospectively or retroactively to comply with applicable law
In the event of a conflict between this presentation the County Code andor the Summary Description the County Code then the Summary Description will govern
Office of Human Resources Montgomery County Government
Thank YouWe hope you enjoyed learning about 2021 Open Enrollment
~Your OHR Health Insurance Team
2021 Open Enrollment Benefits Bonanza
What Is Open Enrollment
What Changes Can be Made
Open Enrollment Dates
MCG Continues to Make Generous Employer Contributions
New for 2021
Special 2021 Plan Rates Announcement
Employee Rate Changes for Calendar Year 2021
Planning Ahead Minimizing Future Rate Increases
New for 2021
Open Enrollment Communications
Itrsquos a New Frontier
2021 Open Enrollment Checklist
Open Enrollment Website Resources
Attend a Virtual Open Enrollment Event
Make Changes Online
Paper Enrollment Form Permitted for Only Two Reasons
Dependent Eligibility
Proof of Dependent Eligibility
Marriage Certificate Example Required Documentation (Contd)
Benefits Refresher
Medical amp Rx
Medical Plan Options
Medical Benefits at-a-Glance
Medical Benefits at-a-Glance (contd)
Prescription Plans Caremark
Prescription Drug Plan Comparison
Prescription Drug Cost Comparison
Dental
Slide Number 30
Vision
Vision Insurance
Optional Life amp Dependent Life
Optional Life Insurance ADampD
Optional Life Insurance Rates
Dependent Life Insurance
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs)Why You Should Enroll
Health Care FSA
Child Care FSA
Commuter Choice Transit FSA
Using Your FSA Funds
AFLAC Voluntary Plans
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Carrier Resources amp Cost-Saving Tips
Lower Your Out-of-Pocket Costs
Built-in Wellness Support
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You Go
Making Changes
Make Changes Online
Questions
Open Enrollment Assistance
Online Resources
Legal Information
Thank You
Cigna Dental Comparison
DHMO
PPO
CIGNA NETWORK
Care-Access PlusDHMO
Total CIGNA PPOPPO
Required to Use An Assigned Provider
Yes In-network only Primary Dental Office will be assigned based on home address
No
Out of Network Benefits Available
No
Yes
Balance Billing for Covered Services
No
Yes if you go out-of-network
Referral Required
Yes
No
Orthodontia Benefits Available
Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime)
Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person)
Unlimited
$200000
Deductible (singlefamily)
None
$50 $ 150 waived for preventive care
1Claim submission would be required and balance billing may occur when visiting a nonparticipating provider2Deductible does not apply to Class I ndash Diagnostic and Preventive Services
Coverage for dependents would cease on the day which the child turns 26Benefit Maximum and Deductibles are for the period of January 01 through December 31
All services listed on this benefit summary are subject to the contractSchedules of Benefits and current Exclusions and Limitations
Medical Benefits at a Glance
Kaiser Permanente HMO + Rx wwwkporg
United HealthCare Select HMO wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS) wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS) wwwcarefirstcom
Plan Type
HMO
HMO
Point-of-Service
Point-of-Service
PCP Required
Yes
Yes
No
No
Provider Network
Regional (MDDCVA)
National
National
National
Out-of-Network Benefits
No
No
Yes
Yes
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
None
None
In-Network None Out-of-Network 80
In-Network None Out-of-Network 80
Dr Office Visits PCPSpecialist
$5 copay
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits
Covered in full
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care
$5 copay
$15 copay
Covered in full
Covered in full
Emergency Room
$50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization
Covered in full
Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
MCG 2018 Medical Plan Comparison Chart
Kaiser Permanente
United HealthCare
CareFirst POS Standard
CareFirst POS High
Plan Type
HMO
HMO
Point of Service
Point of Service
Provider Network
Regional (MDDCVA)
National
National
National
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
Annual Out-of-Pocket Maximum
None
$1100 per individual up to cap of $3600 for a family
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
Physician Servcies
PCP Office Visits
$5 copay
$5 copay PCP
In-Network $15 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Specialist Office Visits
$5 copay
$10 copay
In-Network $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Annual Physical
Covered in full
$5 copay PCP
In-Network $15 copay Primary Care Physician $30 copay specialist Out-of-Network 80 covered after deductible (limit 1calendar year)
In-Network $15 copay Out-of-Network 80 not subject to deductible (up to age 18)
In-Network $10 copay Out-of-Network 80 not subject to deductible (up to age 18)
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Allergy Testing
$5 copay
$5 copay PCP $10 copay Specialist
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Virtual Visits
Labs X-Rays Diagnostics
Outpatient labs
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient X-Rays
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Major Diagnostics
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Immedate Medical Servcies
Emergency Room
$50 copay waived if admitted to hospital
$25 copay waived if admitted to hospital $15 copay for urgent care
In-Network $35 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
Urgent Care
Hospital Services
Inpatient Hospitalization
Covered in full
Covered in full
In-Network Covered in full after $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Services
Surgery
Covered in full
Inpatient covered in full Outpatient $25 copay
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Hearing Aids
For minor children One hearing aid for each hearing impaired ear once every 36 months
For minor children One hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
Hearing Screening
$5 copay for hearing exam (hearing aids are excluded)
$5 Copay PCP $10 Copay Specialist
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
Home Health Care Services
Covered in full if medically necessary
Covered in full No copayment 60 visit maximum for skilled care services per calendar year
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
Hospice
Covered in full
Covered in full (See coverage booklet for eligibility information)
In-Network Covered in full
In-Network Covered in full
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
In vitro Fertilization
Limited to 3 attempts per live birth Lifetime maximum of $100000
Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
Mammography - Preventive Screening Schedule
Schedule consistent with the current recommendations of the American College of Physicians
Covered in full Age 35-39 one baseline mammogram Age 40-49 one mammogram every two calendar years Age 50+ one mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
Maternity
Covered in full once pregnancy is diagnosed
No copayment applies after the first visit
In-Network first visit 100 after $30 copay other visits 100
In-Network First visit 100 after $10 copay other visits 100
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Maximum Lifetime Benefit
Unlimited maximum
Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
Prescriptions
Kaiser Rx plan (included with Kaiser HMO medical plan) $5 at on-site pharmacies and for mail order $15 at participating pharmacies
No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
Rehabilitation Services
Inpatient Covered in full (unlimited) Outpatient $5 copay outpatient services for physical therapy are limited to up to 30 visits occupational and speech therapy per injury incident or condition are covered for a period not to exceed 90 days
$10 copayvisit 60 combined visits per year (short-term non-chronic conditions only)
In-Network
In-Network
100
100
Skilled Nursing Facility
Covered in full 100 days maximum
Covered in full 60 days per calendar year maximum
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Substance AbuseMental Health
Inpatient Covered in full Outpatient $5 copay
Inpatient Covered in full Outpatient $5 copay
In-Network Inpatient- $150 per admission copay Outpatient- $15 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
In-Network Inpatient- covered in full Outpatient- $10 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
Vision (Routine)
$5 copay for exams 25 discount on lensesframes at Kaiser centers 15 discount off the costs of contact lenses
$25 copay for exam 15-20 discount through participating optical centers
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
53116
Medical Benefits at a Glance
Kaiser Permanente HMO + Rx wwwkporg
United HealthCare Select HMO wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS) wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS) wwwcarefirstcom
Plan Type
HMO
HMO
Point-of-Service
Point-of-Service
PCP Required
Yes
Yes
No
No
Provider Network
Regional (MDDCVA)
National
National
National
Out-of-Network Benefits
No
No
Yes
Yes
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
None
None
In-Network None Out-of-Network 80
In-Network None Out-of-Network 80
Dr Office Visits PCPSpecialist
$5 copay
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits
Covered in full
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care
$5 copay
$15 copay
Covered in full
Covered in full
Emergency Room
$50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization
Covered in full
Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
MCG 2018 Medical Plan Comparison Chart
Kaiser Permanente
United HealthCare
CareFirst POS Standard
CareFirst POS High
Plan Type
HMO
HMO
Point of Service
Point of Service
Provider Network
Regional (MDDCVA)
National
National
National
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
Annual Out-of-Pocket Maximum
None
$1100 per individual up to cap of $3600 for a family
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
Physician Servcies
PCP Office Visits
$5 copay
$5 copay PCP
In-Network $15 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Specialist Office Visits
$5 copay
$10 copay
In-Network $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Annual Physical
Covered in full
$5 copay PCP
In-Network $15 copay Primary Care Physician $30 copay specialist Out-of-Network 80 covered after deductible (limit 1calendar year)
In-Network $15 copay Out-of-Network 80 not subject to deductible (up to age 18)
In-Network $10 copay Out-of-Network 80 not subject to deductible (up to age 18)
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Allergy Testing
$5 copay
$5 copay PCP $10 copay Specialist
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Virtual Visits
Labs X-Rays Diagnostics
Outpatient labs
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient X-Rays
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Major Diagnostics
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Immedate Medical Servcies
Emergency Room
$50 copay waived if admitted to hospital
$25 copay waived if admitted to hospital $15 copay for urgent care
In-Network $35 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
Urgent Care
Hospital Services
Inpatient Hospitalization
Covered in full
Covered in full
In-Network Covered in full after $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Services
Surgery
Covered in full
Inpatient covered in full Outpatient $25 copay
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Hearing Aids
For minor children One hearing aid for each hearing impaired ear once every 36 months
For minor children One hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
Hearing Screening
$5 copay for hearing exam (hearing aids are excluded)
$5 Copay PCP $10 Copay Specialist
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
Home Health Care Services
Covered in full if medically necessary
Covered in full No copayment 60 visit maximum for skilled care services per calendar year
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
Hospice
Covered in full
Covered in full (See coverage booklet for eligibility information)
In-Network Covered in full
In-Network Covered in full
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
In vitro Fertilization
Limited to 3 attempts per live birth Lifetime maximum of $100000
Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
Mammography - Preventive Screening Schedule
Schedule consistent with the current recommendations of the American College of Physicians
Covered in full Age 35-39 one baseline mammogram Age 40-49 one mammogram every two calendar years Age 50+ one mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
Maternity
Covered in full once pregnancy is diagnosed
No copayment applies after the first visit
In-Network first visit 100 after $30 copay other visits 100
In-Network First visit 100 after $10 copay other visits 100
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Maximum Lifetime Benefit
Unlimited maximum
Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
Prescriptions
Kaiser Rx plan (included with Kaiser HMO medical plan) $5 at on-site pharmacies and for mail order $15 at participating pharmacies
No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
Rehabilitation Services
Inpatient Covered in full (unlimited) Outpatient $5 copay outpatient services for physical therapy are limited to up to 30 visits occupational and speech therapy per injury incident or condition are covered for a period not to exceed 90 days
$10 copayvisit 60 combined visits per year (short-term non-chronic conditions only)
In-Network
In-Network
100
100
Skilled Nursing Facility
Covered in full 100 days maximum
Covered in full 60 days per calendar year maximum
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Substance AbuseMental Health
Inpatient Covered in full Outpatient $5 copay
Inpatient Covered in full Outpatient $5 copay
In-Network Inpatient- $150 per admission copay Outpatient- $15 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
In-Network Inpatient- covered in full Outpatient- $10 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
Vision (Routine)
$5 copay for exams 25 discount on lensesframes at Kaiser centers 15 discount off the costs of contact lenses
$25 copay for exam 15-20 discount through participating optical centers
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
53116
Office of Human Resources Montgomery County Government
Itrsquos a New Frontier COVID-19 has changed the way we utilize our plans MCGrsquos health insurance plans offer many value-added services and discounts to provide employees with support This year more than ever it is important to know our resources
bull Virtual doctor visits bull Built-in emotional amp wellness supportbull Disease management bull Lifestyle coachingbull Stress relief appsbull Discounts and more
Please see the 2021 Open Enrollment guide for additional information
Office of Human Resources Montgomery County Government
2021 Open Enrollment ChecklistTake Action Early Follow these steps for a successful Open Enrollment1 Review available resources
bull 2021 Open Enrollment Guide (mailed to homes on September 11th)bull Open Enrollment Websitebull County Email for Important Updates and Follow-Ups bull Benefits Bites Section of the MCG Employee Connect Newsletter
2 Attend a virtual Open Enrollment event3 Attend OHR virtual office hours4 Make changes online amp print Confirmation Statement5 (Re)Enroll in Flexible Spending Accounts (FSAs) and check FSA contribution
amounts
Office of Human Resources Montgomery County Government
Open Enrollment Website Resources Visit the Open Enrollment website for a variety of planning tools amp resources Open Enrollment schedule of virtual events Open Enrollment frequently asked questions 2021 Employee Self-Service (ESS) instruction video amp written instructions Side-by-side plan comparisons Life insurance needs estimator FSA tax savings calculator MCG employee discounts amp resources and more
Office of Human Resources Montgomery County Government
Attend a Virtual Open Enrollment Event bull Insurance Carrier Virtual Presentations and QampA Sessions Visit the Open Enrollment website for full schedule of events
bull Attend OHR Virtual Office Hours Virtual Office Hours SchedulePlease note Virtual Office Hours are held in a public virtual meeting If questions will
reveal any personal PHI (protected health information) such as a chronic medical condition or names of specific prescription drugs employees should direct those questions to OHRrsquos customer service center at 240-773-6471 to place a service request
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Paper Enrollment Form Permitted for Only Two ReasonsThere are only two exceptions permitting the use of paper Open Enrollment forms
bull Technical barriers preventing access to ESS (only in the event of no internet no smartphone or computer) the employee should contact MC311 and place a service request to be mailed a paper enrollment form Call 240-773-OHR1 (240-773-6471) available Monday through Friday 8 am to 5 pm
bull Experiencing a Life Event If an employee has a qualified status change (life event) during Open Enrollment they cannot make changes using the Open Enrollment form or online system Instead they should contact the OHR Health Insurance Team via MC311 to make changes Qualifying life events marriage divorce the birth of a child or the death of spouse or a
dependent aging out
Office of Human Resources Montgomery County Government
Dependent EligibilityEligible dependents for medical prescription dental and vision coverage arebull Spouse
Legally married EligibleDivorced Not Eligible
bull Children (biological legally adopted stepchildren or under your legal custody)Under age 26 EligibleAge 26 and over Not Eligible unless incapable of self support
Proof of eligible dependents is required
Office of Human Resources Montgomery County Government
Proof of Dependent EligibilityEmployees enrolling new dependents during Open Enrollment must upload the necessary dependent documentation in ESS prior to October 9 at 5 pmRequired Documentationbull Spouse Official State Marriage Certificate (certified by appropriate State or County Official)bull Biological Child State Birth Certificate (For newborns OHR will accept hospital discharge papers for first 60 days birth
certificate must then be submitted)bull Adopted Child Copy of Adoption or Placement for Adoption Papers bull Step-Child State Birth Certificate Marriage Certificate and Divorce Decree or Custody Papers bull Disabled Child Medical plan verification of disability prior to age 26 bull Legal Custody Copy of Court Order granting legal custody
Office of Human Resources Montgomery County Government
Marriage Certificate Example Required Documentation (Contd)
Office of Human Resources Montgomery County Government
Benefits Refresher
Office of Human Resources Montgomery County Government
Medical amp Rx
Office of Human Resources Montgomery County Government
Medical Plan OptionsHealth Maintenance Organizations (HMO)bull Kaiser Permanente Signature (HMO)bull United Healthcare Select (HMO)
Point of Service Plans (POS)bull CareFirst BCBS (POS) High Optionbull CareFirst BCBS (POS) Standard Option
Three tiers of coverage Self Self + 1 or Family
Office of Human Resources Montgomery County Government
Medical Benefits at-a-Glance To view full carrier medical summaries visit OHRrsquos Health Insurance Website
Kaiser Permanente HMO + Rx
wwwkporg
United HealthCare Select HMO
wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS)
wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS)
wwwcarefirstcom
Plan Type HMO HMO Point-of-Service Point-of-Service
PCP Required Yes Yes No No
Provider Network Regional (MDDCVA) National National National
Out-of-Network Benefits No No Yes Yes
Referrals Required Yes No No No
Annual Deductible None NoneIn-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Sheet1
Sheet1 (2)
Office of Human Resources Montgomery County Government
Medical Benefits at-a-Glance (contd)
New Employee Orientation Program
Kaiser Permanente HMO + Rx
wwwkporg
United HealthCare Select HMO
wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS)
wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS)
wwwcarefirstcom
Dr Office Visits PCPSpecialist $5 copay $5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits Covered in full $5 copay $10 copay In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care $5 copay $15 copay Covered in full Covered in full
Emergency Room $50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization Covered in full Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
Visit OHRrsquos Health Insurance webpage to view Medical summaries
Sheet1
Sheet1 (2)
Office of Human Resources Montgomery County Government
Prescription Plans Caremarkbull Two Rx Plan OptionsStandardHigh
bull If you elect UHC or CareFirst and want Rx coverage you will need to elect the stand-alone Caremark Rx plan (Kaiser already includes Rx coverage)
bull Maintenance Choice Program available for maintenance drugs significant cost savings ndash 1 copay for each 90-day prescription In order to get the Maintenance pricing you must fil Rx at CVS retail pharmacy Mail order
Office of Human Resources Montgomery County Government
Prescription Drug Plan Comparison High Option $48
Only MCGEOIAFF employees can enroll in this High plan
High Option $510Only FOPNON-REP employees
can enroll in this High plan
Standard Option All employees can enroll in this
Standard plan
Copay $4 Generics$8 Brand Name
$5 Generics$10 Brand Name
$10 Generics$20 PBrand Name
$35 NPBrand NameDeductible na na $50yearMail Order Yes Yes Yes
Maintenance Choice Yes Yes YesCovered Drugs Same Same Same
Visit OHRrsquos Health Insurance Website to view Rx summaries
Office of Human Resources Montgomery County Government
Prescription Drug Cost Comparison Cost
High Option $48Only MCGEOIAFF employees
can enroll in this High plan
High Option $510Only FOPNON-REP employees
can enroll in this High plan
Standard Option All employees can enroll in this
Standard plan
Self Only
Bi-Weekly $11339Monthly $24568Yearly $294814
Bi-Weekly $11100Monthly $24050Yearly $288600
Bi-Weekly $2413Monthly $5258Yearly $62738
Self + 1
Bi-Weekly $20979Monthly $45455Yearly $545454
Bi-Weekly $20536Monthly $44495Yearly $533936
Bi-Weekly $4463Monthly $9670
Yearly $116038
Self + Family
Bi-Weekly $32511Monthly $70441Yearly $845286
Bi-Weekly $31824Monthly $68952Yearly $827424
Bi-Weekly $6916Monthly $14985Yearly $179816
Office of Human Resources Montgomery County Government
Dental
Office of Human Resources Montgomery County Government
Dental Comparison Cigna
For a list of HMO covered services and assigned costs (copays) view the HMO benefit summary
Required to Use An Assigned Provider Yes In-network only Primary Dental Office will be
assigned based on home address
No
Out of Network Benefits Available No Yes
Balance Billing for Covered Services No Yes if you go out-of-network
Referral Required Yes No
Orthodontia Benefits Available Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime) Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person) Unlimited $200000
Deductible (singlefamily) None $50 $ 150 waived for preventive care
Table 1
Office of Human Resources Montgomery County Government
Vision
Office of Human Resources Montgomery County Government
Vision Insurancebull The Countyrsquos Vision carrier is EyeMedbull Benefits payable for exams lenses and contacts (elective or necessary) every
calendar year frames every two calendar yearsbull In-network or out-of-network benefits available bull Enhanced Hearing Benefit through EyeMedrsquos partner Amplifon40 off hearing examDiscounted pricing on thousands of hearing aids including latest technologyOne-year free follow-up care with unlimited appointmentsFree batteries for two years with initial purchase Three-year warranty and loss and damage coverage
Visit OHRrsquos Health Insurance webpage to view vision summary
Office of Human Resources Montgomery County Government
Optional Life amp Dependent Life
Office of Human Resources Montgomery County Government
Optional Life Insurance ADampDbull You may elect Optional Life ADampD coverage for yourself in increments of 1 to 8 times
your basic annual earnings ($1 million maximum)
bull NOTE Coverage is not guaranteed issue for any level You must complete an online Statement of Health no matter what level of coverage you elect Later this fall after Open Enrollment ends you will receive an email from MetLife with a link to complete the Statement of Health online
bull An eligible dependent is defined as 1) your opposite or same sex spouse or 2) your unmarried children under age 26 (natural adopted or stepchildrenfoster children who depend on your support)
Office of Human Resources Montgomery County Government
Optional Life Insurance RatesHow to estimate your Optional Life Insurance bi-weekly rate
Example 40-year-old applying for 2 x salary Salary is $49300
Steps Example Calculate for Yourself
A Find your age-based rate on the rate sheet (left) $ 0037 $_________________
B Choose how much coverage you are applying for
$99000 (2 x salary rounded to the nearest $1000 ) $_________________
C Divide that coverage amount by 100099 ($99000 1000) $_________________
D Multiply A x C for estimated bi-weekly cost$366 ($037 x 99) $_________________
Office of Human Resources Montgomery County Government
Dependent Life InsuranceYou may also purchase Dependent Optional Life insurance forbull Your opposite or same sex spouse bull Your unmarried children under age 26
ndash Natural adoptedndash Stepchildrenfoster childrenNote you do not need to supply marriage certificatesbirth certificates for dependent optional life
You may electbull $2000 Spouse$1000 Childbull $4000 Spouse $2000 Childbull $10000 Spouse $5000 Child
The bi-weekly rate is not based on salary
Office of Human Resources Montgomery County Government
Flexible Spending Accounts
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Visit the Open Enrollment website to watch a recorded FSA presentation from MCGrsquos FSA vendor Benefit Strategies
bull What is an FSA It is an IRS-approved tax-free account that saves onQualified out-of-pocket medical and dependent care expensesFederal and State Income taxSocial Security Tax
bull 3 Account Options Health Care FSA Child Care FSA and Commuter Choice Transit bull FSA accounts are administered through Benefit Strategies bull FSAs are ldquouse-it or lose-itrdquo accounts claims must be incurred during the 2021 plan year (January 1
2021 ndash March 15 2022) and submitted by April 30 2022
IMPORTANT You must re-enroll in an FSA every Open Enrollment if you want to participate in the upcoming plan year
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Why You Should EnrollGive yourself a raise by reducing your taxesbull Elect the annual amount you want to place in your FSA(s) for the upcoming plan year during Open Enrollmentbull That amount is divided by 26 and taken from your biweekly paychecks on a pre-tax basis (21 paychecks for
10-month employees)bull Then use your pre-tax FSA dollars to pay for eligible out-of-pocket health care child-care or transit
expenses
Office of Human Resources Montgomery County Government
Health Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull Claims must be submitted by April 30 of the following yearbull You may elect to contribute up to $2750 Your total annual election amount is available to spend on the first
day of the new plan year bull FSA debit card allows you to pay for expenses at the time of servicebull Examples of IRS qualified eligible expenses
bull Copays (medical prescription dental vision) deductibles and coinsurance amounts over reasonable and customary charge
bull Hearing aids bull Acupuncture bull Orthopedic shoes bull Over-the-counter (OTC) drugs (no longer require doctorrsquos prescription)
Office of Human Resources Montgomery County Government
Child Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull $5000 annual maximum per household ($2500 for married filing separately)bull Funds are available to spend as they are accumulated through payroll deductionsbull Reimbursable expenses
bull day care centersbull elder carebull beforeafter school carebull babysitter fees that allow you and your spouse to work or go to school (no child support payments)
bull Qualifying dependentsbull Children under the age of 13 and are a tax dependent of the employeebull Spouse or tax dependent that is physically or mentally incapable of self-care
bull Must coordinate between filing a tax credit with IRS and your Dependent Care FSA plan
Office of Human Resources Montgomery County Government
Commuter Choice Transit FSAbull $230 per month maximum for MCGEO staff $260 per month maximum for Unrepresented staffbull Applies to employee commuting expenses only (not spouses or dependents)bull Can enroll throughout the year (not limited to Open Enrollment election)bull Eligible expenses include Metro Marc Vanpool Lyft Line Uber Poolbull Debit card ndash may be used for some expenses (not Metro)Metro riders will have to submit claim forms for reimbursement
bull Funds must be used within 180 days of election bull If retiring or leaving the County will need to coordinate use all available funds
Office of Human Resources Montgomery County Government
Using Your FSA FundsHealth Care FSA Your full annual election amount is available on the first day of the plan yearChild Care FSA Your funds are available as they accumulate through payroll deductionsCommuterTransit FSA Your funds are available as they accumulate through payroll deductions
The FSA Debit Card bull Your FSA debit card is the same card for your Health Care Child Care and TransitCommuter FSA accountsbull The card is pre-loaded with your full annual Health Care FSA election amount You can use the card to pay for IRS qualified expenses at
the time of service or when paying a bill Receipt notifications will be mailed to you monthly by Benefit Strategies Your response to receipt notifications is necessary under the provisions of the plan No response my result in the ineligibility of the purchase and as a result your card may be temporarily deactivated
bull If you are enrolled in the Child Care FSA the card can also be used in child-care settings Just remember that the card will only work for an amount that does not exceed the available balance in your Child Care FSA account on that day
bull The card can also be used to pay for your commutertransit expenses however it does not work for WMATA metro Metro riders will have to submit manual claims for reimbursement from your CommuterTransit FSA
bull Cards are re-loaded each year after you make your new annual election Please keep your cards You will only receive a new card if your old card is about to expire
Office of Human Resources Montgomery County Government
AFLAC Voluntary Plans
Office of Human Resources Montgomery County Government
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Short-Term Disabilitybull Provides short-term cash benefits in the event of disabilitybull Monthly benefit amounts available from $500 - $6000 (subject to income requirements)bull Benefit options of 3 6 12 18 or 24 months with a variety of elimination periods
Critical Illness Insurancebull Provides a lump sum cash benefit in the event of critical illnessbull Benefit amounts available in $5000 increments from $10000 - $30000
Participants pay 100 through payroll deduction for Short-Term Disability and Critical Illness Insurance
To ENROLL Text SETAPPTrdquo to 41411orCall 920-420-8861 orEmail susan_mcdanielusAflaccom
Office of Human Resources Montgomery County Government
Carrier Resources amp Cost-Saving Tips
Office of Human Resources Montgomery County Government
Lower Your Out-of-Pocket CostsChoose the plan thatrsquos right for youbull See the medical benefits chart for options bull Stay in network Use the provider search engines on your carrier website or mobile app to find in-network providersSeek preventive carebull Check-ups immunizations and screenings are an important part of staying healthy They can detect or prevent serious diseases and keep you healthyKnow where to go for carebull You have many options of places to go when you need care If your medical condition isnrsquot serious or life threatening you can save money by connecting
with a doctor online through a virtual visit or going to an urgent care center or convenience care clinic instead of a hospital emergency roomReview your prescription drug plan optionsbull Decide which Caremark prescription plan is best for you Note that the Kaiser HMO includes prescription drug coverage Both the Standard and High
Option Caremark plans cover the same prescription drugs but have different copay and deductiblesUse generic and long-term prescriptions bull Opt for lower-cost generic drugs whenever possible bull Ask your doctor to write a 90-day prescription instead of a 30-day prescription to participate in the mail order prescription programTake advantage of tax savings by participating in Flexible Spending Accountsbull Use pre-tax dollars for eligible out of pocket services and items
Office of Human Resources Montgomery County Government
Built-in Wellness Support Take advantage of the free programs available to you through your medical carrier Each of MCGrsquos medical carriers (Kaiser UHC amp CareFirst) offer valuable programs to help you manage your health
Disease Management Programsbull Help manage your chronic condition through personalized coaching support and encouragement and online education materialsEmotional Wellness amp Stress Management Support bull Help manage stress through mobile apps and other self-care resources Maternity Programsbull Support healthy moms and healthy babiesWeight-loss Programs bull Offers telephonic coaching support and web-based tools to help ensure long-term weight managementbull See the next slide for an example of an MCG success storySmoking Cessation Programsbull Supportive coaching to make quitting more successfulDiscounts bull Gym memberships weight loss programs and moreFor more information about the programs available to you please see the Open Enrollment Guide and contact your medical carrier
Office of Human Resources Montgomery County Government
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You GoAll of MCGrsquos health insurance carriers offer a simple-to-use tool that can help make your life easier while yoursquore on the go Download your carrierrsquos Mobile App to help you personalize organize and access your important plan information on your phone or tablet
bull Schedule Virtual Visitsbull Manage and track claimsbull View ID card informationbull Find doctor and compare costs and quality ratingsbull Review your coveragebull Track your account balances and deductiblesbull Access a variety of health and wellness tools
Visit Google Play or the Apple App Store to download your carrierrsquos App
Office of Human Resources Montgomery County Government
Making Changes
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Questions
Office of Human Resources Montgomery County Government
Open Enrollment AssistanceFollow these steps (in this order)1 Review the frequently asked questions (FAQs) on the Open Enrollment website at wwwmontgomerycountymdgovoe
(available beginning September 21) You can enter key words into the interactive search bar to quickly locate the answer to your question
2 Visit the MC311 website at wwwmontgomerycountymdgovmc311 and search key words for your question The search results contain various knowledge-based articles with information related to your search words Simply click on the corresponding link and the detailed answer is revealed
3 Attend one of OHRrsquos Virtual Office Hours via Microsoft Teams Members of OHRs Health Insurance Team will be on hand to address employee questions by video or via the chat box View the schedule and access the sessions through the Open Enrollment website at wwwmontgomerycountymdgovoe (available beginning September 21)
4 If you have tried all the methods above and still have Open Enrollment-related questions please contact OHRs MC311 Customer Service Center at 240-773-6471 (Mon-Fri 8 am - 5 pm) to open a service request A member of the health insurance team will respond to service requests in the order they are received Tip Please provide an email address at the time you place your Service Request This will ensure the fastest response possible
Office of Human Resources Montgomery County Government
Online ResourcesVisit the 2021 Open Enrollment Webpage
wwwmontgomerycountymdgovOE
Visit OHRrsquos WebpagewwwmontgomerycountymdgovHR
Health Insurance active employees
Office of Human Resources Montgomery County Government
Legal InformationThe County reserves the right at any time and for any reason to amend the Program subject to the Countys collective bargainingagreements The County expects to continue the Program but it is the Countys position that there is no implied contract between individual employees and the County to do so
The County may amend the Program prospectively or retroactively to comply with applicable law
In the event of a conflict between this presentation the County Code andor the Summary Description the County Code then the Summary Description will govern
Office of Human Resources Montgomery County Government
Thank YouWe hope you enjoyed learning about 2021 Open Enrollment
~Your OHR Health Insurance Team
2021 Open Enrollment Benefits Bonanza
What Is Open Enrollment
What Changes Can be Made
Open Enrollment Dates
MCG Continues to Make Generous Employer Contributions
New for 2021
Special 2021 Plan Rates Announcement
Employee Rate Changes for Calendar Year 2021
Planning Ahead Minimizing Future Rate Increases
New for 2021
Open Enrollment Communications
Itrsquos a New Frontier
2021 Open Enrollment Checklist
Open Enrollment Website Resources
Attend a Virtual Open Enrollment Event
Make Changes Online
Paper Enrollment Form Permitted for Only Two Reasons
Dependent Eligibility
Proof of Dependent Eligibility
Marriage Certificate Example Required Documentation (Contd)
Benefits Refresher
Medical amp Rx
Medical Plan Options
Medical Benefits at-a-Glance
Medical Benefits at-a-Glance (contd)
Prescription Plans Caremark
Prescription Drug Plan Comparison
Prescription Drug Cost Comparison
Dental
Slide Number 30
Vision
Vision Insurance
Optional Life amp Dependent Life
Optional Life Insurance ADampD
Optional Life Insurance Rates
Dependent Life Insurance
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs)Why You Should Enroll
Health Care FSA
Child Care FSA
Commuter Choice Transit FSA
Using Your FSA Funds
AFLAC Voluntary Plans
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Carrier Resources amp Cost-Saving Tips
Lower Your Out-of-Pocket Costs
Built-in Wellness Support
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You Go
Making Changes
Make Changes Online
Questions
Open Enrollment Assistance
Online Resources
Legal Information
Thank You
Cigna Dental Comparison
DHMO
PPO
CIGNA NETWORK
Care-Access PlusDHMO
Total CIGNA PPOPPO
Required to Use An Assigned Provider
Yes In-network only Primary Dental Office will be assigned based on home address
No
Out of Network Benefits Available
No
Yes
Balance Billing for Covered Services
No
Yes if you go out-of-network
Referral Required
Yes
No
Orthodontia Benefits Available
Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime)
Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person)
Unlimited
$200000
Deductible (singlefamily)
None
$50 $ 150 waived for preventive care
1Claim submission would be required and balance billing may occur when visiting a nonparticipating provider2Deductible does not apply to Class I ndash Diagnostic and Preventive Services
Coverage for dependents would cease on the day which the child turns 26Benefit Maximum and Deductibles are for the period of January 01 through December 31
All services listed on this benefit summary are subject to the contractSchedules of Benefits and current Exclusions and Limitations
Medical Benefits at a Glance
Kaiser Permanente HMO + Rx wwwkporg
United HealthCare Select HMO wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS) wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS) wwwcarefirstcom
Plan Type
HMO
HMO
Point-of-Service
Point-of-Service
PCP Required
Yes
Yes
No
No
Provider Network
Regional (MDDCVA)
National
National
National
Out-of-Network Benefits
No
No
Yes
Yes
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
None
None
In-Network None Out-of-Network 80
In-Network None Out-of-Network 80
Dr Office Visits PCPSpecialist
$5 copay
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits
Covered in full
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care
$5 copay
$15 copay
Covered in full
Covered in full
Emergency Room
$50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization
Covered in full
Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
MCG 2018 Medical Plan Comparison Chart
Kaiser Permanente
United HealthCare
CareFirst POS Standard
CareFirst POS High
Plan Type
HMO
HMO
Point of Service
Point of Service
Provider Network
Regional (MDDCVA)
National
National
National
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
Annual Out-of-Pocket Maximum
None
$1100 per individual up to cap of $3600 for a family
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
Physician Servcies
PCP Office Visits
$5 copay
$5 copay PCP
In-Network $15 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Specialist Office Visits
$5 copay
$10 copay
In-Network $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Annual Physical
Covered in full
$5 copay PCP
In-Network $15 copay Primary Care Physician $30 copay specialist Out-of-Network 80 covered after deductible (limit 1calendar year)
In-Network $15 copay Out-of-Network 80 not subject to deductible (up to age 18)
In-Network $10 copay Out-of-Network 80 not subject to deductible (up to age 18)
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Allergy Testing
$5 copay
$5 copay PCP $10 copay Specialist
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Virtual Visits
Labs X-Rays Diagnostics
Outpatient labs
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient X-Rays
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Major Diagnostics
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Immedate Medical Servcies
Emergency Room
$50 copay waived if admitted to hospital
$25 copay waived if admitted to hospital $15 copay for urgent care
In-Network $35 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
Urgent Care
Hospital Services
Inpatient Hospitalization
Covered in full
Covered in full
In-Network Covered in full after $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Services
Surgery
Covered in full
Inpatient covered in full Outpatient $25 copay
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Hearing Aids
For minor children One hearing aid for each hearing impaired ear once every 36 months
For minor children One hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
Hearing Screening
$5 copay for hearing exam (hearing aids are excluded)
$5 Copay PCP $10 Copay Specialist
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
Home Health Care Services
Covered in full if medically necessary
Covered in full No copayment 60 visit maximum for skilled care services per calendar year
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
Hospice
Covered in full
Covered in full (See coverage booklet for eligibility information)
In-Network Covered in full
In-Network Covered in full
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
In vitro Fertilization
Limited to 3 attempts per live birth Lifetime maximum of $100000
Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
Mammography - Preventive Screening Schedule
Schedule consistent with the current recommendations of the American College of Physicians
Covered in full Age 35-39 one baseline mammogram Age 40-49 one mammogram every two calendar years Age 50+ one mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
Maternity
Covered in full once pregnancy is diagnosed
No copayment applies after the first visit
In-Network first visit 100 after $30 copay other visits 100
In-Network First visit 100 after $10 copay other visits 100
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Maximum Lifetime Benefit
Unlimited maximum
Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
Prescriptions
Kaiser Rx plan (included with Kaiser HMO medical plan) $5 at on-site pharmacies and for mail order $15 at participating pharmacies
No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
Rehabilitation Services
Inpatient Covered in full (unlimited) Outpatient $5 copay outpatient services for physical therapy are limited to up to 30 visits occupational and speech therapy per injury incident or condition are covered for a period not to exceed 90 days
$10 copayvisit 60 combined visits per year (short-term non-chronic conditions only)
In-Network
In-Network
100
100
Skilled Nursing Facility
Covered in full 100 days maximum
Covered in full 60 days per calendar year maximum
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Substance AbuseMental Health
Inpatient Covered in full Outpatient $5 copay
Inpatient Covered in full Outpatient $5 copay
In-Network Inpatient- $150 per admission copay Outpatient- $15 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
In-Network Inpatient- covered in full Outpatient- $10 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
Vision (Routine)
$5 copay for exams 25 discount on lensesframes at Kaiser centers 15 discount off the costs of contact lenses
$25 copay for exam 15-20 discount through participating optical centers
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
53116
Medical Benefits at a Glance
Kaiser Permanente HMO + Rx wwwkporg
United HealthCare Select HMO wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS) wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS) wwwcarefirstcom
Plan Type
HMO
HMO
Point-of-Service
Point-of-Service
PCP Required
Yes
Yes
No
No
Provider Network
Regional (MDDCVA)
National
National
National
Out-of-Network Benefits
No
No
Yes
Yes
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
None
None
In-Network None Out-of-Network 80
In-Network None Out-of-Network 80
Dr Office Visits PCPSpecialist
$5 copay
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits
Covered in full
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care
$5 copay
$15 copay
Covered in full
Covered in full
Emergency Room
$50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization
Covered in full
Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
MCG 2018 Medical Plan Comparison Chart
Kaiser Permanente
United HealthCare
CareFirst POS Standard
CareFirst POS High
Plan Type
HMO
HMO
Point of Service
Point of Service
Provider Network
Regional (MDDCVA)
National
National
National
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
Annual Out-of-Pocket Maximum
None
$1100 per individual up to cap of $3600 for a family
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
Physician Servcies
PCP Office Visits
$5 copay
$5 copay PCP
In-Network $15 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Specialist Office Visits
$5 copay
$10 copay
In-Network $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Annual Physical
Covered in full
$5 copay PCP
In-Network $15 copay Primary Care Physician $30 copay specialist Out-of-Network 80 covered after deductible (limit 1calendar year)
In-Network $15 copay Out-of-Network 80 not subject to deductible (up to age 18)
In-Network $10 copay Out-of-Network 80 not subject to deductible (up to age 18)
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Allergy Testing
$5 copay
$5 copay PCP $10 copay Specialist
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Virtual Visits
Labs X-Rays Diagnostics
Outpatient labs
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient X-Rays
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Major Diagnostics
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Immedate Medical Servcies
Emergency Room
$50 copay waived if admitted to hospital
$25 copay waived if admitted to hospital $15 copay for urgent care
In-Network $35 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
Urgent Care
Hospital Services
Inpatient Hospitalization
Covered in full
Covered in full
In-Network Covered in full after $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Services
Surgery
Covered in full
Inpatient covered in full Outpatient $25 copay
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Hearing Aids
For minor children One hearing aid for each hearing impaired ear once every 36 months
For minor children One hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
Hearing Screening
$5 copay for hearing exam (hearing aids are excluded)
$5 Copay PCP $10 Copay Specialist
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
Home Health Care Services
Covered in full if medically necessary
Covered in full No copayment 60 visit maximum for skilled care services per calendar year
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
Hospice
Covered in full
Covered in full (See coverage booklet for eligibility information)
In-Network Covered in full
In-Network Covered in full
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
In vitro Fertilization
Limited to 3 attempts per live birth Lifetime maximum of $100000
Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
Mammography - Preventive Screening Schedule
Schedule consistent with the current recommendations of the American College of Physicians
Covered in full Age 35-39 one baseline mammogram Age 40-49 one mammogram every two calendar years Age 50+ one mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
Maternity
Covered in full once pregnancy is diagnosed
No copayment applies after the first visit
In-Network first visit 100 after $30 copay other visits 100
In-Network First visit 100 after $10 copay other visits 100
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Maximum Lifetime Benefit
Unlimited maximum
Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
Prescriptions
Kaiser Rx plan (included with Kaiser HMO medical plan) $5 at on-site pharmacies and for mail order $15 at participating pharmacies
No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
Rehabilitation Services
Inpatient Covered in full (unlimited) Outpatient $5 copay outpatient services for physical therapy are limited to up to 30 visits occupational and speech therapy per injury incident or condition are covered for a period not to exceed 90 days
$10 copayvisit 60 combined visits per year (short-term non-chronic conditions only)
In-Network
In-Network
100
100
Skilled Nursing Facility
Covered in full 100 days maximum
Covered in full 60 days per calendar year maximum
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Substance AbuseMental Health
Inpatient Covered in full Outpatient $5 copay
Inpatient Covered in full Outpatient $5 copay
In-Network Inpatient- $150 per admission copay Outpatient- $15 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
In-Network Inpatient- covered in full Outpatient- $10 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
Vision (Routine)
$5 copay for exams 25 discount on lensesframes at Kaiser centers 15 discount off the costs of contact lenses
$25 copay for exam 15-20 discount through participating optical centers
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
53116
Office of Human Resources Montgomery County Government
2021 Open Enrollment ChecklistTake Action Early Follow these steps for a successful Open Enrollment1 Review available resources
bull 2021 Open Enrollment Guide (mailed to homes on September 11th)bull Open Enrollment Websitebull County Email for Important Updates and Follow-Ups bull Benefits Bites Section of the MCG Employee Connect Newsletter
2 Attend a virtual Open Enrollment event3 Attend OHR virtual office hours4 Make changes online amp print Confirmation Statement5 (Re)Enroll in Flexible Spending Accounts (FSAs) and check FSA contribution
amounts
Office of Human Resources Montgomery County Government
Open Enrollment Website Resources Visit the Open Enrollment website for a variety of planning tools amp resources Open Enrollment schedule of virtual events Open Enrollment frequently asked questions 2021 Employee Self-Service (ESS) instruction video amp written instructions Side-by-side plan comparisons Life insurance needs estimator FSA tax savings calculator MCG employee discounts amp resources and more
Office of Human Resources Montgomery County Government
Attend a Virtual Open Enrollment Event bull Insurance Carrier Virtual Presentations and QampA Sessions Visit the Open Enrollment website for full schedule of events
bull Attend OHR Virtual Office Hours Virtual Office Hours SchedulePlease note Virtual Office Hours are held in a public virtual meeting If questions will
reveal any personal PHI (protected health information) such as a chronic medical condition or names of specific prescription drugs employees should direct those questions to OHRrsquos customer service center at 240-773-6471 to place a service request
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Paper Enrollment Form Permitted for Only Two ReasonsThere are only two exceptions permitting the use of paper Open Enrollment forms
bull Technical barriers preventing access to ESS (only in the event of no internet no smartphone or computer) the employee should contact MC311 and place a service request to be mailed a paper enrollment form Call 240-773-OHR1 (240-773-6471) available Monday through Friday 8 am to 5 pm
bull Experiencing a Life Event If an employee has a qualified status change (life event) during Open Enrollment they cannot make changes using the Open Enrollment form or online system Instead they should contact the OHR Health Insurance Team via MC311 to make changes Qualifying life events marriage divorce the birth of a child or the death of spouse or a
dependent aging out
Office of Human Resources Montgomery County Government
Dependent EligibilityEligible dependents for medical prescription dental and vision coverage arebull Spouse
Legally married EligibleDivorced Not Eligible
bull Children (biological legally adopted stepchildren or under your legal custody)Under age 26 EligibleAge 26 and over Not Eligible unless incapable of self support
Proof of eligible dependents is required
Office of Human Resources Montgomery County Government
Proof of Dependent EligibilityEmployees enrolling new dependents during Open Enrollment must upload the necessary dependent documentation in ESS prior to October 9 at 5 pmRequired Documentationbull Spouse Official State Marriage Certificate (certified by appropriate State or County Official)bull Biological Child State Birth Certificate (For newborns OHR will accept hospital discharge papers for first 60 days birth
certificate must then be submitted)bull Adopted Child Copy of Adoption or Placement for Adoption Papers bull Step-Child State Birth Certificate Marriage Certificate and Divorce Decree or Custody Papers bull Disabled Child Medical plan verification of disability prior to age 26 bull Legal Custody Copy of Court Order granting legal custody
Office of Human Resources Montgomery County Government
Marriage Certificate Example Required Documentation (Contd)
Office of Human Resources Montgomery County Government
Benefits Refresher
Office of Human Resources Montgomery County Government
Medical amp Rx
Office of Human Resources Montgomery County Government
Medical Plan OptionsHealth Maintenance Organizations (HMO)bull Kaiser Permanente Signature (HMO)bull United Healthcare Select (HMO)
Point of Service Plans (POS)bull CareFirst BCBS (POS) High Optionbull CareFirst BCBS (POS) Standard Option
Three tiers of coverage Self Self + 1 or Family
Office of Human Resources Montgomery County Government
Medical Benefits at-a-Glance To view full carrier medical summaries visit OHRrsquos Health Insurance Website
Kaiser Permanente HMO + Rx
wwwkporg
United HealthCare Select HMO
wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS)
wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS)
wwwcarefirstcom
Plan Type HMO HMO Point-of-Service Point-of-Service
PCP Required Yes Yes No No
Provider Network Regional (MDDCVA) National National National
Out-of-Network Benefits No No Yes Yes
Referrals Required Yes No No No
Annual Deductible None NoneIn-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Sheet1
Sheet1 (2)
Office of Human Resources Montgomery County Government
Medical Benefits at-a-Glance (contd)
New Employee Orientation Program
Kaiser Permanente HMO + Rx
wwwkporg
United HealthCare Select HMO
wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS)
wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS)
wwwcarefirstcom
Dr Office Visits PCPSpecialist $5 copay $5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits Covered in full $5 copay $10 copay In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care $5 copay $15 copay Covered in full Covered in full
Emergency Room $50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization Covered in full Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
Visit OHRrsquos Health Insurance webpage to view Medical summaries
Sheet1
Sheet1 (2)
Office of Human Resources Montgomery County Government
Prescription Plans Caremarkbull Two Rx Plan OptionsStandardHigh
bull If you elect UHC or CareFirst and want Rx coverage you will need to elect the stand-alone Caremark Rx plan (Kaiser already includes Rx coverage)
bull Maintenance Choice Program available for maintenance drugs significant cost savings ndash 1 copay for each 90-day prescription In order to get the Maintenance pricing you must fil Rx at CVS retail pharmacy Mail order
Office of Human Resources Montgomery County Government
Prescription Drug Plan Comparison High Option $48
Only MCGEOIAFF employees can enroll in this High plan
High Option $510Only FOPNON-REP employees
can enroll in this High plan
Standard Option All employees can enroll in this
Standard plan
Copay $4 Generics$8 Brand Name
$5 Generics$10 Brand Name
$10 Generics$20 PBrand Name
$35 NPBrand NameDeductible na na $50yearMail Order Yes Yes Yes
Maintenance Choice Yes Yes YesCovered Drugs Same Same Same
Visit OHRrsquos Health Insurance Website to view Rx summaries
Office of Human Resources Montgomery County Government
Prescription Drug Cost Comparison Cost
High Option $48Only MCGEOIAFF employees
can enroll in this High plan
High Option $510Only FOPNON-REP employees
can enroll in this High plan
Standard Option All employees can enroll in this
Standard plan
Self Only
Bi-Weekly $11339Monthly $24568Yearly $294814
Bi-Weekly $11100Monthly $24050Yearly $288600
Bi-Weekly $2413Monthly $5258Yearly $62738
Self + 1
Bi-Weekly $20979Monthly $45455Yearly $545454
Bi-Weekly $20536Monthly $44495Yearly $533936
Bi-Weekly $4463Monthly $9670
Yearly $116038
Self + Family
Bi-Weekly $32511Monthly $70441Yearly $845286
Bi-Weekly $31824Monthly $68952Yearly $827424
Bi-Weekly $6916Monthly $14985Yearly $179816
Office of Human Resources Montgomery County Government
Dental
Office of Human Resources Montgomery County Government
Dental Comparison Cigna
For a list of HMO covered services and assigned costs (copays) view the HMO benefit summary
Required to Use An Assigned Provider Yes In-network only Primary Dental Office will be
assigned based on home address
No
Out of Network Benefits Available No Yes
Balance Billing for Covered Services No Yes if you go out-of-network
Referral Required Yes No
Orthodontia Benefits Available Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime) Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person) Unlimited $200000
Deductible (singlefamily) None $50 $ 150 waived for preventive care
Table 1
Office of Human Resources Montgomery County Government
Vision
Office of Human Resources Montgomery County Government
Vision Insurancebull The Countyrsquos Vision carrier is EyeMedbull Benefits payable for exams lenses and contacts (elective or necessary) every
calendar year frames every two calendar yearsbull In-network or out-of-network benefits available bull Enhanced Hearing Benefit through EyeMedrsquos partner Amplifon40 off hearing examDiscounted pricing on thousands of hearing aids including latest technologyOne-year free follow-up care with unlimited appointmentsFree batteries for two years with initial purchase Three-year warranty and loss and damage coverage
Visit OHRrsquos Health Insurance webpage to view vision summary
Office of Human Resources Montgomery County Government
Optional Life amp Dependent Life
Office of Human Resources Montgomery County Government
Optional Life Insurance ADampDbull You may elect Optional Life ADampD coverage for yourself in increments of 1 to 8 times
your basic annual earnings ($1 million maximum)
bull NOTE Coverage is not guaranteed issue for any level You must complete an online Statement of Health no matter what level of coverage you elect Later this fall after Open Enrollment ends you will receive an email from MetLife with a link to complete the Statement of Health online
bull An eligible dependent is defined as 1) your opposite or same sex spouse or 2) your unmarried children under age 26 (natural adopted or stepchildrenfoster children who depend on your support)
Office of Human Resources Montgomery County Government
Optional Life Insurance RatesHow to estimate your Optional Life Insurance bi-weekly rate
Example 40-year-old applying for 2 x salary Salary is $49300
Steps Example Calculate for Yourself
A Find your age-based rate on the rate sheet (left) $ 0037 $_________________
B Choose how much coverage you are applying for
$99000 (2 x salary rounded to the nearest $1000 ) $_________________
C Divide that coverage amount by 100099 ($99000 1000) $_________________
D Multiply A x C for estimated bi-weekly cost$366 ($037 x 99) $_________________
Office of Human Resources Montgomery County Government
Dependent Life InsuranceYou may also purchase Dependent Optional Life insurance forbull Your opposite or same sex spouse bull Your unmarried children under age 26
ndash Natural adoptedndash Stepchildrenfoster childrenNote you do not need to supply marriage certificatesbirth certificates for dependent optional life
You may electbull $2000 Spouse$1000 Childbull $4000 Spouse $2000 Childbull $10000 Spouse $5000 Child
The bi-weekly rate is not based on salary
Office of Human Resources Montgomery County Government
Flexible Spending Accounts
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Visit the Open Enrollment website to watch a recorded FSA presentation from MCGrsquos FSA vendor Benefit Strategies
bull What is an FSA It is an IRS-approved tax-free account that saves onQualified out-of-pocket medical and dependent care expensesFederal and State Income taxSocial Security Tax
bull 3 Account Options Health Care FSA Child Care FSA and Commuter Choice Transit bull FSA accounts are administered through Benefit Strategies bull FSAs are ldquouse-it or lose-itrdquo accounts claims must be incurred during the 2021 plan year (January 1
2021 ndash March 15 2022) and submitted by April 30 2022
IMPORTANT You must re-enroll in an FSA every Open Enrollment if you want to participate in the upcoming plan year
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Why You Should EnrollGive yourself a raise by reducing your taxesbull Elect the annual amount you want to place in your FSA(s) for the upcoming plan year during Open Enrollmentbull That amount is divided by 26 and taken from your biweekly paychecks on a pre-tax basis (21 paychecks for
10-month employees)bull Then use your pre-tax FSA dollars to pay for eligible out-of-pocket health care child-care or transit
expenses
Office of Human Resources Montgomery County Government
Health Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull Claims must be submitted by April 30 of the following yearbull You may elect to contribute up to $2750 Your total annual election amount is available to spend on the first
day of the new plan year bull FSA debit card allows you to pay for expenses at the time of servicebull Examples of IRS qualified eligible expenses
bull Copays (medical prescription dental vision) deductibles and coinsurance amounts over reasonable and customary charge
bull Hearing aids bull Acupuncture bull Orthopedic shoes bull Over-the-counter (OTC) drugs (no longer require doctorrsquos prescription)
Office of Human Resources Montgomery County Government
Child Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull $5000 annual maximum per household ($2500 for married filing separately)bull Funds are available to spend as they are accumulated through payroll deductionsbull Reimbursable expenses
bull day care centersbull elder carebull beforeafter school carebull babysitter fees that allow you and your spouse to work or go to school (no child support payments)
bull Qualifying dependentsbull Children under the age of 13 and are a tax dependent of the employeebull Spouse or tax dependent that is physically or mentally incapable of self-care
bull Must coordinate between filing a tax credit with IRS and your Dependent Care FSA plan
Office of Human Resources Montgomery County Government
Commuter Choice Transit FSAbull $230 per month maximum for MCGEO staff $260 per month maximum for Unrepresented staffbull Applies to employee commuting expenses only (not spouses or dependents)bull Can enroll throughout the year (not limited to Open Enrollment election)bull Eligible expenses include Metro Marc Vanpool Lyft Line Uber Poolbull Debit card ndash may be used for some expenses (not Metro)Metro riders will have to submit claim forms for reimbursement
bull Funds must be used within 180 days of election bull If retiring or leaving the County will need to coordinate use all available funds
Office of Human Resources Montgomery County Government
Using Your FSA FundsHealth Care FSA Your full annual election amount is available on the first day of the plan yearChild Care FSA Your funds are available as they accumulate through payroll deductionsCommuterTransit FSA Your funds are available as they accumulate through payroll deductions
The FSA Debit Card bull Your FSA debit card is the same card for your Health Care Child Care and TransitCommuter FSA accountsbull The card is pre-loaded with your full annual Health Care FSA election amount You can use the card to pay for IRS qualified expenses at
the time of service or when paying a bill Receipt notifications will be mailed to you monthly by Benefit Strategies Your response to receipt notifications is necessary under the provisions of the plan No response my result in the ineligibility of the purchase and as a result your card may be temporarily deactivated
bull If you are enrolled in the Child Care FSA the card can also be used in child-care settings Just remember that the card will only work for an amount that does not exceed the available balance in your Child Care FSA account on that day
bull The card can also be used to pay for your commutertransit expenses however it does not work for WMATA metro Metro riders will have to submit manual claims for reimbursement from your CommuterTransit FSA
bull Cards are re-loaded each year after you make your new annual election Please keep your cards You will only receive a new card if your old card is about to expire
Office of Human Resources Montgomery County Government
AFLAC Voluntary Plans
Office of Human Resources Montgomery County Government
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Short-Term Disabilitybull Provides short-term cash benefits in the event of disabilitybull Monthly benefit amounts available from $500 - $6000 (subject to income requirements)bull Benefit options of 3 6 12 18 or 24 months with a variety of elimination periods
Critical Illness Insurancebull Provides a lump sum cash benefit in the event of critical illnessbull Benefit amounts available in $5000 increments from $10000 - $30000
Participants pay 100 through payroll deduction for Short-Term Disability and Critical Illness Insurance
To ENROLL Text SETAPPTrdquo to 41411orCall 920-420-8861 orEmail susan_mcdanielusAflaccom
Office of Human Resources Montgomery County Government
Carrier Resources amp Cost-Saving Tips
Office of Human Resources Montgomery County Government
Lower Your Out-of-Pocket CostsChoose the plan thatrsquos right for youbull See the medical benefits chart for options bull Stay in network Use the provider search engines on your carrier website or mobile app to find in-network providersSeek preventive carebull Check-ups immunizations and screenings are an important part of staying healthy They can detect or prevent serious diseases and keep you healthyKnow where to go for carebull You have many options of places to go when you need care If your medical condition isnrsquot serious or life threatening you can save money by connecting
with a doctor online through a virtual visit or going to an urgent care center or convenience care clinic instead of a hospital emergency roomReview your prescription drug plan optionsbull Decide which Caremark prescription plan is best for you Note that the Kaiser HMO includes prescription drug coverage Both the Standard and High
Option Caremark plans cover the same prescription drugs but have different copay and deductiblesUse generic and long-term prescriptions bull Opt for lower-cost generic drugs whenever possible bull Ask your doctor to write a 90-day prescription instead of a 30-day prescription to participate in the mail order prescription programTake advantage of tax savings by participating in Flexible Spending Accountsbull Use pre-tax dollars for eligible out of pocket services and items
Office of Human Resources Montgomery County Government
Built-in Wellness Support Take advantage of the free programs available to you through your medical carrier Each of MCGrsquos medical carriers (Kaiser UHC amp CareFirst) offer valuable programs to help you manage your health
Disease Management Programsbull Help manage your chronic condition through personalized coaching support and encouragement and online education materialsEmotional Wellness amp Stress Management Support bull Help manage stress through mobile apps and other self-care resources Maternity Programsbull Support healthy moms and healthy babiesWeight-loss Programs bull Offers telephonic coaching support and web-based tools to help ensure long-term weight managementbull See the next slide for an example of an MCG success storySmoking Cessation Programsbull Supportive coaching to make quitting more successfulDiscounts bull Gym memberships weight loss programs and moreFor more information about the programs available to you please see the Open Enrollment Guide and contact your medical carrier
Office of Human Resources Montgomery County Government
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You GoAll of MCGrsquos health insurance carriers offer a simple-to-use tool that can help make your life easier while yoursquore on the go Download your carrierrsquos Mobile App to help you personalize organize and access your important plan information on your phone or tablet
bull Schedule Virtual Visitsbull Manage and track claimsbull View ID card informationbull Find doctor and compare costs and quality ratingsbull Review your coveragebull Track your account balances and deductiblesbull Access a variety of health and wellness tools
Visit Google Play or the Apple App Store to download your carrierrsquos App
Office of Human Resources Montgomery County Government
Making Changes
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Questions
Office of Human Resources Montgomery County Government
Open Enrollment AssistanceFollow these steps (in this order)1 Review the frequently asked questions (FAQs) on the Open Enrollment website at wwwmontgomerycountymdgovoe
(available beginning September 21) You can enter key words into the interactive search bar to quickly locate the answer to your question
2 Visit the MC311 website at wwwmontgomerycountymdgovmc311 and search key words for your question The search results contain various knowledge-based articles with information related to your search words Simply click on the corresponding link and the detailed answer is revealed
3 Attend one of OHRrsquos Virtual Office Hours via Microsoft Teams Members of OHRs Health Insurance Team will be on hand to address employee questions by video or via the chat box View the schedule and access the sessions through the Open Enrollment website at wwwmontgomerycountymdgovoe (available beginning September 21)
4 If you have tried all the methods above and still have Open Enrollment-related questions please contact OHRs MC311 Customer Service Center at 240-773-6471 (Mon-Fri 8 am - 5 pm) to open a service request A member of the health insurance team will respond to service requests in the order they are received Tip Please provide an email address at the time you place your Service Request This will ensure the fastest response possible
Office of Human Resources Montgomery County Government
Online ResourcesVisit the 2021 Open Enrollment Webpage
wwwmontgomerycountymdgovOE
Visit OHRrsquos WebpagewwwmontgomerycountymdgovHR
Health Insurance active employees
Office of Human Resources Montgomery County Government
Legal InformationThe County reserves the right at any time and for any reason to amend the Program subject to the Countys collective bargainingagreements The County expects to continue the Program but it is the Countys position that there is no implied contract between individual employees and the County to do so
The County may amend the Program prospectively or retroactively to comply with applicable law
In the event of a conflict between this presentation the County Code andor the Summary Description the County Code then the Summary Description will govern
Office of Human Resources Montgomery County Government
Thank YouWe hope you enjoyed learning about 2021 Open Enrollment
~Your OHR Health Insurance Team
2021 Open Enrollment Benefits Bonanza
What Is Open Enrollment
What Changes Can be Made
Open Enrollment Dates
MCG Continues to Make Generous Employer Contributions
New for 2021
Special 2021 Plan Rates Announcement
Employee Rate Changes for Calendar Year 2021
Planning Ahead Minimizing Future Rate Increases
New for 2021
Open Enrollment Communications
Itrsquos a New Frontier
2021 Open Enrollment Checklist
Open Enrollment Website Resources
Attend a Virtual Open Enrollment Event
Make Changes Online
Paper Enrollment Form Permitted for Only Two Reasons
Dependent Eligibility
Proof of Dependent Eligibility
Marriage Certificate Example Required Documentation (Contd)
Benefits Refresher
Medical amp Rx
Medical Plan Options
Medical Benefits at-a-Glance
Medical Benefits at-a-Glance (contd)
Prescription Plans Caremark
Prescription Drug Plan Comparison
Prescription Drug Cost Comparison
Dental
Slide Number 30
Vision
Vision Insurance
Optional Life amp Dependent Life
Optional Life Insurance ADampD
Optional Life Insurance Rates
Dependent Life Insurance
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs)Why You Should Enroll
Health Care FSA
Child Care FSA
Commuter Choice Transit FSA
Using Your FSA Funds
AFLAC Voluntary Plans
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Carrier Resources amp Cost-Saving Tips
Lower Your Out-of-Pocket Costs
Built-in Wellness Support
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You Go
Making Changes
Make Changes Online
Questions
Open Enrollment Assistance
Online Resources
Legal Information
Thank You
Cigna Dental Comparison
DHMO
PPO
CIGNA NETWORK
Care-Access PlusDHMO
Total CIGNA PPOPPO
Required to Use An Assigned Provider
Yes In-network only Primary Dental Office will be assigned based on home address
No
Out of Network Benefits Available
No
Yes
Balance Billing for Covered Services
No
Yes if you go out-of-network
Referral Required
Yes
No
Orthodontia Benefits Available
Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime)
Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person)
Unlimited
$200000
Deductible (singlefamily)
None
$50 $ 150 waived for preventive care
1Claim submission would be required and balance billing may occur when visiting a nonparticipating provider2Deductible does not apply to Class I ndash Diagnostic and Preventive Services
Coverage for dependents would cease on the day which the child turns 26Benefit Maximum and Deductibles are for the period of January 01 through December 31
All services listed on this benefit summary are subject to the contractSchedules of Benefits and current Exclusions and Limitations
Medical Benefits at a Glance
Kaiser Permanente HMO + Rx wwwkporg
United HealthCare Select HMO wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS) wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS) wwwcarefirstcom
Plan Type
HMO
HMO
Point-of-Service
Point-of-Service
PCP Required
Yes
Yes
No
No
Provider Network
Regional (MDDCVA)
National
National
National
Out-of-Network Benefits
No
No
Yes
Yes
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
None
None
In-Network None Out-of-Network 80
In-Network None Out-of-Network 80
Dr Office Visits PCPSpecialist
$5 copay
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits
Covered in full
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care
$5 copay
$15 copay
Covered in full
Covered in full
Emergency Room
$50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization
Covered in full
Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
MCG 2018 Medical Plan Comparison Chart
Kaiser Permanente
United HealthCare
CareFirst POS Standard
CareFirst POS High
Plan Type
HMO
HMO
Point of Service
Point of Service
Provider Network
Regional (MDDCVA)
National
National
National
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
Annual Out-of-Pocket Maximum
None
$1100 per individual up to cap of $3600 for a family
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
Physician Servcies
PCP Office Visits
$5 copay
$5 copay PCP
In-Network $15 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Specialist Office Visits
$5 copay
$10 copay
In-Network $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Annual Physical
Covered in full
$5 copay PCP
In-Network $15 copay Primary Care Physician $30 copay specialist Out-of-Network 80 covered after deductible (limit 1calendar year)
In-Network $15 copay Out-of-Network 80 not subject to deductible (up to age 18)
In-Network $10 copay Out-of-Network 80 not subject to deductible (up to age 18)
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Allergy Testing
$5 copay
$5 copay PCP $10 copay Specialist
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Virtual Visits
Labs X-Rays Diagnostics
Outpatient labs
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient X-Rays
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Major Diagnostics
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Immedate Medical Servcies
Emergency Room
$50 copay waived if admitted to hospital
$25 copay waived if admitted to hospital $15 copay for urgent care
In-Network $35 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
Urgent Care
Hospital Services
Inpatient Hospitalization
Covered in full
Covered in full
In-Network Covered in full after $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Services
Surgery
Covered in full
Inpatient covered in full Outpatient $25 copay
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Hearing Aids
For minor children One hearing aid for each hearing impaired ear once every 36 months
For minor children One hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
Hearing Screening
$5 copay for hearing exam (hearing aids are excluded)
$5 Copay PCP $10 Copay Specialist
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
Home Health Care Services
Covered in full if medically necessary
Covered in full No copayment 60 visit maximum for skilled care services per calendar year
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
Hospice
Covered in full
Covered in full (See coverage booklet for eligibility information)
In-Network Covered in full
In-Network Covered in full
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
In vitro Fertilization
Limited to 3 attempts per live birth Lifetime maximum of $100000
Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
Mammography - Preventive Screening Schedule
Schedule consistent with the current recommendations of the American College of Physicians
Covered in full Age 35-39 one baseline mammogram Age 40-49 one mammogram every two calendar years Age 50+ one mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
Maternity
Covered in full once pregnancy is diagnosed
No copayment applies after the first visit
In-Network first visit 100 after $30 copay other visits 100
In-Network First visit 100 after $10 copay other visits 100
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Maximum Lifetime Benefit
Unlimited maximum
Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
Prescriptions
Kaiser Rx plan (included with Kaiser HMO medical plan) $5 at on-site pharmacies and for mail order $15 at participating pharmacies
No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
Rehabilitation Services
Inpatient Covered in full (unlimited) Outpatient $5 copay outpatient services for physical therapy are limited to up to 30 visits occupational and speech therapy per injury incident or condition are covered for a period not to exceed 90 days
$10 copayvisit 60 combined visits per year (short-term non-chronic conditions only)
In-Network
In-Network
100
100
Skilled Nursing Facility
Covered in full 100 days maximum
Covered in full 60 days per calendar year maximum
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Substance AbuseMental Health
Inpatient Covered in full Outpatient $5 copay
Inpatient Covered in full Outpatient $5 copay
In-Network Inpatient- $150 per admission copay Outpatient- $15 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
In-Network Inpatient- covered in full Outpatient- $10 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
Vision (Routine)
$5 copay for exams 25 discount on lensesframes at Kaiser centers 15 discount off the costs of contact lenses
$25 copay for exam 15-20 discount through participating optical centers
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
53116
Medical Benefits at a Glance
Kaiser Permanente HMO + Rx wwwkporg
United HealthCare Select HMO wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS) wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS) wwwcarefirstcom
Plan Type
HMO
HMO
Point-of-Service
Point-of-Service
PCP Required
Yes
Yes
No
No
Provider Network
Regional (MDDCVA)
National
National
National
Out-of-Network Benefits
No
No
Yes
Yes
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
None
None
In-Network None Out-of-Network 80
In-Network None Out-of-Network 80
Dr Office Visits PCPSpecialist
$5 copay
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits
Covered in full
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care
$5 copay
$15 copay
Covered in full
Covered in full
Emergency Room
$50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization
Covered in full
Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
MCG 2018 Medical Plan Comparison Chart
Kaiser Permanente
United HealthCare
CareFirst POS Standard
CareFirst POS High
Plan Type
HMO
HMO
Point of Service
Point of Service
Provider Network
Regional (MDDCVA)
National
National
National
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
Annual Out-of-Pocket Maximum
None
$1100 per individual up to cap of $3600 for a family
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
Physician Servcies
PCP Office Visits
$5 copay
$5 copay PCP
In-Network $15 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Specialist Office Visits
$5 copay
$10 copay
In-Network $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Annual Physical
Covered in full
$5 copay PCP
In-Network $15 copay Primary Care Physician $30 copay specialist Out-of-Network 80 covered after deductible (limit 1calendar year)
In-Network $15 copay Out-of-Network 80 not subject to deductible (up to age 18)
In-Network $10 copay Out-of-Network 80 not subject to deductible (up to age 18)
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Allergy Testing
$5 copay
$5 copay PCP $10 copay Specialist
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Virtual Visits
Labs X-Rays Diagnostics
Outpatient labs
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient X-Rays
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Major Diagnostics
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Immedate Medical Servcies
Emergency Room
$50 copay waived if admitted to hospital
$25 copay waived if admitted to hospital $15 copay for urgent care
In-Network $35 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
Urgent Care
Hospital Services
Inpatient Hospitalization
Covered in full
Covered in full
In-Network Covered in full after $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Services
Surgery
Covered in full
Inpatient covered in full Outpatient $25 copay
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Hearing Aids
For minor children One hearing aid for each hearing impaired ear once every 36 months
For minor children One hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
Hearing Screening
$5 copay for hearing exam (hearing aids are excluded)
$5 Copay PCP $10 Copay Specialist
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
Home Health Care Services
Covered in full if medically necessary
Covered in full No copayment 60 visit maximum for skilled care services per calendar year
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
Hospice
Covered in full
Covered in full (See coverage booklet for eligibility information)
In-Network Covered in full
In-Network Covered in full
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
In vitro Fertilization
Limited to 3 attempts per live birth Lifetime maximum of $100000
Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
Mammography - Preventive Screening Schedule
Schedule consistent with the current recommendations of the American College of Physicians
Covered in full Age 35-39 one baseline mammogram Age 40-49 one mammogram every two calendar years Age 50+ one mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
Maternity
Covered in full once pregnancy is diagnosed
No copayment applies after the first visit
In-Network first visit 100 after $30 copay other visits 100
In-Network First visit 100 after $10 copay other visits 100
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Maximum Lifetime Benefit
Unlimited maximum
Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
Prescriptions
Kaiser Rx plan (included with Kaiser HMO medical plan) $5 at on-site pharmacies and for mail order $15 at participating pharmacies
No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
Rehabilitation Services
Inpatient Covered in full (unlimited) Outpatient $5 copay outpatient services for physical therapy are limited to up to 30 visits occupational and speech therapy per injury incident or condition are covered for a period not to exceed 90 days
$10 copayvisit 60 combined visits per year (short-term non-chronic conditions only)
In-Network
In-Network
100
100
Skilled Nursing Facility
Covered in full 100 days maximum
Covered in full 60 days per calendar year maximum
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Substance AbuseMental Health
Inpatient Covered in full Outpatient $5 copay
Inpatient Covered in full Outpatient $5 copay
In-Network Inpatient- $150 per admission copay Outpatient- $15 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
In-Network Inpatient- covered in full Outpatient- $10 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
Vision (Routine)
$5 copay for exams 25 discount on lensesframes at Kaiser centers 15 discount off the costs of contact lenses
$25 copay for exam 15-20 discount through participating optical centers
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
53116
Office of Human Resources Montgomery County Government
Open Enrollment Website Resources Visit the Open Enrollment website for a variety of planning tools amp resources Open Enrollment schedule of virtual events Open Enrollment frequently asked questions 2021 Employee Self-Service (ESS) instruction video amp written instructions Side-by-side plan comparisons Life insurance needs estimator FSA tax savings calculator MCG employee discounts amp resources and more
Office of Human Resources Montgomery County Government
Attend a Virtual Open Enrollment Event bull Insurance Carrier Virtual Presentations and QampA Sessions Visit the Open Enrollment website for full schedule of events
bull Attend OHR Virtual Office Hours Virtual Office Hours SchedulePlease note Virtual Office Hours are held in a public virtual meeting If questions will
reveal any personal PHI (protected health information) such as a chronic medical condition or names of specific prescription drugs employees should direct those questions to OHRrsquos customer service center at 240-773-6471 to place a service request
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Paper Enrollment Form Permitted for Only Two ReasonsThere are only two exceptions permitting the use of paper Open Enrollment forms
bull Technical barriers preventing access to ESS (only in the event of no internet no smartphone or computer) the employee should contact MC311 and place a service request to be mailed a paper enrollment form Call 240-773-OHR1 (240-773-6471) available Monday through Friday 8 am to 5 pm
bull Experiencing a Life Event If an employee has a qualified status change (life event) during Open Enrollment they cannot make changes using the Open Enrollment form or online system Instead they should contact the OHR Health Insurance Team via MC311 to make changes Qualifying life events marriage divorce the birth of a child or the death of spouse or a
dependent aging out
Office of Human Resources Montgomery County Government
Dependent EligibilityEligible dependents for medical prescription dental and vision coverage arebull Spouse
Legally married EligibleDivorced Not Eligible
bull Children (biological legally adopted stepchildren or under your legal custody)Under age 26 EligibleAge 26 and over Not Eligible unless incapable of self support
Proof of eligible dependents is required
Office of Human Resources Montgomery County Government
Proof of Dependent EligibilityEmployees enrolling new dependents during Open Enrollment must upload the necessary dependent documentation in ESS prior to October 9 at 5 pmRequired Documentationbull Spouse Official State Marriage Certificate (certified by appropriate State or County Official)bull Biological Child State Birth Certificate (For newborns OHR will accept hospital discharge papers for first 60 days birth
certificate must then be submitted)bull Adopted Child Copy of Adoption or Placement for Adoption Papers bull Step-Child State Birth Certificate Marriage Certificate and Divorce Decree or Custody Papers bull Disabled Child Medical plan verification of disability prior to age 26 bull Legal Custody Copy of Court Order granting legal custody
Office of Human Resources Montgomery County Government
Marriage Certificate Example Required Documentation (Contd)
Office of Human Resources Montgomery County Government
Benefits Refresher
Office of Human Resources Montgomery County Government
Medical amp Rx
Office of Human Resources Montgomery County Government
Medical Plan OptionsHealth Maintenance Organizations (HMO)bull Kaiser Permanente Signature (HMO)bull United Healthcare Select (HMO)
Point of Service Plans (POS)bull CareFirst BCBS (POS) High Optionbull CareFirst BCBS (POS) Standard Option
Three tiers of coverage Self Self + 1 or Family
Office of Human Resources Montgomery County Government
Medical Benefits at-a-Glance To view full carrier medical summaries visit OHRrsquos Health Insurance Website
Kaiser Permanente HMO + Rx
wwwkporg
United HealthCare Select HMO
wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS)
wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS)
wwwcarefirstcom
Plan Type HMO HMO Point-of-Service Point-of-Service
PCP Required Yes Yes No No
Provider Network Regional (MDDCVA) National National National
Out-of-Network Benefits No No Yes Yes
Referrals Required Yes No No No
Annual Deductible None NoneIn-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Sheet1
Sheet1 (2)
Office of Human Resources Montgomery County Government
Medical Benefits at-a-Glance (contd)
New Employee Orientation Program
Kaiser Permanente HMO + Rx
wwwkporg
United HealthCare Select HMO
wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS)
wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS)
wwwcarefirstcom
Dr Office Visits PCPSpecialist $5 copay $5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits Covered in full $5 copay $10 copay In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care $5 copay $15 copay Covered in full Covered in full
Emergency Room $50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization Covered in full Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
Visit OHRrsquos Health Insurance webpage to view Medical summaries
Sheet1
Sheet1 (2)
Office of Human Resources Montgomery County Government
Prescription Plans Caremarkbull Two Rx Plan OptionsStandardHigh
bull If you elect UHC or CareFirst and want Rx coverage you will need to elect the stand-alone Caremark Rx plan (Kaiser already includes Rx coverage)
bull Maintenance Choice Program available for maintenance drugs significant cost savings ndash 1 copay for each 90-day prescription In order to get the Maintenance pricing you must fil Rx at CVS retail pharmacy Mail order
Office of Human Resources Montgomery County Government
Prescription Drug Plan Comparison High Option $48
Only MCGEOIAFF employees can enroll in this High plan
High Option $510Only FOPNON-REP employees
can enroll in this High plan
Standard Option All employees can enroll in this
Standard plan
Copay $4 Generics$8 Brand Name
$5 Generics$10 Brand Name
$10 Generics$20 PBrand Name
$35 NPBrand NameDeductible na na $50yearMail Order Yes Yes Yes
Maintenance Choice Yes Yes YesCovered Drugs Same Same Same
Visit OHRrsquos Health Insurance Website to view Rx summaries
Office of Human Resources Montgomery County Government
Prescription Drug Cost Comparison Cost
High Option $48Only MCGEOIAFF employees
can enroll in this High plan
High Option $510Only FOPNON-REP employees
can enroll in this High plan
Standard Option All employees can enroll in this
Standard plan
Self Only
Bi-Weekly $11339Monthly $24568Yearly $294814
Bi-Weekly $11100Monthly $24050Yearly $288600
Bi-Weekly $2413Monthly $5258Yearly $62738
Self + 1
Bi-Weekly $20979Monthly $45455Yearly $545454
Bi-Weekly $20536Monthly $44495Yearly $533936
Bi-Weekly $4463Monthly $9670
Yearly $116038
Self + Family
Bi-Weekly $32511Monthly $70441Yearly $845286
Bi-Weekly $31824Monthly $68952Yearly $827424
Bi-Weekly $6916Monthly $14985Yearly $179816
Office of Human Resources Montgomery County Government
Dental
Office of Human Resources Montgomery County Government
Dental Comparison Cigna
For a list of HMO covered services and assigned costs (copays) view the HMO benefit summary
Required to Use An Assigned Provider Yes In-network only Primary Dental Office will be
assigned based on home address
No
Out of Network Benefits Available No Yes
Balance Billing for Covered Services No Yes if you go out-of-network
Referral Required Yes No
Orthodontia Benefits Available Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime) Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person) Unlimited $200000
Deductible (singlefamily) None $50 $ 150 waived for preventive care
Table 1
Office of Human Resources Montgomery County Government
Vision
Office of Human Resources Montgomery County Government
Vision Insurancebull The Countyrsquos Vision carrier is EyeMedbull Benefits payable for exams lenses and contacts (elective or necessary) every
calendar year frames every two calendar yearsbull In-network or out-of-network benefits available bull Enhanced Hearing Benefit through EyeMedrsquos partner Amplifon40 off hearing examDiscounted pricing on thousands of hearing aids including latest technologyOne-year free follow-up care with unlimited appointmentsFree batteries for two years with initial purchase Three-year warranty and loss and damage coverage
Visit OHRrsquos Health Insurance webpage to view vision summary
Office of Human Resources Montgomery County Government
Optional Life amp Dependent Life
Office of Human Resources Montgomery County Government
Optional Life Insurance ADampDbull You may elect Optional Life ADampD coverage for yourself in increments of 1 to 8 times
your basic annual earnings ($1 million maximum)
bull NOTE Coverage is not guaranteed issue for any level You must complete an online Statement of Health no matter what level of coverage you elect Later this fall after Open Enrollment ends you will receive an email from MetLife with a link to complete the Statement of Health online
bull An eligible dependent is defined as 1) your opposite or same sex spouse or 2) your unmarried children under age 26 (natural adopted or stepchildrenfoster children who depend on your support)
Office of Human Resources Montgomery County Government
Optional Life Insurance RatesHow to estimate your Optional Life Insurance bi-weekly rate
Example 40-year-old applying for 2 x salary Salary is $49300
Steps Example Calculate for Yourself
A Find your age-based rate on the rate sheet (left) $ 0037 $_________________
B Choose how much coverage you are applying for
$99000 (2 x salary rounded to the nearest $1000 ) $_________________
C Divide that coverage amount by 100099 ($99000 1000) $_________________
D Multiply A x C for estimated bi-weekly cost$366 ($037 x 99) $_________________
Office of Human Resources Montgomery County Government
Dependent Life InsuranceYou may also purchase Dependent Optional Life insurance forbull Your opposite or same sex spouse bull Your unmarried children under age 26
ndash Natural adoptedndash Stepchildrenfoster childrenNote you do not need to supply marriage certificatesbirth certificates for dependent optional life
You may electbull $2000 Spouse$1000 Childbull $4000 Spouse $2000 Childbull $10000 Spouse $5000 Child
The bi-weekly rate is not based on salary
Office of Human Resources Montgomery County Government
Flexible Spending Accounts
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Visit the Open Enrollment website to watch a recorded FSA presentation from MCGrsquos FSA vendor Benefit Strategies
bull What is an FSA It is an IRS-approved tax-free account that saves onQualified out-of-pocket medical and dependent care expensesFederal and State Income taxSocial Security Tax
bull 3 Account Options Health Care FSA Child Care FSA and Commuter Choice Transit bull FSA accounts are administered through Benefit Strategies bull FSAs are ldquouse-it or lose-itrdquo accounts claims must be incurred during the 2021 plan year (January 1
2021 ndash March 15 2022) and submitted by April 30 2022
IMPORTANT You must re-enroll in an FSA every Open Enrollment if you want to participate in the upcoming plan year
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Why You Should EnrollGive yourself a raise by reducing your taxesbull Elect the annual amount you want to place in your FSA(s) for the upcoming plan year during Open Enrollmentbull That amount is divided by 26 and taken from your biweekly paychecks on a pre-tax basis (21 paychecks for
10-month employees)bull Then use your pre-tax FSA dollars to pay for eligible out-of-pocket health care child-care or transit
expenses
Office of Human Resources Montgomery County Government
Health Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull Claims must be submitted by April 30 of the following yearbull You may elect to contribute up to $2750 Your total annual election amount is available to spend on the first
day of the new plan year bull FSA debit card allows you to pay for expenses at the time of servicebull Examples of IRS qualified eligible expenses
bull Copays (medical prescription dental vision) deductibles and coinsurance amounts over reasonable and customary charge
bull Hearing aids bull Acupuncture bull Orthopedic shoes bull Over-the-counter (OTC) drugs (no longer require doctorrsquos prescription)
Office of Human Resources Montgomery County Government
Child Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull $5000 annual maximum per household ($2500 for married filing separately)bull Funds are available to spend as they are accumulated through payroll deductionsbull Reimbursable expenses
bull day care centersbull elder carebull beforeafter school carebull babysitter fees that allow you and your spouse to work or go to school (no child support payments)
bull Qualifying dependentsbull Children under the age of 13 and are a tax dependent of the employeebull Spouse or tax dependent that is physically or mentally incapable of self-care
bull Must coordinate between filing a tax credit with IRS and your Dependent Care FSA plan
Office of Human Resources Montgomery County Government
Commuter Choice Transit FSAbull $230 per month maximum for MCGEO staff $260 per month maximum for Unrepresented staffbull Applies to employee commuting expenses only (not spouses or dependents)bull Can enroll throughout the year (not limited to Open Enrollment election)bull Eligible expenses include Metro Marc Vanpool Lyft Line Uber Poolbull Debit card ndash may be used for some expenses (not Metro)Metro riders will have to submit claim forms for reimbursement
bull Funds must be used within 180 days of election bull If retiring or leaving the County will need to coordinate use all available funds
Office of Human Resources Montgomery County Government
Using Your FSA FundsHealth Care FSA Your full annual election amount is available on the first day of the plan yearChild Care FSA Your funds are available as they accumulate through payroll deductionsCommuterTransit FSA Your funds are available as they accumulate through payroll deductions
The FSA Debit Card bull Your FSA debit card is the same card for your Health Care Child Care and TransitCommuter FSA accountsbull The card is pre-loaded with your full annual Health Care FSA election amount You can use the card to pay for IRS qualified expenses at
the time of service or when paying a bill Receipt notifications will be mailed to you monthly by Benefit Strategies Your response to receipt notifications is necessary under the provisions of the plan No response my result in the ineligibility of the purchase and as a result your card may be temporarily deactivated
bull If you are enrolled in the Child Care FSA the card can also be used in child-care settings Just remember that the card will only work for an amount that does not exceed the available balance in your Child Care FSA account on that day
bull The card can also be used to pay for your commutertransit expenses however it does not work for WMATA metro Metro riders will have to submit manual claims for reimbursement from your CommuterTransit FSA
bull Cards are re-loaded each year after you make your new annual election Please keep your cards You will only receive a new card if your old card is about to expire
Office of Human Resources Montgomery County Government
AFLAC Voluntary Plans
Office of Human Resources Montgomery County Government
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Short-Term Disabilitybull Provides short-term cash benefits in the event of disabilitybull Monthly benefit amounts available from $500 - $6000 (subject to income requirements)bull Benefit options of 3 6 12 18 or 24 months with a variety of elimination periods
Critical Illness Insurancebull Provides a lump sum cash benefit in the event of critical illnessbull Benefit amounts available in $5000 increments from $10000 - $30000
Participants pay 100 through payroll deduction for Short-Term Disability and Critical Illness Insurance
To ENROLL Text SETAPPTrdquo to 41411orCall 920-420-8861 orEmail susan_mcdanielusAflaccom
Office of Human Resources Montgomery County Government
Carrier Resources amp Cost-Saving Tips
Office of Human Resources Montgomery County Government
Lower Your Out-of-Pocket CostsChoose the plan thatrsquos right for youbull See the medical benefits chart for options bull Stay in network Use the provider search engines on your carrier website or mobile app to find in-network providersSeek preventive carebull Check-ups immunizations and screenings are an important part of staying healthy They can detect or prevent serious diseases and keep you healthyKnow where to go for carebull You have many options of places to go when you need care If your medical condition isnrsquot serious or life threatening you can save money by connecting
with a doctor online through a virtual visit or going to an urgent care center or convenience care clinic instead of a hospital emergency roomReview your prescription drug plan optionsbull Decide which Caremark prescription plan is best for you Note that the Kaiser HMO includes prescription drug coverage Both the Standard and High
Option Caremark plans cover the same prescription drugs but have different copay and deductiblesUse generic and long-term prescriptions bull Opt for lower-cost generic drugs whenever possible bull Ask your doctor to write a 90-day prescription instead of a 30-day prescription to participate in the mail order prescription programTake advantage of tax savings by participating in Flexible Spending Accountsbull Use pre-tax dollars for eligible out of pocket services and items
Office of Human Resources Montgomery County Government
Built-in Wellness Support Take advantage of the free programs available to you through your medical carrier Each of MCGrsquos medical carriers (Kaiser UHC amp CareFirst) offer valuable programs to help you manage your health
Disease Management Programsbull Help manage your chronic condition through personalized coaching support and encouragement and online education materialsEmotional Wellness amp Stress Management Support bull Help manage stress through mobile apps and other self-care resources Maternity Programsbull Support healthy moms and healthy babiesWeight-loss Programs bull Offers telephonic coaching support and web-based tools to help ensure long-term weight managementbull See the next slide for an example of an MCG success storySmoking Cessation Programsbull Supportive coaching to make quitting more successfulDiscounts bull Gym memberships weight loss programs and moreFor more information about the programs available to you please see the Open Enrollment Guide and contact your medical carrier
Office of Human Resources Montgomery County Government
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You GoAll of MCGrsquos health insurance carriers offer a simple-to-use tool that can help make your life easier while yoursquore on the go Download your carrierrsquos Mobile App to help you personalize organize and access your important plan information on your phone or tablet
bull Schedule Virtual Visitsbull Manage and track claimsbull View ID card informationbull Find doctor and compare costs and quality ratingsbull Review your coveragebull Track your account balances and deductiblesbull Access a variety of health and wellness tools
Visit Google Play or the Apple App Store to download your carrierrsquos App
Office of Human Resources Montgomery County Government
Making Changes
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Questions
Office of Human Resources Montgomery County Government
Open Enrollment AssistanceFollow these steps (in this order)1 Review the frequently asked questions (FAQs) on the Open Enrollment website at wwwmontgomerycountymdgovoe
(available beginning September 21) You can enter key words into the interactive search bar to quickly locate the answer to your question
2 Visit the MC311 website at wwwmontgomerycountymdgovmc311 and search key words for your question The search results contain various knowledge-based articles with information related to your search words Simply click on the corresponding link and the detailed answer is revealed
3 Attend one of OHRrsquos Virtual Office Hours via Microsoft Teams Members of OHRs Health Insurance Team will be on hand to address employee questions by video or via the chat box View the schedule and access the sessions through the Open Enrollment website at wwwmontgomerycountymdgovoe (available beginning September 21)
4 If you have tried all the methods above and still have Open Enrollment-related questions please contact OHRs MC311 Customer Service Center at 240-773-6471 (Mon-Fri 8 am - 5 pm) to open a service request A member of the health insurance team will respond to service requests in the order they are received Tip Please provide an email address at the time you place your Service Request This will ensure the fastest response possible
Office of Human Resources Montgomery County Government
Online ResourcesVisit the 2021 Open Enrollment Webpage
wwwmontgomerycountymdgovOE
Visit OHRrsquos WebpagewwwmontgomerycountymdgovHR
Health Insurance active employees
Office of Human Resources Montgomery County Government
Legal InformationThe County reserves the right at any time and for any reason to amend the Program subject to the Countys collective bargainingagreements The County expects to continue the Program but it is the Countys position that there is no implied contract between individual employees and the County to do so
The County may amend the Program prospectively or retroactively to comply with applicable law
In the event of a conflict between this presentation the County Code andor the Summary Description the County Code then the Summary Description will govern
Office of Human Resources Montgomery County Government
Thank YouWe hope you enjoyed learning about 2021 Open Enrollment
~Your OHR Health Insurance Team
2021 Open Enrollment Benefits Bonanza
What Is Open Enrollment
What Changes Can be Made
Open Enrollment Dates
MCG Continues to Make Generous Employer Contributions
New for 2021
Special 2021 Plan Rates Announcement
Employee Rate Changes for Calendar Year 2021
Planning Ahead Minimizing Future Rate Increases
New for 2021
Open Enrollment Communications
Itrsquos a New Frontier
2021 Open Enrollment Checklist
Open Enrollment Website Resources
Attend a Virtual Open Enrollment Event
Make Changes Online
Paper Enrollment Form Permitted for Only Two Reasons
Dependent Eligibility
Proof of Dependent Eligibility
Marriage Certificate Example Required Documentation (Contd)
Benefits Refresher
Medical amp Rx
Medical Plan Options
Medical Benefits at-a-Glance
Medical Benefits at-a-Glance (contd)
Prescription Plans Caremark
Prescription Drug Plan Comparison
Prescription Drug Cost Comparison
Dental
Slide Number 30
Vision
Vision Insurance
Optional Life amp Dependent Life
Optional Life Insurance ADampD
Optional Life Insurance Rates
Dependent Life Insurance
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs)Why You Should Enroll
Health Care FSA
Child Care FSA
Commuter Choice Transit FSA
Using Your FSA Funds
AFLAC Voluntary Plans
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Carrier Resources amp Cost-Saving Tips
Lower Your Out-of-Pocket Costs
Built-in Wellness Support
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You Go
Making Changes
Make Changes Online
Questions
Open Enrollment Assistance
Online Resources
Legal Information
Thank You
Cigna Dental Comparison
DHMO
PPO
CIGNA NETWORK
Care-Access PlusDHMO
Total CIGNA PPOPPO
Required to Use An Assigned Provider
Yes In-network only Primary Dental Office will be assigned based on home address
No
Out of Network Benefits Available
No
Yes
Balance Billing for Covered Services
No
Yes if you go out-of-network
Referral Required
Yes
No
Orthodontia Benefits Available
Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime)
Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person)
Unlimited
$200000
Deductible (singlefamily)
None
$50 $ 150 waived for preventive care
1Claim submission would be required and balance billing may occur when visiting a nonparticipating provider2Deductible does not apply to Class I ndash Diagnostic and Preventive Services
Coverage for dependents would cease on the day which the child turns 26Benefit Maximum and Deductibles are for the period of January 01 through December 31
All services listed on this benefit summary are subject to the contractSchedules of Benefits and current Exclusions and Limitations
Medical Benefits at a Glance
Kaiser Permanente HMO + Rx wwwkporg
United HealthCare Select HMO wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS) wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS) wwwcarefirstcom
Plan Type
HMO
HMO
Point-of-Service
Point-of-Service
PCP Required
Yes
Yes
No
No
Provider Network
Regional (MDDCVA)
National
National
National
Out-of-Network Benefits
No
No
Yes
Yes
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
None
None
In-Network None Out-of-Network 80
In-Network None Out-of-Network 80
Dr Office Visits PCPSpecialist
$5 copay
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits
Covered in full
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care
$5 copay
$15 copay
Covered in full
Covered in full
Emergency Room
$50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization
Covered in full
Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
MCG 2018 Medical Plan Comparison Chart
Kaiser Permanente
United HealthCare
CareFirst POS Standard
CareFirst POS High
Plan Type
HMO
HMO
Point of Service
Point of Service
Provider Network
Regional (MDDCVA)
National
National
National
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
Annual Out-of-Pocket Maximum
None
$1100 per individual up to cap of $3600 for a family
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
Physician Servcies
PCP Office Visits
$5 copay
$5 copay PCP
In-Network $15 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Specialist Office Visits
$5 copay
$10 copay
In-Network $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Annual Physical
Covered in full
$5 copay PCP
In-Network $15 copay Primary Care Physician $30 copay specialist Out-of-Network 80 covered after deductible (limit 1calendar year)
In-Network $15 copay Out-of-Network 80 not subject to deductible (up to age 18)
In-Network $10 copay Out-of-Network 80 not subject to deductible (up to age 18)
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Allergy Testing
$5 copay
$5 copay PCP $10 copay Specialist
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Virtual Visits
Labs X-Rays Diagnostics
Outpatient labs
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient X-Rays
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Major Diagnostics
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Immedate Medical Servcies
Emergency Room
$50 copay waived if admitted to hospital
$25 copay waived if admitted to hospital $15 copay for urgent care
In-Network $35 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
Urgent Care
Hospital Services
Inpatient Hospitalization
Covered in full
Covered in full
In-Network Covered in full after $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Services
Surgery
Covered in full
Inpatient covered in full Outpatient $25 copay
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Hearing Aids
For minor children One hearing aid for each hearing impaired ear once every 36 months
For minor children One hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
Hearing Screening
$5 copay for hearing exam (hearing aids are excluded)
$5 Copay PCP $10 Copay Specialist
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
Home Health Care Services
Covered in full if medically necessary
Covered in full No copayment 60 visit maximum for skilled care services per calendar year
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
Hospice
Covered in full
Covered in full (See coverage booklet for eligibility information)
In-Network Covered in full
In-Network Covered in full
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
In vitro Fertilization
Limited to 3 attempts per live birth Lifetime maximum of $100000
Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
Mammography - Preventive Screening Schedule
Schedule consistent with the current recommendations of the American College of Physicians
Covered in full Age 35-39 one baseline mammogram Age 40-49 one mammogram every two calendar years Age 50+ one mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
Maternity
Covered in full once pregnancy is diagnosed
No copayment applies after the first visit
In-Network first visit 100 after $30 copay other visits 100
In-Network First visit 100 after $10 copay other visits 100
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Maximum Lifetime Benefit
Unlimited maximum
Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
Prescriptions
Kaiser Rx plan (included with Kaiser HMO medical plan) $5 at on-site pharmacies and for mail order $15 at participating pharmacies
No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
Rehabilitation Services
Inpatient Covered in full (unlimited) Outpatient $5 copay outpatient services for physical therapy are limited to up to 30 visits occupational and speech therapy per injury incident or condition are covered for a period not to exceed 90 days
$10 copayvisit 60 combined visits per year (short-term non-chronic conditions only)
In-Network
In-Network
100
100
Skilled Nursing Facility
Covered in full 100 days maximum
Covered in full 60 days per calendar year maximum
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Substance AbuseMental Health
Inpatient Covered in full Outpatient $5 copay
Inpatient Covered in full Outpatient $5 copay
In-Network Inpatient- $150 per admission copay Outpatient- $15 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
In-Network Inpatient- covered in full Outpatient- $10 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
Vision (Routine)
$5 copay for exams 25 discount on lensesframes at Kaiser centers 15 discount off the costs of contact lenses
$25 copay for exam 15-20 discount through participating optical centers
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
53116
Medical Benefits at a Glance
Kaiser Permanente HMO + Rx wwwkporg
United HealthCare Select HMO wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS) wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS) wwwcarefirstcom
Plan Type
HMO
HMO
Point-of-Service
Point-of-Service
PCP Required
Yes
Yes
No
No
Provider Network
Regional (MDDCVA)
National
National
National
Out-of-Network Benefits
No
No
Yes
Yes
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
None
None
In-Network None Out-of-Network 80
In-Network None Out-of-Network 80
Dr Office Visits PCPSpecialist
$5 copay
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits
Covered in full
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care
$5 copay
$15 copay
Covered in full
Covered in full
Emergency Room
$50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization
Covered in full
Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
MCG 2018 Medical Plan Comparison Chart
Kaiser Permanente
United HealthCare
CareFirst POS Standard
CareFirst POS High
Plan Type
HMO
HMO
Point of Service
Point of Service
Provider Network
Regional (MDDCVA)
National
National
National
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
Annual Out-of-Pocket Maximum
None
$1100 per individual up to cap of $3600 for a family
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
Physician Servcies
PCP Office Visits
$5 copay
$5 copay PCP
In-Network $15 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Specialist Office Visits
$5 copay
$10 copay
In-Network $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Annual Physical
Covered in full
$5 copay PCP
In-Network $15 copay Primary Care Physician $30 copay specialist Out-of-Network 80 covered after deductible (limit 1calendar year)
In-Network $15 copay Out-of-Network 80 not subject to deductible (up to age 18)
In-Network $10 copay Out-of-Network 80 not subject to deductible (up to age 18)
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Allergy Testing
$5 copay
$5 copay PCP $10 copay Specialist
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Virtual Visits
Labs X-Rays Diagnostics
Outpatient labs
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient X-Rays
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Major Diagnostics
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Immedate Medical Servcies
Emergency Room
$50 copay waived if admitted to hospital
$25 copay waived if admitted to hospital $15 copay for urgent care
In-Network $35 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
Urgent Care
Hospital Services
Inpatient Hospitalization
Covered in full
Covered in full
In-Network Covered in full after $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Services
Surgery
Covered in full
Inpatient covered in full Outpatient $25 copay
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Hearing Aids
For minor children One hearing aid for each hearing impaired ear once every 36 months
For minor children One hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
Hearing Screening
$5 copay for hearing exam (hearing aids are excluded)
$5 Copay PCP $10 Copay Specialist
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
Home Health Care Services
Covered in full if medically necessary
Covered in full No copayment 60 visit maximum for skilled care services per calendar year
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
Hospice
Covered in full
Covered in full (See coverage booklet for eligibility information)
In-Network Covered in full
In-Network Covered in full
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
In vitro Fertilization
Limited to 3 attempts per live birth Lifetime maximum of $100000
Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
Mammography - Preventive Screening Schedule
Schedule consistent with the current recommendations of the American College of Physicians
Covered in full Age 35-39 one baseline mammogram Age 40-49 one mammogram every two calendar years Age 50+ one mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
Maternity
Covered in full once pregnancy is diagnosed
No copayment applies after the first visit
In-Network first visit 100 after $30 copay other visits 100
In-Network First visit 100 after $10 copay other visits 100
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Maximum Lifetime Benefit
Unlimited maximum
Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
Prescriptions
Kaiser Rx plan (included with Kaiser HMO medical plan) $5 at on-site pharmacies and for mail order $15 at participating pharmacies
No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
Rehabilitation Services
Inpatient Covered in full (unlimited) Outpatient $5 copay outpatient services for physical therapy are limited to up to 30 visits occupational and speech therapy per injury incident or condition are covered for a period not to exceed 90 days
$10 copayvisit 60 combined visits per year (short-term non-chronic conditions only)
In-Network
In-Network
100
100
Skilled Nursing Facility
Covered in full 100 days maximum
Covered in full 60 days per calendar year maximum
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Substance AbuseMental Health
Inpatient Covered in full Outpatient $5 copay
Inpatient Covered in full Outpatient $5 copay
In-Network Inpatient- $150 per admission copay Outpatient- $15 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
In-Network Inpatient- covered in full Outpatient- $10 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
Vision (Routine)
$5 copay for exams 25 discount on lensesframes at Kaiser centers 15 discount off the costs of contact lenses
$25 copay for exam 15-20 discount through participating optical centers
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
53116
Office of Human Resources Montgomery County Government
Attend a Virtual Open Enrollment Event bull Insurance Carrier Virtual Presentations and QampA Sessions Visit the Open Enrollment website for full schedule of events
bull Attend OHR Virtual Office Hours Virtual Office Hours SchedulePlease note Virtual Office Hours are held in a public virtual meeting If questions will
reveal any personal PHI (protected health information) such as a chronic medical condition or names of specific prescription drugs employees should direct those questions to OHRrsquos customer service center at 240-773-6471 to place a service request
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Paper Enrollment Form Permitted for Only Two ReasonsThere are only two exceptions permitting the use of paper Open Enrollment forms
bull Technical barriers preventing access to ESS (only in the event of no internet no smartphone or computer) the employee should contact MC311 and place a service request to be mailed a paper enrollment form Call 240-773-OHR1 (240-773-6471) available Monday through Friday 8 am to 5 pm
bull Experiencing a Life Event If an employee has a qualified status change (life event) during Open Enrollment they cannot make changes using the Open Enrollment form or online system Instead they should contact the OHR Health Insurance Team via MC311 to make changes Qualifying life events marriage divorce the birth of a child or the death of spouse or a
dependent aging out
Office of Human Resources Montgomery County Government
Dependent EligibilityEligible dependents for medical prescription dental and vision coverage arebull Spouse
Legally married EligibleDivorced Not Eligible
bull Children (biological legally adopted stepchildren or under your legal custody)Under age 26 EligibleAge 26 and over Not Eligible unless incapable of self support
Proof of eligible dependents is required
Office of Human Resources Montgomery County Government
Proof of Dependent EligibilityEmployees enrolling new dependents during Open Enrollment must upload the necessary dependent documentation in ESS prior to October 9 at 5 pmRequired Documentationbull Spouse Official State Marriage Certificate (certified by appropriate State or County Official)bull Biological Child State Birth Certificate (For newborns OHR will accept hospital discharge papers for first 60 days birth
certificate must then be submitted)bull Adopted Child Copy of Adoption or Placement for Adoption Papers bull Step-Child State Birth Certificate Marriage Certificate and Divorce Decree or Custody Papers bull Disabled Child Medical plan verification of disability prior to age 26 bull Legal Custody Copy of Court Order granting legal custody
Office of Human Resources Montgomery County Government
Marriage Certificate Example Required Documentation (Contd)
Office of Human Resources Montgomery County Government
Benefits Refresher
Office of Human Resources Montgomery County Government
Medical amp Rx
Office of Human Resources Montgomery County Government
Medical Plan OptionsHealth Maintenance Organizations (HMO)bull Kaiser Permanente Signature (HMO)bull United Healthcare Select (HMO)
Point of Service Plans (POS)bull CareFirst BCBS (POS) High Optionbull CareFirst BCBS (POS) Standard Option
Three tiers of coverage Self Self + 1 or Family
Office of Human Resources Montgomery County Government
Medical Benefits at-a-Glance To view full carrier medical summaries visit OHRrsquos Health Insurance Website
Kaiser Permanente HMO + Rx
wwwkporg
United HealthCare Select HMO
wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS)
wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS)
wwwcarefirstcom
Plan Type HMO HMO Point-of-Service Point-of-Service
PCP Required Yes Yes No No
Provider Network Regional (MDDCVA) National National National
Out-of-Network Benefits No No Yes Yes
Referrals Required Yes No No No
Annual Deductible None NoneIn-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Sheet1
Sheet1 (2)
Office of Human Resources Montgomery County Government
Medical Benefits at-a-Glance (contd)
New Employee Orientation Program
Kaiser Permanente HMO + Rx
wwwkporg
United HealthCare Select HMO
wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS)
wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS)
wwwcarefirstcom
Dr Office Visits PCPSpecialist $5 copay $5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits Covered in full $5 copay $10 copay In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care $5 copay $15 copay Covered in full Covered in full
Emergency Room $50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization Covered in full Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
Visit OHRrsquos Health Insurance webpage to view Medical summaries
Sheet1
Sheet1 (2)
Office of Human Resources Montgomery County Government
Prescription Plans Caremarkbull Two Rx Plan OptionsStandardHigh
bull If you elect UHC or CareFirst and want Rx coverage you will need to elect the stand-alone Caremark Rx plan (Kaiser already includes Rx coverage)
bull Maintenance Choice Program available for maintenance drugs significant cost savings ndash 1 copay for each 90-day prescription In order to get the Maintenance pricing you must fil Rx at CVS retail pharmacy Mail order
Office of Human Resources Montgomery County Government
Prescription Drug Plan Comparison High Option $48
Only MCGEOIAFF employees can enroll in this High plan
High Option $510Only FOPNON-REP employees
can enroll in this High plan
Standard Option All employees can enroll in this
Standard plan
Copay $4 Generics$8 Brand Name
$5 Generics$10 Brand Name
$10 Generics$20 PBrand Name
$35 NPBrand NameDeductible na na $50yearMail Order Yes Yes Yes
Maintenance Choice Yes Yes YesCovered Drugs Same Same Same
Visit OHRrsquos Health Insurance Website to view Rx summaries
Office of Human Resources Montgomery County Government
Prescription Drug Cost Comparison Cost
High Option $48Only MCGEOIAFF employees
can enroll in this High plan
High Option $510Only FOPNON-REP employees
can enroll in this High plan
Standard Option All employees can enroll in this
Standard plan
Self Only
Bi-Weekly $11339Monthly $24568Yearly $294814
Bi-Weekly $11100Monthly $24050Yearly $288600
Bi-Weekly $2413Monthly $5258Yearly $62738
Self + 1
Bi-Weekly $20979Monthly $45455Yearly $545454
Bi-Weekly $20536Monthly $44495Yearly $533936
Bi-Weekly $4463Monthly $9670
Yearly $116038
Self + Family
Bi-Weekly $32511Monthly $70441Yearly $845286
Bi-Weekly $31824Monthly $68952Yearly $827424
Bi-Weekly $6916Monthly $14985Yearly $179816
Office of Human Resources Montgomery County Government
Dental
Office of Human Resources Montgomery County Government
Dental Comparison Cigna
For a list of HMO covered services and assigned costs (copays) view the HMO benefit summary
Required to Use An Assigned Provider Yes In-network only Primary Dental Office will be
assigned based on home address
No
Out of Network Benefits Available No Yes
Balance Billing for Covered Services No Yes if you go out-of-network
Referral Required Yes No
Orthodontia Benefits Available Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime) Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person) Unlimited $200000
Deductible (singlefamily) None $50 $ 150 waived for preventive care
Table 1
Office of Human Resources Montgomery County Government
Vision
Office of Human Resources Montgomery County Government
Vision Insurancebull The Countyrsquos Vision carrier is EyeMedbull Benefits payable for exams lenses and contacts (elective or necessary) every
calendar year frames every two calendar yearsbull In-network or out-of-network benefits available bull Enhanced Hearing Benefit through EyeMedrsquos partner Amplifon40 off hearing examDiscounted pricing on thousands of hearing aids including latest technologyOne-year free follow-up care with unlimited appointmentsFree batteries for two years with initial purchase Three-year warranty and loss and damage coverage
Visit OHRrsquos Health Insurance webpage to view vision summary
Office of Human Resources Montgomery County Government
Optional Life amp Dependent Life
Office of Human Resources Montgomery County Government
Optional Life Insurance ADampDbull You may elect Optional Life ADampD coverage for yourself in increments of 1 to 8 times
your basic annual earnings ($1 million maximum)
bull NOTE Coverage is not guaranteed issue for any level You must complete an online Statement of Health no matter what level of coverage you elect Later this fall after Open Enrollment ends you will receive an email from MetLife with a link to complete the Statement of Health online
bull An eligible dependent is defined as 1) your opposite or same sex spouse or 2) your unmarried children under age 26 (natural adopted or stepchildrenfoster children who depend on your support)
Office of Human Resources Montgomery County Government
Optional Life Insurance RatesHow to estimate your Optional Life Insurance bi-weekly rate
Example 40-year-old applying for 2 x salary Salary is $49300
Steps Example Calculate for Yourself
A Find your age-based rate on the rate sheet (left) $ 0037 $_________________
B Choose how much coverage you are applying for
$99000 (2 x salary rounded to the nearest $1000 ) $_________________
C Divide that coverage amount by 100099 ($99000 1000) $_________________
D Multiply A x C for estimated bi-weekly cost$366 ($037 x 99) $_________________
Office of Human Resources Montgomery County Government
Dependent Life InsuranceYou may also purchase Dependent Optional Life insurance forbull Your opposite or same sex spouse bull Your unmarried children under age 26
ndash Natural adoptedndash Stepchildrenfoster childrenNote you do not need to supply marriage certificatesbirth certificates for dependent optional life
You may electbull $2000 Spouse$1000 Childbull $4000 Spouse $2000 Childbull $10000 Spouse $5000 Child
The bi-weekly rate is not based on salary
Office of Human Resources Montgomery County Government
Flexible Spending Accounts
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Visit the Open Enrollment website to watch a recorded FSA presentation from MCGrsquos FSA vendor Benefit Strategies
bull What is an FSA It is an IRS-approved tax-free account that saves onQualified out-of-pocket medical and dependent care expensesFederal and State Income taxSocial Security Tax
bull 3 Account Options Health Care FSA Child Care FSA and Commuter Choice Transit bull FSA accounts are administered through Benefit Strategies bull FSAs are ldquouse-it or lose-itrdquo accounts claims must be incurred during the 2021 plan year (January 1
2021 ndash March 15 2022) and submitted by April 30 2022
IMPORTANT You must re-enroll in an FSA every Open Enrollment if you want to participate in the upcoming plan year
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Why You Should EnrollGive yourself a raise by reducing your taxesbull Elect the annual amount you want to place in your FSA(s) for the upcoming plan year during Open Enrollmentbull That amount is divided by 26 and taken from your biweekly paychecks on a pre-tax basis (21 paychecks for
10-month employees)bull Then use your pre-tax FSA dollars to pay for eligible out-of-pocket health care child-care or transit
expenses
Office of Human Resources Montgomery County Government
Health Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull Claims must be submitted by April 30 of the following yearbull You may elect to contribute up to $2750 Your total annual election amount is available to spend on the first
day of the new plan year bull FSA debit card allows you to pay for expenses at the time of servicebull Examples of IRS qualified eligible expenses
bull Copays (medical prescription dental vision) deductibles and coinsurance amounts over reasonable and customary charge
bull Hearing aids bull Acupuncture bull Orthopedic shoes bull Over-the-counter (OTC) drugs (no longer require doctorrsquos prescription)
Office of Human Resources Montgomery County Government
Child Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull $5000 annual maximum per household ($2500 for married filing separately)bull Funds are available to spend as they are accumulated through payroll deductionsbull Reimbursable expenses
bull day care centersbull elder carebull beforeafter school carebull babysitter fees that allow you and your spouse to work or go to school (no child support payments)
bull Qualifying dependentsbull Children under the age of 13 and are a tax dependent of the employeebull Spouse or tax dependent that is physically or mentally incapable of self-care
bull Must coordinate between filing a tax credit with IRS and your Dependent Care FSA plan
Office of Human Resources Montgomery County Government
Commuter Choice Transit FSAbull $230 per month maximum for MCGEO staff $260 per month maximum for Unrepresented staffbull Applies to employee commuting expenses only (not spouses or dependents)bull Can enroll throughout the year (not limited to Open Enrollment election)bull Eligible expenses include Metro Marc Vanpool Lyft Line Uber Poolbull Debit card ndash may be used for some expenses (not Metro)Metro riders will have to submit claim forms for reimbursement
bull Funds must be used within 180 days of election bull If retiring or leaving the County will need to coordinate use all available funds
Office of Human Resources Montgomery County Government
Using Your FSA FundsHealth Care FSA Your full annual election amount is available on the first day of the plan yearChild Care FSA Your funds are available as they accumulate through payroll deductionsCommuterTransit FSA Your funds are available as they accumulate through payroll deductions
The FSA Debit Card bull Your FSA debit card is the same card for your Health Care Child Care and TransitCommuter FSA accountsbull The card is pre-loaded with your full annual Health Care FSA election amount You can use the card to pay for IRS qualified expenses at
the time of service or when paying a bill Receipt notifications will be mailed to you monthly by Benefit Strategies Your response to receipt notifications is necessary under the provisions of the plan No response my result in the ineligibility of the purchase and as a result your card may be temporarily deactivated
bull If you are enrolled in the Child Care FSA the card can also be used in child-care settings Just remember that the card will only work for an amount that does not exceed the available balance in your Child Care FSA account on that day
bull The card can also be used to pay for your commutertransit expenses however it does not work for WMATA metro Metro riders will have to submit manual claims for reimbursement from your CommuterTransit FSA
bull Cards are re-loaded each year after you make your new annual election Please keep your cards You will only receive a new card if your old card is about to expire
Office of Human Resources Montgomery County Government
AFLAC Voluntary Plans
Office of Human Resources Montgomery County Government
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Short-Term Disabilitybull Provides short-term cash benefits in the event of disabilitybull Monthly benefit amounts available from $500 - $6000 (subject to income requirements)bull Benefit options of 3 6 12 18 or 24 months with a variety of elimination periods
Critical Illness Insurancebull Provides a lump sum cash benefit in the event of critical illnessbull Benefit amounts available in $5000 increments from $10000 - $30000
Participants pay 100 through payroll deduction for Short-Term Disability and Critical Illness Insurance
To ENROLL Text SETAPPTrdquo to 41411orCall 920-420-8861 orEmail susan_mcdanielusAflaccom
Office of Human Resources Montgomery County Government
Carrier Resources amp Cost-Saving Tips
Office of Human Resources Montgomery County Government
Lower Your Out-of-Pocket CostsChoose the plan thatrsquos right for youbull See the medical benefits chart for options bull Stay in network Use the provider search engines on your carrier website or mobile app to find in-network providersSeek preventive carebull Check-ups immunizations and screenings are an important part of staying healthy They can detect or prevent serious diseases and keep you healthyKnow where to go for carebull You have many options of places to go when you need care If your medical condition isnrsquot serious or life threatening you can save money by connecting
with a doctor online through a virtual visit or going to an urgent care center or convenience care clinic instead of a hospital emergency roomReview your prescription drug plan optionsbull Decide which Caremark prescription plan is best for you Note that the Kaiser HMO includes prescription drug coverage Both the Standard and High
Option Caremark plans cover the same prescription drugs but have different copay and deductiblesUse generic and long-term prescriptions bull Opt for lower-cost generic drugs whenever possible bull Ask your doctor to write a 90-day prescription instead of a 30-day prescription to participate in the mail order prescription programTake advantage of tax savings by participating in Flexible Spending Accountsbull Use pre-tax dollars for eligible out of pocket services and items
Office of Human Resources Montgomery County Government
Built-in Wellness Support Take advantage of the free programs available to you through your medical carrier Each of MCGrsquos medical carriers (Kaiser UHC amp CareFirst) offer valuable programs to help you manage your health
Disease Management Programsbull Help manage your chronic condition through personalized coaching support and encouragement and online education materialsEmotional Wellness amp Stress Management Support bull Help manage stress through mobile apps and other self-care resources Maternity Programsbull Support healthy moms and healthy babiesWeight-loss Programs bull Offers telephonic coaching support and web-based tools to help ensure long-term weight managementbull See the next slide for an example of an MCG success storySmoking Cessation Programsbull Supportive coaching to make quitting more successfulDiscounts bull Gym memberships weight loss programs and moreFor more information about the programs available to you please see the Open Enrollment Guide and contact your medical carrier
Office of Human Resources Montgomery County Government
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You GoAll of MCGrsquos health insurance carriers offer a simple-to-use tool that can help make your life easier while yoursquore on the go Download your carrierrsquos Mobile App to help you personalize organize and access your important plan information on your phone or tablet
bull Schedule Virtual Visitsbull Manage and track claimsbull View ID card informationbull Find doctor and compare costs and quality ratingsbull Review your coveragebull Track your account balances and deductiblesbull Access a variety of health and wellness tools
Visit Google Play or the Apple App Store to download your carrierrsquos App
Office of Human Resources Montgomery County Government
Making Changes
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Questions
Office of Human Resources Montgomery County Government
Open Enrollment AssistanceFollow these steps (in this order)1 Review the frequently asked questions (FAQs) on the Open Enrollment website at wwwmontgomerycountymdgovoe
(available beginning September 21) You can enter key words into the interactive search bar to quickly locate the answer to your question
2 Visit the MC311 website at wwwmontgomerycountymdgovmc311 and search key words for your question The search results contain various knowledge-based articles with information related to your search words Simply click on the corresponding link and the detailed answer is revealed
3 Attend one of OHRrsquos Virtual Office Hours via Microsoft Teams Members of OHRs Health Insurance Team will be on hand to address employee questions by video or via the chat box View the schedule and access the sessions through the Open Enrollment website at wwwmontgomerycountymdgovoe (available beginning September 21)
4 If you have tried all the methods above and still have Open Enrollment-related questions please contact OHRs MC311 Customer Service Center at 240-773-6471 (Mon-Fri 8 am - 5 pm) to open a service request A member of the health insurance team will respond to service requests in the order they are received Tip Please provide an email address at the time you place your Service Request This will ensure the fastest response possible
Office of Human Resources Montgomery County Government
Online ResourcesVisit the 2021 Open Enrollment Webpage
wwwmontgomerycountymdgovOE
Visit OHRrsquos WebpagewwwmontgomerycountymdgovHR
Health Insurance active employees
Office of Human Resources Montgomery County Government
Legal InformationThe County reserves the right at any time and for any reason to amend the Program subject to the Countys collective bargainingagreements The County expects to continue the Program but it is the Countys position that there is no implied contract between individual employees and the County to do so
The County may amend the Program prospectively or retroactively to comply with applicable law
In the event of a conflict between this presentation the County Code andor the Summary Description the County Code then the Summary Description will govern
Office of Human Resources Montgomery County Government
Thank YouWe hope you enjoyed learning about 2021 Open Enrollment
~Your OHR Health Insurance Team
2021 Open Enrollment Benefits Bonanza
What Is Open Enrollment
What Changes Can be Made
Open Enrollment Dates
MCG Continues to Make Generous Employer Contributions
New for 2021
Special 2021 Plan Rates Announcement
Employee Rate Changes for Calendar Year 2021
Planning Ahead Minimizing Future Rate Increases
New for 2021
Open Enrollment Communications
Itrsquos a New Frontier
2021 Open Enrollment Checklist
Open Enrollment Website Resources
Attend a Virtual Open Enrollment Event
Make Changes Online
Paper Enrollment Form Permitted for Only Two Reasons
Dependent Eligibility
Proof of Dependent Eligibility
Marriage Certificate Example Required Documentation (Contd)
Benefits Refresher
Medical amp Rx
Medical Plan Options
Medical Benefits at-a-Glance
Medical Benefits at-a-Glance (contd)
Prescription Plans Caremark
Prescription Drug Plan Comparison
Prescription Drug Cost Comparison
Dental
Slide Number 30
Vision
Vision Insurance
Optional Life amp Dependent Life
Optional Life Insurance ADampD
Optional Life Insurance Rates
Dependent Life Insurance
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs)Why You Should Enroll
Health Care FSA
Child Care FSA
Commuter Choice Transit FSA
Using Your FSA Funds
AFLAC Voluntary Plans
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Carrier Resources amp Cost-Saving Tips
Lower Your Out-of-Pocket Costs
Built-in Wellness Support
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You Go
Making Changes
Make Changes Online
Questions
Open Enrollment Assistance
Online Resources
Legal Information
Thank You
Cigna Dental Comparison
DHMO
PPO
CIGNA NETWORK
Care-Access PlusDHMO
Total CIGNA PPOPPO
Required to Use An Assigned Provider
Yes In-network only Primary Dental Office will be assigned based on home address
No
Out of Network Benefits Available
No
Yes
Balance Billing for Covered Services
No
Yes if you go out-of-network
Referral Required
Yes
No
Orthodontia Benefits Available
Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime)
Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person)
Unlimited
$200000
Deductible (singlefamily)
None
$50 $ 150 waived for preventive care
1Claim submission would be required and balance billing may occur when visiting a nonparticipating provider2Deductible does not apply to Class I ndash Diagnostic and Preventive Services
Coverage for dependents would cease on the day which the child turns 26Benefit Maximum and Deductibles are for the period of January 01 through December 31
All services listed on this benefit summary are subject to the contractSchedules of Benefits and current Exclusions and Limitations
Medical Benefits at a Glance
Kaiser Permanente HMO + Rx wwwkporg
United HealthCare Select HMO wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS) wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS) wwwcarefirstcom
Plan Type
HMO
HMO
Point-of-Service
Point-of-Service
PCP Required
Yes
Yes
No
No
Provider Network
Regional (MDDCVA)
National
National
National
Out-of-Network Benefits
No
No
Yes
Yes
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
None
None
In-Network None Out-of-Network 80
In-Network None Out-of-Network 80
Dr Office Visits PCPSpecialist
$5 copay
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits
Covered in full
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care
$5 copay
$15 copay
Covered in full
Covered in full
Emergency Room
$50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization
Covered in full
Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
MCG 2018 Medical Plan Comparison Chart
Kaiser Permanente
United HealthCare
CareFirst POS Standard
CareFirst POS High
Plan Type
HMO
HMO
Point of Service
Point of Service
Provider Network
Regional (MDDCVA)
National
National
National
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
Annual Out-of-Pocket Maximum
None
$1100 per individual up to cap of $3600 for a family
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
Physician Servcies
PCP Office Visits
$5 copay
$5 copay PCP
In-Network $15 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Specialist Office Visits
$5 copay
$10 copay
In-Network $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Annual Physical
Covered in full
$5 copay PCP
In-Network $15 copay Primary Care Physician $30 copay specialist Out-of-Network 80 covered after deductible (limit 1calendar year)
In-Network $15 copay Out-of-Network 80 not subject to deductible (up to age 18)
In-Network $10 copay Out-of-Network 80 not subject to deductible (up to age 18)
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Allergy Testing
$5 copay
$5 copay PCP $10 copay Specialist
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Virtual Visits
Labs X-Rays Diagnostics
Outpatient labs
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient X-Rays
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Major Diagnostics
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Immedate Medical Servcies
Emergency Room
$50 copay waived if admitted to hospital
$25 copay waived if admitted to hospital $15 copay for urgent care
In-Network $35 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
Urgent Care
Hospital Services
Inpatient Hospitalization
Covered in full
Covered in full
In-Network Covered in full after $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Services
Surgery
Covered in full
Inpatient covered in full Outpatient $25 copay
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Hearing Aids
For minor children One hearing aid for each hearing impaired ear once every 36 months
For minor children One hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
Hearing Screening
$5 copay for hearing exam (hearing aids are excluded)
$5 Copay PCP $10 Copay Specialist
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
Home Health Care Services
Covered in full if medically necessary
Covered in full No copayment 60 visit maximum for skilled care services per calendar year
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
Hospice
Covered in full
Covered in full (See coverage booklet for eligibility information)
In-Network Covered in full
In-Network Covered in full
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
In vitro Fertilization
Limited to 3 attempts per live birth Lifetime maximum of $100000
Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
Mammography - Preventive Screening Schedule
Schedule consistent with the current recommendations of the American College of Physicians
Covered in full Age 35-39 one baseline mammogram Age 40-49 one mammogram every two calendar years Age 50+ one mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
Maternity
Covered in full once pregnancy is diagnosed
No copayment applies after the first visit
In-Network first visit 100 after $30 copay other visits 100
In-Network First visit 100 after $10 copay other visits 100
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Maximum Lifetime Benefit
Unlimited maximum
Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
Prescriptions
Kaiser Rx plan (included with Kaiser HMO medical plan) $5 at on-site pharmacies and for mail order $15 at participating pharmacies
No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
Rehabilitation Services
Inpatient Covered in full (unlimited) Outpatient $5 copay outpatient services for physical therapy are limited to up to 30 visits occupational and speech therapy per injury incident or condition are covered for a period not to exceed 90 days
$10 copayvisit 60 combined visits per year (short-term non-chronic conditions only)
In-Network
In-Network
100
100
Skilled Nursing Facility
Covered in full 100 days maximum
Covered in full 60 days per calendar year maximum
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Substance AbuseMental Health
Inpatient Covered in full Outpatient $5 copay
Inpatient Covered in full Outpatient $5 copay
In-Network Inpatient- $150 per admission copay Outpatient- $15 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
In-Network Inpatient- covered in full Outpatient- $10 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
Vision (Routine)
$5 copay for exams 25 discount on lensesframes at Kaiser centers 15 discount off the costs of contact lenses
$25 copay for exam 15-20 discount through participating optical centers
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
53116
Medical Benefits at a Glance
Kaiser Permanente HMO + Rx wwwkporg
United HealthCare Select HMO wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS) wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS) wwwcarefirstcom
Plan Type
HMO
HMO
Point-of-Service
Point-of-Service
PCP Required
Yes
Yes
No
No
Provider Network
Regional (MDDCVA)
National
National
National
Out-of-Network Benefits
No
No
Yes
Yes
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
None
None
In-Network None Out-of-Network 80
In-Network None Out-of-Network 80
Dr Office Visits PCPSpecialist
$5 copay
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits
Covered in full
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care
$5 copay
$15 copay
Covered in full
Covered in full
Emergency Room
$50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization
Covered in full
Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
MCG 2018 Medical Plan Comparison Chart
Kaiser Permanente
United HealthCare
CareFirst POS Standard
CareFirst POS High
Plan Type
HMO
HMO
Point of Service
Point of Service
Provider Network
Regional (MDDCVA)
National
National
National
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
Annual Out-of-Pocket Maximum
None
$1100 per individual up to cap of $3600 for a family
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
Physician Servcies
PCP Office Visits
$5 copay
$5 copay PCP
In-Network $15 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Specialist Office Visits
$5 copay
$10 copay
In-Network $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Annual Physical
Covered in full
$5 copay PCP
In-Network $15 copay Primary Care Physician $30 copay specialist Out-of-Network 80 covered after deductible (limit 1calendar year)
In-Network $15 copay Out-of-Network 80 not subject to deductible (up to age 18)
In-Network $10 copay Out-of-Network 80 not subject to deductible (up to age 18)
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Allergy Testing
$5 copay
$5 copay PCP $10 copay Specialist
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Virtual Visits
Labs X-Rays Diagnostics
Outpatient labs
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient X-Rays
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Major Diagnostics
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Immedate Medical Servcies
Emergency Room
$50 copay waived if admitted to hospital
$25 copay waived if admitted to hospital $15 copay for urgent care
In-Network $35 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
Urgent Care
Hospital Services
Inpatient Hospitalization
Covered in full
Covered in full
In-Network Covered in full after $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Services
Surgery
Covered in full
Inpatient covered in full Outpatient $25 copay
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Hearing Aids
For minor children One hearing aid for each hearing impaired ear once every 36 months
For minor children One hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
Hearing Screening
$5 copay for hearing exam (hearing aids are excluded)
$5 Copay PCP $10 Copay Specialist
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
Home Health Care Services
Covered in full if medically necessary
Covered in full No copayment 60 visit maximum for skilled care services per calendar year
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
Hospice
Covered in full
Covered in full (See coverage booklet for eligibility information)
In-Network Covered in full
In-Network Covered in full
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
In vitro Fertilization
Limited to 3 attempts per live birth Lifetime maximum of $100000
Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
Mammography - Preventive Screening Schedule
Schedule consistent with the current recommendations of the American College of Physicians
Covered in full Age 35-39 one baseline mammogram Age 40-49 one mammogram every two calendar years Age 50+ one mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
Maternity
Covered in full once pregnancy is diagnosed
No copayment applies after the first visit
In-Network first visit 100 after $30 copay other visits 100
In-Network First visit 100 after $10 copay other visits 100
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Maximum Lifetime Benefit
Unlimited maximum
Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
Prescriptions
Kaiser Rx plan (included with Kaiser HMO medical plan) $5 at on-site pharmacies and for mail order $15 at participating pharmacies
No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
Rehabilitation Services
Inpatient Covered in full (unlimited) Outpatient $5 copay outpatient services for physical therapy are limited to up to 30 visits occupational and speech therapy per injury incident or condition are covered for a period not to exceed 90 days
$10 copayvisit 60 combined visits per year (short-term non-chronic conditions only)
In-Network
In-Network
100
100
Skilled Nursing Facility
Covered in full 100 days maximum
Covered in full 60 days per calendar year maximum
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Substance AbuseMental Health
Inpatient Covered in full Outpatient $5 copay
Inpatient Covered in full Outpatient $5 copay
In-Network Inpatient- $150 per admission copay Outpatient- $15 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
In-Network Inpatient- covered in full Outpatient- $10 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
Vision (Routine)
$5 copay for exams 25 discount on lensesframes at Kaiser centers 15 discount off the costs of contact lenses
$25 copay for exam 15-20 discount through participating optical centers
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
53116
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Paper Enrollment Form Permitted for Only Two ReasonsThere are only two exceptions permitting the use of paper Open Enrollment forms
bull Technical barriers preventing access to ESS (only in the event of no internet no smartphone or computer) the employee should contact MC311 and place a service request to be mailed a paper enrollment form Call 240-773-OHR1 (240-773-6471) available Monday through Friday 8 am to 5 pm
bull Experiencing a Life Event If an employee has a qualified status change (life event) during Open Enrollment they cannot make changes using the Open Enrollment form or online system Instead they should contact the OHR Health Insurance Team via MC311 to make changes Qualifying life events marriage divorce the birth of a child or the death of spouse or a
dependent aging out
Office of Human Resources Montgomery County Government
Dependent EligibilityEligible dependents for medical prescription dental and vision coverage arebull Spouse
Legally married EligibleDivorced Not Eligible
bull Children (biological legally adopted stepchildren or under your legal custody)Under age 26 EligibleAge 26 and over Not Eligible unless incapable of self support
Proof of eligible dependents is required
Office of Human Resources Montgomery County Government
Proof of Dependent EligibilityEmployees enrolling new dependents during Open Enrollment must upload the necessary dependent documentation in ESS prior to October 9 at 5 pmRequired Documentationbull Spouse Official State Marriage Certificate (certified by appropriate State or County Official)bull Biological Child State Birth Certificate (For newborns OHR will accept hospital discharge papers for first 60 days birth
certificate must then be submitted)bull Adopted Child Copy of Adoption or Placement for Adoption Papers bull Step-Child State Birth Certificate Marriage Certificate and Divorce Decree or Custody Papers bull Disabled Child Medical plan verification of disability prior to age 26 bull Legal Custody Copy of Court Order granting legal custody
Office of Human Resources Montgomery County Government
Marriage Certificate Example Required Documentation (Contd)
Office of Human Resources Montgomery County Government
Benefits Refresher
Office of Human Resources Montgomery County Government
Medical amp Rx
Office of Human Resources Montgomery County Government
Medical Plan OptionsHealth Maintenance Organizations (HMO)bull Kaiser Permanente Signature (HMO)bull United Healthcare Select (HMO)
Point of Service Plans (POS)bull CareFirst BCBS (POS) High Optionbull CareFirst BCBS (POS) Standard Option
Three tiers of coverage Self Self + 1 or Family
Office of Human Resources Montgomery County Government
Medical Benefits at-a-Glance To view full carrier medical summaries visit OHRrsquos Health Insurance Website
Kaiser Permanente HMO + Rx
wwwkporg
United HealthCare Select HMO
wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS)
wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS)
wwwcarefirstcom
Plan Type HMO HMO Point-of-Service Point-of-Service
PCP Required Yes Yes No No
Provider Network Regional (MDDCVA) National National National
Out-of-Network Benefits No No Yes Yes
Referrals Required Yes No No No
Annual Deductible None NoneIn-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Sheet1
Sheet1 (2)
Office of Human Resources Montgomery County Government
Medical Benefits at-a-Glance (contd)
New Employee Orientation Program
Kaiser Permanente HMO + Rx
wwwkporg
United HealthCare Select HMO
wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS)
wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS)
wwwcarefirstcom
Dr Office Visits PCPSpecialist $5 copay $5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits Covered in full $5 copay $10 copay In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care $5 copay $15 copay Covered in full Covered in full
Emergency Room $50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization Covered in full Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
Visit OHRrsquos Health Insurance webpage to view Medical summaries
Sheet1
Sheet1 (2)
Office of Human Resources Montgomery County Government
Prescription Plans Caremarkbull Two Rx Plan OptionsStandardHigh
bull If you elect UHC or CareFirst and want Rx coverage you will need to elect the stand-alone Caremark Rx plan (Kaiser already includes Rx coverage)
bull Maintenance Choice Program available for maintenance drugs significant cost savings ndash 1 copay for each 90-day prescription In order to get the Maintenance pricing you must fil Rx at CVS retail pharmacy Mail order
Office of Human Resources Montgomery County Government
Prescription Drug Plan Comparison High Option $48
Only MCGEOIAFF employees can enroll in this High plan
High Option $510Only FOPNON-REP employees
can enroll in this High plan
Standard Option All employees can enroll in this
Standard plan
Copay $4 Generics$8 Brand Name
$5 Generics$10 Brand Name
$10 Generics$20 PBrand Name
$35 NPBrand NameDeductible na na $50yearMail Order Yes Yes Yes
Maintenance Choice Yes Yes YesCovered Drugs Same Same Same
Visit OHRrsquos Health Insurance Website to view Rx summaries
Office of Human Resources Montgomery County Government
Prescription Drug Cost Comparison Cost
High Option $48Only MCGEOIAFF employees
can enroll in this High plan
High Option $510Only FOPNON-REP employees
can enroll in this High plan
Standard Option All employees can enroll in this
Standard plan
Self Only
Bi-Weekly $11339Monthly $24568Yearly $294814
Bi-Weekly $11100Monthly $24050Yearly $288600
Bi-Weekly $2413Monthly $5258Yearly $62738
Self + 1
Bi-Weekly $20979Monthly $45455Yearly $545454
Bi-Weekly $20536Monthly $44495Yearly $533936
Bi-Weekly $4463Monthly $9670
Yearly $116038
Self + Family
Bi-Weekly $32511Monthly $70441Yearly $845286
Bi-Weekly $31824Monthly $68952Yearly $827424
Bi-Weekly $6916Monthly $14985Yearly $179816
Office of Human Resources Montgomery County Government
Dental
Office of Human Resources Montgomery County Government
Dental Comparison Cigna
For a list of HMO covered services and assigned costs (copays) view the HMO benefit summary
Required to Use An Assigned Provider Yes In-network only Primary Dental Office will be
assigned based on home address
No
Out of Network Benefits Available No Yes
Balance Billing for Covered Services No Yes if you go out-of-network
Referral Required Yes No
Orthodontia Benefits Available Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime) Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person) Unlimited $200000
Deductible (singlefamily) None $50 $ 150 waived for preventive care
Table 1
Office of Human Resources Montgomery County Government
Vision
Office of Human Resources Montgomery County Government
Vision Insurancebull The Countyrsquos Vision carrier is EyeMedbull Benefits payable for exams lenses and contacts (elective or necessary) every
calendar year frames every two calendar yearsbull In-network or out-of-network benefits available bull Enhanced Hearing Benefit through EyeMedrsquos partner Amplifon40 off hearing examDiscounted pricing on thousands of hearing aids including latest technologyOne-year free follow-up care with unlimited appointmentsFree batteries for two years with initial purchase Three-year warranty and loss and damage coverage
Visit OHRrsquos Health Insurance webpage to view vision summary
Office of Human Resources Montgomery County Government
Optional Life amp Dependent Life
Office of Human Resources Montgomery County Government
Optional Life Insurance ADampDbull You may elect Optional Life ADampD coverage for yourself in increments of 1 to 8 times
your basic annual earnings ($1 million maximum)
bull NOTE Coverage is not guaranteed issue for any level You must complete an online Statement of Health no matter what level of coverage you elect Later this fall after Open Enrollment ends you will receive an email from MetLife with a link to complete the Statement of Health online
bull An eligible dependent is defined as 1) your opposite or same sex spouse or 2) your unmarried children under age 26 (natural adopted or stepchildrenfoster children who depend on your support)
Office of Human Resources Montgomery County Government
Optional Life Insurance RatesHow to estimate your Optional Life Insurance bi-weekly rate
Example 40-year-old applying for 2 x salary Salary is $49300
Steps Example Calculate for Yourself
A Find your age-based rate on the rate sheet (left) $ 0037 $_________________
B Choose how much coverage you are applying for
$99000 (2 x salary rounded to the nearest $1000 ) $_________________
C Divide that coverage amount by 100099 ($99000 1000) $_________________
D Multiply A x C for estimated bi-weekly cost$366 ($037 x 99) $_________________
Office of Human Resources Montgomery County Government
Dependent Life InsuranceYou may also purchase Dependent Optional Life insurance forbull Your opposite or same sex spouse bull Your unmarried children under age 26
ndash Natural adoptedndash Stepchildrenfoster childrenNote you do not need to supply marriage certificatesbirth certificates for dependent optional life
You may electbull $2000 Spouse$1000 Childbull $4000 Spouse $2000 Childbull $10000 Spouse $5000 Child
The bi-weekly rate is not based on salary
Office of Human Resources Montgomery County Government
Flexible Spending Accounts
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Visit the Open Enrollment website to watch a recorded FSA presentation from MCGrsquos FSA vendor Benefit Strategies
bull What is an FSA It is an IRS-approved tax-free account that saves onQualified out-of-pocket medical and dependent care expensesFederal and State Income taxSocial Security Tax
bull 3 Account Options Health Care FSA Child Care FSA and Commuter Choice Transit bull FSA accounts are administered through Benefit Strategies bull FSAs are ldquouse-it or lose-itrdquo accounts claims must be incurred during the 2021 plan year (January 1
2021 ndash March 15 2022) and submitted by April 30 2022
IMPORTANT You must re-enroll in an FSA every Open Enrollment if you want to participate in the upcoming plan year
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Why You Should EnrollGive yourself a raise by reducing your taxesbull Elect the annual amount you want to place in your FSA(s) for the upcoming plan year during Open Enrollmentbull That amount is divided by 26 and taken from your biweekly paychecks on a pre-tax basis (21 paychecks for
10-month employees)bull Then use your pre-tax FSA dollars to pay for eligible out-of-pocket health care child-care or transit
expenses
Office of Human Resources Montgomery County Government
Health Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull Claims must be submitted by April 30 of the following yearbull You may elect to contribute up to $2750 Your total annual election amount is available to spend on the first
day of the new plan year bull FSA debit card allows you to pay for expenses at the time of servicebull Examples of IRS qualified eligible expenses
bull Copays (medical prescription dental vision) deductibles and coinsurance amounts over reasonable and customary charge
bull Hearing aids bull Acupuncture bull Orthopedic shoes bull Over-the-counter (OTC) drugs (no longer require doctorrsquos prescription)
Office of Human Resources Montgomery County Government
Child Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull $5000 annual maximum per household ($2500 for married filing separately)bull Funds are available to spend as they are accumulated through payroll deductionsbull Reimbursable expenses
bull day care centersbull elder carebull beforeafter school carebull babysitter fees that allow you and your spouse to work or go to school (no child support payments)
bull Qualifying dependentsbull Children under the age of 13 and are a tax dependent of the employeebull Spouse or tax dependent that is physically or mentally incapable of self-care
bull Must coordinate between filing a tax credit with IRS and your Dependent Care FSA plan
Office of Human Resources Montgomery County Government
Commuter Choice Transit FSAbull $230 per month maximum for MCGEO staff $260 per month maximum for Unrepresented staffbull Applies to employee commuting expenses only (not spouses or dependents)bull Can enroll throughout the year (not limited to Open Enrollment election)bull Eligible expenses include Metro Marc Vanpool Lyft Line Uber Poolbull Debit card ndash may be used for some expenses (not Metro)Metro riders will have to submit claim forms for reimbursement
bull Funds must be used within 180 days of election bull If retiring or leaving the County will need to coordinate use all available funds
Office of Human Resources Montgomery County Government
Using Your FSA FundsHealth Care FSA Your full annual election amount is available on the first day of the plan yearChild Care FSA Your funds are available as they accumulate through payroll deductionsCommuterTransit FSA Your funds are available as they accumulate through payroll deductions
The FSA Debit Card bull Your FSA debit card is the same card for your Health Care Child Care and TransitCommuter FSA accountsbull The card is pre-loaded with your full annual Health Care FSA election amount You can use the card to pay for IRS qualified expenses at
the time of service or when paying a bill Receipt notifications will be mailed to you monthly by Benefit Strategies Your response to receipt notifications is necessary under the provisions of the plan No response my result in the ineligibility of the purchase and as a result your card may be temporarily deactivated
bull If you are enrolled in the Child Care FSA the card can also be used in child-care settings Just remember that the card will only work for an amount that does not exceed the available balance in your Child Care FSA account on that day
bull The card can also be used to pay for your commutertransit expenses however it does not work for WMATA metro Metro riders will have to submit manual claims for reimbursement from your CommuterTransit FSA
bull Cards are re-loaded each year after you make your new annual election Please keep your cards You will only receive a new card if your old card is about to expire
Office of Human Resources Montgomery County Government
AFLAC Voluntary Plans
Office of Human Resources Montgomery County Government
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Short-Term Disabilitybull Provides short-term cash benefits in the event of disabilitybull Monthly benefit amounts available from $500 - $6000 (subject to income requirements)bull Benefit options of 3 6 12 18 or 24 months with a variety of elimination periods
Critical Illness Insurancebull Provides a lump sum cash benefit in the event of critical illnessbull Benefit amounts available in $5000 increments from $10000 - $30000
Participants pay 100 through payroll deduction for Short-Term Disability and Critical Illness Insurance
To ENROLL Text SETAPPTrdquo to 41411orCall 920-420-8861 orEmail susan_mcdanielusAflaccom
Office of Human Resources Montgomery County Government
Carrier Resources amp Cost-Saving Tips
Office of Human Resources Montgomery County Government
Lower Your Out-of-Pocket CostsChoose the plan thatrsquos right for youbull See the medical benefits chart for options bull Stay in network Use the provider search engines on your carrier website or mobile app to find in-network providersSeek preventive carebull Check-ups immunizations and screenings are an important part of staying healthy They can detect or prevent serious diseases and keep you healthyKnow where to go for carebull You have many options of places to go when you need care If your medical condition isnrsquot serious or life threatening you can save money by connecting
with a doctor online through a virtual visit or going to an urgent care center or convenience care clinic instead of a hospital emergency roomReview your prescription drug plan optionsbull Decide which Caremark prescription plan is best for you Note that the Kaiser HMO includes prescription drug coverage Both the Standard and High
Option Caremark plans cover the same prescription drugs but have different copay and deductiblesUse generic and long-term prescriptions bull Opt for lower-cost generic drugs whenever possible bull Ask your doctor to write a 90-day prescription instead of a 30-day prescription to participate in the mail order prescription programTake advantage of tax savings by participating in Flexible Spending Accountsbull Use pre-tax dollars for eligible out of pocket services and items
Office of Human Resources Montgomery County Government
Built-in Wellness Support Take advantage of the free programs available to you through your medical carrier Each of MCGrsquos medical carriers (Kaiser UHC amp CareFirst) offer valuable programs to help you manage your health
Disease Management Programsbull Help manage your chronic condition through personalized coaching support and encouragement and online education materialsEmotional Wellness amp Stress Management Support bull Help manage stress through mobile apps and other self-care resources Maternity Programsbull Support healthy moms and healthy babiesWeight-loss Programs bull Offers telephonic coaching support and web-based tools to help ensure long-term weight managementbull See the next slide for an example of an MCG success storySmoking Cessation Programsbull Supportive coaching to make quitting more successfulDiscounts bull Gym memberships weight loss programs and moreFor more information about the programs available to you please see the Open Enrollment Guide and contact your medical carrier
Office of Human Resources Montgomery County Government
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You GoAll of MCGrsquos health insurance carriers offer a simple-to-use tool that can help make your life easier while yoursquore on the go Download your carrierrsquos Mobile App to help you personalize organize and access your important plan information on your phone or tablet
bull Schedule Virtual Visitsbull Manage and track claimsbull View ID card informationbull Find doctor and compare costs and quality ratingsbull Review your coveragebull Track your account balances and deductiblesbull Access a variety of health and wellness tools
Visit Google Play or the Apple App Store to download your carrierrsquos App
Office of Human Resources Montgomery County Government
Making Changes
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Questions
Office of Human Resources Montgomery County Government
Open Enrollment AssistanceFollow these steps (in this order)1 Review the frequently asked questions (FAQs) on the Open Enrollment website at wwwmontgomerycountymdgovoe
(available beginning September 21) You can enter key words into the interactive search bar to quickly locate the answer to your question
2 Visit the MC311 website at wwwmontgomerycountymdgovmc311 and search key words for your question The search results contain various knowledge-based articles with information related to your search words Simply click on the corresponding link and the detailed answer is revealed
3 Attend one of OHRrsquos Virtual Office Hours via Microsoft Teams Members of OHRs Health Insurance Team will be on hand to address employee questions by video or via the chat box View the schedule and access the sessions through the Open Enrollment website at wwwmontgomerycountymdgovoe (available beginning September 21)
4 If you have tried all the methods above and still have Open Enrollment-related questions please contact OHRs MC311 Customer Service Center at 240-773-6471 (Mon-Fri 8 am - 5 pm) to open a service request A member of the health insurance team will respond to service requests in the order they are received Tip Please provide an email address at the time you place your Service Request This will ensure the fastest response possible
Office of Human Resources Montgomery County Government
Online ResourcesVisit the 2021 Open Enrollment Webpage
wwwmontgomerycountymdgovOE
Visit OHRrsquos WebpagewwwmontgomerycountymdgovHR
Health Insurance active employees
Office of Human Resources Montgomery County Government
Legal InformationThe County reserves the right at any time and for any reason to amend the Program subject to the Countys collective bargainingagreements The County expects to continue the Program but it is the Countys position that there is no implied contract between individual employees and the County to do so
The County may amend the Program prospectively or retroactively to comply with applicable law
In the event of a conflict between this presentation the County Code andor the Summary Description the County Code then the Summary Description will govern
Office of Human Resources Montgomery County Government
Thank YouWe hope you enjoyed learning about 2021 Open Enrollment
~Your OHR Health Insurance Team
2021 Open Enrollment Benefits Bonanza
What Is Open Enrollment
What Changes Can be Made
Open Enrollment Dates
MCG Continues to Make Generous Employer Contributions
New for 2021
Special 2021 Plan Rates Announcement
Employee Rate Changes for Calendar Year 2021
Planning Ahead Minimizing Future Rate Increases
New for 2021
Open Enrollment Communications
Itrsquos a New Frontier
2021 Open Enrollment Checklist
Open Enrollment Website Resources
Attend a Virtual Open Enrollment Event
Make Changes Online
Paper Enrollment Form Permitted for Only Two Reasons
Dependent Eligibility
Proof of Dependent Eligibility
Marriage Certificate Example Required Documentation (Contd)
Benefits Refresher
Medical amp Rx
Medical Plan Options
Medical Benefits at-a-Glance
Medical Benefits at-a-Glance (contd)
Prescription Plans Caremark
Prescription Drug Plan Comparison
Prescription Drug Cost Comparison
Dental
Slide Number 30
Vision
Vision Insurance
Optional Life amp Dependent Life
Optional Life Insurance ADampD
Optional Life Insurance Rates
Dependent Life Insurance
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs)Why You Should Enroll
Health Care FSA
Child Care FSA
Commuter Choice Transit FSA
Using Your FSA Funds
AFLAC Voluntary Plans
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Carrier Resources amp Cost-Saving Tips
Lower Your Out-of-Pocket Costs
Built-in Wellness Support
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You Go
Making Changes
Make Changes Online
Questions
Open Enrollment Assistance
Online Resources
Legal Information
Thank You
Cigna Dental Comparison
DHMO
PPO
CIGNA NETWORK
Care-Access PlusDHMO
Total CIGNA PPOPPO
Required to Use An Assigned Provider
Yes In-network only Primary Dental Office will be assigned based on home address
No
Out of Network Benefits Available
No
Yes
Balance Billing for Covered Services
No
Yes if you go out-of-network
Referral Required
Yes
No
Orthodontia Benefits Available
Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime)
Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person)
Unlimited
$200000
Deductible (singlefamily)
None
$50 $ 150 waived for preventive care
1Claim submission would be required and balance billing may occur when visiting a nonparticipating provider2Deductible does not apply to Class I ndash Diagnostic and Preventive Services
Coverage for dependents would cease on the day which the child turns 26Benefit Maximum and Deductibles are for the period of January 01 through December 31
All services listed on this benefit summary are subject to the contractSchedules of Benefits and current Exclusions and Limitations
Medical Benefits at a Glance
Kaiser Permanente HMO + Rx wwwkporg
United HealthCare Select HMO wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS) wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS) wwwcarefirstcom
Plan Type
HMO
HMO
Point-of-Service
Point-of-Service
PCP Required
Yes
Yes
No
No
Provider Network
Regional (MDDCVA)
National
National
National
Out-of-Network Benefits
No
No
Yes
Yes
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
None
None
In-Network None Out-of-Network 80
In-Network None Out-of-Network 80
Dr Office Visits PCPSpecialist
$5 copay
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits
Covered in full
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care
$5 copay
$15 copay
Covered in full
Covered in full
Emergency Room
$50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization
Covered in full
Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
MCG 2018 Medical Plan Comparison Chart
Kaiser Permanente
United HealthCare
CareFirst POS Standard
CareFirst POS High
Plan Type
HMO
HMO
Point of Service
Point of Service
Provider Network
Regional (MDDCVA)
National
National
National
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
Annual Out-of-Pocket Maximum
None
$1100 per individual up to cap of $3600 for a family
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
Physician Servcies
PCP Office Visits
$5 copay
$5 copay PCP
In-Network $15 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Specialist Office Visits
$5 copay
$10 copay
In-Network $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Annual Physical
Covered in full
$5 copay PCP
In-Network $15 copay Primary Care Physician $30 copay specialist Out-of-Network 80 covered after deductible (limit 1calendar year)
In-Network $15 copay Out-of-Network 80 not subject to deductible (up to age 18)
In-Network $10 copay Out-of-Network 80 not subject to deductible (up to age 18)
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Allergy Testing
$5 copay
$5 copay PCP $10 copay Specialist
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Virtual Visits
Labs X-Rays Diagnostics
Outpatient labs
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient X-Rays
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Major Diagnostics
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Immedate Medical Servcies
Emergency Room
$50 copay waived if admitted to hospital
$25 copay waived if admitted to hospital $15 copay for urgent care
In-Network $35 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
Urgent Care
Hospital Services
Inpatient Hospitalization
Covered in full
Covered in full
In-Network Covered in full after $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Services
Surgery
Covered in full
Inpatient covered in full Outpatient $25 copay
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Hearing Aids
For minor children One hearing aid for each hearing impaired ear once every 36 months
For minor children One hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
Hearing Screening
$5 copay for hearing exam (hearing aids are excluded)
$5 Copay PCP $10 Copay Specialist
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
Home Health Care Services
Covered in full if medically necessary
Covered in full No copayment 60 visit maximum for skilled care services per calendar year
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
Hospice
Covered in full
Covered in full (See coverage booklet for eligibility information)
In-Network Covered in full
In-Network Covered in full
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
In vitro Fertilization
Limited to 3 attempts per live birth Lifetime maximum of $100000
Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
Mammography - Preventive Screening Schedule
Schedule consistent with the current recommendations of the American College of Physicians
Covered in full Age 35-39 one baseline mammogram Age 40-49 one mammogram every two calendar years Age 50+ one mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
Maternity
Covered in full once pregnancy is diagnosed
No copayment applies after the first visit
In-Network first visit 100 after $30 copay other visits 100
In-Network First visit 100 after $10 copay other visits 100
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Maximum Lifetime Benefit
Unlimited maximum
Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
Prescriptions
Kaiser Rx plan (included with Kaiser HMO medical plan) $5 at on-site pharmacies and for mail order $15 at participating pharmacies
No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
Rehabilitation Services
Inpatient Covered in full (unlimited) Outpatient $5 copay outpatient services for physical therapy are limited to up to 30 visits occupational and speech therapy per injury incident or condition are covered for a period not to exceed 90 days
$10 copayvisit 60 combined visits per year (short-term non-chronic conditions only)
In-Network
In-Network
100
100
Skilled Nursing Facility
Covered in full 100 days maximum
Covered in full 60 days per calendar year maximum
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Substance AbuseMental Health
Inpatient Covered in full Outpatient $5 copay
Inpatient Covered in full Outpatient $5 copay
In-Network Inpatient- $150 per admission copay Outpatient- $15 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
In-Network Inpatient- covered in full Outpatient- $10 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
Vision (Routine)
$5 copay for exams 25 discount on lensesframes at Kaiser centers 15 discount off the costs of contact lenses
$25 copay for exam 15-20 discount through participating optical centers
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
53116
Medical Benefits at a Glance
Kaiser Permanente HMO + Rx wwwkporg
United HealthCare Select HMO wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS) wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS) wwwcarefirstcom
Plan Type
HMO
HMO
Point-of-Service
Point-of-Service
PCP Required
Yes
Yes
No
No
Provider Network
Regional (MDDCVA)
National
National
National
Out-of-Network Benefits
No
No
Yes
Yes
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
None
None
In-Network None Out-of-Network 80
In-Network None Out-of-Network 80
Dr Office Visits PCPSpecialist
$5 copay
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits
Covered in full
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care
$5 copay
$15 copay
Covered in full
Covered in full
Emergency Room
$50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization
Covered in full
Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
MCG 2018 Medical Plan Comparison Chart
Kaiser Permanente
United HealthCare
CareFirst POS Standard
CareFirst POS High
Plan Type
HMO
HMO
Point of Service
Point of Service
Provider Network
Regional (MDDCVA)
National
National
National
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
Annual Out-of-Pocket Maximum
None
$1100 per individual up to cap of $3600 for a family
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
Physician Servcies
PCP Office Visits
$5 copay
$5 copay PCP
In-Network $15 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Specialist Office Visits
$5 copay
$10 copay
In-Network $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Annual Physical
Covered in full
$5 copay PCP
In-Network $15 copay Primary Care Physician $30 copay specialist Out-of-Network 80 covered after deductible (limit 1calendar year)
In-Network $15 copay Out-of-Network 80 not subject to deductible (up to age 18)
In-Network $10 copay Out-of-Network 80 not subject to deductible (up to age 18)
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Allergy Testing
$5 copay
$5 copay PCP $10 copay Specialist
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Virtual Visits
Labs X-Rays Diagnostics
Outpatient labs
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient X-Rays
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Major Diagnostics
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Immedate Medical Servcies
Emergency Room
$50 copay waived if admitted to hospital
$25 copay waived if admitted to hospital $15 copay for urgent care
In-Network $35 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
Urgent Care
Hospital Services
Inpatient Hospitalization
Covered in full
Covered in full
In-Network Covered in full after $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Services
Surgery
Covered in full
Inpatient covered in full Outpatient $25 copay
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Hearing Aids
For minor children One hearing aid for each hearing impaired ear once every 36 months
For minor children One hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
Hearing Screening
$5 copay for hearing exam (hearing aids are excluded)
$5 Copay PCP $10 Copay Specialist
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
Home Health Care Services
Covered in full if medically necessary
Covered in full No copayment 60 visit maximum for skilled care services per calendar year
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
Hospice
Covered in full
Covered in full (See coverage booklet for eligibility information)
In-Network Covered in full
In-Network Covered in full
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
In vitro Fertilization
Limited to 3 attempts per live birth Lifetime maximum of $100000
Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
Mammography - Preventive Screening Schedule
Schedule consistent with the current recommendations of the American College of Physicians
Covered in full Age 35-39 one baseline mammogram Age 40-49 one mammogram every two calendar years Age 50+ one mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
Maternity
Covered in full once pregnancy is diagnosed
No copayment applies after the first visit
In-Network first visit 100 after $30 copay other visits 100
In-Network First visit 100 after $10 copay other visits 100
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Maximum Lifetime Benefit
Unlimited maximum
Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
Prescriptions
Kaiser Rx plan (included with Kaiser HMO medical plan) $5 at on-site pharmacies and for mail order $15 at participating pharmacies
No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
Rehabilitation Services
Inpatient Covered in full (unlimited) Outpatient $5 copay outpatient services for physical therapy are limited to up to 30 visits occupational and speech therapy per injury incident or condition are covered for a period not to exceed 90 days
$10 copayvisit 60 combined visits per year (short-term non-chronic conditions only)
In-Network
In-Network
100
100
Skilled Nursing Facility
Covered in full 100 days maximum
Covered in full 60 days per calendar year maximum
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Substance AbuseMental Health
Inpatient Covered in full Outpatient $5 copay
Inpatient Covered in full Outpatient $5 copay
In-Network Inpatient- $150 per admission copay Outpatient- $15 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
In-Network Inpatient- covered in full Outpatient- $10 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
Vision (Routine)
$5 copay for exams 25 discount on lensesframes at Kaiser centers 15 discount off the costs of contact lenses
$25 copay for exam 15-20 discount through participating optical centers
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
53116
Office of Human Resources Montgomery County Government
Paper Enrollment Form Permitted for Only Two ReasonsThere are only two exceptions permitting the use of paper Open Enrollment forms
bull Technical barriers preventing access to ESS (only in the event of no internet no smartphone or computer) the employee should contact MC311 and place a service request to be mailed a paper enrollment form Call 240-773-OHR1 (240-773-6471) available Monday through Friday 8 am to 5 pm
bull Experiencing a Life Event If an employee has a qualified status change (life event) during Open Enrollment they cannot make changes using the Open Enrollment form or online system Instead they should contact the OHR Health Insurance Team via MC311 to make changes Qualifying life events marriage divorce the birth of a child or the death of spouse or a
dependent aging out
Office of Human Resources Montgomery County Government
Dependent EligibilityEligible dependents for medical prescription dental and vision coverage arebull Spouse
Legally married EligibleDivorced Not Eligible
bull Children (biological legally adopted stepchildren or under your legal custody)Under age 26 EligibleAge 26 and over Not Eligible unless incapable of self support
Proof of eligible dependents is required
Office of Human Resources Montgomery County Government
Proof of Dependent EligibilityEmployees enrolling new dependents during Open Enrollment must upload the necessary dependent documentation in ESS prior to October 9 at 5 pmRequired Documentationbull Spouse Official State Marriage Certificate (certified by appropriate State or County Official)bull Biological Child State Birth Certificate (For newborns OHR will accept hospital discharge papers for first 60 days birth
certificate must then be submitted)bull Adopted Child Copy of Adoption or Placement for Adoption Papers bull Step-Child State Birth Certificate Marriage Certificate and Divorce Decree or Custody Papers bull Disabled Child Medical plan verification of disability prior to age 26 bull Legal Custody Copy of Court Order granting legal custody
Office of Human Resources Montgomery County Government
Marriage Certificate Example Required Documentation (Contd)
Office of Human Resources Montgomery County Government
Benefits Refresher
Office of Human Resources Montgomery County Government
Medical amp Rx
Office of Human Resources Montgomery County Government
Medical Plan OptionsHealth Maintenance Organizations (HMO)bull Kaiser Permanente Signature (HMO)bull United Healthcare Select (HMO)
Point of Service Plans (POS)bull CareFirst BCBS (POS) High Optionbull CareFirst BCBS (POS) Standard Option
Three tiers of coverage Self Self + 1 or Family
Office of Human Resources Montgomery County Government
Medical Benefits at-a-Glance To view full carrier medical summaries visit OHRrsquos Health Insurance Website
Kaiser Permanente HMO + Rx
wwwkporg
United HealthCare Select HMO
wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS)
wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS)
wwwcarefirstcom
Plan Type HMO HMO Point-of-Service Point-of-Service
PCP Required Yes Yes No No
Provider Network Regional (MDDCVA) National National National
Out-of-Network Benefits No No Yes Yes
Referrals Required Yes No No No
Annual Deductible None NoneIn-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Sheet1
Sheet1 (2)
Office of Human Resources Montgomery County Government
Medical Benefits at-a-Glance (contd)
New Employee Orientation Program
Kaiser Permanente HMO + Rx
wwwkporg
United HealthCare Select HMO
wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS)
wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS)
wwwcarefirstcom
Dr Office Visits PCPSpecialist $5 copay $5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits Covered in full $5 copay $10 copay In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care $5 copay $15 copay Covered in full Covered in full
Emergency Room $50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization Covered in full Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
Visit OHRrsquos Health Insurance webpage to view Medical summaries
Sheet1
Sheet1 (2)
Office of Human Resources Montgomery County Government
Prescription Plans Caremarkbull Two Rx Plan OptionsStandardHigh
bull If you elect UHC or CareFirst and want Rx coverage you will need to elect the stand-alone Caremark Rx plan (Kaiser already includes Rx coverage)
bull Maintenance Choice Program available for maintenance drugs significant cost savings ndash 1 copay for each 90-day prescription In order to get the Maintenance pricing you must fil Rx at CVS retail pharmacy Mail order
Office of Human Resources Montgomery County Government
Prescription Drug Plan Comparison High Option $48
Only MCGEOIAFF employees can enroll in this High plan
High Option $510Only FOPNON-REP employees
can enroll in this High plan
Standard Option All employees can enroll in this
Standard plan
Copay $4 Generics$8 Brand Name
$5 Generics$10 Brand Name
$10 Generics$20 PBrand Name
$35 NPBrand NameDeductible na na $50yearMail Order Yes Yes Yes
Maintenance Choice Yes Yes YesCovered Drugs Same Same Same
Visit OHRrsquos Health Insurance Website to view Rx summaries
Office of Human Resources Montgomery County Government
Prescription Drug Cost Comparison Cost
High Option $48Only MCGEOIAFF employees
can enroll in this High plan
High Option $510Only FOPNON-REP employees
can enroll in this High plan
Standard Option All employees can enroll in this
Standard plan
Self Only
Bi-Weekly $11339Monthly $24568Yearly $294814
Bi-Weekly $11100Monthly $24050Yearly $288600
Bi-Weekly $2413Monthly $5258Yearly $62738
Self + 1
Bi-Weekly $20979Monthly $45455Yearly $545454
Bi-Weekly $20536Monthly $44495Yearly $533936
Bi-Weekly $4463Monthly $9670
Yearly $116038
Self + Family
Bi-Weekly $32511Monthly $70441Yearly $845286
Bi-Weekly $31824Monthly $68952Yearly $827424
Bi-Weekly $6916Monthly $14985Yearly $179816
Office of Human Resources Montgomery County Government
Dental
Office of Human Resources Montgomery County Government
Dental Comparison Cigna
For a list of HMO covered services and assigned costs (copays) view the HMO benefit summary
Required to Use An Assigned Provider Yes In-network only Primary Dental Office will be
assigned based on home address
No
Out of Network Benefits Available No Yes
Balance Billing for Covered Services No Yes if you go out-of-network
Referral Required Yes No
Orthodontia Benefits Available Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime) Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person) Unlimited $200000
Deductible (singlefamily) None $50 $ 150 waived for preventive care
Table 1
Office of Human Resources Montgomery County Government
Vision
Office of Human Resources Montgomery County Government
Vision Insurancebull The Countyrsquos Vision carrier is EyeMedbull Benefits payable for exams lenses and contacts (elective or necessary) every
calendar year frames every two calendar yearsbull In-network or out-of-network benefits available bull Enhanced Hearing Benefit through EyeMedrsquos partner Amplifon40 off hearing examDiscounted pricing on thousands of hearing aids including latest technologyOne-year free follow-up care with unlimited appointmentsFree batteries for two years with initial purchase Three-year warranty and loss and damage coverage
Visit OHRrsquos Health Insurance webpage to view vision summary
Office of Human Resources Montgomery County Government
Optional Life amp Dependent Life
Office of Human Resources Montgomery County Government
Optional Life Insurance ADampDbull You may elect Optional Life ADampD coverage for yourself in increments of 1 to 8 times
your basic annual earnings ($1 million maximum)
bull NOTE Coverage is not guaranteed issue for any level You must complete an online Statement of Health no matter what level of coverage you elect Later this fall after Open Enrollment ends you will receive an email from MetLife with a link to complete the Statement of Health online
bull An eligible dependent is defined as 1) your opposite or same sex spouse or 2) your unmarried children under age 26 (natural adopted or stepchildrenfoster children who depend on your support)
Office of Human Resources Montgomery County Government
Optional Life Insurance RatesHow to estimate your Optional Life Insurance bi-weekly rate
Example 40-year-old applying for 2 x salary Salary is $49300
Steps Example Calculate for Yourself
A Find your age-based rate on the rate sheet (left) $ 0037 $_________________
B Choose how much coverage you are applying for
$99000 (2 x salary rounded to the nearest $1000 ) $_________________
C Divide that coverage amount by 100099 ($99000 1000) $_________________
D Multiply A x C for estimated bi-weekly cost$366 ($037 x 99) $_________________
Office of Human Resources Montgomery County Government
Dependent Life InsuranceYou may also purchase Dependent Optional Life insurance forbull Your opposite or same sex spouse bull Your unmarried children under age 26
ndash Natural adoptedndash Stepchildrenfoster childrenNote you do not need to supply marriage certificatesbirth certificates for dependent optional life
You may electbull $2000 Spouse$1000 Childbull $4000 Spouse $2000 Childbull $10000 Spouse $5000 Child
The bi-weekly rate is not based on salary
Office of Human Resources Montgomery County Government
Flexible Spending Accounts
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Visit the Open Enrollment website to watch a recorded FSA presentation from MCGrsquos FSA vendor Benefit Strategies
bull What is an FSA It is an IRS-approved tax-free account that saves onQualified out-of-pocket medical and dependent care expensesFederal and State Income taxSocial Security Tax
bull 3 Account Options Health Care FSA Child Care FSA and Commuter Choice Transit bull FSA accounts are administered through Benefit Strategies bull FSAs are ldquouse-it or lose-itrdquo accounts claims must be incurred during the 2021 plan year (January 1
2021 ndash March 15 2022) and submitted by April 30 2022
IMPORTANT You must re-enroll in an FSA every Open Enrollment if you want to participate in the upcoming plan year
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Why You Should EnrollGive yourself a raise by reducing your taxesbull Elect the annual amount you want to place in your FSA(s) for the upcoming plan year during Open Enrollmentbull That amount is divided by 26 and taken from your biweekly paychecks on a pre-tax basis (21 paychecks for
10-month employees)bull Then use your pre-tax FSA dollars to pay for eligible out-of-pocket health care child-care or transit
expenses
Office of Human Resources Montgomery County Government
Health Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull Claims must be submitted by April 30 of the following yearbull You may elect to contribute up to $2750 Your total annual election amount is available to spend on the first
day of the new plan year bull FSA debit card allows you to pay for expenses at the time of servicebull Examples of IRS qualified eligible expenses
bull Copays (medical prescription dental vision) deductibles and coinsurance amounts over reasonable and customary charge
bull Hearing aids bull Acupuncture bull Orthopedic shoes bull Over-the-counter (OTC) drugs (no longer require doctorrsquos prescription)
Office of Human Resources Montgomery County Government
Child Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull $5000 annual maximum per household ($2500 for married filing separately)bull Funds are available to spend as they are accumulated through payroll deductionsbull Reimbursable expenses
bull day care centersbull elder carebull beforeafter school carebull babysitter fees that allow you and your spouse to work or go to school (no child support payments)
bull Qualifying dependentsbull Children under the age of 13 and are a tax dependent of the employeebull Spouse or tax dependent that is physically or mentally incapable of self-care
bull Must coordinate between filing a tax credit with IRS and your Dependent Care FSA plan
Office of Human Resources Montgomery County Government
Commuter Choice Transit FSAbull $230 per month maximum for MCGEO staff $260 per month maximum for Unrepresented staffbull Applies to employee commuting expenses only (not spouses or dependents)bull Can enroll throughout the year (not limited to Open Enrollment election)bull Eligible expenses include Metro Marc Vanpool Lyft Line Uber Poolbull Debit card ndash may be used for some expenses (not Metro)Metro riders will have to submit claim forms for reimbursement
bull Funds must be used within 180 days of election bull If retiring or leaving the County will need to coordinate use all available funds
Office of Human Resources Montgomery County Government
Using Your FSA FundsHealth Care FSA Your full annual election amount is available on the first day of the plan yearChild Care FSA Your funds are available as they accumulate through payroll deductionsCommuterTransit FSA Your funds are available as they accumulate through payroll deductions
The FSA Debit Card bull Your FSA debit card is the same card for your Health Care Child Care and TransitCommuter FSA accountsbull The card is pre-loaded with your full annual Health Care FSA election amount You can use the card to pay for IRS qualified expenses at
the time of service or when paying a bill Receipt notifications will be mailed to you monthly by Benefit Strategies Your response to receipt notifications is necessary under the provisions of the plan No response my result in the ineligibility of the purchase and as a result your card may be temporarily deactivated
bull If you are enrolled in the Child Care FSA the card can also be used in child-care settings Just remember that the card will only work for an amount that does not exceed the available balance in your Child Care FSA account on that day
bull The card can also be used to pay for your commutertransit expenses however it does not work for WMATA metro Metro riders will have to submit manual claims for reimbursement from your CommuterTransit FSA
bull Cards are re-loaded each year after you make your new annual election Please keep your cards You will only receive a new card if your old card is about to expire
Office of Human Resources Montgomery County Government
AFLAC Voluntary Plans
Office of Human Resources Montgomery County Government
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Short-Term Disabilitybull Provides short-term cash benefits in the event of disabilitybull Monthly benefit amounts available from $500 - $6000 (subject to income requirements)bull Benefit options of 3 6 12 18 or 24 months with a variety of elimination periods
Critical Illness Insurancebull Provides a lump sum cash benefit in the event of critical illnessbull Benefit amounts available in $5000 increments from $10000 - $30000
Participants pay 100 through payroll deduction for Short-Term Disability and Critical Illness Insurance
To ENROLL Text SETAPPTrdquo to 41411orCall 920-420-8861 orEmail susan_mcdanielusAflaccom
Office of Human Resources Montgomery County Government
Carrier Resources amp Cost-Saving Tips
Office of Human Resources Montgomery County Government
Lower Your Out-of-Pocket CostsChoose the plan thatrsquos right for youbull See the medical benefits chart for options bull Stay in network Use the provider search engines on your carrier website or mobile app to find in-network providersSeek preventive carebull Check-ups immunizations and screenings are an important part of staying healthy They can detect or prevent serious diseases and keep you healthyKnow where to go for carebull You have many options of places to go when you need care If your medical condition isnrsquot serious or life threatening you can save money by connecting
with a doctor online through a virtual visit or going to an urgent care center or convenience care clinic instead of a hospital emergency roomReview your prescription drug plan optionsbull Decide which Caremark prescription plan is best for you Note that the Kaiser HMO includes prescription drug coverage Both the Standard and High
Option Caremark plans cover the same prescription drugs but have different copay and deductiblesUse generic and long-term prescriptions bull Opt for lower-cost generic drugs whenever possible bull Ask your doctor to write a 90-day prescription instead of a 30-day prescription to participate in the mail order prescription programTake advantage of tax savings by participating in Flexible Spending Accountsbull Use pre-tax dollars for eligible out of pocket services and items
Office of Human Resources Montgomery County Government
Built-in Wellness Support Take advantage of the free programs available to you through your medical carrier Each of MCGrsquos medical carriers (Kaiser UHC amp CareFirst) offer valuable programs to help you manage your health
Disease Management Programsbull Help manage your chronic condition through personalized coaching support and encouragement and online education materialsEmotional Wellness amp Stress Management Support bull Help manage stress through mobile apps and other self-care resources Maternity Programsbull Support healthy moms and healthy babiesWeight-loss Programs bull Offers telephonic coaching support and web-based tools to help ensure long-term weight managementbull See the next slide for an example of an MCG success storySmoking Cessation Programsbull Supportive coaching to make quitting more successfulDiscounts bull Gym memberships weight loss programs and moreFor more information about the programs available to you please see the Open Enrollment Guide and contact your medical carrier
Office of Human Resources Montgomery County Government
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You GoAll of MCGrsquos health insurance carriers offer a simple-to-use tool that can help make your life easier while yoursquore on the go Download your carrierrsquos Mobile App to help you personalize organize and access your important plan information on your phone or tablet
bull Schedule Virtual Visitsbull Manage and track claimsbull View ID card informationbull Find doctor and compare costs and quality ratingsbull Review your coveragebull Track your account balances and deductiblesbull Access a variety of health and wellness tools
Visit Google Play or the Apple App Store to download your carrierrsquos App
Office of Human Resources Montgomery County Government
Making Changes
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Questions
Office of Human Resources Montgomery County Government
Open Enrollment AssistanceFollow these steps (in this order)1 Review the frequently asked questions (FAQs) on the Open Enrollment website at wwwmontgomerycountymdgovoe
(available beginning September 21) You can enter key words into the interactive search bar to quickly locate the answer to your question
2 Visit the MC311 website at wwwmontgomerycountymdgovmc311 and search key words for your question The search results contain various knowledge-based articles with information related to your search words Simply click on the corresponding link and the detailed answer is revealed
3 Attend one of OHRrsquos Virtual Office Hours via Microsoft Teams Members of OHRs Health Insurance Team will be on hand to address employee questions by video or via the chat box View the schedule and access the sessions through the Open Enrollment website at wwwmontgomerycountymdgovoe (available beginning September 21)
4 If you have tried all the methods above and still have Open Enrollment-related questions please contact OHRs MC311 Customer Service Center at 240-773-6471 (Mon-Fri 8 am - 5 pm) to open a service request A member of the health insurance team will respond to service requests in the order they are received Tip Please provide an email address at the time you place your Service Request This will ensure the fastest response possible
Office of Human Resources Montgomery County Government
Online ResourcesVisit the 2021 Open Enrollment Webpage
wwwmontgomerycountymdgovOE
Visit OHRrsquos WebpagewwwmontgomerycountymdgovHR
Health Insurance active employees
Office of Human Resources Montgomery County Government
Legal InformationThe County reserves the right at any time and for any reason to amend the Program subject to the Countys collective bargainingagreements The County expects to continue the Program but it is the Countys position that there is no implied contract between individual employees and the County to do so
The County may amend the Program prospectively or retroactively to comply with applicable law
In the event of a conflict between this presentation the County Code andor the Summary Description the County Code then the Summary Description will govern
Office of Human Resources Montgomery County Government
Thank YouWe hope you enjoyed learning about 2021 Open Enrollment
~Your OHR Health Insurance Team
2021 Open Enrollment Benefits Bonanza
What Is Open Enrollment
What Changes Can be Made
Open Enrollment Dates
MCG Continues to Make Generous Employer Contributions
New for 2021
Special 2021 Plan Rates Announcement
Employee Rate Changes for Calendar Year 2021
Planning Ahead Minimizing Future Rate Increases
New for 2021
Open Enrollment Communications
Itrsquos a New Frontier
2021 Open Enrollment Checklist
Open Enrollment Website Resources
Attend a Virtual Open Enrollment Event
Make Changes Online
Paper Enrollment Form Permitted for Only Two Reasons
Dependent Eligibility
Proof of Dependent Eligibility
Marriage Certificate Example Required Documentation (Contd)
Benefits Refresher
Medical amp Rx
Medical Plan Options
Medical Benefits at-a-Glance
Medical Benefits at-a-Glance (contd)
Prescription Plans Caremark
Prescription Drug Plan Comparison
Prescription Drug Cost Comparison
Dental
Slide Number 30
Vision
Vision Insurance
Optional Life amp Dependent Life
Optional Life Insurance ADampD
Optional Life Insurance Rates
Dependent Life Insurance
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs)Why You Should Enroll
Health Care FSA
Child Care FSA
Commuter Choice Transit FSA
Using Your FSA Funds
AFLAC Voluntary Plans
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Carrier Resources amp Cost-Saving Tips
Lower Your Out-of-Pocket Costs
Built-in Wellness Support
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You Go
Making Changes
Make Changes Online
Questions
Open Enrollment Assistance
Online Resources
Legal Information
Thank You
Cigna Dental Comparison
DHMO
PPO
CIGNA NETWORK
Care-Access PlusDHMO
Total CIGNA PPOPPO
Required to Use An Assigned Provider
Yes In-network only Primary Dental Office will be assigned based on home address
No
Out of Network Benefits Available
No
Yes
Balance Billing for Covered Services
No
Yes if you go out-of-network
Referral Required
Yes
No
Orthodontia Benefits Available
Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime)
Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person)
Unlimited
$200000
Deductible (singlefamily)
None
$50 $ 150 waived for preventive care
1Claim submission would be required and balance billing may occur when visiting a nonparticipating provider2Deductible does not apply to Class I ndash Diagnostic and Preventive Services
Coverage for dependents would cease on the day which the child turns 26Benefit Maximum and Deductibles are for the period of January 01 through December 31
All services listed on this benefit summary are subject to the contractSchedules of Benefits and current Exclusions and Limitations
Medical Benefits at a Glance
Kaiser Permanente HMO + Rx wwwkporg
United HealthCare Select HMO wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS) wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS) wwwcarefirstcom
Plan Type
HMO
HMO
Point-of-Service
Point-of-Service
PCP Required
Yes
Yes
No
No
Provider Network
Regional (MDDCVA)
National
National
National
Out-of-Network Benefits
No
No
Yes
Yes
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
None
None
In-Network None Out-of-Network 80
In-Network None Out-of-Network 80
Dr Office Visits PCPSpecialist
$5 copay
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits
Covered in full
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care
$5 copay
$15 copay
Covered in full
Covered in full
Emergency Room
$50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization
Covered in full
Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
MCG 2018 Medical Plan Comparison Chart
Kaiser Permanente
United HealthCare
CareFirst POS Standard
CareFirst POS High
Plan Type
HMO
HMO
Point of Service
Point of Service
Provider Network
Regional (MDDCVA)
National
National
National
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
Annual Out-of-Pocket Maximum
None
$1100 per individual up to cap of $3600 for a family
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
Physician Servcies
PCP Office Visits
$5 copay
$5 copay PCP
In-Network $15 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Specialist Office Visits
$5 copay
$10 copay
In-Network $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Annual Physical
Covered in full
$5 copay PCP
In-Network $15 copay Primary Care Physician $30 copay specialist Out-of-Network 80 covered after deductible (limit 1calendar year)
In-Network $15 copay Out-of-Network 80 not subject to deductible (up to age 18)
In-Network $10 copay Out-of-Network 80 not subject to deductible (up to age 18)
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Allergy Testing
$5 copay
$5 copay PCP $10 copay Specialist
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Virtual Visits
Labs X-Rays Diagnostics
Outpatient labs
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient X-Rays
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Major Diagnostics
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Immedate Medical Servcies
Emergency Room
$50 copay waived if admitted to hospital
$25 copay waived if admitted to hospital $15 copay for urgent care
In-Network $35 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
Urgent Care
Hospital Services
Inpatient Hospitalization
Covered in full
Covered in full
In-Network Covered in full after $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Services
Surgery
Covered in full
Inpatient covered in full Outpatient $25 copay
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Hearing Aids
For minor children One hearing aid for each hearing impaired ear once every 36 months
For minor children One hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
Hearing Screening
$5 copay for hearing exam (hearing aids are excluded)
$5 Copay PCP $10 Copay Specialist
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
Home Health Care Services
Covered in full if medically necessary
Covered in full No copayment 60 visit maximum for skilled care services per calendar year
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
Hospice
Covered in full
Covered in full (See coverage booklet for eligibility information)
In-Network Covered in full
In-Network Covered in full
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
In vitro Fertilization
Limited to 3 attempts per live birth Lifetime maximum of $100000
Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
Mammography - Preventive Screening Schedule
Schedule consistent with the current recommendations of the American College of Physicians
Covered in full Age 35-39 one baseline mammogram Age 40-49 one mammogram every two calendar years Age 50+ one mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
Maternity
Covered in full once pregnancy is diagnosed
No copayment applies after the first visit
In-Network first visit 100 after $30 copay other visits 100
In-Network First visit 100 after $10 copay other visits 100
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Maximum Lifetime Benefit
Unlimited maximum
Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
Prescriptions
Kaiser Rx plan (included with Kaiser HMO medical plan) $5 at on-site pharmacies and for mail order $15 at participating pharmacies
No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
Rehabilitation Services
Inpatient Covered in full (unlimited) Outpatient $5 copay outpatient services for physical therapy are limited to up to 30 visits occupational and speech therapy per injury incident or condition are covered for a period not to exceed 90 days
$10 copayvisit 60 combined visits per year (short-term non-chronic conditions only)
In-Network
In-Network
100
100
Skilled Nursing Facility
Covered in full 100 days maximum
Covered in full 60 days per calendar year maximum
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Substance AbuseMental Health
Inpatient Covered in full Outpatient $5 copay
Inpatient Covered in full Outpatient $5 copay
In-Network Inpatient- $150 per admission copay Outpatient- $15 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
In-Network Inpatient- covered in full Outpatient- $10 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
Vision (Routine)
$5 copay for exams 25 discount on lensesframes at Kaiser centers 15 discount off the costs of contact lenses
$25 copay for exam 15-20 discount through participating optical centers
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
53116
Medical Benefits at a Glance
Kaiser Permanente HMO + Rx wwwkporg
United HealthCare Select HMO wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS) wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS) wwwcarefirstcom
Plan Type
HMO
HMO
Point-of-Service
Point-of-Service
PCP Required
Yes
Yes
No
No
Provider Network
Regional (MDDCVA)
National
National
National
Out-of-Network Benefits
No
No
Yes
Yes
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
None
None
In-Network None Out-of-Network 80
In-Network None Out-of-Network 80
Dr Office Visits PCPSpecialist
$5 copay
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits
Covered in full
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care
$5 copay
$15 copay
Covered in full
Covered in full
Emergency Room
$50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization
Covered in full
Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
MCG 2018 Medical Plan Comparison Chart
Kaiser Permanente
United HealthCare
CareFirst POS Standard
CareFirst POS High
Plan Type
HMO
HMO
Point of Service
Point of Service
Provider Network
Regional (MDDCVA)
National
National
National
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
Annual Out-of-Pocket Maximum
None
$1100 per individual up to cap of $3600 for a family
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
Physician Servcies
PCP Office Visits
$5 copay
$5 copay PCP
In-Network $15 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Specialist Office Visits
$5 copay
$10 copay
In-Network $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Annual Physical
Covered in full
$5 copay PCP
In-Network $15 copay Primary Care Physician $30 copay specialist Out-of-Network 80 covered after deductible (limit 1calendar year)
In-Network $15 copay Out-of-Network 80 not subject to deductible (up to age 18)
In-Network $10 copay Out-of-Network 80 not subject to deductible (up to age 18)
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Allergy Testing
$5 copay
$5 copay PCP $10 copay Specialist
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Virtual Visits
Labs X-Rays Diagnostics
Outpatient labs
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient X-Rays
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Major Diagnostics
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Immedate Medical Servcies
Emergency Room
$50 copay waived if admitted to hospital
$25 copay waived if admitted to hospital $15 copay for urgent care
In-Network $35 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
Urgent Care
Hospital Services
Inpatient Hospitalization
Covered in full
Covered in full
In-Network Covered in full after $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Services
Surgery
Covered in full
Inpatient covered in full Outpatient $25 copay
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Hearing Aids
For minor children One hearing aid for each hearing impaired ear once every 36 months
For minor children One hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
Hearing Screening
$5 copay for hearing exam (hearing aids are excluded)
$5 Copay PCP $10 Copay Specialist
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
Home Health Care Services
Covered in full if medically necessary
Covered in full No copayment 60 visit maximum for skilled care services per calendar year
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
Hospice
Covered in full
Covered in full (See coverage booklet for eligibility information)
In-Network Covered in full
In-Network Covered in full
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
In vitro Fertilization
Limited to 3 attempts per live birth Lifetime maximum of $100000
Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
Mammography - Preventive Screening Schedule
Schedule consistent with the current recommendations of the American College of Physicians
Covered in full Age 35-39 one baseline mammogram Age 40-49 one mammogram every two calendar years Age 50+ one mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
Maternity
Covered in full once pregnancy is diagnosed
No copayment applies after the first visit
In-Network first visit 100 after $30 copay other visits 100
In-Network First visit 100 after $10 copay other visits 100
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Maximum Lifetime Benefit
Unlimited maximum
Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
Prescriptions
Kaiser Rx plan (included with Kaiser HMO medical plan) $5 at on-site pharmacies and for mail order $15 at participating pharmacies
No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
Rehabilitation Services
Inpatient Covered in full (unlimited) Outpatient $5 copay outpatient services for physical therapy are limited to up to 30 visits occupational and speech therapy per injury incident or condition are covered for a period not to exceed 90 days
$10 copayvisit 60 combined visits per year (short-term non-chronic conditions only)
In-Network
In-Network
100
100
Skilled Nursing Facility
Covered in full 100 days maximum
Covered in full 60 days per calendar year maximum
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Substance AbuseMental Health
Inpatient Covered in full Outpatient $5 copay
Inpatient Covered in full Outpatient $5 copay
In-Network Inpatient- $150 per admission copay Outpatient- $15 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
In-Network Inpatient- covered in full Outpatient- $10 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
Vision (Routine)
$5 copay for exams 25 discount on lensesframes at Kaiser centers 15 discount off the costs of contact lenses
$25 copay for exam 15-20 discount through participating optical centers
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
53116
Office of Human Resources Montgomery County Government
Dependent EligibilityEligible dependents for medical prescription dental and vision coverage arebull Spouse
Legally married EligibleDivorced Not Eligible
bull Children (biological legally adopted stepchildren or under your legal custody)Under age 26 EligibleAge 26 and over Not Eligible unless incapable of self support
Proof of eligible dependents is required
Office of Human Resources Montgomery County Government
Proof of Dependent EligibilityEmployees enrolling new dependents during Open Enrollment must upload the necessary dependent documentation in ESS prior to October 9 at 5 pmRequired Documentationbull Spouse Official State Marriage Certificate (certified by appropriate State or County Official)bull Biological Child State Birth Certificate (For newborns OHR will accept hospital discharge papers for first 60 days birth
certificate must then be submitted)bull Adopted Child Copy of Adoption or Placement for Adoption Papers bull Step-Child State Birth Certificate Marriage Certificate and Divorce Decree or Custody Papers bull Disabled Child Medical plan verification of disability prior to age 26 bull Legal Custody Copy of Court Order granting legal custody
Office of Human Resources Montgomery County Government
Marriage Certificate Example Required Documentation (Contd)
Office of Human Resources Montgomery County Government
Benefits Refresher
Office of Human Resources Montgomery County Government
Medical amp Rx
Office of Human Resources Montgomery County Government
Medical Plan OptionsHealth Maintenance Organizations (HMO)bull Kaiser Permanente Signature (HMO)bull United Healthcare Select (HMO)
Point of Service Plans (POS)bull CareFirst BCBS (POS) High Optionbull CareFirst BCBS (POS) Standard Option
Three tiers of coverage Self Self + 1 or Family
Office of Human Resources Montgomery County Government
Medical Benefits at-a-Glance To view full carrier medical summaries visit OHRrsquos Health Insurance Website
Kaiser Permanente HMO + Rx
wwwkporg
United HealthCare Select HMO
wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS)
wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS)
wwwcarefirstcom
Plan Type HMO HMO Point-of-Service Point-of-Service
PCP Required Yes Yes No No
Provider Network Regional (MDDCVA) National National National
Out-of-Network Benefits No No Yes Yes
Referrals Required Yes No No No
Annual Deductible None NoneIn-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Sheet1
Sheet1 (2)
Office of Human Resources Montgomery County Government
Medical Benefits at-a-Glance (contd)
New Employee Orientation Program
Kaiser Permanente HMO + Rx
wwwkporg
United HealthCare Select HMO
wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS)
wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS)
wwwcarefirstcom
Dr Office Visits PCPSpecialist $5 copay $5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits Covered in full $5 copay $10 copay In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care $5 copay $15 copay Covered in full Covered in full
Emergency Room $50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization Covered in full Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
Visit OHRrsquos Health Insurance webpage to view Medical summaries
Sheet1
Sheet1 (2)
Office of Human Resources Montgomery County Government
Prescription Plans Caremarkbull Two Rx Plan OptionsStandardHigh
bull If you elect UHC or CareFirst and want Rx coverage you will need to elect the stand-alone Caremark Rx plan (Kaiser already includes Rx coverage)
bull Maintenance Choice Program available for maintenance drugs significant cost savings ndash 1 copay for each 90-day prescription In order to get the Maintenance pricing you must fil Rx at CVS retail pharmacy Mail order
Office of Human Resources Montgomery County Government
Prescription Drug Plan Comparison High Option $48
Only MCGEOIAFF employees can enroll in this High plan
High Option $510Only FOPNON-REP employees
can enroll in this High plan
Standard Option All employees can enroll in this
Standard plan
Copay $4 Generics$8 Brand Name
$5 Generics$10 Brand Name
$10 Generics$20 PBrand Name
$35 NPBrand NameDeductible na na $50yearMail Order Yes Yes Yes
Maintenance Choice Yes Yes YesCovered Drugs Same Same Same
Visit OHRrsquos Health Insurance Website to view Rx summaries
Office of Human Resources Montgomery County Government
Prescription Drug Cost Comparison Cost
High Option $48Only MCGEOIAFF employees
can enroll in this High plan
High Option $510Only FOPNON-REP employees
can enroll in this High plan
Standard Option All employees can enroll in this
Standard plan
Self Only
Bi-Weekly $11339Monthly $24568Yearly $294814
Bi-Weekly $11100Monthly $24050Yearly $288600
Bi-Weekly $2413Monthly $5258Yearly $62738
Self + 1
Bi-Weekly $20979Monthly $45455Yearly $545454
Bi-Weekly $20536Monthly $44495Yearly $533936
Bi-Weekly $4463Monthly $9670
Yearly $116038
Self + Family
Bi-Weekly $32511Monthly $70441Yearly $845286
Bi-Weekly $31824Monthly $68952Yearly $827424
Bi-Weekly $6916Monthly $14985Yearly $179816
Office of Human Resources Montgomery County Government
Dental
Office of Human Resources Montgomery County Government
Dental Comparison Cigna
For a list of HMO covered services and assigned costs (copays) view the HMO benefit summary
Required to Use An Assigned Provider Yes In-network only Primary Dental Office will be
assigned based on home address
No
Out of Network Benefits Available No Yes
Balance Billing for Covered Services No Yes if you go out-of-network
Referral Required Yes No
Orthodontia Benefits Available Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime) Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person) Unlimited $200000
Deductible (singlefamily) None $50 $ 150 waived for preventive care
Table 1
Office of Human Resources Montgomery County Government
Vision
Office of Human Resources Montgomery County Government
Vision Insurancebull The Countyrsquos Vision carrier is EyeMedbull Benefits payable for exams lenses and contacts (elective or necessary) every
calendar year frames every two calendar yearsbull In-network or out-of-network benefits available bull Enhanced Hearing Benefit through EyeMedrsquos partner Amplifon40 off hearing examDiscounted pricing on thousands of hearing aids including latest technologyOne-year free follow-up care with unlimited appointmentsFree batteries for two years with initial purchase Three-year warranty and loss and damage coverage
Visit OHRrsquos Health Insurance webpage to view vision summary
Office of Human Resources Montgomery County Government
Optional Life amp Dependent Life
Office of Human Resources Montgomery County Government
Optional Life Insurance ADampDbull You may elect Optional Life ADampD coverage for yourself in increments of 1 to 8 times
your basic annual earnings ($1 million maximum)
bull NOTE Coverage is not guaranteed issue for any level You must complete an online Statement of Health no matter what level of coverage you elect Later this fall after Open Enrollment ends you will receive an email from MetLife with a link to complete the Statement of Health online
bull An eligible dependent is defined as 1) your opposite or same sex spouse or 2) your unmarried children under age 26 (natural adopted or stepchildrenfoster children who depend on your support)
Office of Human Resources Montgomery County Government
Optional Life Insurance RatesHow to estimate your Optional Life Insurance bi-weekly rate
Example 40-year-old applying for 2 x salary Salary is $49300
Steps Example Calculate for Yourself
A Find your age-based rate on the rate sheet (left) $ 0037 $_________________
B Choose how much coverage you are applying for
$99000 (2 x salary rounded to the nearest $1000 ) $_________________
C Divide that coverage amount by 100099 ($99000 1000) $_________________
D Multiply A x C for estimated bi-weekly cost$366 ($037 x 99) $_________________
Office of Human Resources Montgomery County Government
Dependent Life InsuranceYou may also purchase Dependent Optional Life insurance forbull Your opposite or same sex spouse bull Your unmarried children under age 26
ndash Natural adoptedndash Stepchildrenfoster childrenNote you do not need to supply marriage certificatesbirth certificates for dependent optional life
You may electbull $2000 Spouse$1000 Childbull $4000 Spouse $2000 Childbull $10000 Spouse $5000 Child
The bi-weekly rate is not based on salary
Office of Human Resources Montgomery County Government
Flexible Spending Accounts
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Visit the Open Enrollment website to watch a recorded FSA presentation from MCGrsquos FSA vendor Benefit Strategies
bull What is an FSA It is an IRS-approved tax-free account that saves onQualified out-of-pocket medical and dependent care expensesFederal and State Income taxSocial Security Tax
bull 3 Account Options Health Care FSA Child Care FSA and Commuter Choice Transit bull FSA accounts are administered through Benefit Strategies bull FSAs are ldquouse-it or lose-itrdquo accounts claims must be incurred during the 2021 plan year (January 1
2021 ndash March 15 2022) and submitted by April 30 2022
IMPORTANT You must re-enroll in an FSA every Open Enrollment if you want to participate in the upcoming plan year
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Why You Should EnrollGive yourself a raise by reducing your taxesbull Elect the annual amount you want to place in your FSA(s) for the upcoming plan year during Open Enrollmentbull That amount is divided by 26 and taken from your biweekly paychecks on a pre-tax basis (21 paychecks for
10-month employees)bull Then use your pre-tax FSA dollars to pay for eligible out-of-pocket health care child-care or transit
expenses
Office of Human Resources Montgomery County Government
Health Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull Claims must be submitted by April 30 of the following yearbull You may elect to contribute up to $2750 Your total annual election amount is available to spend on the first
day of the new plan year bull FSA debit card allows you to pay for expenses at the time of servicebull Examples of IRS qualified eligible expenses
bull Copays (medical prescription dental vision) deductibles and coinsurance amounts over reasonable and customary charge
bull Hearing aids bull Acupuncture bull Orthopedic shoes bull Over-the-counter (OTC) drugs (no longer require doctorrsquos prescription)
Office of Human Resources Montgomery County Government
Child Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull $5000 annual maximum per household ($2500 for married filing separately)bull Funds are available to spend as they are accumulated through payroll deductionsbull Reimbursable expenses
bull day care centersbull elder carebull beforeafter school carebull babysitter fees that allow you and your spouse to work or go to school (no child support payments)
bull Qualifying dependentsbull Children under the age of 13 and are a tax dependent of the employeebull Spouse or tax dependent that is physically or mentally incapable of self-care
bull Must coordinate between filing a tax credit with IRS and your Dependent Care FSA plan
Office of Human Resources Montgomery County Government
Commuter Choice Transit FSAbull $230 per month maximum for MCGEO staff $260 per month maximum for Unrepresented staffbull Applies to employee commuting expenses only (not spouses or dependents)bull Can enroll throughout the year (not limited to Open Enrollment election)bull Eligible expenses include Metro Marc Vanpool Lyft Line Uber Poolbull Debit card ndash may be used for some expenses (not Metro)Metro riders will have to submit claim forms for reimbursement
bull Funds must be used within 180 days of election bull If retiring or leaving the County will need to coordinate use all available funds
Office of Human Resources Montgomery County Government
Using Your FSA FundsHealth Care FSA Your full annual election amount is available on the first day of the plan yearChild Care FSA Your funds are available as they accumulate through payroll deductionsCommuterTransit FSA Your funds are available as they accumulate through payroll deductions
The FSA Debit Card bull Your FSA debit card is the same card for your Health Care Child Care and TransitCommuter FSA accountsbull The card is pre-loaded with your full annual Health Care FSA election amount You can use the card to pay for IRS qualified expenses at
the time of service or when paying a bill Receipt notifications will be mailed to you monthly by Benefit Strategies Your response to receipt notifications is necessary under the provisions of the plan No response my result in the ineligibility of the purchase and as a result your card may be temporarily deactivated
bull If you are enrolled in the Child Care FSA the card can also be used in child-care settings Just remember that the card will only work for an amount that does not exceed the available balance in your Child Care FSA account on that day
bull The card can also be used to pay for your commutertransit expenses however it does not work for WMATA metro Metro riders will have to submit manual claims for reimbursement from your CommuterTransit FSA
bull Cards are re-loaded each year after you make your new annual election Please keep your cards You will only receive a new card if your old card is about to expire
Office of Human Resources Montgomery County Government
AFLAC Voluntary Plans
Office of Human Resources Montgomery County Government
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Short-Term Disabilitybull Provides short-term cash benefits in the event of disabilitybull Monthly benefit amounts available from $500 - $6000 (subject to income requirements)bull Benefit options of 3 6 12 18 or 24 months with a variety of elimination periods
Critical Illness Insurancebull Provides a lump sum cash benefit in the event of critical illnessbull Benefit amounts available in $5000 increments from $10000 - $30000
Participants pay 100 through payroll deduction for Short-Term Disability and Critical Illness Insurance
To ENROLL Text SETAPPTrdquo to 41411orCall 920-420-8861 orEmail susan_mcdanielusAflaccom
Office of Human Resources Montgomery County Government
Carrier Resources amp Cost-Saving Tips
Office of Human Resources Montgomery County Government
Lower Your Out-of-Pocket CostsChoose the plan thatrsquos right for youbull See the medical benefits chart for options bull Stay in network Use the provider search engines on your carrier website or mobile app to find in-network providersSeek preventive carebull Check-ups immunizations and screenings are an important part of staying healthy They can detect or prevent serious diseases and keep you healthyKnow where to go for carebull You have many options of places to go when you need care If your medical condition isnrsquot serious or life threatening you can save money by connecting
with a doctor online through a virtual visit or going to an urgent care center or convenience care clinic instead of a hospital emergency roomReview your prescription drug plan optionsbull Decide which Caremark prescription plan is best for you Note that the Kaiser HMO includes prescription drug coverage Both the Standard and High
Option Caremark plans cover the same prescription drugs but have different copay and deductiblesUse generic and long-term prescriptions bull Opt for lower-cost generic drugs whenever possible bull Ask your doctor to write a 90-day prescription instead of a 30-day prescription to participate in the mail order prescription programTake advantage of tax savings by participating in Flexible Spending Accountsbull Use pre-tax dollars for eligible out of pocket services and items
Office of Human Resources Montgomery County Government
Built-in Wellness Support Take advantage of the free programs available to you through your medical carrier Each of MCGrsquos medical carriers (Kaiser UHC amp CareFirst) offer valuable programs to help you manage your health
Disease Management Programsbull Help manage your chronic condition through personalized coaching support and encouragement and online education materialsEmotional Wellness amp Stress Management Support bull Help manage stress through mobile apps and other self-care resources Maternity Programsbull Support healthy moms and healthy babiesWeight-loss Programs bull Offers telephonic coaching support and web-based tools to help ensure long-term weight managementbull See the next slide for an example of an MCG success storySmoking Cessation Programsbull Supportive coaching to make quitting more successfulDiscounts bull Gym memberships weight loss programs and moreFor more information about the programs available to you please see the Open Enrollment Guide and contact your medical carrier
Office of Human Resources Montgomery County Government
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You GoAll of MCGrsquos health insurance carriers offer a simple-to-use tool that can help make your life easier while yoursquore on the go Download your carrierrsquos Mobile App to help you personalize organize and access your important plan information on your phone or tablet
bull Schedule Virtual Visitsbull Manage and track claimsbull View ID card informationbull Find doctor and compare costs and quality ratingsbull Review your coveragebull Track your account balances and deductiblesbull Access a variety of health and wellness tools
Visit Google Play or the Apple App Store to download your carrierrsquos App
Office of Human Resources Montgomery County Government
Making Changes
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Questions
Office of Human Resources Montgomery County Government
Open Enrollment AssistanceFollow these steps (in this order)1 Review the frequently asked questions (FAQs) on the Open Enrollment website at wwwmontgomerycountymdgovoe
(available beginning September 21) You can enter key words into the interactive search bar to quickly locate the answer to your question
2 Visit the MC311 website at wwwmontgomerycountymdgovmc311 and search key words for your question The search results contain various knowledge-based articles with information related to your search words Simply click on the corresponding link and the detailed answer is revealed
3 Attend one of OHRrsquos Virtual Office Hours via Microsoft Teams Members of OHRs Health Insurance Team will be on hand to address employee questions by video or via the chat box View the schedule and access the sessions through the Open Enrollment website at wwwmontgomerycountymdgovoe (available beginning September 21)
4 If you have tried all the methods above and still have Open Enrollment-related questions please contact OHRs MC311 Customer Service Center at 240-773-6471 (Mon-Fri 8 am - 5 pm) to open a service request A member of the health insurance team will respond to service requests in the order they are received Tip Please provide an email address at the time you place your Service Request This will ensure the fastest response possible
Office of Human Resources Montgomery County Government
Online ResourcesVisit the 2021 Open Enrollment Webpage
wwwmontgomerycountymdgovOE
Visit OHRrsquos WebpagewwwmontgomerycountymdgovHR
Health Insurance active employees
Office of Human Resources Montgomery County Government
Legal InformationThe County reserves the right at any time and for any reason to amend the Program subject to the Countys collective bargainingagreements The County expects to continue the Program but it is the Countys position that there is no implied contract between individual employees and the County to do so
The County may amend the Program prospectively or retroactively to comply with applicable law
In the event of a conflict between this presentation the County Code andor the Summary Description the County Code then the Summary Description will govern
Office of Human Resources Montgomery County Government
Thank YouWe hope you enjoyed learning about 2021 Open Enrollment
~Your OHR Health Insurance Team
2021 Open Enrollment Benefits Bonanza
What Is Open Enrollment
What Changes Can be Made
Open Enrollment Dates
MCG Continues to Make Generous Employer Contributions
New for 2021
Special 2021 Plan Rates Announcement
Employee Rate Changes for Calendar Year 2021
Planning Ahead Minimizing Future Rate Increases
New for 2021
Open Enrollment Communications
Itrsquos a New Frontier
2021 Open Enrollment Checklist
Open Enrollment Website Resources
Attend a Virtual Open Enrollment Event
Make Changes Online
Paper Enrollment Form Permitted for Only Two Reasons
Dependent Eligibility
Proof of Dependent Eligibility
Marriage Certificate Example Required Documentation (Contd)
Benefits Refresher
Medical amp Rx
Medical Plan Options
Medical Benefits at-a-Glance
Medical Benefits at-a-Glance (contd)
Prescription Plans Caremark
Prescription Drug Plan Comparison
Prescription Drug Cost Comparison
Dental
Slide Number 30
Vision
Vision Insurance
Optional Life amp Dependent Life
Optional Life Insurance ADampD
Optional Life Insurance Rates
Dependent Life Insurance
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs)Why You Should Enroll
Health Care FSA
Child Care FSA
Commuter Choice Transit FSA
Using Your FSA Funds
AFLAC Voluntary Plans
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Carrier Resources amp Cost-Saving Tips
Lower Your Out-of-Pocket Costs
Built-in Wellness Support
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You Go
Making Changes
Make Changes Online
Questions
Open Enrollment Assistance
Online Resources
Legal Information
Thank You
Cigna Dental Comparison
DHMO
PPO
CIGNA NETWORK
Care-Access PlusDHMO
Total CIGNA PPOPPO
Required to Use An Assigned Provider
Yes In-network only Primary Dental Office will be assigned based on home address
No
Out of Network Benefits Available
No
Yes
Balance Billing for Covered Services
No
Yes if you go out-of-network
Referral Required
Yes
No
Orthodontia Benefits Available
Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime)
Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person)
Unlimited
$200000
Deductible (singlefamily)
None
$50 $ 150 waived for preventive care
1Claim submission would be required and balance billing may occur when visiting a nonparticipating provider2Deductible does not apply to Class I ndash Diagnostic and Preventive Services
Coverage for dependents would cease on the day which the child turns 26Benefit Maximum and Deductibles are for the period of January 01 through December 31
All services listed on this benefit summary are subject to the contractSchedules of Benefits and current Exclusions and Limitations
Medical Benefits at a Glance
Kaiser Permanente HMO + Rx wwwkporg
United HealthCare Select HMO wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS) wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS) wwwcarefirstcom
Plan Type
HMO
HMO
Point-of-Service
Point-of-Service
PCP Required
Yes
Yes
No
No
Provider Network
Regional (MDDCVA)
National
National
National
Out-of-Network Benefits
No
No
Yes
Yes
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
None
None
In-Network None Out-of-Network 80
In-Network None Out-of-Network 80
Dr Office Visits PCPSpecialist
$5 copay
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits
Covered in full
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care
$5 copay
$15 copay
Covered in full
Covered in full
Emergency Room
$50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization
Covered in full
Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
MCG 2018 Medical Plan Comparison Chart
Kaiser Permanente
United HealthCare
CareFirst POS Standard
CareFirst POS High
Plan Type
HMO
HMO
Point of Service
Point of Service
Provider Network
Regional (MDDCVA)
National
National
National
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
Annual Out-of-Pocket Maximum
None
$1100 per individual up to cap of $3600 for a family
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
Physician Servcies
PCP Office Visits
$5 copay
$5 copay PCP
In-Network $15 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Specialist Office Visits
$5 copay
$10 copay
In-Network $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Annual Physical
Covered in full
$5 copay PCP
In-Network $15 copay Primary Care Physician $30 copay specialist Out-of-Network 80 covered after deductible (limit 1calendar year)
In-Network $15 copay Out-of-Network 80 not subject to deductible (up to age 18)
In-Network $10 copay Out-of-Network 80 not subject to deductible (up to age 18)
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Allergy Testing
$5 copay
$5 copay PCP $10 copay Specialist
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Virtual Visits
Labs X-Rays Diagnostics
Outpatient labs
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient X-Rays
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Major Diagnostics
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Immedate Medical Servcies
Emergency Room
$50 copay waived if admitted to hospital
$25 copay waived if admitted to hospital $15 copay for urgent care
In-Network $35 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
Urgent Care
Hospital Services
Inpatient Hospitalization
Covered in full
Covered in full
In-Network Covered in full after $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Services
Surgery
Covered in full
Inpatient covered in full Outpatient $25 copay
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Hearing Aids
For minor children One hearing aid for each hearing impaired ear once every 36 months
For minor children One hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
Hearing Screening
$5 copay for hearing exam (hearing aids are excluded)
$5 Copay PCP $10 Copay Specialist
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
Home Health Care Services
Covered in full if medically necessary
Covered in full No copayment 60 visit maximum for skilled care services per calendar year
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
Hospice
Covered in full
Covered in full (See coverage booklet for eligibility information)
In-Network Covered in full
In-Network Covered in full
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
In vitro Fertilization
Limited to 3 attempts per live birth Lifetime maximum of $100000
Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
Mammography - Preventive Screening Schedule
Schedule consistent with the current recommendations of the American College of Physicians
Covered in full Age 35-39 one baseline mammogram Age 40-49 one mammogram every two calendar years Age 50+ one mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
Maternity
Covered in full once pregnancy is diagnosed
No copayment applies after the first visit
In-Network first visit 100 after $30 copay other visits 100
In-Network First visit 100 after $10 copay other visits 100
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Maximum Lifetime Benefit
Unlimited maximum
Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
Prescriptions
Kaiser Rx plan (included with Kaiser HMO medical plan) $5 at on-site pharmacies and for mail order $15 at participating pharmacies
No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
Rehabilitation Services
Inpatient Covered in full (unlimited) Outpatient $5 copay outpatient services for physical therapy are limited to up to 30 visits occupational and speech therapy per injury incident or condition are covered for a period not to exceed 90 days
$10 copayvisit 60 combined visits per year (short-term non-chronic conditions only)
In-Network
In-Network
100
100
Skilled Nursing Facility
Covered in full 100 days maximum
Covered in full 60 days per calendar year maximum
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Substance AbuseMental Health
Inpatient Covered in full Outpatient $5 copay
Inpatient Covered in full Outpatient $5 copay
In-Network Inpatient- $150 per admission copay Outpatient- $15 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
In-Network Inpatient- covered in full Outpatient- $10 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
Vision (Routine)
$5 copay for exams 25 discount on lensesframes at Kaiser centers 15 discount off the costs of contact lenses
$25 copay for exam 15-20 discount through participating optical centers
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
53116
Medical Benefits at a Glance
Kaiser Permanente HMO + Rx wwwkporg
United HealthCare Select HMO wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS) wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS) wwwcarefirstcom
Plan Type
HMO
HMO
Point-of-Service
Point-of-Service
PCP Required
Yes
Yes
No
No
Provider Network
Regional (MDDCVA)
National
National
National
Out-of-Network Benefits
No
No
Yes
Yes
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
None
None
In-Network None Out-of-Network 80
In-Network None Out-of-Network 80
Dr Office Visits PCPSpecialist
$5 copay
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits
Covered in full
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care
$5 copay
$15 copay
Covered in full
Covered in full
Emergency Room
$50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization
Covered in full
Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
MCG 2018 Medical Plan Comparison Chart
Kaiser Permanente
United HealthCare
CareFirst POS Standard
CareFirst POS High
Plan Type
HMO
HMO
Point of Service
Point of Service
Provider Network
Regional (MDDCVA)
National
National
National
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
Annual Out-of-Pocket Maximum
None
$1100 per individual up to cap of $3600 for a family
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
Physician Servcies
PCP Office Visits
$5 copay
$5 copay PCP
In-Network $15 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Specialist Office Visits
$5 copay
$10 copay
In-Network $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Annual Physical
Covered in full
$5 copay PCP
In-Network $15 copay Primary Care Physician $30 copay specialist Out-of-Network 80 covered after deductible (limit 1calendar year)
In-Network $15 copay Out-of-Network 80 not subject to deductible (up to age 18)
In-Network $10 copay Out-of-Network 80 not subject to deductible (up to age 18)
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Allergy Testing
$5 copay
$5 copay PCP $10 copay Specialist
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Virtual Visits
Labs X-Rays Diagnostics
Outpatient labs
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient X-Rays
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Major Diagnostics
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Immedate Medical Servcies
Emergency Room
$50 copay waived if admitted to hospital
$25 copay waived if admitted to hospital $15 copay for urgent care
In-Network $35 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
Urgent Care
Hospital Services
Inpatient Hospitalization
Covered in full
Covered in full
In-Network Covered in full after $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Services
Surgery
Covered in full
Inpatient covered in full Outpatient $25 copay
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Hearing Aids
For minor children One hearing aid for each hearing impaired ear once every 36 months
For minor children One hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
Hearing Screening
$5 copay for hearing exam (hearing aids are excluded)
$5 Copay PCP $10 Copay Specialist
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
Home Health Care Services
Covered in full if medically necessary
Covered in full No copayment 60 visit maximum for skilled care services per calendar year
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
Hospice
Covered in full
Covered in full (See coverage booklet for eligibility information)
In-Network Covered in full
In-Network Covered in full
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
In vitro Fertilization
Limited to 3 attempts per live birth Lifetime maximum of $100000
Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
Mammography - Preventive Screening Schedule
Schedule consistent with the current recommendations of the American College of Physicians
Covered in full Age 35-39 one baseline mammogram Age 40-49 one mammogram every two calendar years Age 50+ one mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
Maternity
Covered in full once pregnancy is diagnosed
No copayment applies after the first visit
In-Network first visit 100 after $30 copay other visits 100
In-Network First visit 100 after $10 copay other visits 100
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Maximum Lifetime Benefit
Unlimited maximum
Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
Prescriptions
Kaiser Rx plan (included with Kaiser HMO medical plan) $5 at on-site pharmacies and for mail order $15 at participating pharmacies
No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
Rehabilitation Services
Inpatient Covered in full (unlimited) Outpatient $5 copay outpatient services for physical therapy are limited to up to 30 visits occupational and speech therapy per injury incident or condition are covered for a period not to exceed 90 days
$10 copayvisit 60 combined visits per year (short-term non-chronic conditions only)
In-Network
In-Network
100
100
Skilled Nursing Facility
Covered in full 100 days maximum
Covered in full 60 days per calendar year maximum
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Substance AbuseMental Health
Inpatient Covered in full Outpatient $5 copay
Inpatient Covered in full Outpatient $5 copay
In-Network Inpatient- $150 per admission copay Outpatient- $15 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
In-Network Inpatient- covered in full Outpatient- $10 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
Vision (Routine)
$5 copay for exams 25 discount on lensesframes at Kaiser centers 15 discount off the costs of contact lenses
$25 copay for exam 15-20 discount through participating optical centers
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
53116
Office of Human Resources Montgomery County Government
Proof of Dependent EligibilityEmployees enrolling new dependents during Open Enrollment must upload the necessary dependent documentation in ESS prior to October 9 at 5 pmRequired Documentationbull Spouse Official State Marriage Certificate (certified by appropriate State or County Official)bull Biological Child State Birth Certificate (For newborns OHR will accept hospital discharge papers for first 60 days birth
certificate must then be submitted)bull Adopted Child Copy of Adoption or Placement for Adoption Papers bull Step-Child State Birth Certificate Marriage Certificate and Divorce Decree or Custody Papers bull Disabled Child Medical plan verification of disability prior to age 26 bull Legal Custody Copy of Court Order granting legal custody
Office of Human Resources Montgomery County Government
Marriage Certificate Example Required Documentation (Contd)
Office of Human Resources Montgomery County Government
Benefits Refresher
Office of Human Resources Montgomery County Government
Medical amp Rx
Office of Human Resources Montgomery County Government
Medical Plan OptionsHealth Maintenance Organizations (HMO)bull Kaiser Permanente Signature (HMO)bull United Healthcare Select (HMO)
Point of Service Plans (POS)bull CareFirst BCBS (POS) High Optionbull CareFirst BCBS (POS) Standard Option
Three tiers of coverage Self Self + 1 or Family
Office of Human Resources Montgomery County Government
Medical Benefits at-a-Glance To view full carrier medical summaries visit OHRrsquos Health Insurance Website
Kaiser Permanente HMO + Rx
wwwkporg
United HealthCare Select HMO
wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS)
wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS)
wwwcarefirstcom
Plan Type HMO HMO Point-of-Service Point-of-Service
PCP Required Yes Yes No No
Provider Network Regional (MDDCVA) National National National
Out-of-Network Benefits No No Yes Yes
Referrals Required Yes No No No
Annual Deductible None NoneIn-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Sheet1
Sheet1 (2)
Office of Human Resources Montgomery County Government
Medical Benefits at-a-Glance (contd)
New Employee Orientation Program
Kaiser Permanente HMO + Rx
wwwkporg
United HealthCare Select HMO
wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS)
wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS)
wwwcarefirstcom
Dr Office Visits PCPSpecialist $5 copay $5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits Covered in full $5 copay $10 copay In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care $5 copay $15 copay Covered in full Covered in full
Emergency Room $50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization Covered in full Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
Visit OHRrsquos Health Insurance webpage to view Medical summaries
Sheet1
Sheet1 (2)
Office of Human Resources Montgomery County Government
Prescription Plans Caremarkbull Two Rx Plan OptionsStandardHigh
bull If you elect UHC or CareFirst and want Rx coverage you will need to elect the stand-alone Caremark Rx plan (Kaiser already includes Rx coverage)
bull Maintenance Choice Program available for maintenance drugs significant cost savings ndash 1 copay for each 90-day prescription In order to get the Maintenance pricing you must fil Rx at CVS retail pharmacy Mail order
Office of Human Resources Montgomery County Government
Prescription Drug Plan Comparison High Option $48
Only MCGEOIAFF employees can enroll in this High plan
High Option $510Only FOPNON-REP employees
can enroll in this High plan
Standard Option All employees can enroll in this
Standard plan
Copay $4 Generics$8 Brand Name
$5 Generics$10 Brand Name
$10 Generics$20 PBrand Name
$35 NPBrand NameDeductible na na $50yearMail Order Yes Yes Yes
Maintenance Choice Yes Yes YesCovered Drugs Same Same Same
Visit OHRrsquos Health Insurance Website to view Rx summaries
Office of Human Resources Montgomery County Government
Prescription Drug Cost Comparison Cost
High Option $48Only MCGEOIAFF employees
can enroll in this High plan
High Option $510Only FOPNON-REP employees
can enroll in this High plan
Standard Option All employees can enroll in this
Standard plan
Self Only
Bi-Weekly $11339Monthly $24568Yearly $294814
Bi-Weekly $11100Monthly $24050Yearly $288600
Bi-Weekly $2413Monthly $5258Yearly $62738
Self + 1
Bi-Weekly $20979Monthly $45455Yearly $545454
Bi-Weekly $20536Monthly $44495Yearly $533936
Bi-Weekly $4463Monthly $9670
Yearly $116038
Self + Family
Bi-Weekly $32511Monthly $70441Yearly $845286
Bi-Weekly $31824Monthly $68952Yearly $827424
Bi-Weekly $6916Monthly $14985Yearly $179816
Office of Human Resources Montgomery County Government
Dental
Office of Human Resources Montgomery County Government
Dental Comparison Cigna
For a list of HMO covered services and assigned costs (copays) view the HMO benefit summary
Required to Use An Assigned Provider Yes In-network only Primary Dental Office will be
assigned based on home address
No
Out of Network Benefits Available No Yes
Balance Billing for Covered Services No Yes if you go out-of-network
Referral Required Yes No
Orthodontia Benefits Available Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime) Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person) Unlimited $200000
Deductible (singlefamily) None $50 $ 150 waived for preventive care
Table 1
Office of Human Resources Montgomery County Government
Vision
Office of Human Resources Montgomery County Government
Vision Insurancebull The Countyrsquos Vision carrier is EyeMedbull Benefits payable for exams lenses and contacts (elective or necessary) every
calendar year frames every two calendar yearsbull In-network or out-of-network benefits available bull Enhanced Hearing Benefit through EyeMedrsquos partner Amplifon40 off hearing examDiscounted pricing on thousands of hearing aids including latest technologyOne-year free follow-up care with unlimited appointmentsFree batteries for two years with initial purchase Three-year warranty and loss and damage coverage
Visit OHRrsquos Health Insurance webpage to view vision summary
Office of Human Resources Montgomery County Government
Optional Life amp Dependent Life
Office of Human Resources Montgomery County Government
Optional Life Insurance ADampDbull You may elect Optional Life ADampD coverage for yourself in increments of 1 to 8 times
your basic annual earnings ($1 million maximum)
bull NOTE Coverage is not guaranteed issue for any level You must complete an online Statement of Health no matter what level of coverage you elect Later this fall after Open Enrollment ends you will receive an email from MetLife with a link to complete the Statement of Health online
bull An eligible dependent is defined as 1) your opposite or same sex spouse or 2) your unmarried children under age 26 (natural adopted or stepchildrenfoster children who depend on your support)
Office of Human Resources Montgomery County Government
Optional Life Insurance RatesHow to estimate your Optional Life Insurance bi-weekly rate
Example 40-year-old applying for 2 x salary Salary is $49300
Steps Example Calculate for Yourself
A Find your age-based rate on the rate sheet (left) $ 0037 $_________________
B Choose how much coverage you are applying for
$99000 (2 x salary rounded to the nearest $1000 ) $_________________
C Divide that coverage amount by 100099 ($99000 1000) $_________________
D Multiply A x C for estimated bi-weekly cost$366 ($037 x 99) $_________________
Office of Human Resources Montgomery County Government
Dependent Life InsuranceYou may also purchase Dependent Optional Life insurance forbull Your opposite or same sex spouse bull Your unmarried children under age 26
ndash Natural adoptedndash Stepchildrenfoster childrenNote you do not need to supply marriage certificatesbirth certificates for dependent optional life
You may electbull $2000 Spouse$1000 Childbull $4000 Spouse $2000 Childbull $10000 Spouse $5000 Child
The bi-weekly rate is not based on salary
Office of Human Resources Montgomery County Government
Flexible Spending Accounts
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Visit the Open Enrollment website to watch a recorded FSA presentation from MCGrsquos FSA vendor Benefit Strategies
bull What is an FSA It is an IRS-approved tax-free account that saves onQualified out-of-pocket medical and dependent care expensesFederal and State Income taxSocial Security Tax
bull 3 Account Options Health Care FSA Child Care FSA and Commuter Choice Transit bull FSA accounts are administered through Benefit Strategies bull FSAs are ldquouse-it or lose-itrdquo accounts claims must be incurred during the 2021 plan year (January 1
2021 ndash March 15 2022) and submitted by April 30 2022
IMPORTANT You must re-enroll in an FSA every Open Enrollment if you want to participate in the upcoming plan year
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Why You Should EnrollGive yourself a raise by reducing your taxesbull Elect the annual amount you want to place in your FSA(s) for the upcoming plan year during Open Enrollmentbull That amount is divided by 26 and taken from your biweekly paychecks on a pre-tax basis (21 paychecks for
10-month employees)bull Then use your pre-tax FSA dollars to pay for eligible out-of-pocket health care child-care or transit
expenses
Office of Human Resources Montgomery County Government
Health Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull Claims must be submitted by April 30 of the following yearbull You may elect to contribute up to $2750 Your total annual election amount is available to spend on the first
day of the new plan year bull FSA debit card allows you to pay for expenses at the time of servicebull Examples of IRS qualified eligible expenses
bull Copays (medical prescription dental vision) deductibles and coinsurance amounts over reasonable and customary charge
bull Hearing aids bull Acupuncture bull Orthopedic shoes bull Over-the-counter (OTC) drugs (no longer require doctorrsquos prescription)
Office of Human Resources Montgomery County Government
Child Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull $5000 annual maximum per household ($2500 for married filing separately)bull Funds are available to spend as they are accumulated through payroll deductionsbull Reimbursable expenses
bull day care centersbull elder carebull beforeafter school carebull babysitter fees that allow you and your spouse to work or go to school (no child support payments)
bull Qualifying dependentsbull Children under the age of 13 and are a tax dependent of the employeebull Spouse or tax dependent that is physically or mentally incapable of self-care
bull Must coordinate between filing a tax credit with IRS and your Dependent Care FSA plan
Office of Human Resources Montgomery County Government
Commuter Choice Transit FSAbull $230 per month maximum for MCGEO staff $260 per month maximum for Unrepresented staffbull Applies to employee commuting expenses only (not spouses or dependents)bull Can enroll throughout the year (not limited to Open Enrollment election)bull Eligible expenses include Metro Marc Vanpool Lyft Line Uber Poolbull Debit card ndash may be used for some expenses (not Metro)Metro riders will have to submit claim forms for reimbursement
bull Funds must be used within 180 days of election bull If retiring or leaving the County will need to coordinate use all available funds
Office of Human Resources Montgomery County Government
Using Your FSA FundsHealth Care FSA Your full annual election amount is available on the first day of the plan yearChild Care FSA Your funds are available as they accumulate through payroll deductionsCommuterTransit FSA Your funds are available as they accumulate through payroll deductions
The FSA Debit Card bull Your FSA debit card is the same card for your Health Care Child Care and TransitCommuter FSA accountsbull The card is pre-loaded with your full annual Health Care FSA election amount You can use the card to pay for IRS qualified expenses at
the time of service or when paying a bill Receipt notifications will be mailed to you monthly by Benefit Strategies Your response to receipt notifications is necessary under the provisions of the plan No response my result in the ineligibility of the purchase and as a result your card may be temporarily deactivated
bull If you are enrolled in the Child Care FSA the card can also be used in child-care settings Just remember that the card will only work for an amount that does not exceed the available balance in your Child Care FSA account on that day
bull The card can also be used to pay for your commutertransit expenses however it does not work for WMATA metro Metro riders will have to submit manual claims for reimbursement from your CommuterTransit FSA
bull Cards are re-loaded each year after you make your new annual election Please keep your cards You will only receive a new card if your old card is about to expire
Office of Human Resources Montgomery County Government
AFLAC Voluntary Plans
Office of Human Resources Montgomery County Government
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Short-Term Disabilitybull Provides short-term cash benefits in the event of disabilitybull Monthly benefit amounts available from $500 - $6000 (subject to income requirements)bull Benefit options of 3 6 12 18 or 24 months with a variety of elimination periods
Critical Illness Insurancebull Provides a lump sum cash benefit in the event of critical illnessbull Benefit amounts available in $5000 increments from $10000 - $30000
Participants pay 100 through payroll deduction for Short-Term Disability and Critical Illness Insurance
To ENROLL Text SETAPPTrdquo to 41411orCall 920-420-8861 orEmail susan_mcdanielusAflaccom
Office of Human Resources Montgomery County Government
Carrier Resources amp Cost-Saving Tips
Office of Human Resources Montgomery County Government
Lower Your Out-of-Pocket CostsChoose the plan thatrsquos right for youbull See the medical benefits chart for options bull Stay in network Use the provider search engines on your carrier website or mobile app to find in-network providersSeek preventive carebull Check-ups immunizations and screenings are an important part of staying healthy They can detect or prevent serious diseases and keep you healthyKnow where to go for carebull You have many options of places to go when you need care If your medical condition isnrsquot serious or life threatening you can save money by connecting
with a doctor online through a virtual visit or going to an urgent care center or convenience care clinic instead of a hospital emergency roomReview your prescription drug plan optionsbull Decide which Caremark prescription plan is best for you Note that the Kaiser HMO includes prescription drug coverage Both the Standard and High
Option Caremark plans cover the same prescription drugs but have different copay and deductiblesUse generic and long-term prescriptions bull Opt for lower-cost generic drugs whenever possible bull Ask your doctor to write a 90-day prescription instead of a 30-day prescription to participate in the mail order prescription programTake advantage of tax savings by participating in Flexible Spending Accountsbull Use pre-tax dollars for eligible out of pocket services and items
Office of Human Resources Montgomery County Government
Built-in Wellness Support Take advantage of the free programs available to you through your medical carrier Each of MCGrsquos medical carriers (Kaiser UHC amp CareFirst) offer valuable programs to help you manage your health
Disease Management Programsbull Help manage your chronic condition through personalized coaching support and encouragement and online education materialsEmotional Wellness amp Stress Management Support bull Help manage stress through mobile apps and other self-care resources Maternity Programsbull Support healthy moms and healthy babiesWeight-loss Programs bull Offers telephonic coaching support and web-based tools to help ensure long-term weight managementbull See the next slide for an example of an MCG success storySmoking Cessation Programsbull Supportive coaching to make quitting more successfulDiscounts bull Gym memberships weight loss programs and moreFor more information about the programs available to you please see the Open Enrollment Guide and contact your medical carrier
Office of Human Resources Montgomery County Government
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You GoAll of MCGrsquos health insurance carriers offer a simple-to-use tool that can help make your life easier while yoursquore on the go Download your carrierrsquos Mobile App to help you personalize organize and access your important plan information on your phone or tablet
bull Schedule Virtual Visitsbull Manage and track claimsbull View ID card informationbull Find doctor and compare costs and quality ratingsbull Review your coveragebull Track your account balances and deductiblesbull Access a variety of health and wellness tools
Visit Google Play or the Apple App Store to download your carrierrsquos App
Office of Human Resources Montgomery County Government
Making Changes
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Questions
Office of Human Resources Montgomery County Government
Open Enrollment AssistanceFollow these steps (in this order)1 Review the frequently asked questions (FAQs) on the Open Enrollment website at wwwmontgomerycountymdgovoe
(available beginning September 21) You can enter key words into the interactive search bar to quickly locate the answer to your question
2 Visit the MC311 website at wwwmontgomerycountymdgovmc311 and search key words for your question The search results contain various knowledge-based articles with information related to your search words Simply click on the corresponding link and the detailed answer is revealed
3 Attend one of OHRrsquos Virtual Office Hours via Microsoft Teams Members of OHRs Health Insurance Team will be on hand to address employee questions by video or via the chat box View the schedule and access the sessions through the Open Enrollment website at wwwmontgomerycountymdgovoe (available beginning September 21)
4 If you have tried all the methods above and still have Open Enrollment-related questions please contact OHRs MC311 Customer Service Center at 240-773-6471 (Mon-Fri 8 am - 5 pm) to open a service request A member of the health insurance team will respond to service requests in the order they are received Tip Please provide an email address at the time you place your Service Request This will ensure the fastest response possible
Office of Human Resources Montgomery County Government
Online ResourcesVisit the 2021 Open Enrollment Webpage
wwwmontgomerycountymdgovOE
Visit OHRrsquos WebpagewwwmontgomerycountymdgovHR
Health Insurance active employees
Office of Human Resources Montgomery County Government
Legal InformationThe County reserves the right at any time and for any reason to amend the Program subject to the Countys collective bargainingagreements The County expects to continue the Program but it is the Countys position that there is no implied contract between individual employees and the County to do so
The County may amend the Program prospectively or retroactively to comply with applicable law
In the event of a conflict between this presentation the County Code andor the Summary Description the County Code then the Summary Description will govern
Office of Human Resources Montgomery County Government
Thank YouWe hope you enjoyed learning about 2021 Open Enrollment
~Your OHR Health Insurance Team
2021 Open Enrollment Benefits Bonanza
What Is Open Enrollment
What Changes Can be Made
Open Enrollment Dates
MCG Continues to Make Generous Employer Contributions
New for 2021
Special 2021 Plan Rates Announcement
Employee Rate Changes for Calendar Year 2021
Planning Ahead Minimizing Future Rate Increases
New for 2021
Open Enrollment Communications
Itrsquos a New Frontier
2021 Open Enrollment Checklist
Open Enrollment Website Resources
Attend a Virtual Open Enrollment Event
Make Changes Online
Paper Enrollment Form Permitted for Only Two Reasons
Dependent Eligibility
Proof of Dependent Eligibility
Marriage Certificate Example Required Documentation (Contd)
Benefits Refresher
Medical amp Rx
Medical Plan Options
Medical Benefits at-a-Glance
Medical Benefits at-a-Glance (contd)
Prescription Plans Caremark
Prescription Drug Plan Comparison
Prescription Drug Cost Comparison
Dental
Slide Number 30
Vision
Vision Insurance
Optional Life amp Dependent Life
Optional Life Insurance ADampD
Optional Life Insurance Rates
Dependent Life Insurance
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs)Why You Should Enroll
Health Care FSA
Child Care FSA
Commuter Choice Transit FSA
Using Your FSA Funds
AFLAC Voluntary Plans
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Carrier Resources amp Cost-Saving Tips
Lower Your Out-of-Pocket Costs
Built-in Wellness Support
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You Go
Making Changes
Make Changes Online
Questions
Open Enrollment Assistance
Online Resources
Legal Information
Thank You
Cigna Dental Comparison
DHMO
PPO
CIGNA NETWORK
Care-Access PlusDHMO
Total CIGNA PPOPPO
Required to Use An Assigned Provider
Yes In-network only Primary Dental Office will be assigned based on home address
No
Out of Network Benefits Available
No
Yes
Balance Billing for Covered Services
No
Yes if you go out-of-network
Referral Required
Yes
No
Orthodontia Benefits Available
Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime)
Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person)
Unlimited
$200000
Deductible (singlefamily)
None
$50 $ 150 waived for preventive care
1Claim submission would be required and balance billing may occur when visiting a nonparticipating provider2Deductible does not apply to Class I ndash Diagnostic and Preventive Services
Coverage for dependents would cease on the day which the child turns 26Benefit Maximum and Deductibles are for the period of January 01 through December 31
All services listed on this benefit summary are subject to the contractSchedules of Benefits and current Exclusions and Limitations
Medical Benefits at a Glance
Kaiser Permanente HMO + Rx wwwkporg
United HealthCare Select HMO wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS) wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS) wwwcarefirstcom
Plan Type
HMO
HMO
Point-of-Service
Point-of-Service
PCP Required
Yes
Yes
No
No
Provider Network
Regional (MDDCVA)
National
National
National
Out-of-Network Benefits
No
No
Yes
Yes
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
None
None
In-Network None Out-of-Network 80
In-Network None Out-of-Network 80
Dr Office Visits PCPSpecialist
$5 copay
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits
Covered in full
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care
$5 copay
$15 copay
Covered in full
Covered in full
Emergency Room
$50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization
Covered in full
Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
MCG 2018 Medical Plan Comparison Chart
Kaiser Permanente
United HealthCare
CareFirst POS Standard
CareFirst POS High
Plan Type
HMO
HMO
Point of Service
Point of Service
Provider Network
Regional (MDDCVA)
National
National
National
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
Annual Out-of-Pocket Maximum
None
$1100 per individual up to cap of $3600 for a family
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
Physician Servcies
PCP Office Visits
$5 copay
$5 copay PCP
In-Network $15 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Specialist Office Visits
$5 copay
$10 copay
In-Network $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Annual Physical
Covered in full
$5 copay PCP
In-Network $15 copay Primary Care Physician $30 copay specialist Out-of-Network 80 covered after deductible (limit 1calendar year)
In-Network $15 copay Out-of-Network 80 not subject to deductible (up to age 18)
In-Network $10 copay Out-of-Network 80 not subject to deductible (up to age 18)
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Allergy Testing
$5 copay
$5 copay PCP $10 copay Specialist
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Virtual Visits
Labs X-Rays Diagnostics
Outpatient labs
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient X-Rays
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Major Diagnostics
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Immedate Medical Servcies
Emergency Room
$50 copay waived if admitted to hospital
$25 copay waived if admitted to hospital $15 copay for urgent care
In-Network $35 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
Urgent Care
Hospital Services
Inpatient Hospitalization
Covered in full
Covered in full
In-Network Covered in full after $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Services
Surgery
Covered in full
Inpatient covered in full Outpatient $25 copay
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Hearing Aids
For minor children One hearing aid for each hearing impaired ear once every 36 months
For minor children One hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
Hearing Screening
$5 copay for hearing exam (hearing aids are excluded)
$5 Copay PCP $10 Copay Specialist
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
Home Health Care Services
Covered in full if medically necessary
Covered in full No copayment 60 visit maximum for skilled care services per calendar year
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
Hospice
Covered in full
Covered in full (See coverage booklet for eligibility information)
In-Network Covered in full
In-Network Covered in full
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
In vitro Fertilization
Limited to 3 attempts per live birth Lifetime maximum of $100000
Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
Mammography - Preventive Screening Schedule
Schedule consistent with the current recommendations of the American College of Physicians
Covered in full Age 35-39 one baseline mammogram Age 40-49 one mammogram every two calendar years Age 50+ one mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
Maternity
Covered in full once pregnancy is diagnosed
No copayment applies after the first visit
In-Network first visit 100 after $30 copay other visits 100
In-Network First visit 100 after $10 copay other visits 100
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Maximum Lifetime Benefit
Unlimited maximum
Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
Prescriptions
Kaiser Rx plan (included with Kaiser HMO medical plan) $5 at on-site pharmacies and for mail order $15 at participating pharmacies
No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
Rehabilitation Services
Inpatient Covered in full (unlimited) Outpatient $5 copay outpatient services for physical therapy are limited to up to 30 visits occupational and speech therapy per injury incident or condition are covered for a period not to exceed 90 days
$10 copayvisit 60 combined visits per year (short-term non-chronic conditions only)
In-Network
In-Network
100
100
Skilled Nursing Facility
Covered in full 100 days maximum
Covered in full 60 days per calendar year maximum
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Substance AbuseMental Health
Inpatient Covered in full Outpatient $5 copay
Inpatient Covered in full Outpatient $5 copay
In-Network Inpatient- $150 per admission copay Outpatient- $15 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
In-Network Inpatient- covered in full Outpatient- $10 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
Vision (Routine)
$5 copay for exams 25 discount on lensesframes at Kaiser centers 15 discount off the costs of contact lenses
$25 copay for exam 15-20 discount through participating optical centers
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
53116
Medical Benefits at a Glance
Kaiser Permanente HMO + Rx wwwkporg
United HealthCare Select HMO wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS) wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS) wwwcarefirstcom
Plan Type
HMO
HMO
Point-of-Service
Point-of-Service
PCP Required
Yes
Yes
No
No
Provider Network
Regional (MDDCVA)
National
National
National
Out-of-Network Benefits
No
No
Yes
Yes
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
None
None
In-Network None Out-of-Network 80
In-Network None Out-of-Network 80
Dr Office Visits PCPSpecialist
$5 copay
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits
Covered in full
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care
$5 copay
$15 copay
Covered in full
Covered in full
Emergency Room
$50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization
Covered in full
Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
MCG 2018 Medical Plan Comparison Chart
Kaiser Permanente
United HealthCare
CareFirst POS Standard
CareFirst POS High
Plan Type
HMO
HMO
Point of Service
Point of Service
Provider Network
Regional (MDDCVA)
National
National
National
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
Annual Out-of-Pocket Maximum
None
$1100 per individual up to cap of $3600 for a family
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
Physician Servcies
PCP Office Visits
$5 copay
$5 copay PCP
In-Network $15 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Specialist Office Visits
$5 copay
$10 copay
In-Network $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Annual Physical
Covered in full
$5 copay PCP
In-Network $15 copay Primary Care Physician $30 copay specialist Out-of-Network 80 covered after deductible (limit 1calendar year)
In-Network $15 copay Out-of-Network 80 not subject to deductible (up to age 18)
In-Network $10 copay Out-of-Network 80 not subject to deductible (up to age 18)
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Allergy Testing
$5 copay
$5 copay PCP $10 copay Specialist
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Virtual Visits
Labs X-Rays Diagnostics
Outpatient labs
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient X-Rays
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Major Diagnostics
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Immedate Medical Servcies
Emergency Room
$50 copay waived if admitted to hospital
$25 copay waived if admitted to hospital $15 copay for urgent care
In-Network $35 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
Urgent Care
Hospital Services
Inpatient Hospitalization
Covered in full
Covered in full
In-Network Covered in full after $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Services
Surgery
Covered in full
Inpatient covered in full Outpatient $25 copay
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Hearing Aids
For minor children One hearing aid for each hearing impaired ear once every 36 months
For minor children One hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
Hearing Screening
$5 copay for hearing exam (hearing aids are excluded)
$5 Copay PCP $10 Copay Specialist
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
Home Health Care Services
Covered in full if medically necessary
Covered in full No copayment 60 visit maximum for skilled care services per calendar year
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
Hospice
Covered in full
Covered in full (See coverage booklet for eligibility information)
In-Network Covered in full
In-Network Covered in full
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
In vitro Fertilization
Limited to 3 attempts per live birth Lifetime maximum of $100000
Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
Mammography - Preventive Screening Schedule
Schedule consistent with the current recommendations of the American College of Physicians
Covered in full Age 35-39 one baseline mammogram Age 40-49 one mammogram every two calendar years Age 50+ one mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
Maternity
Covered in full once pregnancy is diagnosed
No copayment applies after the first visit
In-Network first visit 100 after $30 copay other visits 100
In-Network First visit 100 after $10 copay other visits 100
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Maximum Lifetime Benefit
Unlimited maximum
Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
Prescriptions
Kaiser Rx plan (included with Kaiser HMO medical plan) $5 at on-site pharmacies and for mail order $15 at participating pharmacies
No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
Rehabilitation Services
Inpatient Covered in full (unlimited) Outpatient $5 copay outpatient services for physical therapy are limited to up to 30 visits occupational and speech therapy per injury incident or condition are covered for a period not to exceed 90 days
$10 copayvisit 60 combined visits per year (short-term non-chronic conditions only)
In-Network
In-Network
100
100
Skilled Nursing Facility
Covered in full 100 days maximum
Covered in full 60 days per calendar year maximum
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Substance AbuseMental Health
Inpatient Covered in full Outpatient $5 copay
Inpatient Covered in full Outpatient $5 copay
In-Network Inpatient- $150 per admission copay Outpatient- $15 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
In-Network Inpatient- covered in full Outpatient- $10 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
Vision (Routine)
$5 copay for exams 25 discount on lensesframes at Kaiser centers 15 discount off the costs of contact lenses
$25 copay for exam 15-20 discount through participating optical centers
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
53116
Office of Human Resources Montgomery County Government
Marriage Certificate Example Required Documentation (Contd)
Office of Human Resources Montgomery County Government
Benefits Refresher
Office of Human Resources Montgomery County Government
Medical amp Rx
Office of Human Resources Montgomery County Government
Medical Plan OptionsHealth Maintenance Organizations (HMO)bull Kaiser Permanente Signature (HMO)bull United Healthcare Select (HMO)
Point of Service Plans (POS)bull CareFirst BCBS (POS) High Optionbull CareFirst BCBS (POS) Standard Option
Three tiers of coverage Self Self + 1 or Family
Office of Human Resources Montgomery County Government
Medical Benefits at-a-Glance To view full carrier medical summaries visit OHRrsquos Health Insurance Website
Kaiser Permanente HMO + Rx
wwwkporg
United HealthCare Select HMO
wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS)
wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS)
wwwcarefirstcom
Plan Type HMO HMO Point-of-Service Point-of-Service
PCP Required Yes Yes No No
Provider Network Regional (MDDCVA) National National National
Out-of-Network Benefits No No Yes Yes
Referrals Required Yes No No No
Annual Deductible None NoneIn-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Sheet1
Sheet1 (2)
Office of Human Resources Montgomery County Government
Medical Benefits at-a-Glance (contd)
New Employee Orientation Program
Kaiser Permanente HMO + Rx
wwwkporg
United HealthCare Select HMO
wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS)
wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS)
wwwcarefirstcom
Dr Office Visits PCPSpecialist $5 copay $5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits Covered in full $5 copay $10 copay In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care $5 copay $15 copay Covered in full Covered in full
Emergency Room $50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization Covered in full Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
Visit OHRrsquos Health Insurance webpage to view Medical summaries
Sheet1
Sheet1 (2)
Office of Human Resources Montgomery County Government
Prescription Plans Caremarkbull Two Rx Plan OptionsStandardHigh
bull If you elect UHC or CareFirst and want Rx coverage you will need to elect the stand-alone Caremark Rx plan (Kaiser already includes Rx coverage)
bull Maintenance Choice Program available for maintenance drugs significant cost savings ndash 1 copay for each 90-day prescription In order to get the Maintenance pricing you must fil Rx at CVS retail pharmacy Mail order
Office of Human Resources Montgomery County Government
Prescription Drug Plan Comparison High Option $48
Only MCGEOIAFF employees can enroll in this High plan
High Option $510Only FOPNON-REP employees
can enroll in this High plan
Standard Option All employees can enroll in this
Standard plan
Copay $4 Generics$8 Brand Name
$5 Generics$10 Brand Name
$10 Generics$20 PBrand Name
$35 NPBrand NameDeductible na na $50yearMail Order Yes Yes Yes
Maintenance Choice Yes Yes YesCovered Drugs Same Same Same
Visit OHRrsquos Health Insurance Website to view Rx summaries
Office of Human Resources Montgomery County Government
Prescription Drug Cost Comparison Cost
High Option $48Only MCGEOIAFF employees
can enroll in this High plan
High Option $510Only FOPNON-REP employees
can enroll in this High plan
Standard Option All employees can enroll in this
Standard plan
Self Only
Bi-Weekly $11339Monthly $24568Yearly $294814
Bi-Weekly $11100Monthly $24050Yearly $288600
Bi-Weekly $2413Monthly $5258Yearly $62738
Self + 1
Bi-Weekly $20979Monthly $45455Yearly $545454
Bi-Weekly $20536Monthly $44495Yearly $533936
Bi-Weekly $4463Monthly $9670
Yearly $116038
Self + Family
Bi-Weekly $32511Monthly $70441Yearly $845286
Bi-Weekly $31824Monthly $68952Yearly $827424
Bi-Weekly $6916Monthly $14985Yearly $179816
Office of Human Resources Montgomery County Government
Dental
Office of Human Resources Montgomery County Government
Dental Comparison Cigna
For a list of HMO covered services and assigned costs (copays) view the HMO benefit summary
Required to Use An Assigned Provider Yes In-network only Primary Dental Office will be
assigned based on home address
No
Out of Network Benefits Available No Yes
Balance Billing for Covered Services No Yes if you go out-of-network
Referral Required Yes No
Orthodontia Benefits Available Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime) Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person) Unlimited $200000
Deductible (singlefamily) None $50 $ 150 waived for preventive care
Table 1
Office of Human Resources Montgomery County Government
Vision
Office of Human Resources Montgomery County Government
Vision Insurancebull The Countyrsquos Vision carrier is EyeMedbull Benefits payable for exams lenses and contacts (elective or necessary) every
calendar year frames every two calendar yearsbull In-network or out-of-network benefits available bull Enhanced Hearing Benefit through EyeMedrsquos partner Amplifon40 off hearing examDiscounted pricing on thousands of hearing aids including latest technologyOne-year free follow-up care with unlimited appointmentsFree batteries for two years with initial purchase Three-year warranty and loss and damage coverage
Visit OHRrsquos Health Insurance webpage to view vision summary
Office of Human Resources Montgomery County Government
Optional Life amp Dependent Life
Office of Human Resources Montgomery County Government
Optional Life Insurance ADampDbull You may elect Optional Life ADampD coverage for yourself in increments of 1 to 8 times
your basic annual earnings ($1 million maximum)
bull NOTE Coverage is not guaranteed issue for any level You must complete an online Statement of Health no matter what level of coverage you elect Later this fall after Open Enrollment ends you will receive an email from MetLife with a link to complete the Statement of Health online
bull An eligible dependent is defined as 1) your opposite or same sex spouse or 2) your unmarried children under age 26 (natural adopted or stepchildrenfoster children who depend on your support)
Office of Human Resources Montgomery County Government
Optional Life Insurance RatesHow to estimate your Optional Life Insurance bi-weekly rate
Example 40-year-old applying for 2 x salary Salary is $49300
Steps Example Calculate for Yourself
A Find your age-based rate on the rate sheet (left) $ 0037 $_________________
B Choose how much coverage you are applying for
$99000 (2 x salary rounded to the nearest $1000 ) $_________________
C Divide that coverage amount by 100099 ($99000 1000) $_________________
D Multiply A x C for estimated bi-weekly cost$366 ($037 x 99) $_________________
Office of Human Resources Montgomery County Government
Dependent Life InsuranceYou may also purchase Dependent Optional Life insurance forbull Your opposite or same sex spouse bull Your unmarried children under age 26
ndash Natural adoptedndash Stepchildrenfoster childrenNote you do not need to supply marriage certificatesbirth certificates for dependent optional life
You may electbull $2000 Spouse$1000 Childbull $4000 Spouse $2000 Childbull $10000 Spouse $5000 Child
The bi-weekly rate is not based on salary
Office of Human Resources Montgomery County Government
Flexible Spending Accounts
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Visit the Open Enrollment website to watch a recorded FSA presentation from MCGrsquos FSA vendor Benefit Strategies
bull What is an FSA It is an IRS-approved tax-free account that saves onQualified out-of-pocket medical and dependent care expensesFederal and State Income taxSocial Security Tax
bull 3 Account Options Health Care FSA Child Care FSA and Commuter Choice Transit bull FSA accounts are administered through Benefit Strategies bull FSAs are ldquouse-it or lose-itrdquo accounts claims must be incurred during the 2021 plan year (January 1
2021 ndash March 15 2022) and submitted by April 30 2022
IMPORTANT You must re-enroll in an FSA every Open Enrollment if you want to participate in the upcoming plan year
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Why You Should EnrollGive yourself a raise by reducing your taxesbull Elect the annual amount you want to place in your FSA(s) for the upcoming plan year during Open Enrollmentbull That amount is divided by 26 and taken from your biweekly paychecks on a pre-tax basis (21 paychecks for
10-month employees)bull Then use your pre-tax FSA dollars to pay for eligible out-of-pocket health care child-care or transit
expenses
Office of Human Resources Montgomery County Government
Health Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull Claims must be submitted by April 30 of the following yearbull You may elect to contribute up to $2750 Your total annual election amount is available to spend on the first
day of the new plan year bull FSA debit card allows you to pay for expenses at the time of servicebull Examples of IRS qualified eligible expenses
bull Copays (medical prescription dental vision) deductibles and coinsurance amounts over reasonable and customary charge
bull Hearing aids bull Acupuncture bull Orthopedic shoes bull Over-the-counter (OTC) drugs (no longer require doctorrsquos prescription)
Office of Human Resources Montgomery County Government
Child Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull $5000 annual maximum per household ($2500 for married filing separately)bull Funds are available to spend as they are accumulated through payroll deductionsbull Reimbursable expenses
bull day care centersbull elder carebull beforeafter school carebull babysitter fees that allow you and your spouse to work or go to school (no child support payments)
bull Qualifying dependentsbull Children under the age of 13 and are a tax dependent of the employeebull Spouse or tax dependent that is physically or mentally incapable of self-care
bull Must coordinate between filing a tax credit with IRS and your Dependent Care FSA plan
Office of Human Resources Montgomery County Government
Commuter Choice Transit FSAbull $230 per month maximum for MCGEO staff $260 per month maximum for Unrepresented staffbull Applies to employee commuting expenses only (not spouses or dependents)bull Can enroll throughout the year (not limited to Open Enrollment election)bull Eligible expenses include Metro Marc Vanpool Lyft Line Uber Poolbull Debit card ndash may be used for some expenses (not Metro)Metro riders will have to submit claim forms for reimbursement
bull Funds must be used within 180 days of election bull If retiring or leaving the County will need to coordinate use all available funds
Office of Human Resources Montgomery County Government
Using Your FSA FundsHealth Care FSA Your full annual election amount is available on the first day of the plan yearChild Care FSA Your funds are available as they accumulate through payroll deductionsCommuterTransit FSA Your funds are available as they accumulate through payroll deductions
The FSA Debit Card bull Your FSA debit card is the same card for your Health Care Child Care and TransitCommuter FSA accountsbull The card is pre-loaded with your full annual Health Care FSA election amount You can use the card to pay for IRS qualified expenses at
the time of service or when paying a bill Receipt notifications will be mailed to you monthly by Benefit Strategies Your response to receipt notifications is necessary under the provisions of the plan No response my result in the ineligibility of the purchase and as a result your card may be temporarily deactivated
bull If you are enrolled in the Child Care FSA the card can also be used in child-care settings Just remember that the card will only work for an amount that does not exceed the available balance in your Child Care FSA account on that day
bull The card can also be used to pay for your commutertransit expenses however it does not work for WMATA metro Metro riders will have to submit manual claims for reimbursement from your CommuterTransit FSA
bull Cards are re-loaded each year after you make your new annual election Please keep your cards You will only receive a new card if your old card is about to expire
Office of Human Resources Montgomery County Government
AFLAC Voluntary Plans
Office of Human Resources Montgomery County Government
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Short-Term Disabilitybull Provides short-term cash benefits in the event of disabilitybull Monthly benefit amounts available from $500 - $6000 (subject to income requirements)bull Benefit options of 3 6 12 18 or 24 months with a variety of elimination periods
Critical Illness Insurancebull Provides a lump sum cash benefit in the event of critical illnessbull Benefit amounts available in $5000 increments from $10000 - $30000
Participants pay 100 through payroll deduction for Short-Term Disability and Critical Illness Insurance
To ENROLL Text SETAPPTrdquo to 41411orCall 920-420-8861 orEmail susan_mcdanielusAflaccom
Office of Human Resources Montgomery County Government
Carrier Resources amp Cost-Saving Tips
Office of Human Resources Montgomery County Government
Lower Your Out-of-Pocket CostsChoose the plan thatrsquos right for youbull See the medical benefits chart for options bull Stay in network Use the provider search engines on your carrier website or mobile app to find in-network providersSeek preventive carebull Check-ups immunizations and screenings are an important part of staying healthy They can detect or prevent serious diseases and keep you healthyKnow where to go for carebull You have many options of places to go when you need care If your medical condition isnrsquot serious or life threatening you can save money by connecting
with a doctor online through a virtual visit or going to an urgent care center or convenience care clinic instead of a hospital emergency roomReview your prescription drug plan optionsbull Decide which Caremark prescription plan is best for you Note that the Kaiser HMO includes prescription drug coverage Both the Standard and High
Option Caremark plans cover the same prescription drugs but have different copay and deductiblesUse generic and long-term prescriptions bull Opt for lower-cost generic drugs whenever possible bull Ask your doctor to write a 90-day prescription instead of a 30-day prescription to participate in the mail order prescription programTake advantage of tax savings by participating in Flexible Spending Accountsbull Use pre-tax dollars for eligible out of pocket services and items
Office of Human Resources Montgomery County Government
Built-in Wellness Support Take advantage of the free programs available to you through your medical carrier Each of MCGrsquos medical carriers (Kaiser UHC amp CareFirst) offer valuable programs to help you manage your health
Disease Management Programsbull Help manage your chronic condition through personalized coaching support and encouragement and online education materialsEmotional Wellness amp Stress Management Support bull Help manage stress through mobile apps and other self-care resources Maternity Programsbull Support healthy moms and healthy babiesWeight-loss Programs bull Offers telephonic coaching support and web-based tools to help ensure long-term weight managementbull See the next slide for an example of an MCG success storySmoking Cessation Programsbull Supportive coaching to make quitting more successfulDiscounts bull Gym memberships weight loss programs and moreFor more information about the programs available to you please see the Open Enrollment Guide and contact your medical carrier
Office of Human Resources Montgomery County Government
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You GoAll of MCGrsquos health insurance carriers offer a simple-to-use tool that can help make your life easier while yoursquore on the go Download your carrierrsquos Mobile App to help you personalize organize and access your important plan information on your phone or tablet
bull Schedule Virtual Visitsbull Manage and track claimsbull View ID card informationbull Find doctor and compare costs and quality ratingsbull Review your coveragebull Track your account balances and deductiblesbull Access a variety of health and wellness tools
Visit Google Play or the Apple App Store to download your carrierrsquos App
Office of Human Resources Montgomery County Government
Making Changes
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Questions
Office of Human Resources Montgomery County Government
Open Enrollment AssistanceFollow these steps (in this order)1 Review the frequently asked questions (FAQs) on the Open Enrollment website at wwwmontgomerycountymdgovoe
(available beginning September 21) You can enter key words into the interactive search bar to quickly locate the answer to your question
2 Visit the MC311 website at wwwmontgomerycountymdgovmc311 and search key words for your question The search results contain various knowledge-based articles with information related to your search words Simply click on the corresponding link and the detailed answer is revealed
3 Attend one of OHRrsquos Virtual Office Hours via Microsoft Teams Members of OHRs Health Insurance Team will be on hand to address employee questions by video or via the chat box View the schedule and access the sessions through the Open Enrollment website at wwwmontgomerycountymdgovoe (available beginning September 21)
4 If you have tried all the methods above and still have Open Enrollment-related questions please contact OHRs MC311 Customer Service Center at 240-773-6471 (Mon-Fri 8 am - 5 pm) to open a service request A member of the health insurance team will respond to service requests in the order they are received Tip Please provide an email address at the time you place your Service Request This will ensure the fastest response possible
Office of Human Resources Montgomery County Government
Online ResourcesVisit the 2021 Open Enrollment Webpage
wwwmontgomerycountymdgovOE
Visit OHRrsquos WebpagewwwmontgomerycountymdgovHR
Health Insurance active employees
Office of Human Resources Montgomery County Government
Legal InformationThe County reserves the right at any time and for any reason to amend the Program subject to the Countys collective bargainingagreements The County expects to continue the Program but it is the Countys position that there is no implied contract between individual employees and the County to do so
The County may amend the Program prospectively or retroactively to comply with applicable law
In the event of a conflict between this presentation the County Code andor the Summary Description the County Code then the Summary Description will govern
Office of Human Resources Montgomery County Government
Thank YouWe hope you enjoyed learning about 2021 Open Enrollment
~Your OHR Health Insurance Team
2021 Open Enrollment Benefits Bonanza
What Is Open Enrollment
What Changes Can be Made
Open Enrollment Dates
MCG Continues to Make Generous Employer Contributions
New for 2021
Special 2021 Plan Rates Announcement
Employee Rate Changes for Calendar Year 2021
Planning Ahead Minimizing Future Rate Increases
New for 2021
Open Enrollment Communications
Itrsquos a New Frontier
2021 Open Enrollment Checklist
Open Enrollment Website Resources
Attend a Virtual Open Enrollment Event
Make Changes Online
Paper Enrollment Form Permitted for Only Two Reasons
Dependent Eligibility
Proof of Dependent Eligibility
Marriage Certificate Example Required Documentation (Contd)
Benefits Refresher
Medical amp Rx
Medical Plan Options
Medical Benefits at-a-Glance
Medical Benefits at-a-Glance (contd)
Prescription Plans Caremark
Prescription Drug Plan Comparison
Prescription Drug Cost Comparison
Dental
Slide Number 30
Vision
Vision Insurance
Optional Life amp Dependent Life
Optional Life Insurance ADampD
Optional Life Insurance Rates
Dependent Life Insurance
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs)Why You Should Enroll
Health Care FSA
Child Care FSA
Commuter Choice Transit FSA
Using Your FSA Funds
AFLAC Voluntary Plans
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Carrier Resources amp Cost-Saving Tips
Lower Your Out-of-Pocket Costs
Built-in Wellness Support
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You Go
Making Changes
Make Changes Online
Questions
Open Enrollment Assistance
Online Resources
Legal Information
Thank You
Cigna Dental Comparison
DHMO
PPO
CIGNA NETWORK
Care-Access PlusDHMO
Total CIGNA PPOPPO
Required to Use An Assigned Provider
Yes In-network only Primary Dental Office will be assigned based on home address
No
Out of Network Benefits Available
No
Yes
Balance Billing for Covered Services
No
Yes if you go out-of-network
Referral Required
Yes
No
Orthodontia Benefits Available
Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime)
Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person)
Unlimited
$200000
Deductible (singlefamily)
None
$50 $ 150 waived for preventive care
1Claim submission would be required and balance billing may occur when visiting a nonparticipating provider2Deductible does not apply to Class I ndash Diagnostic and Preventive Services
Coverage for dependents would cease on the day which the child turns 26Benefit Maximum and Deductibles are for the period of January 01 through December 31
All services listed on this benefit summary are subject to the contractSchedules of Benefits and current Exclusions and Limitations
Medical Benefits at a Glance
Kaiser Permanente HMO + Rx wwwkporg
United HealthCare Select HMO wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS) wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS) wwwcarefirstcom
Plan Type
HMO
HMO
Point-of-Service
Point-of-Service
PCP Required
Yes
Yes
No
No
Provider Network
Regional (MDDCVA)
National
National
National
Out-of-Network Benefits
No
No
Yes
Yes
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
None
None
In-Network None Out-of-Network 80
In-Network None Out-of-Network 80
Dr Office Visits PCPSpecialist
$5 copay
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits
Covered in full
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care
$5 copay
$15 copay
Covered in full
Covered in full
Emergency Room
$50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization
Covered in full
Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
MCG 2018 Medical Plan Comparison Chart
Kaiser Permanente
United HealthCare
CareFirst POS Standard
CareFirst POS High
Plan Type
HMO
HMO
Point of Service
Point of Service
Provider Network
Regional (MDDCVA)
National
National
National
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
Annual Out-of-Pocket Maximum
None
$1100 per individual up to cap of $3600 for a family
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
Physician Servcies
PCP Office Visits
$5 copay
$5 copay PCP
In-Network $15 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Specialist Office Visits
$5 copay
$10 copay
In-Network $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Annual Physical
Covered in full
$5 copay PCP
In-Network $15 copay Primary Care Physician $30 copay specialist Out-of-Network 80 covered after deductible (limit 1calendar year)
In-Network $15 copay Out-of-Network 80 not subject to deductible (up to age 18)
In-Network $10 copay Out-of-Network 80 not subject to deductible (up to age 18)
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Allergy Testing
$5 copay
$5 copay PCP $10 copay Specialist
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Virtual Visits
Labs X-Rays Diagnostics
Outpatient labs
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient X-Rays
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Major Diagnostics
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Immedate Medical Servcies
Emergency Room
$50 copay waived if admitted to hospital
$25 copay waived if admitted to hospital $15 copay for urgent care
In-Network $35 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
Urgent Care
Hospital Services
Inpatient Hospitalization
Covered in full
Covered in full
In-Network Covered in full after $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Services
Surgery
Covered in full
Inpatient covered in full Outpatient $25 copay
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Hearing Aids
For minor children One hearing aid for each hearing impaired ear once every 36 months
For minor children One hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
Hearing Screening
$5 copay for hearing exam (hearing aids are excluded)
$5 Copay PCP $10 Copay Specialist
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
Home Health Care Services
Covered in full if medically necessary
Covered in full No copayment 60 visit maximum for skilled care services per calendar year
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
Hospice
Covered in full
Covered in full (See coverage booklet for eligibility information)
In-Network Covered in full
In-Network Covered in full
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
In vitro Fertilization
Limited to 3 attempts per live birth Lifetime maximum of $100000
Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
Mammography - Preventive Screening Schedule
Schedule consistent with the current recommendations of the American College of Physicians
Covered in full Age 35-39 one baseline mammogram Age 40-49 one mammogram every two calendar years Age 50+ one mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
Maternity
Covered in full once pregnancy is diagnosed
No copayment applies after the first visit
In-Network first visit 100 after $30 copay other visits 100
In-Network First visit 100 after $10 copay other visits 100
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Maximum Lifetime Benefit
Unlimited maximum
Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
Prescriptions
Kaiser Rx plan (included with Kaiser HMO medical plan) $5 at on-site pharmacies and for mail order $15 at participating pharmacies
No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
Rehabilitation Services
Inpatient Covered in full (unlimited) Outpatient $5 copay outpatient services for physical therapy are limited to up to 30 visits occupational and speech therapy per injury incident or condition are covered for a period not to exceed 90 days
$10 copayvisit 60 combined visits per year (short-term non-chronic conditions only)
In-Network
In-Network
100
100
Skilled Nursing Facility
Covered in full 100 days maximum
Covered in full 60 days per calendar year maximum
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Substance AbuseMental Health
Inpatient Covered in full Outpatient $5 copay
Inpatient Covered in full Outpatient $5 copay
In-Network Inpatient- $150 per admission copay Outpatient- $15 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
In-Network Inpatient- covered in full Outpatient- $10 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
Vision (Routine)
$5 copay for exams 25 discount on lensesframes at Kaiser centers 15 discount off the costs of contact lenses
$25 copay for exam 15-20 discount through participating optical centers
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
53116
Medical Benefits at a Glance
Kaiser Permanente HMO + Rx wwwkporg
United HealthCare Select HMO wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS) wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS) wwwcarefirstcom
Plan Type
HMO
HMO
Point-of-Service
Point-of-Service
PCP Required
Yes
Yes
No
No
Provider Network
Regional (MDDCVA)
National
National
National
Out-of-Network Benefits
No
No
Yes
Yes
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
None
None
In-Network None Out-of-Network 80
In-Network None Out-of-Network 80
Dr Office Visits PCPSpecialist
$5 copay
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits
Covered in full
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care
$5 copay
$15 copay
Covered in full
Covered in full
Emergency Room
$50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization
Covered in full
Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
MCG 2018 Medical Plan Comparison Chart
Kaiser Permanente
United HealthCare
CareFirst POS Standard
CareFirst POS High
Plan Type
HMO
HMO
Point of Service
Point of Service
Provider Network
Regional (MDDCVA)
National
National
National
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
Annual Out-of-Pocket Maximum
None
$1100 per individual up to cap of $3600 for a family
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
Physician Servcies
PCP Office Visits
$5 copay
$5 copay PCP
In-Network $15 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Specialist Office Visits
$5 copay
$10 copay
In-Network $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Annual Physical
Covered in full
$5 copay PCP
In-Network $15 copay Primary Care Physician $30 copay specialist Out-of-Network 80 covered after deductible (limit 1calendar year)
In-Network $15 copay Out-of-Network 80 not subject to deductible (up to age 18)
In-Network $10 copay Out-of-Network 80 not subject to deductible (up to age 18)
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Allergy Testing
$5 copay
$5 copay PCP $10 copay Specialist
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Virtual Visits
Labs X-Rays Diagnostics
Outpatient labs
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient X-Rays
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Major Diagnostics
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Immedate Medical Servcies
Emergency Room
$50 copay waived if admitted to hospital
$25 copay waived if admitted to hospital $15 copay for urgent care
In-Network $35 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
Urgent Care
Hospital Services
Inpatient Hospitalization
Covered in full
Covered in full
In-Network Covered in full after $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Services
Surgery
Covered in full
Inpatient covered in full Outpatient $25 copay
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Hearing Aids
For minor children One hearing aid for each hearing impaired ear once every 36 months
For minor children One hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
Hearing Screening
$5 copay for hearing exam (hearing aids are excluded)
$5 Copay PCP $10 Copay Specialist
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
Home Health Care Services
Covered in full if medically necessary
Covered in full No copayment 60 visit maximum for skilled care services per calendar year
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
Hospice
Covered in full
Covered in full (See coverage booklet for eligibility information)
In-Network Covered in full
In-Network Covered in full
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
In vitro Fertilization
Limited to 3 attempts per live birth Lifetime maximum of $100000
Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
Mammography - Preventive Screening Schedule
Schedule consistent with the current recommendations of the American College of Physicians
Covered in full Age 35-39 one baseline mammogram Age 40-49 one mammogram every two calendar years Age 50+ one mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
Maternity
Covered in full once pregnancy is diagnosed
No copayment applies after the first visit
In-Network first visit 100 after $30 copay other visits 100
In-Network First visit 100 after $10 copay other visits 100
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Maximum Lifetime Benefit
Unlimited maximum
Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
Prescriptions
Kaiser Rx plan (included with Kaiser HMO medical plan) $5 at on-site pharmacies and for mail order $15 at participating pharmacies
No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
Rehabilitation Services
Inpatient Covered in full (unlimited) Outpatient $5 copay outpatient services for physical therapy are limited to up to 30 visits occupational and speech therapy per injury incident or condition are covered for a period not to exceed 90 days
$10 copayvisit 60 combined visits per year (short-term non-chronic conditions only)
In-Network
In-Network
100
100
Skilled Nursing Facility
Covered in full 100 days maximum
Covered in full 60 days per calendar year maximum
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Substance AbuseMental Health
Inpatient Covered in full Outpatient $5 copay
Inpatient Covered in full Outpatient $5 copay
In-Network Inpatient- $150 per admission copay Outpatient- $15 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
In-Network Inpatient- covered in full Outpatient- $10 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
Vision (Routine)
$5 copay for exams 25 discount on lensesframes at Kaiser centers 15 discount off the costs of contact lenses
$25 copay for exam 15-20 discount through participating optical centers
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
53116
Office of Human Resources Montgomery County Government
Benefits Refresher
Office of Human Resources Montgomery County Government
Medical amp Rx
Office of Human Resources Montgomery County Government
Medical Plan OptionsHealth Maintenance Organizations (HMO)bull Kaiser Permanente Signature (HMO)bull United Healthcare Select (HMO)
Point of Service Plans (POS)bull CareFirst BCBS (POS) High Optionbull CareFirst BCBS (POS) Standard Option
Three tiers of coverage Self Self + 1 or Family
Office of Human Resources Montgomery County Government
Medical Benefits at-a-Glance To view full carrier medical summaries visit OHRrsquos Health Insurance Website
Kaiser Permanente HMO + Rx
wwwkporg
United HealthCare Select HMO
wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS)
wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS)
wwwcarefirstcom
Plan Type HMO HMO Point-of-Service Point-of-Service
PCP Required Yes Yes No No
Provider Network Regional (MDDCVA) National National National
Out-of-Network Benefits No No Yes Yes
Referrals Required Yes No No No
Annual Deductible None NoneIn-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Sheet1
Sheet1 (2)
Office of Human Resources Montgomery County Government
Medical Benefits at-a-Glance (contd)
New Employee Orientation Program
Kaiser Permanente HMO + Rx
wwwkporg
United HealthCare Select HMO
wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS)
wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS)
wwwcarefirstcom
Dr Office Visits PCPSpecialist $5 copay $5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits Covered in full $5 copay $10 copay In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care $5 copay $15 copay Covered in full Covered in full
Emergency Room $50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization Covered in full Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
Visit OHRrsquos Health Insurance webpage to view Medical summaries
Sheet1
Sheet1 (2)
Office of Human Resources Montgomery County Government
Prescription Plans Caremarkbull Two Rx Plan OptionsStandardHigh
bull If you elect UHC or CareFirst and want Rx coverage you will need to elect the stand-alone Caremark Rx plan (Kaiser already includes Rx coverage)
bull Maintenance Choice Program available for maintenance drugs significant cost savings ndash 1 copay for each 90-day prescription In order to get the Maintenance pricing you must fil Rx at CVS retail pharmacy Mail order
Office of Human Resources Montgomery County Government
Prescription Drug Plan Comparison High Option $48
Only MCGEOIAFF employees can enroll in this High plan
High Option $510Only FOPNON-REP employees
can enroll in this High plan
Standard Option All employees can enroll in this
Standard plan
Copay $4 Generics$8 Brand Name
$5 Generics$10 Brand Name
$10 Generics$20 PBrand Name
$35 NPBrand NameDeductible na na $50yearMail Order Yes Yes Yes
Maintenance Choice Yes Yes YesCovered Drugs Same Same Same
Visit OHRrsquos Health Insurance Website to view Rx summaries
Office of Human Resources Montgomery County Government
Prescription Drug Cost Comparison Cost
High Option $48Only MCGEOIAFF employees
can enroll in this High plan
High Option $510Only FOPNON-REP employees
can enroll in this High plan
Standard Option All employees can enroll in this
Standard plan
Self Only
Bi-Weekly $11339Monthly $24568Yearly $294814
Bi-Weekly $11100Monthly $24050Yearly $288600
Bi-Weekly $2413Monthly $5258Yearly $62738
Self + 1
Bi-Weekly $20979Monthly $45455Yearly $545454
Bi-Weekly $20536Monthly $44495Yearly $533936
Bi-Weekly $4463Monthly $9670
Yearly $116038
Self + Family
Bi-Weekly $32511Monthly $70441Yearly $845286
Bi-Weekly $31824Monthly $68952Yearly $827424
Bi-Weekly $6916Monthly $14985Yearly $179816
Office of Human Resources Montgomery County Government
Dental
Office of Human Resources Montgomery County Government
Dental Comparison Cigna
For a list of HMO covered services and assigned costs (copays) view the HMO benefit summary
Required to Use An Assigned Provider Yes In-network only Primary Dental Office will be
assigned based on home address
No
Out of Network Benefits Available No Yes
Balance Billing for Covered Services No Yes if you go out-of-network
Referral Required Yes No
Orthodontia Benefits Available Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime) Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person) Unlimited $200000
Deductible (singlefamily) None $50 $ 150 waived for preventive care
Table 1
Office of Human Resources Montgomery County Government
Vision
Office of Human Resources Montgomery County Government
Vision Insurancebull The Countyrsquos Vision carrier is EyeMedbull Benefits payable for exams lenses and contacts (elective or necessary) every
calendar year frames every two calendar yearsbull In-network or out-of-network benefits available bull Enhanced Hearing Benefit through EyeMedrsquos partner Amplifon40 off hearing examDiscounted pricing on thousands of hearing aids including latest technologyOne-year free follow-up care with unlimited appointmentsFree batteries for two years with initial purchase Three-year warranty and loss and damage coverage
Visit OHRrsquos Health Insurance webpage to view vision summary
Office of Human Resources Montgomery County Government
Optional Life amp Dependent Life
Office of Human Resources Montgomery County Government
Optional Life Insurance ADampDbull You may elect Optional Life ADampD coverage for yourself in increments of 1 to 8 times
your basic annual earnings ($1 million maximum)
bull NOTE Coverage is not guaranteed issue for any level You must complete an online Statement of Health no matter what level of coverage you elect Later this fall after Open Enrollment ends you will receive an email from MetLife with a link to complete the Statement of Health online
bull An eligible dependent is defined as 1) your opposite or same sex spouse or 2) your unmarried children under age 26 (natural adopted or stepchildrenfoster children who depend on your support)
Office of Human Resources Montgomery County Government
Optional Life Insurance RatesHow to estimate your Optional Life Insurance bi-weekly rate
Example 40-year-old applying for 2 x salary Salary is $49300
Steps Example Calculate for Yourself
A Find your age-based rate on the rate sheet (left) $ 0037 $_________________
B Choose how much coverage you are applying for
$99000 (2 x salary rounded to the nearest $1000 ) $_________________
C Divide that coverage amount by 100099 ($99000 1000) $_________________
D Multiply A x C for estimated bi-weekly cost$366 ($037 x 99) $_________________
Office of Human Resources Montgomery County Government
Dependent Life InsuranceYou may also purchase Dependent Optional Life insurance forbull Your opposite or same sex spouse bull Your unmarried children under age 26
ndash Natural adoptedndash Stepchildrenfoster childrenNote you do not need to supply marriage certificatesbirth certificates for dependent optional life
You may electbull $2000 Spouse$1000 Childbull $4000 Spouse $2000 Childbull $10000 Spouse $5000 Child
The bi-weekly rate is not based on salary
Office of Human Resources Montgomery County Government
Flexible Spending Accounts
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Visit the Open Enrollment website to watch a recorded FSA presentation from MCGrsquos FSA vendor Benefit Strategies
bull What is an FSA It is an IRS-approved tax-free account that saves onQualified out-of-pocket medical and dependent care expensesFederal and State Income taxSocial Security Tax
bull 3 Account Options Health Care FSA Child Care FSA and Commuter Choice Transit bull FSA accounts are administered through Benefit Strategies bull FSAs are ldquouse-it or lose-itrdquo accounts claims must be incurred during the 2021 plan year (January 1
2021 ndash March 15 2022) and submitted by April 30 2022
IMPORTANT You must re-enroll in an FSA every Open Enrollment if you want to participate in the upcoming plan year
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Why You Should EnrollGive yourself a raise by reducing your taxesbull Elect the annual amount you want to place in your FSA(s) for the upcoming plan year during Open Enrollmentbull That amount is divided by 26 and taken from your biweekly paychecks on a pre-tax basis (21 paychecks for
10-month employees)bull Then use your pre-tax FSA dollars to pay for eligible out-of-pocket health care child-care or transit
expenses
Office of Human Resources Montgomery County Government
Health Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull Claims must be submitted by April 30 of the following yearbull You may elect to contribute up to $2750 Your total annual election amount is available to spend on the first
day of the new plan year bull FSA debit card allows you to pay for expenses at the time of servicebull Examples of IRS qualified eligible expenses
bull Copays (medical prescription dental vision) deductibles and coinsurance amounts over reasonable and customary charge
bull Hearing aids bull Acupuncture bull Orthopedic shoes bull Over-the-counter (OTC) drugs (no longer require doctorrsquos prescription)
Office of Human Resources Montgomery County Government
Child Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull $5000 annual maximum per household ($2500 for married filing separately)bull Funds are available to spend as they are accumulated through payroll deductionsbull Reimbursable expenses
bull day care centersbull elder carebull beforeafter school carebull babysitter fees that allow you and your spouse to work or go to school (no child support payments)
bull Qualifying dependentsbull Children under the age of 13 and are a tax dependent of the employeebull Spouse or tax dependent that is physically or mentally incapable of self-care
bull Must coordinate between filing a tax credit with IRS and your Dependent Care FSA plan
Office of Human Resources Montgomery County Government
Commuter Choice Transit FSAbull $230 per month maximum for MCGEO staff $260 per month maximum for Unrepresented staffbull Applies to employee commuting expenses only (not spouses or dependents)bull Can enroll throughout the year (not limited to Open Enrollment election)bull Eligible expenses include Metro Marc Vanpool Lyft Line Uber Poolbull Debit card ndash may be used for some expenses (not Metro)Metro riders will have to submit claim forms for reimbursement
bull Funds must be used within 180 days of election bull If retiring or leaving the County will need to coordinate use all available funds
Office of Human Resources Montgomery County Government
Using Your FSA FundsHealth Care FSA Your full annual election amount is available on the first day of the plan yearChild Care FSA Your funds are available as they accumulate through payroll deductionsCommuterTransit FSA Your funds are available as they accumulate through payroll deductions
The FSA Debit Card bull Your FSA debit card is the same card for your Health Care Child Care and TransitCommuter FSA accountsbull The card is pre-loaded with your full annual Health Care FSA election amount You can use the card to pay for IRS qualified expenses at
the time of service or when paying a bill Receipt notifications will be mailed to you monthly by Benefit Strategies Your response to receipt notifications is necessary under the provisions of the plan No response my result in the ineligibility of the purchase and as a result your card may be temporarily deactivated
bull If you are enrolled in the Child Care FSA the card can also be used in child-care settings Just remember that the card will only work for an amount that does not exceed the available balance in your Child Care FSA account on that day
bull The card can also be used to pay for your commutertransit expenses however it does not work for WMATA metro Metro riders will have to submit manual claims for reimbursement from your CommuterTransit FSA
bull Cards are re-loaded each year after you make your new annual election Please keep your cards You will only receive a new card if your old card is about to expire
Office of Human Resources Montgomery County Government
AFLAC Voluntary Plans
Office of Human Resources Montgomery County Government
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Short-Term Disabilitybull Provides short-term cash benefits in the event of disabilitybull Monthly benefit amounts available from $500 - $6000 (subject to income requirements)bull Benefit options of 3 6 12 18 or 24 months with a variety of elimination periods
Critical Illness Insurancebull Provides a lump sum cash benefit in the event of critical illnessbull Benefit amounts available in $5000 increments from $10000 - $30000
Participants pay 100 through payroll deduction for Short-Term Disability and Critical Illness Insurance
To ENROLL Text SETAPPTrdquo to 41411orCall 920-420-8861 orEmail susan_mcdanielusAflaccom
Office of Human Resources Montgomery County Government
Carrier Resources amp Cost-Saving Tips
Office of Human Resources Montgomery County Government
Lower Your Out-of-Pocket CostsChoose the plan thatrsquos right for youbull See the medical benefits chart for options bull Stay in network Use the provider search engines on your carrier website or mobile app to find in-network providersSeek preventive carebull Check-ups immunizations and screenings are an important part of staying healthy They can detect or prevent serious diseases and keep you healthyKnow where to go for carebull You have many options of places to go when you need care If your medical condition isnrsquot serious or life threatening you can save money by connecting
with a doctor online through a virtual visit or going to an urgent care center or convenience care clinic instead of a hospital emergency roomReview your prescription drug plan optionsbull Decide which Caremark prescription plan is best for you Note that the Kaiser HMO includes prescription drug coverage Both the Standard and High
Option Caremark plans cover the same prescription drugs but have different copay and deductiblesUse generic and long-term prescriptions bull Opt for lower-cost generic drugs whenever possible bull Ask your doctor to write a 90-day prescription instead of a 30-day prescription to participate in the mail order prescription programTake advantage of tax savings by participating in Flexible Spending Accountsbull Use pre-tax dollars for eligible out of pocket services and items
Office of Human Resources Montgomery County Government
Built-in Wellness Support Take advantage of the free programs available to you through your medical carrier Each of MCGrsquos medical carriers (Kaiser UHC amp CareFirst) offer valuable programs to help you manage your health
Disease Management Programsbull Help manage your chronic condition through personalized coaching support and encouragement and online education materialsEmotional Wellness amp Stress Management Support bull Help manage stress through mobile apps and other self-care resources Maternity Programsbull Support healthy moms and healthy babiesWeight-loss Programs bull Offers telephonic coaching support and web-based tools to help ensure long-term weight managementbull See the next slide for an example of an MCG success storySmoking Cessation Programsbull Supportive coaching to make quitting more successfulDiscounts bull Gym memberships weight loss programs and moreFor more information about the programs available to you please see the Open Enrollment Guide and contact your medical carrier
Office of Human Resources Montgomery County Government
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You GoAll of MCGrsquos health insurance carriers offer a simple-to-use tool that can help make your life easier while yoursquore on the go Download your carrierrsquos Mobile App to help you personalize organize and access your important plan information on your phone or tablet
bull Schedule Virtual Visitsbull Manage and track claimsbull View ID card informationbull Find doctor and compare costs and quality ratingsbull Review your coveragebull Track your account balances and deductiblesbull Access a variety of health and wellness tools
Visit Google Play or the Apple App Store to download your carrierrsquos App
Office of Human Resources Montgomery County Government
Making Changes
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Questions
Office of Human Resources Montgomery County Government
Open Enrollment AssistanceFollow these steps (in this order)1 Review the frequently asked questions (FAQs) on the Open Enrollment website at wwwmontgomerycountymdgovoe
(available beginning September 21) You can enter key words into the interactive search bar to quickly locate the answer to your question
2 Visit the MC311 website at wwwmontgomerycountymdgovmc311 and search key words for your question The search results contain various knowledge-based articles with information related to your search words Simply click on the corresponding link and the detailed answer is revealed
3 Attend one of OHRrsquos Virtual Office Hours via Microsoft Teams Members of OHRs Health Insurance Team will be on hand to address employee questions by video or via the chat box View the schedule and access the sessions through the Open Enrollment website at wwwmontgomerycountymdgovoe (available beginning September 21)
4 If you have tried all the methods above and still have Open Enrollment-related questions please contact OHRs MC311 Customer Service Center at 240-773-6471 (Mon-Fri 8 am - 5 pm) to open a service request A member of the health insurance team will respond to service requests in the order they are received Tip Please provide an email address at the time you place your Service Request This will ensure the fastest response possible
Office of Human Resources Montgomery County Government
Online ResourcesVisit the 2021 Open Enrollment Webpage
wwwmontgomerycountymdgovOE
Visit OHRrsquos WebpagewwwmontgomerycountymdgovHR
Health Insurance active employees
Office of Human Resources Montgomery County Government
Legal InformationThe County reserves the right at any time and for any reason to amend the Program subject to the Countys collective bargainingagreements The County expects to continue the Program but it is the Countys position that there is no implied contract between individual employees and the County to do so
The County may amend the Program prospectively or retroactively to comply with applicable law
In the event of a conflict between this presentation the County Code andor the Summary Description the County Code then the Summary Description will govern
Office of Human Resources Montgomery County Government
Thank YouWe hope you enjoyed learning about 2021 Open Enrollment
~Your OHR Health Insurance Team
2021 Open Enrollment Benefits Bonanza
What Is Open Enrollment
What Changes Can be Made
Open Enrollment Dates
MCG Continues to Make Generous Employer Contributions
New for 2021
Special 2021 Plan Rates Announcement
Employee Rate Changes for Calendar Year 2021
Planning Ahead Minimizing Future Rate Increases
New for 2021
Open Enrollment Communications
Itrsquos a New Frontier
2021 Open Enrollment Checklist
Open Enrollment Website Resources
Attend a Virtual Open Enrollment Event
Make Changes Online
Paper Enrollment Form Permitted for Only Two Reasons
Dependent Eligibility
Proof of Dependent Eligibility
Marriage Certificate Example Required Documentation (Contd)
Benefits Refresher
Medical amp Rx
Medical Plan Options
Medical Benefits at-a-Glance
Medical Benefits at-a-Glance (contd)
Prescription Plans Caremark
Prescription Drug Plan Comparison
Prescription Drug Cost Comparison
Dental
Slide Number 30
Vision
Vision Insurance
Optional Life amp Dependent Life
Optional Life Insurance ADampD
Optional Life Insurance Rates
Dependent Life Insurance
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs)Why You Should Enroll
Health Care FSA
Child Care FSA
Commuter Choice Transit FSA
Using Your FSA Funds
AFLAC Voluntary Plans
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Carrier Resources amp Cost-Saving Tips
Lower Your Out-of-Pocket Costs
Built-in Wellness Support
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You Go
Making Changes
Make Changes Online
Questions
Open Enrollment Assistance
Online Resources
Legal Information
Thank You
Cigna Dental Comparison
DHMO
PPO
CIGNA NETWORK
Care-Access PlusDHMO
Total CIGNA PPOPPO
Required to Use An Assigned Provider
Yes In-network only Primary Dental Office will be assigned based on home address
No
Out of Network Benefits Available
No
Yes
Balance Billing for Covered Services
No
Yes if you go out-of-network
Referral Required
Yes
No
Orthodontia Benefits Available
Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime)
Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person)
Unlimited
$200000
Deductible (singlefamily)
None
$50 $ 150 waived for preventive care
1Claim submission would be required and balance billing may occur when visiting a nonparticipating provider2Deductible does not apply to Class I ndash Diagnostic and Preventive Services
Coverage for dependents would cease on the day which the child turns 26Benefit Maximum and Deductibles are for the period of January 01 through December 31
All services listed on this benefit summary are subject to the contractSchedules of Benefits and current Exclusions and Limitations
Medical Benefits at a Glance
Kaiser Permanente HMO + Rx wwwkporg
United HealthCare Select HMO wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS) wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS) wwwcarefirstcom
Plan Type
HMO
HMO
Point-of-Service
Point-of-Service
PCP Required
Yes
Yes
No
No
Provider Network
Regional (MDDCVA)
National
National
National
Out-of-Network Benefits
No
No
Yes
Yes
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
None
None
In-Network None Out-of-Network 80
In-Network None Out-of-Network 80
Dr Office Visits PCPSpecialist
$5 copay
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits
Covered in full
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care
$5 copay
$15 copay
Covered in full
Covered in full
Emergency Room
$50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization
Covered in full
Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
MCG 2018 Medical Plan Comparison Chart
Kaiser Permanente
United HealthCare
CareFirst POS Standard
CareFirst POS High
Plan Type
HMO
HMO
Point of Service
Point of Service
Provider Network
Regional (MDDCVA)
National
National
National
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
Annual Out-of-Pocket Maximum
None
$1100 per individual up to cap of $3600 for a family
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
Physician Servcies
PCP Office Visits
$5 copay
$5 copay PCP
In-Network $15 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Specialist Office Visits
$5 copay
$10 copay
In-Network $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Annual Physical
Covered in full
$5 copay PCP
In-Network $15 copay Primary Care Physician $30 copay specialist Out-of-Network 80 covered after deductible (limit 1calendar year)
In-Network $15 copay Out-of-Network 80 not subject to deductible (up to age 18)
In-Network $10 copay Out-of-Network 80 not subject to deductible (up to age 18)
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Allergy Testing
$5 copay
$5 copay PCP $10 copay Specialist
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Virtual Visits
Labs X-Rays Diagnostics
Outpatient labs
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient X-Rays
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Major Diagnostics
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Immedate Medical Servcies
Emergency Room
$50 copay waived if admitted to hospital
$25 copay waived if admitted to hospital $15 copay for urgent care
In-Network $35 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
Urgent Care
Hospital Services
Inpatient Hospitalization
Covered in full
Covered in full
In-Network Covered in full after $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Services
Surgery
Covered in full
Inpatient covered in full Outpatient $25 copay
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Hearing Aids
For minor children One hearing aid for each hearing impaired ear once every 36 months
For minor children One hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
Hearing Screening
$5 copay for hearing exam (hearing aids are excluded)
$5 Copay PCP $10 Copay Specialist
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
Home Health Care Services
Covered in full if medically necessary
Covered in full No copayment 60 visit maximum for skilled care services per calendar year
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
Hospice
Covered in full
Covered in full (See coverage booklet for eligibility information)
In-Network Covered in full
In-Network Covered in full
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
In vitro Fertilization
Limited to 3 attempts per live birth Lifetime maximum of $100000
Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
Mammography - Preventive Screening Schedule
Schedule consistent with the current recommendations of the American College of Physicians
Covered in full Age 35-39 one baseline mammogram Age 40-49 one mammogram every two calendar years Age 50+ one mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
Maternity
Covered in full once pregnancy is diagnosed
No copayment applies after the first visit
In-Network first visit 100 after $30 copay other visits 100
In-Network First visit 100 after $10 copay other visits 100
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Maximum Lifetime Benefit
Unlimited maximum
Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
Prescriptions
Kaiser Rx plan (included with Kaiser HMO medical plan) $5 at on-site pharmacies and for mail order $15 at participating pharmacies
No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
Rehabilitation Services
Inpatient Covered in full (unlimited) Outpatient $5 copay outpatient services for physical therapy are limited to up to 30 visits occupational and speech therapy per injury incident or condition are covered for a period not to exceed 90 days
$10 copayvisit 60 combined visits per year (short-term non-chronic conditions only)
In-Network
In-Network
100
100
Skilled Nursing Facility
Covered in full 100 days maximum
Covered in full 60 days per calendar year maximum
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Substance AbuseMental Health
Inpatient Covered in full Outpatient $5 copay
Inpatient Covered in full Outpatient $5 copay
In-Network Inpatient- $150 per admission copay Outpatient- $15 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
In-Network Inpatient- covered in full Outpatient- $10 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
Vision (Routine)
$5 copay for exams 25 discount on lensesframes at Kaiser centers 15 discount off the costs of contact lenses
$25 copay for exam 15-20 discount through participating optical centers
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
53116
Medical Benefits at a Glance
Kaiser Permanente HMO + Rx wwwkporg
United HealthCare Select HMO wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS) wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS) wwwcarefirstcom
Plan Type
HMO
HMO
Point-of-Service
Point-of-Service
PCP Required
Yes
Yes
No
No
Provider Network
Regional (MDDCVA)
National
National
National
Out-of-Network Benefits
No
No
Yes
Yes
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
None
None
In-Network None Out-of-Network 80
In-Network None Out-of-Network 80
Dr Office Visits PCPSpecialist
$5 copay
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits
Covered in full
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care
$5 copay
$15 copay
Covered in full
Covered in full
Emergency Room
$50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization
Covered in full
Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
MCG 2018 Medical Plan Comparison Chart
Kaiser Permanente
United HealthCare
CareFirst POS Standard
CareFirst POS High
Plan Type
HMO
HMO
Point of Service
Point of Service
Provider Network
Regional (MDDCVA)
National
National
National
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
Annual Out-of-Pocket Maximum
None
$1100 per individual up to cap of $3600 for a family
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
Physician Servcies
PCP Office Visits
$5 copay
$5 copay PCP
In-Network $15 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Specialist Office Visits
$5 copay
$10 copay
In-Network $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Annual Physical
Covered in full
$5 copay PCP
In-Network $15 copay Primary Care Physician $30 copay specialist Out-of-Network 80 covered after deductible (limit 1calendar year)
In-Network $15 copay Out-of-Network 80 not subject to deductible (up to age 18)
In-Network $10 copay Out-of-Network 80 not subject to deductible (up to age 18)
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Allergy Testing
$5 copay
$5 copay PCP $10 copay Specialist
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Virtual Visits
Labs X-Rays Diagnostics
Outpatient labs
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient X-Rays
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Major Diagnostics
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Immedate Medical Servcies
Emergency Room
$50 copay waived if admitted to hospital
$25 copay waived if admitted to hospital $15 copay for urgent care
In-Network $35 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
Urgent Care
Hospital Services
Inpatient Hospitalization
Covered in full
Covered in full
In-Network Covered in full after $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Services
Surgery
Covered in full
Inpatient covered in full Outpatient $25 copay
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Hearing Aids
For minor children One hearing aid for each hearing impaired ear once every 36 months
For minor children One hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
Hearing Screening
$5 copay for hearing exam (hearing aids are excluded)
$5 Copay PCP $10 Copay Specialist
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
Home Health Care Services
Covered in full if medically necessary
Covered in full No copayment 60 visit maximum for skilled care services per calendar year
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
Hospice
Covered in full
Covered in full (See coverage booklet for eligibility information)
In-Network Covered in full
In-Network Covered in full
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
In vitro Fertilization
Limited to 3 attempts per live birth Lifetime maximum of $100000
Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
Mammography - Preventive Screening Schedule
Schedule consistent with the current recommendations of the American College of Physicians
Covered in full Age 35-39 one baseline mammogram Age 40-49 one mammogram every two calendar years Age 50+ one mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
Maternity
Covered in full once pregnancy is diagnosed
No copayment applies after the first visit
In-Network first visit 100 after $30 copay other visits 100
In-Network First visit 100 after $10 copay other visits 100
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Maximum Lifetime Benefit
Unlimited maximum
Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
Prescriptions
Kaiser Rx plan (included with Kaiser HMO medical plan) $5 at on-site pharmacies and for mail order $15 at participating pharmacies
No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
Rehabilitation Services
Inpatient Covered in full (unlimited) Outpatient $5 copay outpatient services for physical therapy are limited to up to 30 visits occupational and speech therapy per injury incident or condition are covered for a period not to exceed 90 days
$10 copayvisit 60 combined visits per year (short-term non-chronic conditions only)
In-Network
In-Network
100
100
Skilled Nursing Facility
Covered in full 100 days maximum
Covered in full 60 days per calendar year maximum
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Substance AbuseMental Health
Inpatient Covered in full Outpatient $5 copay
Inpatient Covered in full Outpatient $5 copay
In-Network Inpatient- $150 per admission copay Outpatient- $15 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
In-Network Inpatient- covered in full Outpatient- $10 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
Vision (Routine)
$5 copay for exams 25 discount on lensesframes at Kaiser centers 15 discount off the costs of contact lenses
$25 copay for exam 15-20 discount through participating optical centers
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
53116
Office of Human Resources Montgomery County Government
Medical amp Rx
Office of Human Resources Montgomery County Government
Medical Plan OptionsHealth Maintenance Organizations (HMO)bull Kaiser Permanente Signature (HMO)bull United Healthcare Select (HMO)
Point of Service Plans (POS)bull CareFirst BCBS (POS) High Optionbull CareFirst BCBS (POS) Standard Option
Three tiers of coverage Self Self + 1 or Family
Office of Human Resources Montgomery County Government
Medical Benefits at-a-Glance To view full carrier medical summaries visit OHRrsquos Health Insurance Website
Kaiser Permanente HMO + Rx
wwwkporg
United HealthCare Select HMO
wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS)
wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS)
wwwcarefirstcom
Plan Type HMO HMO Point-of-Service Point-of-Service
PCP Required Yes Yes No No
Provider Network Regional (MDDCVA) National National National
Out-of-Network Benefits No No Yes Yes
Referrals Required Yes No No No
Annual Deductible None NoneIn-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Sheet1
Sheet1 (2)
Office of Human Resources Montgomery County Government
Medical Benefits at-a-Glance (contd)
New Employee Orientation Program
Kaiser Permanente HMO + Rx
wwwkporg
United HealthCare Select HMO
wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS)
wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS)
wwwcarefirstcom
Dr Office Visits PCPSpecialist $5 copay $5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits Covered in full $5 copay $10 copay In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care $5 copay $15 copay Covered in full Covered in full
Emergency Room $50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization Covered in full Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
Visit OHRrsquos Health Insurance webpage to view Medical summaries
Sheet1
Sheet1 (2)
Office of Human Resources Montgomery County Government
Prescription Plans Caremarkbull Two Rx Plan OptionsStandardHigh
bull If you elect UHC or CareFirst and want Rx coverage you will need to elect the stand-alone Caremark Rx plan (Kaiser already includes Rx coverage)
bull Maintenance Choice Program available for maintenance drugs significant cost savings ndash 1 copay for each 90-day prescription In order to get the Maintenance pricing you must fil Rx at CVS retail pharmacy Mail order
Office of Human Resources Montgomery County Government
Prescription Drug Plan Comparison High Option $48
Only MCGEOIAFF employees can enroll in this High plan
High Option $510Only FOPNON-REP employees
can enroll in this High plan
Standard Option All employees can enroll in this
Standard plan
Copay $4 Generics$8 Brand Name
$5 Generics$10 Brand Name
$10 Generics$20 PBrand Name
$35 NPBrand NameDeductible na na $50yearMail Order Yes Yes Yes
Maintenance Choice Yes Yes YesCovered Drugs Same Same Same
Visit OHRrsquos Health Insurance Website to view Rx summaries
Office of Human Resources Montgomery County Government
Prescription Drug Cost Comparison Cost
High Option $48Only MCGEOIAFF employees
can enroll in this High plan
High Option $510Only FOPNON-REP employees
can enroll in this High plan
Standard Option All employees can enroll in this
Standard plan
Self Only
Bi-Weekly $11339Monthly $24568Yearly $294814
Bi-Weekly $11100Monthly $24050Yearly $288600
Bi-Weekly $2413Monthly $5258Yearly $62738
Self + 1
Bi-Weekly $20979Monthly $45455Yearly $545454
Bi-Weekly $20536Monthly $44495Yearly $533936
Bi-Weekly $4463Monthly $9670
Yearly $116038
Self + Family
Bi-Weekly $32511Monthly $70441Yearly $845286
Bi-Weekly $31824Monthly $68952Yearly $827424
Bi-Weekly $6916Monthly $14985Yearly $179816
Office of Human Resources Montgomery County Government
Dental
Office of Human Resources Montgomery County Government
Dental Comparison Cigna
For a list of HMO covered services and assigned costs (copays) view the HMO benefit summary
Required to Use An Assigned Provider Yes In-network only Primary Dental Office will be
assigned based on home address
No
Out of Network Benefits Available No Yes
Balance Billing for Covered Services No Yes if you go out-of-network
Referral Required Yes No
Orthodontia Benefits Available Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime) Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person) Unlimited $200000
Deductible (singlefamily) None $50 $ 150 waived for preventive care
Table 1
Office of Human Resources Montgomery County Government
Vision
Office of Human Resources Montgomery County Government
Vision Insurancebull The Countyrsquos Vision carrier is EyeMedbull Benefits payable for exams lenses and contacts (elective or necessary) every
calendar year frames every two calendar yearsbull In-network or out-of-network benefits available bull Enhanced Hearing Benefit through EyeMedrsquos partner Amplifon40 off hearing examDiscounted pricing on thousands of hearing aids including latest technologyOne-year free follow-up care with unlimited appointmentsFree batteries for two years with initial purchase Three-year warranty and loss and damage coverage
Visit OHRrsquos Health Insurance webpage to view vision summary
Office of Human Resources Montgomery County Government
Optional Life amp Dependent Life
Office of Human Resources Montgomery County Government
Optional Life Insurance ADampDbull You may elect Optional Life ADampD coverage for yourself in increments of 1 to 8 times
your basic annual earnings ($1 million maximum)
bull NOTE Coverage is not guaranteed issue for any level You must complete an online Statement of Health no matter what level of coverage you elect Later this fall after Open Enrollment ends you will receive an email from MetLife with a link to complete the Statement of Health online
bull An eligible dependent is defined as 1) your opposite or same sex spouse or 2) your unmarried children under age 26 (natural adopted or stepchildrenfoster children who depend on your support)
Office of Human Resources Montgomery County Government
Optional Life Insurance RatesHow to estimate your Optional Life Insurance bi-weekly rate
Example 40-year-old applying for 2 x salary Salary is $49300
Steps Example Calculate for Yourself
A Find your age-based rate on the rate sheet (left) $ 0037 $_________________
B Choose how much coverage you are applying for
$99000 (2 x salary rounded to the nearest $1000 ) $_________________
C Divide that coverage amount by 100099 ($99000 1000) $_________________
D Multiply A x C for estimated bi-weekly cost$366 ($037 x 99) $_________________
Office of Human Resources Montgomery County Government
Dependent Life InsuranceYou may also purchase Dependent Optional Life insurance forbull Your opposite or same sex spouse bull Your unmarried children under age 26
ndash Natural adoptedndash Stepchildrenfoster childrenNote you do not need to supply marriage certificatesbirth certificates for dependent optional life
You may electbull $2000 Spouse$1000 Childbull $4000 Spouse $2000 Childbull $10000 Spouse $5000 Child
The bi-weekly rate is not based on salary
Office of Human Resources Montgomery County Government
Flexible Spending Accounts
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Visit the Open Enrollment website to watch a recorded FSA presentation from MCGrsquos FSA vendor Benefit Strategies
bull What is an FSA It is an IRS-approved tax-free account that saves onQualified out-of-pocket medical and dependent care expensesFederal and State Income taxSocial Security Tax
bull 3 Account Options Health Care FSA Child Care FSA and Commuter Choice Transit bull FSA accounts are administered through Benefit Strategies bull FSAs are ldquouse-it or lose-itrdquo accounts claims must be incurred during the 2021 plan year (January 1
2021 ndash March 15 2022) and submitted by April 30 2022
IMPORTANT You must re-enroll in an FSA every Open Enrollment if you want to participate in the upcoming plan year
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Why You Should EnrollGive yourself a raise by reducing your taxesbull Elect the annual amount you want to place in your FSA(s) for the upcoming plan year during Open Enrollmentbull That amount is divided by 26 and taken from your biweekly paychecks on a pre-tax basis (21 paychecks for
10-month employees)bull Then use your pre-tax FSA dollars to pay for eligible out-of-pocket health care child-care or transit
expenses
Office of Human Resources Montgomery County Government
Health Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull Claims must be submitted by April 30 of the following yearbull You may elect to contribute up to $2750 Your total annual election amount is available to spend on the first
day of the new plan year bull FSA debit card allows you to pay for expenses at the time of servicebull Examples of IRS qualified eligible expenses
bull Copays (medical prescription dental vision) deductibles and coinsurance amounts over reasonable and customary charge
bull Hearing aids bull Acupuncture bull Orthopedic shoes bull Over-the-counter (OTC) drugs (no longer require doctorrsquos prescription)
Office of Human Resources Montgomery County Government
Child Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull $5000 annual maximum per household ($2500 for married filing separately)bull Funds are available to spend as they are accumulated through payroll deductionsbull Reimbursable expenses
bull day care centersbull elder carebull beforeafter school carebull babysitter fees that allow you and your spouse to work or go to school (no child support payments)
bull Qualifying dependentsbull Children under the age of 13 and are a tax dependent of the employeebull Spouse or tax dependent that is physically or mentally incapable of self-care
bull Must coordinate between filing a tax credit with IRS and your Dependent Care FSA plan
Office of Human Resources Montgomery County Government
Commuter Choice Transit FSAbull $230 per month maximum for MCGEO staff $260 per month maximum for Unrepresented staffbull Applies to employee commuting expenses only (not spouses or dependents)bull Can enroll throughout the year (not limited to Open Enrollment election)bull Eligible expenses include Metro Marc Vanpool Lyft Line Uber Poolbull Debit card ndash may be used for some expenses (not Metro)Metro riders will have to submit claim forms for reimbursement
bull Funds must be used within 180 days of election bull If retiring or leaving the County will need to coordinate use all available funds
Office of Human Resources Montgomery County Government
Using Your FSA FundsHealth Care FSA Your full annual election amount is available on the first day of the plan yearChild Care FSA Your funds are available as they accumulate through payroll deductionsCommuterTransit FSA Your funds are available as they accumulate through payroll deductions
The FSA Debit Card bull Your FSA debit card is the same card for your Health Care Child Care and TransitCommuter FSA accountsbull The card is pre-loaded with your full annual Health Care FSA election amount You can use the card to pay for IRS qualified expenses at
the time of service or when paying a bill Receipt notifications will be mailed to you monthly by Benefit Strategies Your response to receipt notifications is necessary under the provisions of the plan No response my result in the ineligibility of the purchase and as a result your card may be temporarily deactivated
bull If you are enrolled in the Child Care FSA the card can also be used in child-care settings Just remember that the card will only work for an amount that does not exceed the available balance in your Child Care FSA account on that day
bull The card can also be used to pay for your commutertransit expenses however it does not work for WMATA metro Metro riders will have to submit manual claims for reimbursement from your CommuterTransit FSA
bull Cards are re-loaded each year after you make your new annual election Please keep your cards You will only receive a new card if your old card is about to expire
Office of Human Resources Montgomery County Government
AFLAC Voluntary Plans
Office of Human Resources Montgomery County Government
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Short-Term Disabilitybull Provides short-term cash benefits in the event of disabilitybull Monthly benefit amounts available from $500 - $6000 (subject to income requirements)bull Benefit options of 3 6 12 18 or 24 months with a variety of elimination periods
Critical Illness Insurancebull Provides a lump sum cash benefit in the event of critical illnessbull Benefit amounts available in $5000 increments from $10000 - $30000
Participants pay 100 through payroll deduction for Short-Term Disability and Critical Illness Insurance
To ENROLL Text SETAPPTrdquo to 41411orCall 920-420-8861 orEmail susan_mcdanielusAflaccom
Office of Human Resources Montgomery County Government
Carrier Resources amp Cost-Saving Tips
Office of Human Resources Montgomery County Government
Lower Your Out-of-Pocket CostsChoose the plan thatrsquos right for youbull See the medical benefits chart for options bull Stay in network Use the provider search engines on your carrier website or mobile app to find in-network providersSeek preventive carebull Check-ups immunizations and screenings are an important part of staying healthy They can detect or prevent serious diseases and keep you healthyKnow where to go for carebull You have many options of places to go when you need care If your medical condition isnrsquot serious or life threatening you can save money by connecting
with a doctor online through a virtual visit or going to an urgent care center or convenience care clinic instead of a hospital emergency roomReview your prescription drug plan optionsbull Decide which Caremark prescription plan is best for you Note that the Kaiser HMO includes prescription drug coverage Both the Standard and High
Option Caremark plans cover the same prescription drugs but have different copay and deductiblesUse generic and long-term prescriptions bull Opt for lower-cost generic drugs whenever possible bull Ask your doctor to write a 90-day prescription instead of a 30-day prescription to participate in the mail order prescription programTake advantage of tax savings by participating in Flexible Spending Accountsbull Use pre-tax dollars for eligible out of pocket services and items
Office of Human Resources Montgomery County Government
Built-in Wellness Support Take advantage of the free programs available to you through your medical carrier Each of MCGrsquos medical carriers (Kaiser UHC amp CareFirst) offer valuable programs to help you manage your health
Disease Management Programsbull Help manage your chronic condition through personalized coaching support and encouragement and online education materialsEmotional Wellness amp Stress Management Support bull Help manage stress through mobile apps and other self-care resources Maternity Programsbull Support healthy moms and healthy babiesWeight-loss Programs bull Offers telephonic coaching support and web-based tools to help ensure long-term weight managementbull See the next slide for an example of an MCG success storySmoking Cessation Programsbull Supportive coaching to make quitting more successfulDiscounts bull Gym memberships weight loss programs and moreFor more information about the programs available to you please see the Open Enrollment Guide and contact your medical carrier
Office of Human Resources Montgomery County Government
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You GoAll of MCGrsquos health insurance carriers offer a simple-to-use tool that can help make your life easier while yoursquore on the go Download your carrierrsquos Mobile App to help you personalize organize and access your important plan information on your phone or tablet
bull Schedule Virtual Visitsbull Manage and track claimsbull View ID card informationbull Find doctor and compare costs and quality ratingsbull Review your coveragebull Track your account balances and deductiblesbull Access a variety of health and wellness tools
Visit Google Play or the Apple App Store to download your carrierrsquos App
Office of Human Resources Montgomery County Government
Making Changes
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Questions
Office of Human Resources Montgomery County Government
Open Enrollment AssistanceFollow these steps (in this order)1 Review the frequently asked questions (FAQs) on the Open Enrollment website at wwwmontgomerycountymdgovoe
(available beginning September 21) You can enter key words into the interactive search bar to quickly locate the answer to your question
2 Visit the MC311 website at wwwmontgomerycountymdgovmc311 and search key words for your question The search results contain various knowledge-based articles with information related to your search words Simply click on the corresponding link and the detailed answer is revealed
3 Attend one of OHRrsquos Virtual Office Hours via Microsoft Teams Members of OHRs Health Insurance Team will be on hand to address employee questions by video or via the chat box View the schedule and access the sessions through the Open Enrollment website at wwwmontgomerycountymdgovoe (available beginning September 21)
4 If you have tried all the methods above and still have Open Enrollment-related questions please contact OHRs MC311 Customer Service Center at 240-773-6471 (Mon-Fri 8 am - 5 pm) to open a service request A member of the health insurance team will respond to service requests in the order they are received Tip Please provide an email address at the time you place your Service Request This will ensure the fastest response possible
Office of Human Resources Montgomery County Government
Online ResourcesVisit the 2021 Open Enrollment Webpage
wwwmontgomerycountymdgovOE
Visit OHRrsquos WebpagewwwmontgomerycountymdgovHR
Health Insurance active employees
Office of Human Resources Montgomery County Government
Legal InformationThe County reserves the right at any time and for any reason to amend the Program subject to the Countys collective bargainingagreements The County expects to continue the Program but it is the Countys position that there is no implied contract between individual employees and the County to do so
The County may amend the Program prospectively or retroactively to comply with applicable law
In the event of a conflict between this presentation the County Code andor the Summary Description the County Code then the Summary Description will govern
Office of Human Resources Montgomery County Government
Thank YouWe hope you enjoyed learning about 2021 Open Enrollment
~Your OHR Health Insurance Team
2021 Open Enrollment Benefits Bonanza
What Is Open Enrollment
What Changes Can be Made
Open Enrollment Dates
MCG Continues to Make Generous Employer Contributions
New for 2021
Special 2021 Plan Rates Announcement
Employee Rate Changes for Calendar Year 2021
Planning Ahead Minimizing Future Rate Increases
New for 2021
Open Enrollment Communications
Itrsquos a New Frontier
2021 Open Enrollment Checklist
Open Enrollment Website Resources
Attend a Virtual Open Enrollment Event
Make Changes Online
Paper Enrollment Form Permitted for Only Two Reasons
Dependent Eligibility
Proof of Dependent Eligibility
Marriage Certificate Example Required Documentation (Contd)
Benefits Refresher
Medical amp Rx
Medical Plan Options
Medical Benefits at-a-Glance
Medical Benefits at-a-Glance (contd)
Prescription Plans Caremark
Prescription Drug Plan Comparison
Prescription Drug Cost Comparison
Dental
Slide Number 30
Vision
Vision Insurance
Optional Life amp Dependent Life
Optional Life Insurance ADampD
Optional Life Insurance Rates
Dependent Life Insurance
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs)Why You Should Enroll
Health Care FSA
Child Care FSA
Commuter Choice Transit FSA
Using Your FSA Funds
AFLAC Voluntary Plans
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Carrier Resources amp Cost-Saving Tips
Lower Your Out-of-Pocket Costs
Built-in Wellness Support
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You Go
Making Changes
Make Changes Online
Questions
Open Enrollment Assistance
Online Resources
Legal Information
Thank You
Cigna Dental Comparison
DHMO
PPO
CIGNA NETWORK
Care-Access PlusDHMO
Total CIGNA PPOPPO
Required to Use An Assigned Provider
Yes In-network only Primary Dental Office will be assigned based on home address
No
Out of Network Benefits Available
No
Yes
Balance Billing for Covered Services
No
Yes if you go out-of-network
Referral Required
Yes
No
Orthodontia Benefits Available
Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime)
Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person)
Unlimited
$200000
Deductible (singlefamily)
None
$50 $ 150 waived for preventive care
1Claim submission would be required and balance billing may occur when visiting a nonparticipating provider2Deductible does not apply to Class I ndash Diagnostic and Preventive Services
Coverage for dependents would cease on the day which the child turns 26Benefit Maximum and Deductibles are for the period of January 01 through December 31
All services listed on this benefit summary are subject to the contractSchedules of Benefits and current Exclusions and Limitations
Medical Benefits at a Glance
Kaiser Permanente HMO + Rx wwwkporg
United HealthCare Select HMO wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS) wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS) wwwcarefirstcom
Plan Type
HMO
HMO
Point-of-Service
Point-of-Service
PCP Required
Yes
Yes
No
No
Provider Network
Regional (MDDCVA)
National
National
National
Out-of-Network Benefits
No
No
Yes
Yes
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
None
None
In-Network None Out-of-Network 80
In-Network None Out-of-Network 80
Dr Office Visits PCPSpecialist
$5 copay
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits
Covered in full
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care
$5 copay
$15 copay
Covered in full
Covered in full
Emergency Room
$50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization
Covered in full
Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
MCG 2018 Medical Plan Comparison Chart
Kaiser Permanente
United HealthCare
CareFirst POS Standard
CareFirst POS High
Plan Type
HMO
HMO
Point of Service
Point of Service
Provider Network
Regional (MDDCVA)
National
National
National
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
Annual Out-of-Pocket Maximum
None
$1100 per individual up to cap of $3600 for a family
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
Physician Servcies
PCP Office Visits
$5 copay
$5 copay PCP
In-Network $15 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Specialist Office Visits
$5 copay
$10 copay
In-Network $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Annual Physical
Covered in full
$5 copay PCP
In-Network $15 copay Primary Care Physician $30 copay specialist Out-of-Network 80 covered after deductible (limit 1calendar year)
In-Network $15 copay Out-of-Network 80 not subject to deductible (up to age 18)
In-Network $10 copay Out-of-Network 80 not subject to deductible (up to age 18)
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Allergy Testing
$5 copay
$5 copay PCP $10 copay Specialist
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Virtual Visits
Labs X-Rays Diagnostics
Outpatient labs
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient X-Rays
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Major Diagnostics
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Immedate Medical Servcies
Emergency Room
$50 copay waived if admitted to hospital
$25 copay waived if admitted to hospital $15 copay for urgent care
In-Network $35 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
Urgent Care
Hospital Services
Inpatient Hospitalization
Covered in full
Covered in full
In-Network Covered in full after $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Services
Surgery
Covered in full
Inpatient covered in full Outpatient $25 copay
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Hearing Aids
For minor children One hearing aid for each hearing impaired ear once every 36 months
For minor children One hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
Hearing Screening
$5 copay for hearing exam (hearing aids are excluded)
$5 Copay PCP $10 Copay Specialist
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
Home Health Care Services
Covered in full if medically necessary
Covered in full No copayment 60 visit maximum for skilled care services per calendar year
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
Hospice
Covered in full
Covered in full (See coverage booklet for eligibility information)
In-Network Covered in full
In-Network Covered in full
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
In vitro Fertilization
Limited to 3 attempts per live birth Lifetime maximum of $100000
Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
Mammography - Preventive Screening Schedule
Schedule consistent with the current recommendations of the American College of Physicians
Covered in full Age 35-39 one baseline mammogram Age 40-49 one mammogram every two calendar years Age 50+ one mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
Maternity
Covered in full once pregnancy is diagnosed
No copayment applies after the first visit
In-Network first visit 100 after $30 copay other visits 100
In-Network First visit 100 after $10 copay other visits 100
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Maximum Lifetime Benefit
Unlimited maximum
Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
Prescriptions
Kaiser Rx plan (included with Kaiser HMO medical plan) $5 at on-site pharmacies and for mail order $15 at participating pharmacies
No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
Rehabilitation Services
Inpatient Covered in full (unlimited) Outpatient $5 copay outpatient services for physical therapy are limited to up to 30 visits occupational and speech therapy per injury incident or condition are covered for a period not to exceed 90 days
$10 copayvisit 60 combined visits per year (short-term non-chronic conditions only)
In-Network
In-Network
100
100
Skilled Nursing Facility
Covered in full 100 days maximum
Covered in full 60 days per calendar year maximum
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Substance AbuseMental Health
Inpatient Covered in full Outpatient $5 copay
Inpatient Covered in full Outpatient $5 copay
In-Network Inpatient- $150 per admission copay Outpatient- $15 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
In-Network Inpatient- covered in full Outpatient- $10 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
Vision (Routine)
$5 copay for exams 25 discount on lensesframes at Kaiser centers 15 discount off the costs of contact lenses
$25 copay for exam 15-20 discount through participating optical centers
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
53116
Medical Benefits at a Glance
Kaiser Permanente HMO + Rx wwwkporg
United HealthCare Select HMO wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS) wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS) wwwcarefirstcom
Plan Type
HMO
HMO
Point-of-Service
Point-of-Service
PCP Required
Yes
Yes
No
No
Provider Network
Regional (MDDCVA)
National
National
National
Out-of-Network Benefits
No
No
Yes
Yes
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
None
None
In-Network None Out-of-Network 80
In-Network None Out-of-Network 80
Dr Office Visits PCPSpecialist
$5 copay
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits
Covered in full
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care
$5 copay
$15 copay
Covered in full
Covered in full
Emergency Room
$50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization
Covered in full
Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
MCG 2018 Medical Plan Comparison Chart
Kaiser Permanente
United HealthCare
CareFirst POS Standard
CareFirst POS High
Plan Type
HMO
HMO
Point of Service
Point of Service
Provider Network
Regional (MDDCVA)
National
National
National
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
Annual Out-of-Pocket Maximum
None
$1100 per individual up to cap of $3600 for a family
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
Physician Servcies
PCP Office Visits
$5 copay
$5 copay PCP
In-Network $15 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Specialist Office Visits
$5 copay
$10 copay
In-Network $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Annual Physical
Covered in full
$5 copay PCP
In-Network $15 copay Primary Care Physician $30 copay specialist Out-of-Network 80 covered after deductible (limit 1calendar year)
In-Network $15 copay Out-of-Network 80 not subject to deductible (up to age 18)
In-Network $10 copay Out-of-Network 80 not subject to deductible (up to age 18)
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Allergy Testing
$5 copay
$5 copay PCP $10 copay Specialist
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Virtual Visits
Labs X-Rays Diagnostics
Outpatient labs
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient X-Rays
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Major Diagnostics
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Immedate Medical Servcies
Emergency Room
$50 copay waived if admitted to hospital
$25 copay waived if admitted to hospital $15 copay for urgent care
In-Network $35 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
Urgent Care
Hospital Services
Inpatient Hospitalization
Covered in full
Covered in full
In-Network Covered in full after $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Services
Surgery
Covered in full
Inpatient covered in full Outpatient $25 copay
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Hearing Aids
For minor children One hearing aid for each hearing impaired ear once every 36 months
For minor children One hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
Hearing Screening
$5 copay for hearing exam (hearing aids are excluded)
$5 Copay PCP $10 Copay Specialist
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
Home Health Care Services
Covered in full if medically necessary
Covered in full No copayment 60 visit maximum for skilled care services per calendar year
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
Hospice
Covered in full
Covered in full (See coverage booklet for eligibility information)
In-Network Covered in full
In-Network Covered in full
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
In vitro Fertilization
Limited to 3 attempts per live birth Lifetime maximum of $100000
Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
Mammography - Preventive Screening Schedule
Schedule consistent with the current recommendations of the American College of Physicians
Covered in full Age 35-39 one baseline mammogram Age 40-49 one mammogram every two calendar years Age 50+ one mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
Maternity
Covered in full once pregnancy is diagnosed
No copayment applies after the first visit
In-Network first visit 100 after $30 copay other visits 100
In-Network First visit 100 after $10 copay other visits 100
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Maximum Lifetime Benefit
Unlimited maximum
Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
Prescriptions
Kaiser Rx plan (included with Kaiser HMO medical plan) $5 at on-site pharmacies and for mail order $15 at participating pharmacies
No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
Rehabilitation Services
Inpatient Covered in full (unlimited) Outpatient $5 copay outpatient services for physical therapy are limited to up to 30 visits occupational and speech therapy per injury incident or condition are covered for a period not to exceed 90 days
$10 copayvisit 60 combined visits per year (short-term non-chronic conditions only)
In-Network
In-Network
100
100
Skilled Nursing Facility
Covered in full 100 days maximum
Covered in full 60 days per calendar year maximum
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Substance AbuseMental Health
Inpatient Covered in full Outpatient $5 copay
Inpatient Covered in full Outpatient $5 copay
In-Network Inpatient- $150 per admission copay Outpatient- $15 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
In-Network Inpatient- covered in full Outpatient- $10 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
Vision (Routine)
$5 copay for exams 25 discount on lensesframes at Kaiser centers 15 discount off the costs of contact lenses
$25 copay for exam 15-20 discount through participating optical centers
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
53116
Office of Human Resources Montgomery County Government
Medical Plan OptionsHealth Maintenance Organizations (HMO)bull Kaiser Permanente Signature (HMO)bull United Healthcare Select (HMO)
Point of Service Plans (POS)bull CareFirst BCBS (POS) High Optionbull CareFirst BCBS (POS) Standard Option
Three tiers of coverage Self Self + 1 or Family
Office of Human Resources Montgomery County Government
Medical Benefits at-a-Glance To view full carrier medical summaries visit OHRrsquos Health Insurance Website
Kaiser Permanente HMO + Rx
wwwkporg
United HealthCare Select HMO
wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS)
wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS)
wwwcarefirstcom
Plan Type HMO HMO Point-of-Service Point-of-Service
PCP Required Yes Yes No No
Provider Network Regional (MDDCVA) National National National
Out-of-Network Benefits No No Yes Yes
Referrals Required Yes No No No
Annual Deductible None NoneIn-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Sheet1
Sheet1 (2)
Office of Human Resources Montgomery County Government
Medical Benefits at-a-Glance (contd)
New Employee Orientation Program
Kaiser Permanente HMO + Rx
wwwkporg
United HealthCare Select HMO
wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS)
wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS)
wwwcarefirstcom
Dr Office Visits PCPSpecialist $5 copay $5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits Covered in full $5 copay $10 copay In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care $5 copay $15 copay Covered in full Covered in full
Emergency Room $50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization Covered in full Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
Visit OHRrsquos Health Insurance webpage to view Medical summaries
Sheet1
Sheet1 (2)
Office of Human Resources Montgomery County Government
Prescription Plans Caremarkbull Two Rx Plan OptionsStandardHigh
bull If you elect UHC or CareFirst and want Rx coverage you will need to elect the stand-alone Caremark Rx plan (Kaiser already includes Rx coverage)
bull Maintenance Choice Program available for maintenance drugs significant cost savings ndash 1 copay for each 90-day prescription In order to get the Maintenance pricing you must fil Rx at CVS retail pharmacy Mail order
Office of Human Resources Montgomery County Government
Prescription Drug Plan Comparison High Option $48
Only MCGEOIAFF employees can enroll in this High plan
High Option $510Only FOPNON-REP employees
can enroll in this High plan
Standard Option All employees can enroll in this
Standard plan
Copay $4 Generics$8 Brand Name
$5 Generics$10 Brand Name
$10 Generics$20 PBrand Name
$35 NPBrand NameDeductible na na $50yearMail Order Yes Yes Yes
Maintenance Choice Yes Yes YesCovered Drugs Same Same Same
Visit OHRrsquos Health Insurance Website to view Rx summaries
Office of Human Resources Montgomery County Government
Prescription Drug Cost Comparison Cost
High Option $48Only MCGEOIAFF employees
can enroll in this High plan
High Option $510Only FOPNON-REP employees
can enroll in this High plan
Standard Option All employees can enroll in this
Standard plan
Self Only
Bi-Weekly $11339Monthly $24568Yearly $294814
Bi-Weekly $11100Monthly $24050Yearly $288600
Bi-Weekly $2413Monthly $5258Yearly $62738
Self + 1
Bi-Weekly $20979Monthly $45455Yearly $545454
Bi-Weekly $20536Monthly $44495Yearly $533936
Bi-Weekly $4463Monthly $9670
Yearly $116038
Self + Family
Bi-Weekly $32511Monthly $70441Yearly $845286
Bi-Weekly $31824Monthly $68952Yearly $827424
Bi-Weekly $6916Monthly $14985Yearly $179816
Office of Human Resources Montgomery County Government
Dental
Office of Human Resources Montgomery County Government
Dental Comparison Cigna
For a list of HMO covered services and assigned costs (copays) view the HMO benefit summary
Required to Use An Assigned Provider Yes In-network only Primary Dental Office will be
assigned based on home address
No
Out of Network Benefits Available No Yes
Balance Billing for Covered Services No Yes if you go out-of-network
Referral Required Yes No
Orthodontia Benefits Available Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime) Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person) Unlimited $200000
Deductible (singlefamily) None $50 $ 150 waived for preventive care
Table 1
Office of Human Resources Montgomery County Government
Vision
Office of Human Resources Montgomery County Government
Vision Insurancebull The Countyrsquos Vision carrier is EyeMedbull Benefits payable for exams lenses and contacts (elective or necessary) every
calendar year frames every two calendar yearsbull In-network or out-of-network benefits available bull Enhanced Hearing Benefit through EyeMedrsquos partner Amplifon40 off hearing examDiscounted pricing on thousands of hearing aids including latest technologyOne-year free follow-up care with unlimited appointmentsFree batteries for two years with initial purchase Three-year warranty and loss and damage coverage
Visit OHRrsquos Health Insurance webpage to view vision summary
Office of Human Resources Montgomery County Government
Optional Life amp Dependent Life
Office of Human Resources Montgomery County Government
Optional Life Insurance ADampDbull You may elect Optional Life ADampD coverage for yourself in increments of 1 to 8 times
your basic annual earnings ($1 million maximum)
bull NOTE Coverage is not guaranteed issue for any level You must complete an online Statement of Health no matter what level of coverage you elect Later this fall after Open Enrollment ends you will receive an email from MetLife with a link to complete the Statement of Health online
bull An eligible dependent is defined as 1) your opposite or same sex spouse or 2) your unmarried children under age 26 (natural adopted or stepchildrenfoster children who depend on your support)
Office of Human Resources Montgomery County Government
Optional Life Insurance RatesHow to estimate your Optional Life Insurance bi-weekly rate
Example 40-year-old applying for 2 x salary Salary is $49300
Steps Example Calculate for Yourself
A Find your age-based rate on the rate sheet (left) $ 0037 $_________________
B Choose how much coverage you are applying for
$99000 (2 x salary rounded to the nearest $1000 ) $_________________
C Divide that coverage amount by 100099 ($99000 1000) $_________________
D Multiply A x C for estimated bi-weekly cost$366 ($037 x 99) $_________________
Office of Human Resources Montgomery County Government
Dependent Life InsuranceYou may also purchase Dependent Optional Life insurance forbull Your opposite or same sex spouse bull Your unmarried children under age 26
ndash Natural adoptedndash Stepchildrenfoster childrenNote you do not need to supply marriage certificatesbirth certificates for dependent optional life
You may electbull $2000 Spouse$1000 Childbull $4000 Spouse $2000 Childbull $10000 Spouse $5000 Child
The bi-weekly rate is not based on salary
Office of Human Resources Montgomery County Government
Flexible Spending Accounts
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Visit the Open Enrollment website to watch a recorded FSA presentation from MCGrsquos FSA vendor Benefit Strategies
bull What is an FSA It is an IRS-approved tax-free account that saves onQualified out-of-pocket medical and dependent care expensesFederal and State Income taxSocial Security Tax
bull 3 Account Options Health Care FSA Child Care FSA and Commuter Choice Transit bull FSA accounts are administered through Benefit Strategies bull FSAs are ldquouse-it or lose-itrdquo accounts claims must be incurred during the 2021 plan year (January 1
2021 ndash March 15 2022) and submitted by April 30 2022
IMPORTANT You must re-enroll in an FSA every Open Enrollment if you want to participate in the upcoming plan year
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Why You Should EnrollGive yourself a raise by reducing your taxesbull Elect the annual amount you want to place in your FSA(s) for the upcoming plan year during Open Enrollmentbull That amount is divided by 26 and taken from your biweekly paychecks on a pre-tax basis (21 paychecks for
10-month employees)bull Then use your pre-tax FSA dollars to pay for eligible out-of-pocket health care child-care or transit
expenses
Office of Human Resources Montgomery County Government
Health Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull Claims must be submitted by April 30 of the following yearbull You may elect to contribute up to $2750 Your total annual election amount is available to spend on the first
day of the new plan year bull FSA debit card allows you to pay for expenses at the time of servicebull Examples of IRS qualified eligible expenses
bull Copays (medical prescription dental vision) deductibles and coinsurance amounts over reasonable and customary charge
bull Hearing aids bull Acupuncture bull Orthopedic shoes bull Over-the-counter (OTC) drugs (no longer require doctorrsquos prescription)
Office of Human Resources Montgomery County Government
Child Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull $5000 annual maximum per household ($2500 for married filing separately)bull Funds are available to spend as they are accumulated through payroll deductionsbull Reimbursable expenses
bull day care centersbull elder carebull beforeafter school carebull babysitter fees that allow you and your spouse to work or go to school (no child support payments)
bull Qualifying dependentsbull Children under the age of 13 and are a tax dependent of the employeebull Spouse or tax dependent that is physically or mentally incapable of self-care
bull Must coordinate between filing a tax credit with IRS and your Dependent Care FSA plan
Office of Human Resources Montgomery County Government
Commuter Choice Transit FSAbull $230 per month maximum for MCGEO staff $260 per month maximum for Unrepresented staffbull Applies to employee commuting expenses only (not spouses or dependents)bull Can enroll throughout the year (not limited to Open Enrollment election)bull Eligible expenses include Metro Marc Vanpool Lyft Line Uber Poolbull Debit card ndash may be used for some expenses (not Metro)Metro riders will have to submit claim forms for reimbursement
bull Funds must be used within 180 days of election bull If retiring or leaving the County will need to coordinate use all available funds
Office of Human Resources Montgomery County Government
Using Your FSA FundsHealth Care FSA Your full annual election amount is available on the first day of the plan yearChild Care FSA Your funds are available as they accumulate through payroll deductionsCommuterTransit FSA Your funds are available as they accumulate through payroll deductions
The FSA Debit Card bull Your FSA debit card is the same card for your Health Care Child Care and TransitCommuter FSA accountsbull The card is pre-loaded with your full annual Health Care FSA election amount You can use the card to pay for IRS qualified expenses at
the time of service or when paying a bill Receipt notifications will be mailed to you monthly by Benefit Strategies Your response to receipt notifications is necessary under the provisions of the plan No response my result in the ineligibility of the purchase and as a result your card may be temporarily deactivated
bull If you are enrolled in the Child Care FSA the card can also be used in child-care settings Just remember that the card will only work for an amount that does not exceed the available balance in your Child Care FSA account on that day
bull The card can also be used to pay for your commutertransit expenses however it does not work for WMATA metro Metro riders will have to submit manual claims for reimbursement from your CommuterTransit FSA
bull Cards are re-loaded each year after you make your new annual election Please keep your cards You will only receive a new card if your old card is about to expire
Office of Human Resources Montgomery County Government
AFLAC Voluntary Plans
Office of Human Resources Montgomery County Government
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Short-Term Disabilitybull Provides short-term cash benefits in the event of disabilitybull Monthly benefit amounts available from $500 - $6000 (subject to income requirements)bull Benefit options of 3 6 12 18 or 24 months with a variety of elimination periods
Critical Illness Insurancebull Provides a lump sum cash benefit in the event of critical illnessbull Benefit amounts available in $5000 increments from $10000 - $30000
Participants pay 100 through payroll deduction for Short-Term Disability and Critical Illness Insurance
To ENROLL Text SETAPPTrdquo to 41411orCall 920-420-8861 orEmail susan_mcdanielusAflaccom
Office of Human Resources Montgomery County Government
Carrier Resources amp Cost-Saving Tips
Office of Human Resources Montgomery County Government
Lower Your Out-of-Pocket CostsChoose the plan thatrsquos right for youbull See the medical benefits chart for options bull Stay in network Use the provider search engines on your carrier website or mobile app to find in-network providersSeek preventive carebull Check-ups immunizations and screenings are an important part of staying healthy They can detect or prevent serious diseases and keep you healthyKnow where to go for carebull You have many options of places to go when you need care If your medical condition isnrsquot serious or life threatening you can save money by connecting
with a doctor online through a virtual visit or going to an urgent care center or convenience care clinic instead of a hospital emergency roomReview your prescription drug plan optionsbull Decide which Caremark prescription plan is best for you Note that the Kaiser HMO includes prescription drug coverage Both the Standard and High
Option Caremark plans cover the same prescription drugs but have different copay and deductiblesUse generic and long-term prescriptions bull Opt for lower-cost generic drugs whenever possible bull Ask your doctor to write a 90-day prescription instead of a 30-day prescription to participate in the mail order prescription programTake advantage of tax savings by participating in Flexible Spending Accountsbull Use pre-tax dollars for eligible out of pocket services and items
Office of Human Resources Montgomery County Government
Built-in Wellness Support Take advantage of the free programs available to you through your medical carrier Each of MCGrsquos medical carriers (Kaiser UHC amp CareFirst) offer valuable programs to help you manage your health
Disease Management Programsbull Help manage your chronic condition through personalized coaching support and encouragement and online education materialsEmotional Wellness amp Stress Management Support bull Help manage stress through mobile apps and other self-care resources Maternity Programsbull Support healthy moms and healthy babiesWeight-loss Programs bull Offers telephonic coaching support and web-based tools to help ensure long-term weight managementbull See the next slide for an example of an MCG success storySmoking Cessation Programsbull Supportive coaching to make quitting more successfulDiscounts bull Gym memberships weight loss programs and moreFor more information about the programs available to you please see the Open Enrollment Guide and contact your medical carrier
Office of Human Resources Montgomery County Government
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You GoAll of MCGrsquos health insurance carriers offer a simple-to-use tool that can help make your life easier while yoursquore on the go Download your carrierrsquos Mobile App to help you personalize organize and access your important plan information on your phone or tablet
bull Schedule Virtual Visitsbull Manage and track claimsbull View ID card informationbull Find doctor and compare costs and quality ratingsbull Review your coveragebull Track your account balances and deductiblesbull Access a variety of health and wellness tools
Visit Google Play or the Apple App Store to download your carrierrsquos App
Office of Human Resources Montgomery County Government
Making Changes
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Questions
Office of Human Resources Montgomery County Government
Open Enrollment AssistanceFollow these steps (in this order)1 Review the frequently asked questions (FAQs) on the Open Enrollment website at wwwmontgomerycountymdgovoe
(available beginning September 21) You can enter key words into the interactive search bar to quickly locate the answer to your question
2 Visit the MC311 website at wwwmontgomerycountymdgovmc311 and search key words for your question The search results contain various knowledge-based articles with information related to your search words Simply click on the corresponding link and the detailed answer is revealed
3 Attend one of OHRrsquos Virtual Office Hours via Microsoft Teams Members of OHRs Health Insurance Team will be on hand to address employee questions by video or via the chat box View the schedule and access the sessions through the Open Enrollment website at wwwmontgomerycountymdgovoe (available beginning September 21)
4 If you have tried all the methods above and still have Open Enrollment-related questions please contact OHRs MC311 Customer Service Center at 240-773-6471 (Mon-Fri 8 am - 5 pm) to open a service request A member of the health insurance team will respond to service requests in the order they are received Tip Please provide an email address at the time you place your Service Request This will ensure the fastest response possible
Office of Human Resources Montgomery County Government
Online ResourcesVisit the 2021 Open Enrollment Webpage
wwwmontgomerycountymdgovOE
Visit OHRrsquos WebpagewwwmontgomerycountymdgovHR
Health Insurance active employees
Office of Human Resources Montgomery County Government
Legal InformationThe County reserves the right at any time and for any reason to amend the Program subject to the Countys collective bargainingagreements The County expects to continue the Program but it is the Countys position that there is no implied contract between individual employees and the County to do so
The County may amend the Program prospectively or retroactively to comply with applicable law
In the event of a conflict between this presentation the County Code andor the Summary Description the County Code then the Summary Description will govern
Office of Human Resources Montgomery County Government
Thank YouWe hope you enjoyed learning about 2021 Open Enrollment
~Your OHR Health Insurance Team
2021 Open Enrollment Benefits Bonanza
What Is Open Enrollment
What Changes Can be Made
Open Enrollment Dates
MCG Continues to Make Generous Employer Contributions
New for 2021
Special 2021 Plan Rates Announcement
Employee Rate Changes for Calendar Year 2021
Planning Ahead Minimizing Future Rate Increases
New for 2021
Open Enrollment Communications
Itrsquos a New Frontier
2021 Open Enrollment Checklist
Open Enrollment Website Resources
Attend a Virtual Open Enrollment Event
Make Changes Online
Paper Enrollment Form Permitted for Only Two Reasons
Dependent Eligibility
Proof of Dependent Eligibility
Marriage Certificate Example Required Documentation (Contd)
Benefits Refresher
Medical amp Rx
Medical Plan Options
Medical Benefits at-a-Glance
Medical Benefits at-a-Glance (contd)
Prescription Plans Caremark
Prescription Drug Plan Comparison
Prescription Drug Cost Comparison
Dental
Slide Number 30
Vision
Vision Insurance
Optional Life amp Dependent Life
Optional Life Insurance ADampD
Optional Life Insurance Rates
Dependent Life Insurance
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs)Why You Should Enroll
Health Care FSA
Child Care FSA
Commuter Choice Transit FSA
Using Your FSA Funds
AFLAC Voluntary Plans
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Carrier Resources amp Cost-Saving Tips
Lower Your Out-of-Pocket Costs
Built-in Wellness Support
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You Go
Making Changes
Make Changes Online
Questions
Open Enrollment Assistance
Online Resources
Legal Information
Thank You
Cigna Dental Comparison
DHMO
PPO
CIGNA NETWORK
Care-Access PlusDHMO
Total CIGNA PPOPPO
Required to Use An Assigned Provider
Yes In-network only Primary Dental Office will be assigned based on home address
No
Out of Network Benefits Available
No
Yes
Balance Billing for Covered Services
No
Yes if you go out-of-network
Referral Required
Yes
No
Orthodontia Benefits Available
Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime)
Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person)
Unlimited
$200000
Deductible (singlefamily)
None
$50 $ 150 waived for preventive care
1Claim submission would be required and balance billing may occur when visiting a nonparticipating provider2Deductible does not apply to Class I ndash Diagnostic and Preventive Services
Coverage for dependents would cease on the day which the child turns 26Benefit Maximum and Deductibles are for the period of January 01 through December 31
All services listed on this benefit summary are subject to the contractSchedules of Benefits and current Exclusions and Limitations
Medical Benefits at a Glance
Kaiser Permanente HMO + Rx wwwkporg
United HealthCare Select HMO wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS) wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS) wwwcarefirstcom
Plan Type
HMO
HMO
Point-of-Service
Point-of-Service
PCP Required
Yes
Yes
No
No
Provider Network
Regional (MDDCVA)
National
National
National
Out-of-Network Benefits
No
No
Yes
Yes
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
None
None
In-Network None Out-of-Network 80
In-Network None Out-of-Network 80
Dr Office Visits PCPSpecialist
$5 copay
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits
Covered in full
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care
$5 copay
$15 copay
Covered in full
Covered in full
Emergency Room
$50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization
Covered in full
Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
MCG 2018 Medical Plan Comparison Chart
Kaiser Permanente
United HealthCare
CareFirst POS Standard
CareFirst POS High
Plan Type
HMO
HMO
Point of Service
Point of Service
Provider Network
Regional (MDDCVA)
National
National
National
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
Annual Out-of-Pocket Maximum
None
$1100 per individual up to cap of $3600 for a family
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
Physician Servcies
PCP Office Visits
$5 copay
$5 copay PCP
In-Network $15 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Specialist Office Visits
$5 copay
$10 copay
In-Network $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Annual Physical
Covered in full
$5 copay PCP
In-Network $15 copay Primary Care Physician $30 copay specialist Out-of-Network 80 covered after deductible (limit 1calendar year)
In-Network $15 copay Out-of-Network 80 not subject to deductible (up to age 18)
In-Network $10 copay Out-of-Network 80 not subject to deductible (up to age 18)
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Allergy Testing
$5 copay
$5 copay PCP $10 copay Specialist
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Virtual Visits
Labs X-Rays Diagnostics
Outpatient labs
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient X-Rays
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Major Diagnostics
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Immedate Medical Servcies
Emergency Room
$50 copay waived if admitted to hospital
$25 copay waived if admitted to hospital $15 copay for urgent care
In-Network $35 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
Urgent Care
Hospital Services
Inpatient Hospitalization
Covered in full
Covered in full
In-Network Covered in full after $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Services
Surgery
Covered in full
Inpatient covered in full Outpatient $25 copay
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Hearing Aids
For minor children One hearing aid for each hearing impaired ear once every 36 months
For minor children One hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
Hearing Screening
$5 copay for hearing exam (hearing aids are excluded)
$5 Copay PCP $10 Copay Specialist
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
Home Health Care Services
Covered in full if medically necessary
Covered in full No copayment 60 visit maximum for skilled care services per calendar year
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
Hospice
Covered in full
Covered in full (See coverage booklet for eligibility information)
In-Network Covered in full
In-Network Covered in full
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
In vitro Fertilization
Limited to 3 attempts per live birth Lifetime maximum of $100000
Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
Mammography - Preventive Screening Schedule
Schedule consistent with the current recommendations of the American College of Physicians
Covered in full Age 35-39 one baseline mammogram Age 40-49 one mammogram every two calendar years Age 50+ one mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
Maternity
Covered in full once pregnancy is diagnosed
No copayment applies after the first visit
In-Network first visit 100 after $30 copay other visits 100
In-Network First visit 100 after $10 copay other visits 100
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Maximum Lifetime Benefit
Unlimited maximum
Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
Prescriptions
Kaiser Rx plan (included with Kaiser HMO medical plan) $5 at on-site pharmacies and for mail order $15 at participating pharmacies
No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
Rehabilitation Services
Inpatient Covered in full (unlimited) Outpatient $5 copay outpatient services for physical therapy are limited to up to 30 visits occupational and speech therapy per injury incident or condition are covered for a period not to exceed 90 days
$10 copayvisit 60 combined visits per year (short-term non-chronic conditions only)
In-Network
In-Network
100
100
Skilled Nursing Facility
Covered in full 100 days maximum
Covered in full 60 days per calendar year maximum
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Substance AbuseMental Health
Inpatient Covered in full Outpatient $5 copay
Inpatient Covered in full Outpatient $5 copay
In-Network Inpatient- $150 per admission copay Outpatient- $15 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
In-Network Inpatient- covered in full Outpatient- $10 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
Vision (Routine)
$5 copay for exams 25 discount on lensesframes at Kaiser centers 15 discount off the costs of contact lenses
$25 copay for exam 15-20 discount through participating optical centers
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
53116
Medical Benefits at a Glance
Kaiser Permanente HMO + Rx wwwkporg
United HealthCare Select HMO wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS) wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS) wwwcarefirstcom
Plan Type
HMO
HMO
Point-of-Service
Point-of-Service
PCP Required
Yes
Yes
No
No
Provider Network
Regional (MDDCVA)
National
National
National
Out-of-Network Benefits
No
No
Yes
Yes
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
None
None
In-Network None Out-of-Network 80
In-Network None Out-of-Network 80
Dr Office Visits PCPSpecialist
$5 copay
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits
Covered in full
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care
$5 copay
$15 copay
Covered in full
Covered in full
Emergency Room
$50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization
Covered in full
Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
MCG 2018 Medical Plan Comparison Chart
Kaiser Permanente
United HealthCare
CareFirst POS Standard
CareFirst POS High
Plan Type
HMO
HMO
Point of Service
Point of Service
Provider Network
Regional (MDDCVA)
National
National
National
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
Annual Out-of-Pocket Maximum
None
$1100 per individual up to cap of $3600 for a family
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
Physician Servcies
PCP Office Visits
$5 copay
$5 copay PCP
In-Network $15 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Specialist Office Visits
$5 copay
$10 copay
In-Network $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Annual Physical
Covered in full
$5 copay PCP
In-Network $15 copay Primary Care Physician $30 copay specialist Out-of-Network 80 covered after deductible (limit 1calendar year)
In-Network $15 copay Out-of-Network 80 not subject to deductible (up to age 18)
In-Network $10 copay Out-of-Network 80 not subject to deductible (up to age 18)
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Allergy Testing
$5 copay
$5 copay PCP $10 copay Specialist
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Virtual Visits
Labs X-Rays Diagnostics
Outpatient labs
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient X-Rays
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Major Diagnostics
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Immedate Medical Servcies
Emergency Room
$50 copay waived if admitted to hospital
$25 copay waived if admitted to hospital $15 copay for urgent care
In-Network $35 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
Urgent Care
Hospital Services
Inpatient Hospitalization
Covered in full
Covered in full
In-Network Covered in full after $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Services
Surgery
Covered in full
Inpatient covered in full Outpatient $25 copay
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Hearing Aids
For minor children One hearing aid for each hearing impaired ear once every 36 months
For minor children One hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
Hearing Screening
$5 copay for hearing exam (hearing aids are excluded)
$5 Copay PCP $10 Copay Specialist
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
Home Health Care Services
Covered in full if medically necessary
Covered in full No copayment 60 visit maximum for skilled care services per calendar year
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
Hospice
Covered in full
Covered in full (See coverage booklet for eligibility information)
In-Network Covered in full
In-Network Covered in full
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
In vitro Fertilization
Limited to 3 attempts per live birth Lifetime maximum of $100000
Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
Mammography - Preventive Screening Schedule
Schedule consistent with the current recommendations of the American College of Physicians
Covered in full Age 35-39 one baseline mammogram Age 40-49 one mammogram every two calendar years Age 50+ one mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
Maternity
Covered in full once pregnancy is diagnosed
No copayment applies after the first visit
In-Network first visit 100 after $30 copay other visits 100
In-Network First visit 100 after $10 copay other visits 100
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Maximum Lifetime Benefit
Unlimited maximum
Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
Prescriptions
Kaiser Rx plan (included with Kaiser HMO medical plan) $5 at on-site pharmacies and for mail order $15 at participating pharmacies
No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
Rehabilitation Services
Inpatient Covered in full (unlimited) Outpatient $5 copay outpatient services for physical therapy are limited to up to 30 visits occupational and speech therapy per injury incident or condition are covered for a period not to exceed 90 days
$10 copayvisit 60 combined visits per year (short-term non-chronic conditions only)
In-Network
In-Network
100
100
Skilled Nursing Facility
Covered in full 100 days maximum
Covered in full 60 days per calendar year maximum
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Substance AbuseMental Health
Inpatient Covered in full Outpatient $5 copay
Inpatient Covered in full Outpatient $5 copay
In-Network Inpatient- $150 per admission copay Outpatient- $15 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
In-Network Inpatient- covered in full Outpatient- $10 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
Vision (Routine)
$5 copay for exams 25 discount on lensesframes at Kaiser centers 15 discount off the costs of contact lenses
$25 copay for exam 15-20 discount through participating optical centers
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
53116
Office of Human Resources Montgomery County Government
Medical Benefits at-a-Glance To view full carrier medical summaries visit OHRrsquos Health Insurance Website
Kaiser Permanente HMO + Rx
wwwkporg
United HealthCare Select HMO
wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS)
wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS)
wwwcarefirstcom
Plan Type HMO HMO Point-of-Service Point-of-Service
PCP Required Yes Yes No No
Provider Network Regional (MDDCVA) National National National
Out-of-Network Benefits No No Yes Yes
Referrals Required Yes No No No
Annual Deductible None NoneIn-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Sheet1
Sheet1 (2)
Office of Human Resources Montgomery County Government
Medical Benefits at-a-Glance (contd)
New Employee Orientation Program
Kaiser Permanente HMO + Rx
wwwkporg
United HealthCare Select HMO
wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS)
wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS)
wwwcarefirstcom
Dr Office Visits PCPSpecialist $5 copay $5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits Covered in full $5 copay $10 copay In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care $5 copay $15 copay Covered in full Covered in full
Emergency Room $50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization Covered in full Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
Visit OHRrsquos Health Insurance webpage to view Medical summaries
Sheet1
Sheet1 (2)
Office of Human Resources Montgomery County Government
Prescription Plans Caremarkbull Two Rx Plan OptionsStandardHigh
bull If you elect UHC or CareFirst and want Rx coverage you will need to elect the stand-alone Caremark Rx plan (Kaiser already includes Rx coverage)
bull Maintenance Choice Program available for maintenance drugs significant cost savings ndash 1 copay for each 90-day prescription In order to get the Maintenance pricing you must fil Rx at CVS retail pharmacy Mail order
Office of Human Resources Montgomery County Government
Prescription Drug Plan Comparison High Option $48
Only MCGEOIAFF employees can enroll in this High plan
High Option $510Only FOPNON-REP employees
can enroll in this High plan
Standard Option All employees can enroll in this
Standard plan
Copay $4 Generics$8 Brand Name
$5 Generics$10 Brand Name
$10 Generics$20 PBrand Name
$35 NPBrand NameDeductible na na $50yearMail Order Yes Yes Yes
Maintenance Choice Yes Yes YesCovered Drugs Same Same Same
Visit OHRrsquos Health Insurance Website to view Rx summaries
Office of Human Resources Montgomery County Government
Prescription Drug Cost Comparison Cost
High Option $48Only MCGEOIAFF employees
can enroll in this High plan
High Option $510Only FOPNON-REP employees
can enroll in this High plan
Standard Option All employees can enroll in this
Standard plan
Self Only
Bi-Weekly $11339Monthly $24568Yearly $294814
Bi-Weekly $11100Monthly $24050Yearly $288600
Bi-Weekly $2413Monthly $5258Yearly $62738
Self + 1
Bi-Weekly $20979Monthly $45455Yearly $545454
Bi-Weekly $20536Monthly $44495Yearly $533936
Bi-Weekly $4463Monthly $9670
Yearly $116038
Self + Family
Bi-Weekly $32511Monthly $70441Yearly $845286
Bi-Weekly $31824Monthly $68952Yearly $827424
Bi-Weekly $6916Monthly $14985Yearly $179816
Office of Human Resources Montgomery County Government
Dental
Office of Human Resources Montgomery County Government
Dental Comparison Cigna
For a list of HMO covered services and assigned costs (copays) view the HMO benefit summary
Required to Use An Assigned Provider Yes In-network only Primary Dental Office will be
assigned based on home address
No
Out of Network Benefits Available No Yes
Balance Billing for Covered Services No Yes if you go out-of-network
Referral Required Yes No
Orthodontia Benefits Available Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime) Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person) Unlimited $200000
Deductible (singlefamily) None $50 $ 150 waived for preventive care
Table 1
Office of Human Resources Montgomery County Government
Vision
Office of Human Resources Montgomery County Government
Vision Insurancebull The Countyrsquos Vision carrier is EyeMedbull Benefits payable for exams lenses and contacts (elective or necessary) every
calendar year frames every two calendar yearsbull In-network or out-of-network benefits available bull Enhanced Hearing Benefit through EyeMedrsquos partner Amplifon40 off hearing examDiscounted pricing on thousands of hearing aids including latest technologyOne-year free follow-up care with unlimited appointmentsFree batteries for two years with initial purchase Three-year warranty and loss and damage coverage
Visit OHRrsquos Health Insurance webpage to view vision summary
Office of Human Resources Montgomery County Government
Optional Life amp Dependent Life
Office of Human Resources Montgomery County Government
Optional Life Insurance ADampDbull You may elect Optional Life ADampD coverage for yourself in increments of 1 to 8 times
your basic annual earnings ($1 million maximum)
bull NOTE Coverage is not guaranteed issue for any level You must complete an online Statement of Health no matter what level of coverage you elect Later this fall after Open Enrollment ends you will receive an email from MetLife with a link to complete the Statement of Health online
bull An eligible dependent is defined as 1) your opposite or same sex spouse or 2) your unmarried children under age 26 (natural adopted or stepchildrenfoster children who depend on your support)
Office of Human Resources Montgomery County Government
Optional Life Insurance RatesHow to estimate your Optional Life Insurance bi-weekly rate
Example 40-year-old applying for 2 x salary Salary is $49300
Steps Example Calculate for Yourself
A Find your age-based rate on the rate sheet (left) $ 0037 $_________________
B Choose how much coverage you are applying for
$99000 (2 x salary rounded to the nearest $1000 ) $_________________
C Divide that coverage amount by 100099 ($99000 1000) $_________________
D Multiply A x C for estimated bi-weekly cost$366 ($037 x 99) $_________________
Office of Human Resources Montgomery County Government
Dependent Life InsuranceYou may also purchase Dependent Optional Life insurance forbull Your opposite or same sex spouse bull Your unmarried children under age 26
ndash Natural adoptedndash Stepchildrenfoster childrenNote you do not need to supply marriage certificatesbirth certificates for dependent optional life
You may electbull $2000 Spouse$1000 Childbull $4000 Spouse $2000 Childbull $10000 Spouse $5000 Child
The bi-weekly rate is not based on salary
Office of Human Resources Montgomery County Government
Flexible Spending Accounts
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Visit the Open Enrollment website to watch a recorded FSA presentation from MCGrsquos FSA vendor Benefit Strategies
bull What is an FSA It is an IRS-approved tax-free account that saves onQualified out-of-pocket medical and dependent care expensesFederal and State Income taxSocial Security Tax
bull 3 Account Options Health Care FSA Child Care FSA and Commuter Choice Transit bull FSA accounts are administered through Benefit Strategies bull FSAs are ldquouse-it or lose-itrdquo accounts claims must be incurred during the 2021 plan year (January 1
2021 ndash March 15 2022) and submitted by April 30 2022
IMPORTANT You must re-enroll in an FSA every Open Enrollment if you want to participate in the upcoming plan year
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Why You Should EnrollGive yourself a raise by reducing your taxesbull Elect the annual amount you want to place in your FSA(s) for the upcoming plan year during Open Enrollmentbull That amount is divided by 26 and taken from your biweekly paychecks on a pre-tax basis (21 paychecks for
10-month employees)bull Then use your pre-tax FSA dollars to pay for eligible out-of-pocket health care child-care or transit
expenses
Office of Human Resources Montgomery County Government
Health Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull Claims must be submitted by April 30 of the following yearbull You may elect to contribute up to $2750 Your total annual election amount is available to spend on the first
day of the new plan year bull FSA debit card allows you to pay for expenses at the time of servicebull Examples of IRS qualified eligible expenses
bull Copays (medical prescription dental vision) deductibles and coinsurance amounts over reasonable and customary charge
bull Hearing aids bull Acupuncture bull Orthopedic shoes bull Over-the-counter (OTC) drugs (no longer require doctorrsquos prescription)
Office of Human Resources Montgomery County Government
Child Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull $5000 annual maximum per household ($2500 for married filing separately)bull Funds are available to spend as they are accumulated through payroll deductionsbull Reimbursable expenses
bull day care centersbull elder carebull beforeafter school carebull babysitter fees that allow you and your spouse to work or go to school (no child support payments)
bull Qualifying dependentsbull Children under the age of 13 and are a tax dependent of the employeebull Spouse or tax dependent that is physically or mentally incapable of self-care
bull Must coordinate between filing a tax credit with IRS and your Dependent Care FSA plan
Office of Human Resources Montgomery County Government
Commuter Choice Transit FSAbull $230 per month maximum for MCGEO staff $260 per month maximum for Unrepresented staffbull Applies to employee commuting expenses only (not spouses or dependents)bull Can enroll throughout the year (not limited to Open Enrollment election)bull Eligible expenses include Metro Marc Vanpool Lyft Line Uber Poolbull Debit card ndash may be used for some expenses (not Metro)Metro riders will have to submit claim forms for reimbursement
bull Funds must be used within 180 days of election bull If retiring or leaving the County will need to coordinate use all available funds
Office of Human Resources Montgomery County Government
Using Your FSA FundsHealth Care FSA Your full annual election amount is available on the first day of the plan yearChild Care FSA Your funds are available as they accumulate through payroll deductionsCommuterTransit FSA Your funds are available as they accumulate through payroll deductions
The FSA Debit Card bull Your FSA debit card is the same card for your Health Care Child Care and TransitCommuter FSA accountsbull The card is pre-loaded with your full annual Health Care FSA election amount You can use the card to pay for IRS qualified expenses at
the time of service or when paying a bill Receipt notifications will be mailed to you monthly by Benefit Strategies Your response to receipt notifications is necessary under the provisions of the plan No response my result in the ineligibility of the purchase and as a result your card may be temporarily deactivated
bull If you are enrolled in the Child Care FSA the card can also be used in child-care settings Just remember that the card will only work for an amount that does not exceed the available balance in your Child Care FSA account on that day
bull The card can also be used to pay for your commutertransit expenses however it does not work for WMATA metro Metro riders will have to submit manual claims for reimbursement from your CommuterTransit FSA
bull Cards are re-loaded each year after you make your new annual election Please keep your cards You will only receive a new card if your old card is about to expire
Office of Human Resources Montgomery County Government
AFLAC Voluntary Plans
Office of Human Resources Montgomery County Government
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Short-Term Disabilitybull Provides short-term cash benefits in the event of disabilitybull Monthly benefit amounts available from $500 - $6000 (subject to income requirements)bull Benefit options of 3 6 12 18 or 24 months with a variety of elimination periods
Critical Illness Insurancebull Provides a lump sum cash benefit in the event of critical illnessbull Benefit amounts available in $5000 increments from $10000 - $30000
Participants pay 100 through payroll deduction for Short-Term Disability and Critical Illness Insurance
To ENROLL Text SETAPPTrdquo to 41411orCall 920-420-8861 orEmail susan_mcdanielusAflaccom
Office of Human Resources Montgomery County Government
Carrier Resources amp Cost-Saving Tips
Office of Human Resources Montgomery County Government
Lower Your Out-of-Pocket CostsChoose the plan thatrsquos right for youbull See the medical benefits chart for options bull Stay in network Use the provider search engines on your carrier website or mobile app to find in-network providersSeek preventive carebull Check-ups immunizations and screenings are an important part of staying healthy They can detect or prevent serious diseases and keep you healthyKnow where to go for carebull You have many options of places to go when you need care If your medical condition isnrsquot serious or life threatening you can save money by connecting
with a doctor online through a virtual visit or going to an urgent care center or convenience care clinic instead of a hospital emergency roomReview your prescription drug plan optionsbull Decide which Caremark prescription plan is best for you Note that the Kaiser HMO includes prescription drug coverage Both the Standard and High
Option Caremark plans cover the same prescription drugs but have different copay and deductiblesUse generic and long-term prescriptions bull Opt for lower-cost generic drugs whenever possible bull Ask your doctor to write a 90-day prescription instead of a 30-day prescription to participate in the mail order prescription programTake advantage of tax savings by participating in Flexible Spending Accountsbull Use pre-tax dollars for eligible out of pocket services and items
Office of Human Resources Montgomery County Government
Built-in Wellness Support Take advantage of the free programs available to you through your medical carrier Each of MCGrsquos medical carriers (Kaiser UHC amp CareFirst) offer valuable programs to help you manage your health
Disease Management Programsbull Help manage your chronic condition through personalized coaching support and encouragement and online education materialsEmotional Wellness amp Stress Management Support bull Help manage stress through mobile apps and other self-care resources Maternity Programsbull Support healthy moms and healthy babiesWeight-loss Programs bull Offers telephonic coaching support and web-based tools to help ensure long-term weight managementbull See the next slide for an example of an MCG success storySmoking Cessation Programsbull Supportive coaching to make quitting more successfulDiscounts bull Gym memberships weight loss programs and moreFor more information about the programs available to you please see the Open Enrollment Guide and contact your medical carrier
Office of Human Resources Montgomery County Government
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You GoAll of MCGrsquos health insurance carriers offer a simple-to-use tool that can help make your life easier while yoursquore on the go Download your carrierrsquos Mobile App to help you personalize organize and access your important plan information on your phone or tablet
bull Schedule Virtual Visitsbull Manage and track claimsbull View ID card informationbull Find doctor and compare costs and quality ratingsbull Review your coveragebull Track your account balances and deductiblesbull Access a variety of health and wellness tools
Visit Google Play or the Apple App Store to download your carrierrsquos App
Office of Human Resources Montgomery County Government
Making Changes
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Questions
Office of Human Resources Montgomery County Government
Open Enrollment AssistanceFollow these steps (in this order)1 Review the frequently asked questions (FAQs) on the Open Enrollment website at wwwmontgomerycountymdgovoe
(available beginning September 21) You can enter key words into the interactive search bar to quickly locate the answer to your question
2 Visit the MC311 website at wwwmontgomerycountymdgovmc311 and search key words for your question The search results contain various knowledge-based articles with information related to your search words Simply click on the corresponding link and the detailed answer is revealed
3 Attend one of OHRrsquos Virtual Office Hours via Microsoft Teams Members of OHRs Health Insurance Team will be on hand to address employee questions by video or via the chat box View the schedule and access the sessions through the Open Enrollment website at wwwmontgomerycountymdgovoe (available beginning September 21)
4 If you have tried all the methods above and still have Open Enrollment-related questions please contact OHRs MC311 Customer Service Center at 240-773-6471 (Mon-Fri 8 am - 5 pm) to open a service request A member of the health insurance team will respond to service requests in the order they are received Tip Please provide an email address at the time you place your Service Request This will ensure the fastest response possible
Office of Human Resources Montgomery County Government
Online ResourcesVisit the 2021 Open Enrollment Webpage
wwwmontgomerycountymdgovOE
Visit OHRrsquos WebpagewwwmontgomerycountymdgovHR
Health Insurance active employees
Office of Human Resources Montgomery County Government
Legal InformationThe County reserves the right at any time and for any reason to amend the Program subject to the Countys collective bargainingagreements The County expects to continue the Program but it is the Countys position that there is no implied contract between individual employees and the County to do so
The County may amend the Program prospectively or retroactively to comply with applicable law
In the event of a conflict between this presentation the County Code andor the Summary Description the County Code then the Summary Description will govern
Office of Human Resources Montgomery County Government
Thank YouWe hope you enjoyed learning about 2021 Open Enrollment
~Your OHR Health Insurance Team
2021 Open Enrollment Benefits Bonanza
What Is Open Enrollment
What Changes Can be Made
Open Enrollment Dates
MCG Continues to Make Generous Employer Contributions
New for 2021
Special 2021 Plan Rates Announcement
Employee Rate Changes for Calendar Year 2021
Planning Ahead Minimizing Future Rate Increases
New for 2021
Open Enrollment Communications
Itrsquos a New Frontier
2021 Open Enrollment Checklist
Open Enrollment Website Resources
Attend a Virtual Open Enrollment Event
Make Changes Online
Paper Enrollment Form Permitted for Only Two Reasons
Dependent Eligibility
Proof of Dependent Eligibility
Marriage Certificate Example Required Documentation (Contd)
Benefits Refresher
Medical amp Rx
Medical Plan Options
Medical Benefits at-a-Glance
Medical Benefits at-a-Glance (contd)
Prescription Plans Caremark
Prescription Drug Plan Comparison
Prescription Drug Cost Comparison
Dental
Slide Number 30
Vision
Vision Insurance
Optional Life amp Dependent Life
Optional Life Insurance ADampD
Optional Life Insurance Rates
Dependent Life Insurance
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs)Why You Should Enroll
Health Care FSA
Child Care FSA
Commuter Choice Transit FSA
Using Your FSA Funds
AFLAC Voluntary Plans
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Carrier Resources amp Cost-Saving Tips
Lower Your Out-of-Pocket Costs
Built-in Wellness Support
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You Go
Making Changes
Make Changes Online
Questions
Open Enrollment Assistance
Online Resources
Legal Information
Thank You
Cigna Dental Comparison
DHMO
PPO
CIGNA NETWORK
Care-Access PlusDHMO
Total CIGNA PPOPPO
Required to Use An Assigned Provider
Yes In-network only Primary Dental Office will be assigned based on home address
No
Out of Network Benefits Available
No
Yes
Balance Billing for Covered Services
No
Yes if you go out-of-network
Referral Required
Yes
No
Orthodontia Benefits Available
Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime)
Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person)
Unlimited
$200000
Deductible (singlefamily)
None
$50 $ 150 waived for preventive care
1Claim submission would be required and balance billing may occur when visiting a nonparticipating provider2Deductible does not apply to Class I ndash Diagnostic and Preventive Services
Coverage for dependents would cease on the day which the child turns 26Benefit Maximum and Deductibles are for the period of January 01 through December 31
All services listed on this benefit summary are subject to the contractSchedules of Benefits and current Exclusions and Limitations
Medical Benefits at a Glance
Kaiser Permanente HMO + Rx wwwkporg
United HealthCare Select HMO wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS) wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS) wwwcarefirstcom
Plan Type
HMO
HMO
Point-of-Service
Point-of-Service
PCP Required
Yes
Yes
No
No
Provider Network
Regional (MDDCVA)
National
National
National
Out-of-Network Benefits
No
No
Yes
Yes
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
None
None
In-Network None Out-of-Network 80
In-Network None Out-of-Network 80
Dr Office Visits PCPSpecialist
$5 copay
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits
Covered in full
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care
$5 copay
$15 copay
Covered in full
Covered in full
Emergency Room
$50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization
Covered in full
Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
MCG 2018 Medical Plan Comparison Chart
Kaiser Permanente
United HealthCare
CareFirst POS Standard
CareFirst POS High
Plan Type
HMO
HMO
Point of Service
Point of Service
Provider Network
Regional (MDDCVA)
National
National
National
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
Annual Out-of-Pocket Maximum
None
$1100 per individual up to cap of $3600 for a family
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
Physician Servcies
PCP Office Visits
$5 copay
$5 copay PCP
In-Network $15 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Specialist Office Visits
$5 copay
$10 copay
In-Network $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Annual Physical
Covered in full
$5 copay PCP
In-Network $15 copay Primary Care Physician $30 copay specialist Out-of-Network 80 covered after deductible (limit 1calendar year)
In-Network $15 copay Out-of-Network 80 not subject to deductible (up to age 18)
In-Network $10 copay Out-of-Network 80 not subject to deductible (up to age 18)
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Allergy Testing
$5 copay
$5 copay PCP $10 copay Specialist
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Virtual Visits
Labs X-Rays Diagnostics
Outpatient labs
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient X-Rays
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Major Diagnostics
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Immedate Medical Servcies
Emergency Room
$50 copay waived if admitted to hospital
$25 copay waived if admitted to hospital $15 copay for urgent care
In-Network $35 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
Urgent Care
Hospital Services
Inpatient Hospitalization
Covered in full
Covered in full
In-Network Covered in full after $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Services
Surgery
Covered in full
Inpatient covered in full Outpatient $25 copay
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Hearing Aids
For minor children One hearing aid for each hearing impaired ear once every 36 months
For minor children One hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
Hearing Screening
$5 copay for hearing exam (hearing aids are excluded)
$5 Copay PCP $10 Copay Specialist
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
Home Health Care Services
Covered in full if medically necessary
Covered in full No copayment 60 visit maximum for skilled care services per calendar year
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
Hospice
Covered in full
Covered in full (See coverage booklet for eligibility information)
In-Network Covered in full
In-Network Covered in full
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
In vitro Fertilization
Limited to 3 attempts per live birth Lifetime maximum of $100000
Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
Mammography - Preventive Screening Schedule
Schedule consistent with the current recommendations of the American College of Physicians
Covered in full Age 35-39 one baseline mammogram Age 40-49 one mammogram every two calendar years Age 50+ one mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
Maternity
Covered in full once pregnancy is diagnosed
No copayment applies after the first visit
In-Network first visit 100 after $30 copay other visits 100
In-Network First visit 100 after $10 copay other visits 100
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Maximum Lifetime Benefit
Unlimited maximum
Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
Prescriptions
Kaiser Rx plan (included with Kaiser HMO medical plan) $5 at on-site pharmacies and for mail order $15 at participating pharmacies
No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
Rehabilitation Services
Inpatient Covered in full (unlimited) Outpatient $5 copay outpatient services for physical therapy are limited to up to 30 visits occupational and speech therapy per injury incident or condition are covered for a period not to exceed 90 days
$10 copayvisit 60 combined visits per year (short-term non-chronic conditions only)
In-Network
In-Network
100
100
Skilled Nursing Facility
Covered in full 100 days maximum
Covered in full 60 days per calendar year maximum
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Substance AbuseMental Health
Inpatient Covered in full Outpatient $5 copay
Inpatient Covered in full Outpatient $5 copay
In-Network Inpatient- $150 per admission copay Outpatient- $15 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
In-Network Inpatient- covered in full Outpatient- $10 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
Vision (Routine)
$5 copay for exams 25 discount on lensesframes at Kaiser centers 15 discount off the costs of contact lenses
$25 copay for exam 15-20 discount through participating optical centers
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
53116
Medical Benefits at a Glance
Kaiser Permanente HMO + Rx wwwkporg
United HealthCare Select HMO wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS) wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS) wwwcarefirstcom
Plan Type
HMO
HMO
Point-of-Service
Point-of-Service
PCP Required
Yes
Yes
No
No
Provider Network
Regional (MDDCVA)
National
National
National
Out-of-Network Benefits
No
No
Yes
Yes
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
None
None
In-Network None Out-of-Network 80
In-Network None Out-of-Network 80
Dr Office Visits PCPSpecialist
$5 copay
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits
Covered in full
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care
$5 copay
$15 copay
Covered in full
Covered in full
Emergency Room
$50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization
Covered in full
Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
MCG 2018 Medical Plan Comparison Chart
Kaiser Permanente
United HealthCare
CareFirst POS Standard
CareFirst POS High
Plan Type
HMO
HMO
Point of Service
Point of Service
Provider Network
Regional (MDDCVA)
National
National
National
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
Annual Out-of-Pocket Maximum
None
$1100 per individual up to cap of $3600 for a family
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
Physician Servcies
PCP Office Visits
$5 copay
$5 copay PCP
In-Network $15 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Specialist Office Visits
$5 copay
$10 copay
In-Network $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Annual Physical
Covered in full
$5 copay PCP
In-Network $15 copay Primary Care Physician $30 copay specialist Out-of-Network 80 covered after deductible (limit 1calendar year)
In-Network $15 copay Out-of-Network 80 not subject to deductible (up to age 18)
In-Network $10 copay Out-of-Network 80 not subject to deductible (up to age 18)
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Allergy Testing
$5 copay
$5 copay PCP $10 copay Specialist
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Virtual Visits
Labs X-Rays Diagnostics
Outpatient labs
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient X-Rays
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Major Diagnostics
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Immedate Medical Servcies
Emergency Room
$50 copay waived if admitted to hospital
$25 copay waived if admitted to hospital $15 copay for urgent care
In-Network $35 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
Urgent Care
Hospital Services
Inpatient Hospitalization
Covered in full
Covered in full
In-Network Covered in full after $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Services
Surgery
Covered in full
Inpatient covered in full Outpatient $25 copay
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Hearing Aids
For minor children One hearing aid for each hearing impaired ear once every 36 months
For minor children One hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
Hearing Screening
$5 copay for hearing exam (hearing aids are excluded)
$5 Copay PCP $10 Copay Specialist
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
Home Health Care Services
Covered in full if medically necessary
Covered in full No copayment 60 visit maximum for skilled care services per calendar year
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
Hospice
Covered in full
Covered in full (See coverage booklet for eligibility information)
In-Network Covered in full
In-Network Covered in full
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
In vitro Fertilization
Limited to 3 attempts per live birth Lifetime maximum of $100000
Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
Mammography - Preventive Screening Schedule
Schedule consistent with the current recommendations of the American College of Physicians
Covered in full Age 35-39 one baseline mammogram Age 40-49 one mammogram every two calendar years Age 50+ one mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
Maternity
Covered in full once pregnancy is diagnosed
No copayment applies after the first visit
In-Network first visit 100 after $30 copay other visits 100
In-Network First visit 100 after $10 copay other visits 100
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Maximum Lifetime Benefit
Unlimited maximum
Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
Prescriptions
Kaiser Rx plan (included with Kaiser HMO medical plan) $5 at on-site pharmacies and for mail order $15 at participating pharmacies
No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
Rehabilitation Services
Inpatient Covered in full (unlimited) Outpatient $5 copay outpatient services for physical therapy are limited to up to 30 visits occupational and speech therapy per injury incident or condition are covered for a period not to exceed 90 days
$10 copayvisit 60 combined visits per year (short-term non-chronic conditions only)
In-Network
In-Network
100
100
Skilled Nursing Facility
Covered in full 100 days maximum
Covered in full 60 days per calendar year maximum
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Substance AbuseMental Health
Inpatient Covered in full Outpatient $5 copay
Inpatient Covered in full Outpatient $5 copay
In-Network Inpatient- $150 per admission copay Outpatient- $15 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
In-Network Inpatient- covered in full Outpatient- $10 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
Vision (Routine)
$5 copay for exams 25 discount on lensesframes at Kaiser centers 15 discount off the costs of contact lenses
$25 copay for exam 15-20 discount through participating optical centers
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
53116
Office of Human Resources Montgomery County Government
Medical Benefits at-a-Glance (contd)
New Employee Orientation Program
Kaiser Permanente HMO + Rx
wwwkporg
United HealthCare Select HMO
wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS)
wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS)
wwwcarefirstcom
Dr Office Visits PCPSpecialist $5 copay $5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits Covered in full $5 copay $10 copay In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care $5 copay $15 copay Covered in full Covered in full
Emergency Room $50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization Covered in full Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
Visit OHRrsquos Health Insurance webpage to view Medical summaries
Sheet1
Sheet1 (2)
Office of Human Resources Montgomery County Government
Prescription Plans Caremarkbull Two Rx Plan OptionsStandardHigh
bull If you elect UHC or CareFirst and want Rx coverage you will need to elect the stand-alone Caremark Rx plan (Kaiser already includes Rx coverage)
bull Maintenance Choice Program available for maintenance drugs significant cost savings ndash 1 copay for each 90-day prescription In order to get the Maintenance pricing you must fil Rx at CVS retail pharmacy Mail order
Office of Human Resources Montgomery County Government
Prescription Drug Plan Comparison High Option $48
Only MCGEOIAFF employees can enroll in this High plan
High Option $510Only FOPNON-REP employees
can enroll in this High plan
Standard Option All employees can enroll in this
Standard plan
Copay $4 Generics$8 Brand Name
$5 Generics$10 Brand Name
$10 Generics$20 PBrand Name
$35 NPBrand NameDeductible na na $50yearMail Order Yes Yes Yes
Maintenance Choice Yes Yes YesCovered Drugs Same Same Same
Visit OHRrsquos Health Insurance Website to view Rx summaries
Office of Human Resources Montgomery County Government
Prescription Drug Cost Comparison Cost
High Option $48Only MCGEOIAFF employees
can enroll in this High plan
High Option $510Only FOPNON-REP employees
can enroll in this High plan
Standard Option All employees can enroll in this
Standard plan
Self Only
Bi-Weekly $11339Monthly $24568Yearly $294814
Bi-Weekly $11100Monthly $24050Yearly $288600
Bi-Weekly $2413Monthly $5258Yearly $62738
Self + 1
Bi-Weekly $20979Monthly $45455Yearly $545454
Bi-Weekly $20536Monthly $44495Yearly $533936
Bi-Weekly $4463Monthly $9670
Yearly $116038
Self + Family
Bi-Weekly $32511Monthly $70441Yearly $845286
Bi-Weekly $31824Monthly $68952Yearly $827424
Bi-Weekly $6916Monthly $14985Yearly $179816
Office of Human Resources Montgomery County Government
Dental
Office of Human Resources Montgomery County Government
Dental Comparison Cigna
For a list of HMO covered services and assigned costs (copays) view the HMO benefit summary
Required to Use An Assigned Provider Yes In-network only Primary Dental Office will be
assigned based on home address
No
Out of Network Benefits Available No Yes
Balance Billing for Covered Services No Yes if you go out-of-network
Referral Required Yes No
Orthodontia Benefits Available Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime) Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person) Unlimited $200000
Deductible (singlefamily) None $50 $ 150 waived for preventive care
Table 1
Office of Human Resources Montgomery County Government
Vision
Office of Human Resources Montgomery County Government
Vision Insurancebull The Countyrsquos Vision carrier is EyeMedbull Benefits payable for exams lenses and contacts (elective or necessary) every
calendar year frames every two calendar yearsbull In-network or out-of-network benefits available bull Enhanced Hearing Benefit through EyeMedrsquos partner Amplifon40 off hearing examDiscounted pricing on thousands of hearing aids including latest technologyOne-year free follow-up care with unlimited appointmentsFree batteries for two years with initial purchase Three-year warranty and loss and damage coverage
Visit OHRrsquos Health Insurance webpage to view vision summary
Office of Human Resources Montgomery County Government
Optional Life amp Dependent Life
Office of Human Resources Montgomery County Government
Optional Life Insurance ADampDbull You may elect Optional Life ADampD coverage for yourself in increments of 1 to 8 times
your basic annual earnings ($1 million maximum)
bull NOTE Coverage is not guaranteed issue for any level You must complete an online Statement of Health no matter what level of coverage you elect Later this fall after Open Enrollment ends you will receive an email from MetLife with a link to complete the Statement of Health online
bull An eligible dependent is defined as 1) your opposite or same sex spouse or 2) your unmarried children under age 26 (natural adopted or stepchildrenfoster children who depend on your support)
Office of Human Resources Montgomery County Government
Optional Life Insurance RatesHow to estimate your Optional Life Insurance bi-weekly rate
Example 40-year-old applying for 2 x salary Salary is $49300
Steps Example Calculate for Yourself
A Find your age-based rate on the rate sheet (left) $ 0037 $_________________
B Choose how much coverage you are applying for
$99000 (2 x salary rounded to the nearest $1000 ) $_________________
C Divide that coverage amount by 100099 ($99000 1000) $_________________
D Multiply A x C for estimated bi-weekly cost$366 ($037 x 99) $_________________
Office of Human Resources Montgomery County Government
Dependent Life InsuranceYou may also purchase Dependent Optional Life insurance forbull Your opposite or same sex spouse bull Your unmarried children under age 26
ndash Natural adoptedndash Stepchildrenfoster childrenNote you do not need to supply marriage certificatesbirth certificates for dependent optional life
You may electbull $2000 Spouse$1000 Childbull $4000 Spouse $2000 Childbull $10000 Spouse $5000 Child
The bi-weekly rate is not based on salary
Office of Human Resources Montgomery County Government
Flexible Spending Accounts
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Visit the Open Enrollment website to watch a recorded FSA presentation from MCGrsquos FSA vendor Benefit Strategies
bull What is an FSA It is an IRS-approved tax-free account that saves onQualified out-of-pocket medical and dependent care expensesFederal and State Income taxSocial Security Tax
bull 3 Account Options Health Care FSA Child Care FSA and Commuter Choice Transit bull FSA accounts are administered through Benefit Strategies bull FSAs are ldquouse-it or lose-itrdquo accounts claims must be incurred during the 2021 plan year (January 1
2021 ndash March 15 2022) and submitted by April 30 2022
IMPORTANT You must re-enroll in an FSA every Open Enrollment if you want to participate in the upcoming plan year
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Why You Should EnrollGive yourself a raise by reducing your taxesbull Elect the annual amount you want to place in your FSA(s) for the upcoming plan year during Open Enrollmentbull That amount is divided by 26 and taken from your biweekly paychecks on a pre-tax basis (21 paychecks for
10-month employees)bull Then use your pre-tax FSA dollars to pay for eligible out-of-pocket health care child-care or transit
expenses
Office of Human Resources Montgomery County Government
Health Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull Claims must be submitted by April 30 of the following yearbull You may elect to contribute up to $2750 Your total annual election amount is available to spend on the first
day of the new plan year bull FSA debit card allows you to pay for expenses at the time of servicebull Examples of IRS qualified eligible expenses
bull Copays (medical prescription dental vision) deductibles and coinsurance amounts over reasonable and customary charge
bull Hearing aids bull Acupuncture bull Orthopedic shoes bull Over-the-counter (OTC) drugs (no longer require doctorrsquos prescription)
Office of Human Resources Montgomery County Government
Child Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull $5000 annual maximum per household ($2500 for married filing separately)bull Funds are available to spend as they are accumulated through payroll deductionsbull Reimbursable expenses
bull day care centersbull elder carebull beforeafter school carebull babysitter fees that allow you and your spouse to work or go to school (no child support payments)
bull Qualifying dependentsbull Children under the age of 13 and are a tax dependent of the employeebull Spouse or tax dependent that is physically or mentally incapable of self-care
bull Must coordinate between filing a tax credit with IRS and your Dependent Care FSA plan
Office of Human Resources Montgomery County Government
Commuter Choice Transit FSAbull $230 per month maximum for MCGEO staff $260 per month maximum for Unrepresented staffbull Applies to employee commuting expenses only (not spouses or dependents)bull Can enroll throughout the year (not limited to Open Enrollment election)bull Eligible expenses include Metro Marc Vanpool Lyft Line Uber Poolbull Debit card ndash may be used for some expenses (not Metro)Metro riders will have to submit claim forms for reimbursement
bull Funds must be used within 180 days of election bull If retiring or leaving the County will need to coordinate use all available funds
Office of Human Resources Montgomery County Government
Using Your FSA FundsHealth Care FSA Your full annual election amount is available on the first day of the plan yearChild Care FSA Your funds are available as they accumulate through payroll deductionsCommuterTransit FSA Your funds are available as they accumulate through payroll deductions
The FSA Debit Card bull Your FSA debit card is the same card for your Health Care Child Care and TransitCommuter FSA accountsbull The card is pre-loaded with your full annual Health Care FSA election amount You can use the card to pay for IRS qualified expenses at
the time of service or when paying a bill Receipt notifications will be mailed to you monthly by Benefit Strategies Your response to receipt notifications is necessary under the provisions of the plan No response my result in the ineligibility of the purchase and as a result your card may be temporarily deactivated
bull If you are enrolled in the Child Care FSA the card can also be used in child-care settings Just remember that the card will only work for an amount that does not exceed the available balance in your Child Care FSA account on that day
bull The card can also be used to pay for your commutertransit expenses however it does not work for WMATA metro Metro riders will have to submit manual claims for reimbursement from your CommuterTransit FSA
bull Cards are re-loaded each year after you make your new annual election Please keep your cards You will only receive a new card if your old card is about to expire
Office of Human Resources Montgomery County Government
AFLAC Voluntary Plans
Office of Human Resources Montgomery County Government
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Short-Term Disabilitybull Provides short-term cash benefits in the event of disabilitybull Monthly benefit amounts available from $500 - $6000 (subject to income requirements)bull Benefit options of 3 6 12 18 or 24 months with a variety of elimination periods
Critical Illness Insurancebull Provides a lump sum cash benefit in the event of critical illnessbull Benefit amounts available in $5000 increments from $10000 - $30000
Participants pay 100 through payroll deduction for Short-Term Disability and Critical Illness Insurance
To ENROLL Text SETAPPTrdquo to 41411orCall 920-420-8861 orEmail susan_mcdanielusAflaccom
Office of Human Resources Montgomery County Government
Carrier Resources amp Cost-Saving Tips
Office of Human Resources Montgomery County Government
Lower Your Out-of-Pocket CostsChoose the plan thatrsquos right for youbull See the medical benefits chart for options bull Stay in network Use the provider search engines on your carrier website or mobile app to find in-network providersSeek preventive carebull Check-ups immunizations and screenings are an important part of staying healthy They can detect or prevent serious diseases and keep you healthyKnow where to go for carebull You have many options of places to go when you need care If your medical condition isnrsquot serious or life threatening you can save money by connecting
with a doctor online through a virtual visit or going to an urgent care center or convenience care clinic instead of a hospital emergency roomReview your prescription drug plan optionsbull Decide which Caremark prescription plan is best for you Note that the Kaiser HMO includes prescription drug coverage Both the Standard and High
Option Caremark plans cover the same prescription drugs but have different copay and deductiblesUse generic and long-term prescriptions bull Opt for lower-cost generic drugs whenever possible bull Ask your doctor to write a 90-day prescription instead of a 30-day prescription to participate in the mail order prescription programTake advantage of tax savings by participating in Flexible Spending Accountsbull Use pre-tax dollars for eligible out of pocket services and items
Office of Human Resources Montgomery County Government
Built-in Wellness Support Take advantage of the free programs available to you through your medical carrier Each of MCGrsquos medical carriers (Kaiser UHC amp CareFirst) offer valuable programs to help you manage your health
Disease Management Programsbull Help manage your chronic condition through personalized coaching support and encouragement and online education materialsEmotional Wellness amp Stress Management Support bull Help manage stress through mobile apps and other self-care resources Maternity Programsbull Support healthy moms and healthy babiesWeight-loss Programs bull Offers telephonic coaching support and web-based tools to help ensure long-term weight managementbull See the next slide for an example of an MCG success storySmoking Cessation Programsbull Supportive coaching to make quitting more successfulDiscounts bull Gym memberships weight loss programs and moreFor more information about the programs available to you please see the Open Enrollment Guide and contact your medical carrier
Office of Human Resources Montgomery County Government
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You GoAll of MCGrsquos health insurance carriers offer a simple-to-use tool that can help make your life easier while yoursquore on the go Download your carrierrsquos Mobile App to help you personalize organize and access your important plan information on your phone or tablet
bull Schedule Virtual Visitsbull Manage and track claimsbull View ID card informationbull Find doctor and compare costs and quality ratingsbull Review your coveragebull Track your account balances and deductiblesbull Access a variety of health and wellness tools
Visit Google Play or the Apple App Store to download your carrierrsquos App
Office of Human Resources Montgomery County Government
Making Changes
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Questions
Office of Human Resources Montgomery County Government
Open Enrollment AssistanceFollow these steps (in this order)1 Review the frequently asked questions (FAQs) on the Open Enrollment website at wwwmontgomerycountymdgovoe
(available beginning September 21) You can enter key words into the interactive search bar to quickly locate the answer to your question
2 Visit the MC311 website at wwwmontgomerycountymdgovmc311 and search key words for your question The search results contain various knowledge-based articles with information related to your search words Simply click on the corresponding link and the detailed answer is revealed
3 Attend one of OHRrsquos Virtual Office Hours via Microsoft Teams Members of OHRs Health Insurance Team will be on hand to address employee questions by video or via the chat box View the schedule and access the sessions through the Open Enrollment website at wwwmontgomerycountymdgovoe (available beginning September 21)
4 If you have tried all the methods above and still have Open Enrollment-related questions please contact OHRs MC311 Customer Service Center at 240-773-6471 (Mon-Fri 8 am - 5 pm) to open a service request A member of the health insurance team will respond to service requests in the order they are received Tip Please provide an email address at the time you place your Service Request This will ensure the fastest response possible
Office of Human Resources Montgomery County Government
Online ResourcesVisit the 2021 Open Enrollment Webpage
wwwmontgomerycountymdgovOE
Visit OHRrsquos WebpagewwwmontgomerycountymdgovHR
Health Insurance active employees
Office of Human Resources Montgomery County Government
Legal InformationThe County reserves the right at any time and for any reason to amend the Program subject to the Countys collective bargainingagreements The County expects to continue the Program but it is the Countys position that there is no implied contract between individual employees and the County to do so
The County may amend the Program prospectively or retroactively to comply with applicable law
In the event of a conflict between this presentation the County Code andor the Summary Description the County Code then the Summary Description will govern
Office of Human Resources Montgomery County Government
Thank YouWe hope you enjoyed learning about 2021 Open Enrollment
~Your OHR Health Insurance Team
2021 Open Enrollment Benefits Bonanza
What Is Open Enrollment
What Changes Can be Made
Open Enrollment Dates
MCG Continues to Make Generous Employer Contributions
New for 2021
Special 2021 Plan Rates Announcement
Employee Rate Changes for Calendar Year 2021
Planning Ahead Minimizing Future Rate Increases
New for 2021
Open Enrollment Communications
Itrsquos a New Frontier
2021 Open Enrollment Checklist
Open Enrollment Website Resources
Attend a Virtual Open Enrollment Event
Make Changes Online
Paper Enrollment Form Permitted for Only Two Reasons
Dependent Eligibility
Proof of Dependent Eligibility
Marriage Certificate Example Required Documentation (Contd)
Benefits Refresher
Medical amp Rx
Medical Plan Options
Medical Benefits at-a-Glance
Medical Benefits at-a-Glance (contd)
Prescription Plans Caremark
Prescription Drug Plan Comparison
Prescription Drug Cost Comparison
Dental
Slide Number 30
Vision
Vision Insurance
Optional Life amp Dependent Life
Optional Life Insurance ADampD
Optional Life Insurance Rates
Dependent Life Insurance
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs)Why You Should Enroll
Health Care FSA
Child Care FSA
Commuter Choice Transit FSA
Using Your FSA Funds
AFLAC Voluntary Plans
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Carrier Resources amp Cost-Saving Tips
Lower Your Out-of-Pocket Costs
Built-in Wellness Support
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You Go
Making Changes
Make Changes Online
Questions
Open Enrollment Assistance
Online Resources
Legal Information
Thank You
Cigna Dental Comparison
DHMO
PPO
CIGNA NETWORK
Care-Access PlusDHMO
Total CIGNA PPOPPO
Required to Use An Assigned Provider
Yes In-network only Primary Dental Office will be assigned based on home address
No
Out of Network Benefits Available
No
Yes
Balance Billing for Covered Services
No
Yes if you go out-of-network
Referral Required
Yes
No
Orthodontia Benefits Available
Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime)
Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person)
Unlimited
$200000
Deductible (singlefamily)
None
$50 $ 150 waived for preventive care
1Claim submission would be required and balance billing may occur when visiting a nonparticipating provider2Deductible does not apply to Class I ndash Diagnostic and Preventive Services
Coverage for dependents would cease on the day which the child turns 26Benefit Maximum and Deductibles are for the period of January 01 through December 31
All services listed on this benefit summary are subject to the contractSchedules of Benefits and current Exclusions and Limitations
Medical Benefits at a Glance
Kaiser Permanente HMO + Rx wwwkporg
United HealthCare Select HMO wwwmyuhccom
CareFirst Blue Choice Advantage Standard (POS) wwwcarefirstcom
CareFirst Blue Choice Advantage High (POS) wwwcarefirstcom
Plan Type
HMO
HMO
Point-of-Service
Point-of-Service
PCP Required
Yes
Yes
No
No
Provider Network
Regional (MDDCVA)
National
National
National
Out-of-Network Benefits
No
No
Yes
Yes
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
None
None
In-Network None Out-of-Network 80
In-Network None Out-of-Network 80
Dr Office Visits PCPSpecialist
$5 copay
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Virtual Visits
Covered in full
$5 copay $10 copay
In-Network $15 copay $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Urgent Care
$5 copay
$15 copay
Covered in full
Covered in full
Emergency Room
$50 copay waived if admitted
$25 copay waived if admitted
In-Network $35 copay waived if admitted Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted Out-of-Network 80 covered after deductible
Inpatient Hospitalization
Covered in full
Covered in full
In-Network $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Prescriptions
$5 copay at Kaiser pharmacy $15 copay at other participating pharmacies (Mail Order Maintenance Program - 1 x copay for 90 day supply)
None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
In-NetworkOut-of-Network None except for diabetic supplies
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
MCG 2018 Medical Plan Comparison Chart
Kaiser Permanente
United HealthCare
CareFirst POS Standard
CareFirst POS High
Plan Type
HMO
HMO
Point of Service
Point of Service
Provider Network
Regional (MDDCVA)
National
National
National
Referrals Required
Yes
No
No
No
Annual Deductible
None
None
In-Network None Out-of-Network $300 individual $600 family
In-Network None Out-of-Network $300 individual $600 family
Coinsurance
Annual Out-of-Pocket Maximum
None
$1100 per individual up to cap of $3600 for a family
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
In-Network Individual $1000 plus the annual deductible Family $2000 plus the annual deductible Out-of-Network Individual $2000 plus the annual deductible Family $4000 plus the annual deductible
Physician Servcies
PCP Office Visits
$5 copay
$5 copay PCP
In-Network $15 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Specialist Office Visits
$5 copay
$10 copay
In-Network $30 copay Out-of-Network 80 covered after deductible
In-Network $10 copay Out-of-Network 80 covered after deductible
Annual Physical
Covered in full
$5 copay PCP
In-Network $15 copay Primary Care Physician $30 copay specialist Out-of-Network 80 covered after deductible (limit 1calendar year)
In-Network $15 copay Out-of-Network 80 not subject to deductible (up to age 18)
In-Network $10 copay Out-of-Network 80 not subject to deductible (up to age 18)
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Allergy Testing
$5 copay
$5 copay PCP $10 copay Specialist
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Virtual Visits
Labs X-Rays Diagnostics
Outpatient labs
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient X-Rays
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Major Diagnostics
Covered in full
Covered in full
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Immedate Medical Servcies
Emergency Room
$50 copay waived if admitted to hospital
$25 copay waived if admitted to hospital $15 copay for urgent care
In-Network $35 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
In-Network $25 copay waived if admitted to hospital Out-of-Network 80 covered after deductible
Urgent Care
Hospital Services
Inpatient Hospitalization
Covered in full
Covered in full
In-Network Covered in full after $150 copay per admission Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Outpatient Services
Surgery
Covered in full
Inpatient covered in full Outpatient $25 copay
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
Hearing Aids
For minor children One hearing aid for each hearing impaired ear once every 36 months
For minor children One hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
In-NetworkOut-of-Network For minor children one hearing aid for each hearing impaired ear once every 36 months
Hearing Screening
$5 copay for hearing exam (hearing aids are excluded)
$5 Copay PCP $10 Copay Specialist
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
In-Network Childhood hearing screening covered in full Out-of-Network Child hood hearing screening 80 not subject to deductible
Home Health Care Services
Covered in full if medically necessary
Covered in full No copayment 60 visit maximum for skilled care services per calendar year
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
In-Network Covered in full (90 visits maxcalendar year Out-of-Network 80 covered after deductible (90 visits maxcalendar year)
Hospice
Covered in full
Covered in full (See coverage booklet for eligibility information)
In-Network Covered in full
In-Network Covered in full
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Immunizations
Included in well child care visits up to age 5 at no charge
$5 copay PCP
In-Network Covered in full Out-of-Network 80 covered after deductible
In-Network Covered in full Out-of-Network 80 covered after deductible
In vitro Fertilization
Limited to 3 attempts per live birth Lifetime maximum of $100000
Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
In-NetworkOut-of-Network Limited to 3 attempts per live birth Lifetime maximum of $100000
Mammography - Preventive Screening Schedule
Schedule consistent with the current recommendations of the American College of Physicians
Covered in full Age 35-39 one baseline mammogram Age 40-49 one mammogram every two calendar years Age 50+ one mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
In-NetworkOut-of-Network Covered in full Age 35-39 one baseline mammogram Age 40-49 One mammogram every two calendar years Age 50+ One mammogram per calendar year
Maternity
Covered in full once pregnancy is diagnosed
No copayment applies after the first visit
In-Network first visit 100 after $30 copay other visits 100
In-Network First visit 100 after $10 copay other visits 100
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Maximum Lifetime Benefit
Unlimited maximum
Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
In-NetworkOut-of-Network Unlimited maximum
Prescriptions
Kaiser Rx plan (included with Kaiser HMO medical plan) $5 at on-site pharmacies and for mail order $15 at participating pharmacies
No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
In-NetworkOut-of-Network No Rx Plan included diabetic supplies covered under a pharmacy rider
Rehabilitation Services
Inpatient Covered in full (unlimited) Outpatient $5 copay outpatient services for physical therapy are limited to up to 30 visits occupational and speech therapy per injury incident or condition are covered for a period not to exceed 90 days
$10 copayvisit 60 combined visits per year (short-term non-chronic conditions only)
In-Network
In-Network
100
100
Skilled Nursing Facility
Covered in full 100 days maximum
Covered in full 60 days per calendar year maximum
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Out-of-Network 80 covered after deductible (100 days maxcalendar year)
Substance AbuseMental Health
Inpatient Covered in full Outpatient $5 copay
Inpatient Covered in full Outpatient $5 copay
In-Network Inpatient- $150 per admission copay Outpatient- $15 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
In-Network Inpatient- covered in full Outpatient- $10 copay Out-of-Network Inpatient- 80 covered after deductible Outpatient- 80 covered after deductible
Vision (Routine)
$5 copay for exams 25 discount on lensesframes at Kaiser centers 15 discount off the costs of contact lenses
$25 copay for exam 15-20 discount through participating optical centers
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
In-Network Refraction not covered (pediatric visual screening - covered in full under well child care) Out-of-Network Refraction not covered (pediatric visual screening - 80 not subject to deductible under well child care)
The County expects to continue its group insurance plans but it is the Countys position that there is no implied contract to do so The County reserves the right to change or discontinue any terms of the plans subject to applicable laws and collective bargaining agreements The County may amend the plans either prospectively or retroactively as required by Federal or State law In the event of a conflict between this chart the County Code the Summary Description andor the Plan documents the County Code then the Plan Document and then the Summary Description will govern
53116
Office of Human Resources Montgomery County Government
Prescription Plans Caremarkbull Two Rx Plan OptionsStandardHigh
bull If you elect UHC or CareFirst and want Rx coverage you will need to elect the stand-alone Caremark Rx plan (Kaiser already includes Rx coverage)
bull Maintenance Choice Program available for maintenance drugs significant cost savings ndash 1 copay for each 90-day prescription In order to get the Maintenance pricing you must fil Rx at CVS retail pharmacy Mail order
Office of Human Resources Montgomery County Government
Prescription Drug Plan Comparison High Option $48
Only MCGEOIAFF employees can enroll in this High plan
High Option $510Only FOPNON-REP employees
can enroll in this High plan
Standard Option All employees can enroll in this
Standard plan
Copay $4 Generics$8 Brand Name
$5 Generics$10 Brand Name
$10 Generics$20 PBrand Name
$35 NPBrand NameDeductible na na $50yearMail Order Yes Yes Yes
Maintenance Choice Yes Yes YesCovered Drugs Same Same Same
Visit OHRrsquos Health Insurance Website to view Rx summaries
Office of Human Resources Montgomery County Government
Prescription Drug Cost Comparison Cost
High Option $48Only MCGEOIAFF employees
can enroll in this High plan
High Option $510Only FOPNON-REP employees
can enroll in this High plan
Standard Option All employees can enroll in this
Standard plan
Self Only
Bi-Weekly $11339Monthly $24568Yearly $294814
Bi-Weekly $11100Monthly $24050Yearly $288600
Bi-Weekly $2413Monthly $5258Yearly $62738
Self + 1
Bi-Weekly $20979Monthly $45455Yearly $545454
Bi-Weekly $20536Monthly $44495Yearly $533936
Bi-Weekly $4463Monthly $9670
Yearly $116038
Self + Family
Bi-Weekly $32511Monthly $70441Yearly $845286
Bi-Weekly $31824Monthly $68952Yearly $827424
Bi-Weekly $6916Monthly $14985Yearly $179816
Office of Human Resources Montgomery County Government
Dental
Office of Human Resources Montgomery County Government
Dental Comparison Cigna
For a list of HMO covered services and assigned costs (copays) view the HMO benefit summary
Required to Use An Assigned Provider Yes In-network only Primary Dental Office will be
assigned based on home address
No
Out of Network Benefits Available No Yes
Balance Billing for Covered Services No Yes if you go out-of-network
Referral Required Yes No
Orthodontia Benefits Available Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime) Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person) Unlimited $200000
Deductible (singlefamily) None $50 $ 150 waived for preventive care
Table 1
Office of Human Resources Montgomery County Government
Vision
Office of Human Resources Montgomery County Government
Vision Insurancebull The Countyrsquos Vision carrier is EyeMedbull Benefits payable for exams lenses and contacts (elective or necessary) every
calendar year frames every two calendar yearsbull In-network or out-of-network benefits available bull Enhanced Hearing Benefit through EyeMedrsquos partner Amplifon40 off hearing examDiscounted pricing on thousands of hearing aids including latest technologyOne-year free follow-up care with unlimited appointmentsFree batteries for two years with initial purchase Three-year warranty and loss and damage coverage
Visit OHRrsquos Health Insurance webpage to view vision summary
Office of Human Resources Montgomery County Government
Optional Life amp Dependent Life
Office of Human Resources Montgomery County Government
Optional Life Insurance ADampDbull You may elect Optional Life ADampD coverage for yourself in increments of 1 to 8 times
your basic annual earnings ($1 million maximum)
bull NOTE Coverage is not guaranteed issue for any level You must complete an online Statement of Health no matter what level of coverage you elect Later this fall after Open Enrollment ends you will receive an email from MetLife with a link to complete the Statement of Health online
bull An eligible dependent is defined as 1) your opposite or same sex spouse or 2) your unmarried children under age 26 (natural adopted or stepchildrenfoster children who depend on your support)
Office of Human Resources Montgomery County Government
Optional Life Insurance RatesHow to estimate your Optional Life Insurance bi-weekly rate
Example 40-year-old applying for 2 x salary Salary is $49300
Steps Example Calculate for Yourself
A Find your age-based rate on the rate sheet (left) $ 0037 $_________________
B Choose how much coverage you are applying for
$99000 (2 x salary rounded to the nearest $1000 ) $_________________
C Divide that coverage amount by 100099 ($99000 1000) $_________________
D Multiply A x C for estimated bi-weekly cost$366 ($037 x 99) $_________________
Office of Human Resources Montgomery County Government
Dependent Life InsuranceYou may also purchase Dependent Optional Life insurance forbull Your opposite or same sex spouse bull Your unmarried children under age 26
ndash Natural adoptedndash Stepchildrenfoster childrenNote you do not need to supply marriage certificatesbirth certificates for dependent optional life
You may electbull $2000 Spouse$1000 Childbull $4000 Spouse $2000 Childbull $10000 Spouse $5000 Child
The bi-weekly rate is not based on salary
Office of Human Resources Montgomery County Government
Flexible Spending Accounts
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Visit the Open Enrollment website to watch a recorded FSA presentation from MCGrsquos FSA vendor Benefit Strategies
bull What is an FSA It is an IRS-approved tax-free account that saves onQualified out-of-pocket medical and dependent care expensesFederal and State Income taxSocial Security Tax
bull 3 Account Options Health Care FSA Child Care FSA and Commuter Choice Transit bull FSA accounts are administered through Benefit Strategies bull FSAs are ldquouse-it or lose-itrdquo accounts claims must be incurred during the 2021 plan year (January 1
2021 ndash March 15 2022) and submitted by April 30 2022
IMPORTANT You must re-enroll in an FSA every Open Enrollment if you want to participate in the upcoming plan year
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Why You Should EnrollGive yourself a raise by reducing your taxesbull Elect the annual amount you want to place in your FSA(s) for the upcoming plan year during Open Enrollmentbull That amount is divided by 26 and taken from your biweekly paychecks on a pre-tax basis (21 paychecks for
10-month employees)bull Then use your pre-tax FSA dollars to pay for eligible out-of-pocket health care child-care or transit
expenses
Office of Human Resources Montgomery County Government
Health Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull Claims must be submitted by April 30 of the following yearbull You may elect to contribute up to $2750 Your total annual election amount is available to spend on the first
day of the new plan year bull FSA debit card allows you to pay for expenses at the time of servicebull Examples of IRS qualified eligible expenses
bull Copays (medical prescription dental vision) deductibles and coinsurance amounts over reasonable and customary charge
bull Hearing aids bull Acupuncture bull Orthopedic shoes bull Over-the-counter (OTC) drugs (no longer require doctorrsquos prescription)
Office of Human Resources Montgomery County Government
Child Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull $5000 annual maximum per household ($2500 for married filing separately)bull Funds are available to spend as they are accumulated through payroll deductionsbull Reimbursable expenses
bull day care centersbull elder carebull beforeafter school carebull babysitter fees that allow you and your spouse to work or go to school (no child support payments)
bull Qualifying dependentsbull Children under the age of 13 and are a tax dependent of the employeebull Spouse or tax dependent that is physically or mentally incapable of self-care
bull Must coordinate between filing a tax credit with IRS and your Dependent Care FSA plan
Office of Human Resources Montgomery County Government
Commuter Choice Transit FSAbull $230 per month maximum for MCGEO staff $260 per month maximum for Unrepresented staffbull Applies to employee commuting expenses only (not spouses or dependents)bull Can enroll throughout the year (not limited to Open Enrollment election)bull Eligible expenses include Metro Marc Vanpool Lyft Line Uber Poolbull Debit card ndash may be used for some expenses (not Metro)Metro riders will have to submit claim forms for reimbursement
bull Funds must be used within 180 days of election bull If retiring or leaving the County will need to coordinate use all available funds
Office of Human Resources Montgomery County Government
Using Your FSA FundsHealth Care FSA Your full annual election amount is available on the first day of the plan yearChild Care FSA Your funds are available as they accumulate through payroll deductionsCommuterTransit FSA Your funds are available as they accumulate through payroll deductions
The FSA Debit Card bull Your FSA debit card is the same card for your Health Care Child Care and TransitCommuter FSA accountsbull The card is pre-loaded with your full annual Health Care FSA election amount You can use the card to pay for IRS qualified expenses at
the time of service or when paying a bill Receipt notifications will be mailed to you monthly by Benefit Strategies Your response to receipt notifications is necessary under the provisions of the plan No response my result in the ineligibility of the purchase and as a result your card may be temporarily deactivated
bull If you are enrolled in the Child Care FSA the card can also be used in child-care settings Just remember that the card will only work for an amount that does not exceed the available balance in your Child Care FSA account on that day
bull The card can also be used to pay for your commutertransit expenses however it does not work for WMATA metro Metro riders will have to submit manual claims for reimbursement from your CommuterTransit FSA
bull Cards are re-loaded each year after you make your new annual election Please keep your cards You will only receive a new card if your old card is about to expire
Office of Human Resources Montgomery County Government
AFLAC Voluntary Plans
Office of Human Resources Montgomery County Government
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Short-Term Disabilitybull Provides short-term cash benefits in the event of disabilitybull Monthly benefit amounts available from $500 - $6000 (subject to income requirements)bull Benefit options of 3 6 12 18 or 24 months with a variety of elimination periods
Critical Illness Insurancebull Provides a lump sum cash benefit in the event of critical illnessbull Benefit amounts available in $5000 increments from $10000 - $30000
Participants pay 100 through payroll deduction for Short-Term Disability and Critical Illness Insurance
To ENROLL Text SETAPPTrdquo to 41411orCall 920-420-8861 orEmail susan_mcdanielusAflaccom
Office of Human Resources Montgomery County Government
Carrier Resources amp Cost-Saving Tips
Office of Human Resources Montgomery County Government
Lower Your Out-of-Pocket CostsChoose the plan thatrsquos right for youbull See the medical benefits chart for options bull Stay in network Use the provider search engines on your carrier website or mobile app to find in-network providersSeek preventive carebull Check-ups immunizations and screenings are an important part of staying healthy They can detect or prevent serious diseases and keep you healthyKnow where to go for carebull You have many options of places to go when you need care If your medical condition isnrsquot serious or life threatening you can save money by connecting
with a doctor online through a virtual visit or going to an urgent care center or convenience care clinic instead of a hospital emergency roomReview your prescription drug plan optionsbull Decide which Caremark prescription plan is best for you Note that the Kaiser HMO includes prescription drug coverage Both the Standard and High
Option Caremark plans cover the same prescription drugs but have different copay and deductiblesUse generic and long-term prescriptions bull Opt for lower-cost generic drugs whenever possible bull Ask your doctor to write a 90-day prescription instead of a 30-day prescription to participate in the mail order prescription programTake advantage of tax savings by participating in Flexible Spending Accountsbull Use pre-tax dollars for eligible out of pocket services and items
Office of Human Resources Montgomery County Government
Built-in Wellness Support Take advantage of the free programs available to you through your medical carrier Each of MCGrsquos medical carriers (Kaiser UHC amp CareFirst) offer valuable programs to help you manage your health
Disease Management Programsbull Help manage your chronic condition through personalized coaching support and encouragement and online education materialsEmotional Wellness amp Stress Management Support bull Help manage stress through mobile apps and other self-care resources Maternity Programsbull Support healthy moms and healthy babiesWeight-loss Programs bull Offers telephonic coaching support and web-based tools to help ensure long-term weight managementbull See the next slide for an example of an MCG success storySmoking Cessation Programsbull Supportive coaching to make quitting more successfulDiscounts bull Gym memberships weight loss programs and moreFor more information about the programs available to you please see the Open Enrollment Guide and contact your medical carrier
Office of Human Resources Montgomery County Government
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You GoAll of MCGrsquos health insurance carriers offer a simple-to-use tool that can help make your life easier while yoursquore on the go Download your carrierrsquos Mobile App to help you personalize organize and access your important plan information on your phone or tablet
bull Schedule Virtual Visitsbull Manage and track claimsbull View ID card informationbull Find doctor and compare costs and quality ratingsbull Review your coveragebull Track your account balances and deductiblesbull Access a variety of health and wellness tools
Visit Google Play or the Apple App Store to download your carrierrsquos App
Office of Human Resources Montgomery County Government
Making Changes
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Questions
Office of Human Resources Montgomery County Government
Open Enrollment AssistanceFollow these steps (in this order)1 Review the frequently asked questions (FAQs) on the Open Enrollment website at wwwmontgomerycountymdgovoe
(available beginning September 21) You can enter key words into the interactive search bar to quickly locate the answer to your question
2 Visit the MC311 website at wwwmontgomerycountymdgovmc311 and search key words for your question The search results contain various knowledge-based articles with information related to your search words Simply click on the corresponding link and the detailed answer is revealed
3 Attend one of OHRrsquos Virtual Office Hours via Microsoft Teams Members of OHRs Health Insurance Team will be on hand to address employee questions by video or via the chat box View the schedule and access the sessions through the Open Enrollment website at wwwmontgomerycountymdgovoe (available beginning September 21)
4 If you have tried all the methods above and still have Open Enrollment-related questions please contact OHRs MC311 Customer Service Center at 240-773-6471 (Mon-Fri 8 am - 5 pm) to open a service request A member of the health insurance team will respond to service requests in the order they are received Tip Please provide an email address at the time you place your Service Request This will ensure the fastest response possible
Office of Human Resources Montgomery County Government
Online ResourcesVisit the 2021 Open Enrollment Webpage
wwwmontgomerycountymdgovOE
Visit OHRrsquos WebpagewwwmontgomerycountymdgovHR
Health Insurance active employees
Office of Human Resources Montgomery County Government
Legal InformationThe County reserves the right at any time and for any reason to amend the Program subject to the Countys collective bargainingagreements The County expects to continue the Program but it is the Countys position that there is no implied contract between individual employees and the County to do so
The County may amend the Program prospectively or retroactively to comply with applicable law
In the event of a conflict between this presentation the County Code andor the Summary Description the County Code then the Summary Description will govern
Office of Human Resources Montgomery County Government
Thank YouWe hope you enjoyed learning about 2021 Open Enrollment
~Your OHR Health Insurance Team
2021 Open Enrollment Benefits Bonanza
What Is Open Enrollment
What Changes Can be Made
Open Enrollment Dates
MCG Continues to Make Generous Employer Contributions
New for 2021
Special 2021 Plan Rates Announcement
Employee Rate Changes for Calendar Year 2021
Planning Ahead Minimizing Future Rate Increases
New for 2021
Open Enrollment Communications
Itrsquos a New Frontier
2021 Open Enrollment Checklist
Open Enrollment Website Resources
Attend a Virtual Open Enrollment Event
Make Changes Online
Paper Enrollment Form Permitted for Only Two Reasons
Dependent Eligibility
Proof of Dependent Eligibility
Marriage Certificate Example Required Documentation (Contd)
Benefits Refresher
Medical amp Rx
Medical Plan Options
Medical Benefits at-a-Glance
Medical Benefits at-a-Glance (contd)
Prescription Plans Caremark
Prescription Drug Plan Comparison
Prescription Drug Cost Comparison
Dental
Slide Number 30
Vision
Vision Insurance
Optional Life amp Dependent Life
Optional Life Insurance ADampD
Optional Life Insurance Rates
Dependent Life Insurance
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs)Why You Should Enroll
Health Care FSA
Child Care FSA
Commuter Choice Transit FSA
Using Your FSA Funds
AFLAC Voluntary Plans
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Carrier Resources amp Cost-Saving Tips
Lower Your Out-of-Pocket Costs
Built-in Wellness Support
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You Go
Making Changes
Make Changes Online
Questions
Open Enrollment Assistance
Online Resources
Legal Information
Thank You
Cigna Dental Comparison
DHMO
PPO
CIGNA NETWORK
Care-Access PlusDHMO
Total CIGNA PPOPPO
Required to Use An Assigned Provider
Yes In-network only Primary Dental Office will be assigned based on home address
No
Out of Network Benefits Available
No
Yes
Balance Billing for Covered Services
No
Yes if you go out-of-network
Referral Required
Yes
No
Orthodontia Benefits Available
Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime)
Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person)
Unlimited
$200000
Deductible (singlefamily)
None
$50 $ 150 waived for preventive care
1Claim submission would be required and balance billing may occur when visiting a nonparticipating provider2Deductible does not apply to Class I ndash Diagnostic and Preventive Services
Coverage for dependents would cease on the day which the child turns 26Benefit Maximum and Deductibles are for the period of January 01 through December 31
All services listed on this benefit summary are subject to the contractSchedules of Benefits and current Exclusions and Limitations
Office of Human Resources Montgomery County Government
Prescription Drug Plan Comparison High Option $48
Only MCGEOIAFF employees can enroll in this High plan
High Option $510Only FOPNON-REP employees
can enroll in this High plan
Standard Option All employees can enroll in this
Standard plan
Copay $4 Generics$8 Brand Name
$5 Generics$10 Brand Name
$10 Generics$20 PBrand Name
$35 NPBrand NameDeductible na na $50yearMail Order Yes Yes Yes
Maintenance Choice Yes Yes YesCovered Drugs Same Same Same
Visit OHRrsquos Health Insurance Website to view Rx summaries
Office of Human Resources Montgomery County Government
Prescription Drug Cost Comparison Cost
High Option $48Only MCGEOIAFF employees
can enroll in this High plan
High Option $510Only FOPNON-REP employees
can enroll in this High plan
Standard Option All employees can enroll in this
Standard plan
Self Only
Bi-Weekly $11339Monthly $24568Yearly $294814
Bi-Weekly $11100Monthly $24050Yearly $288600
Bi-Weekly $2413Monthly $5258Yearly $62738
Self + 1
Bi-Weekly $20979Monthly $45455Yearly $545454
Bi-Weekly $20536Monthly $44495Yearly $533936
Bi-Weekly $4463Monthly $9670
Yearly $116038
Self + Family
Bi-Weekly $32511Monthly $70441Yearly $845286
Bi-Weekly $31824Monthly $68952Yearly $827424
Bi-Weekly $6916Monthly $14985Yearly $179816
Office of Human Resources Montgomery County Government
Dental
Office of Human Resources Montgomery County Government
Dental Comparison Cigna
For a list of HMO covered services and assigned costs (copays) view the HMO benefit summary
Required to Use An Assigned Provider Yes In-network only Primary Dental Office will be
assigned based on home address
No
Out of Network Benefits Available No Yes
Balance Billing for Covered Services No Yes if you go out-of-network
Referral Required Yes No
Orthodontia Benefits Available Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime) Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person) Unlimited $200000
Deductible (singlefamily) None $50 $ 150 waived for preventive care
Table 1
Office of Human Resources Montgomery County Government
Vision
Office of Human Resources Montgomery County Government
Vision Insurancebull The Countyrsquos Vision carrier is EyeMedbull Benefits payable for exams lenses and contacts (elective or necessary) every
calendar year frames every two calendar yearsbull In-network or out-of-network benefits available bull Enhanced Hearing Benefit through EyeMedrsquos partner Amplifon40 off hearing examDiscounted pricing on thousands of hearing aids including latest technologyOne-year free follow-up care with unlimited appointmentsFree batteries for two years with initial purchase Three-year warranty and loss and damage coverage
Visit OHRrsquos Health Insurance webpage to view vision summary
Office of Human Resources Montgomery County Government
Optional Life amp Dependent Life
Office of Human Resources Montgomery County Government
Optional Life Insurance ADampDbull You may elect Optional Life ADampD coverage for yourself in increments of 1 to 8 times
your basic annual earnings ($1 million maximum)
bull NOTE Coverage is not guaranteed issue for any level You must complete an online Statement of Health no matter what level of coverage you elect Later this fall after Open Enrollment ends you will receive an email from MetLife with a link to complete the Statement of Health online
bull An eligible dependent is defined as 1) your opposite or same sex spouse or 2) your unmarried children under age 26 (natural adopted or stepchildrenfoster children who depend on your support)
Office of Human Resources Montgomery County Government
Optional Life Insurance RatesHow to estimate your Optional Life Insurance bi-weekly rate
Example 40-year-old applying for 2 x salary Salary is $49300
Steps Example Calculate for Yourself
A Find your age-based rate on the rate sheet (left) $ 0037 $_________________
B Choose how much coverage you are applying for
$99000 (2 x salary rounded to the nearest $1000 ) $_________________
C Divide that coverage amount by 100099 ($99000 1000) $_________________
D Multiply A x C for estimated bi-weekly cost$366 ($037 x 99) $_________________
Office of Human Resources Montgomery County Government
Dependent Life InsuranceYou may also purchase Dependent Optional Life insurance forbull Your opposite or same sex spouse bull Your unmarried children under age 26
ndash Natural adoptedndash Stepchildrenfoster childrenNote you do not need to supply marriage certificatesbirth certificates for dependent optional life
You may electbull $2000 Spouse$1000 Childbull $4000 Spouse $2000 Childbull $10000 Spouse $5000 Child
The bi-weekly rate is not based on salary
Office of Human Resources Montgomery County Government
Flexible Spending Accounts
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Visit the Open Enrollment website to watch a recorded FSA presentation from MCGrsquos FSA vendor Benefit Strategies
bull What is an FSA It is an IRS-approved tax-free account that saves onQualified out-of-pocket medical and dependent care expensesFederal and State Income taxSocial Security Tax
bull 3 Account Options Health Care FSA Child Care FSA and Commuter Choice Transit bull FSA accounts are administered through Benefit Strategies bull FSAs are ldquouse-it or lose-itrdquo accounts claims must be incurred during the 2021 plan year (January 1
2021 ndash March 15 2022) and submitted by April 30 2022
IMPORTANT You must re-enroll in an FSA every Open Enrollment if you want to participate in the upcoming plan year
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Why You Should EnrollGive yourself a raise by reducing your taxesbull Elect the annual amount you want to place in your FSA(s) for the upcoming plan year during Open Enrollmentbull That amount is divided by 26 and taken from your biweekly paychecks on a pre-tax basis (21 paychecks for
10-month employees)bull Then use your pre-tax FSA dollars to pay for eligible out-of-pocket health care child-care or transit
expenses
Office of Human Resources Montgomery County Government
Health Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull Claims must be submitted by April 30 of the following yearbull You may elect to contribute up to $2750 Your total annual election amount is available to spend on the first
day of the new plan year bull FSA debit card allows you to pay for expenses at the time of servicebull Examples of IRS qualified eligible expenses
bull Copays (medical prescription dental vision) deductibles and coinsurance amounts over reasonable and customary charge
bull Hearing aids bull Acupuncture bull Orthopedic shoes bull Over-the-counter (OTC) drugs (no longer require doctorrsquos prescription)
Office of Human Resources Montgomery County Government
Child Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull $5000 annual maximum per household ($2500 for married filing separately)bull Funds are available to spend as they are accumulated through payroll deductionsbull Reimbursable expenses
bull day care centersbull elder carebull beforeafter school carebull babysitter fees that allow you and your spouse to work or go to school (no child support payments)
bull Qualifying dependentsbull Children under the age of 13 and are a tax dependent of the employeebull Spouse or tax dependent that is physically or mentally incapable of self-care
bull Must coordinate between filing a tax credit with IRS and your Dependent Care FSA plan
Office of Human Resources Montgomery County Government
Commuter Choice Transit FSAbull $230 per month maximum for MCGEO staff $260 per month maximum for Unrepresented staffbull Applies to employee commuting expenses only (not spouses or dependents)bull Can enroll throughout the year (not limited to Open Enrollment election)bull Eligible expenses include Metro Marc Vanpool Lyft Line Uber Poolbull Debit card ndash may be used for some expenses (not Metro)Metro riders will have to submit claim forms for reimbursement
bull Funds must be used within 180 days of election bull If retiring or leaving the County will need to coordinate use all available funds
Office of Human Resources Montgomery County Government
Using Your FSA FundsHealth Care FSA Your full annual election amount is available on the first day of the plan yearChild Care FSA Your funds are available as they accumulate through payroll deductionsCommuterTransit FSA Your funds are available as they accumulate through payroll deductions
The FSA Debit Card bull Your FSA debit card is the same card for your Health Care Child Care and TransitCommuter FSA accountsbull The card is pre-loaded with your full annual Health Care FSA election amount You can use the card to pay for IRS qualified expenses at
the time of service or when paying a bill Receipt notifications will be mailed to you monthly by Benefit Strategies Your response to receipt notifications is necessary under the provisions of the plan No response my result in the ineligibility of the purchase and as a result your card may be temporarily deactivated
bull If you are enrolled in the Child Care FSA the card can also be used in child-care settings Just remember that the card will only work for an amount that does not exceed the available balance in your Child Care FSA account on that day
bull The card can also be used to pay for your commutertransit expenses however it does not work for WMATA metro Metro riders will have to submit manual claims for reimbursement from your CommuterTransit FSA
bull Cards are re-loaded each year after you make your new annual election Please keep your cards You will only receive a new card if your old card is about to expire
Office of Human Resources Montgomery County Government
AFLAC Voluntary Plans
Office of Human Resources Montgomery County Government
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Short-Term Disabilitybull Provides short-term cash benefits in the event of disabilitybull Monthly benefit amounts available from $500 - $6000 (subject to income requirements)bull Benefit options of 3 6 12 18 or 24 months with a variety of elimination periods
Critical Illness Insurancebull Provides a lump sum cash benefit in the event of critical illnessbull Benefit amounts available in $5000 increments from $10000 - $30000
Participants pay 100 through payroll deduction for Short-Term Disability and Critical Illness Insurance
To ENROLL Text SETAPPTrdquo to 41411orCall 920-420-8861 orEmail susan_mcdanielusAflaccom
Office of Human Resources Montgomery County Government
Carrier Resources amp Cost-Saving Tips
Office of Human Resources Montgomery County Government
Lower Your Out-of-Pocket CostsChoose the plan thatrsquos right for youbull See the medical benefits chart for options bull Stay in network Use the provider search engines on your carrier website or mobile app to find in-network providersSeek preventive carebull Check-ups immunizations and screenings are an important part of staying healthy They can detect or prevent serious diseases and keep you healthyKnow where to go for carebull You have many options of places to go when you need care If your medical condition isnrsquot serious or life threatening you can save money by connecting
with a doctor online through a virtual visit or going to an urgent care center or convenience care clinic instead of a hospital emergency roomReview your prescription drug plan optionsbull Decide which Caremark prescription plan is best for you Note that the Kaiser HMO includes prescription drug coverage Both the Standard and High
Option Caremark plans cover the same prescription drugs but have different copay and deductiblesUse generic and long-term prescriptions bull Opt for lower-cost generic drugs whenever possible bull Ask your doctor to write a 90-day prescription instead of a 30-day prescription to participate in the mail order prescription programTake advantage of tax savings by participating in Flexible Spending Accountsbull Use pre-tax dollars for eligible out of pocket services and items
Office of Human Resources Montgomery County Government
Built-in Wellness Support Take advantage of the free programs available to you through your medical carrier Each of MCGrsquos medical carriers (Kaiser UHC amp CareFirst) offer valuable programs to help you manage your health
Disease Management Programsbull Help manage your chronic condition through personalized coaching support and encouragement and online education materialsEmotional Wellness amp Stress Management Support bull Help manage stress through mobile apps and other self-care resources Maternity Programsbull Support healthy moms and healthy babiesWeight-loss Programs bull Offers telephonic coaching support and web-based tools to help ensure long-term weight managementbull See the next slide for an example of an MCG success storySmoking Cessation Programsbull Supportive coaching to make quitting more successfulDiscounts bull Gym memberships weight loss programs and moreFor more information about the programs available to you please see the Open Enrollment Guide and contact your medical carrier
Office of Human Resources Montgomery County Government
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You GoAll of MCGrsquos health insurance carriers offer a simple-to-use tool that can help make your life easier while yoursquore on the go Download your carrierrsquos Mobile App to help you personalize organize and access your important plan information on your phone or tablet
bull Schedule Virtual Visitsbull Manage and track claimsbull View ID card informationbull Find doctor and compare costs and quality ratingsbull Review your coveragebull Track your account balances and deductiblesbull Access a variety of health and wellness tools
Visit Google Play or the Apple App Store to download your carrierrsquos App
Office of Human Resources Montgomery County Government
Making Changes
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Questions
Office of Human Resources Montgomery County Government
Open Enrollment AssistanceFollow these steps (in this order)1 Review the frequently asked questions (FAQs) on the Open Enrollment website at wwwmontgomerycountymdgovoe
(available beginning September 21) You can enter key words into the interactive search bar to quickly locate the answer to your question
2 Visit the MC311 website at wwwmontgomerycountymdgovmc311 and search key words for your question The search results contain various knowledge-based articles with information related to your search words Simply click on the corresponding link and the detailed answer is revealed
3 Attend one of OHRrsquos Virtual Office Hours via Microsoft Teams Members of OHRs Health Insurance Team will be on hand to address employee questions by video or via the chat box View the schedule and access the sessions through the Open Enrollment website at wwwmontgomerycountymdgovoe (available beginning September 21)
4 If you have tried all the methods above and still have Open Enrollment-related questions please contact OHRs MC311 Customer Service Center at 240-773-6471 (Mon-Fri 8 am - 5 pm) to open a service request A member of the health insurance team will respond to service requests in the order they are received Tip Please provide an email address at the time you place your Service Request This will ensure the fastest response possible
Office of Human Resources Montgomery County Government
Online ResourcesVisit the 2021 Open Enrollment Webpage
wwwmontgomerycountymdgovOE
Visit OHRrsquos WebpagewwwmontgomerycountymdgovHR
Health Insurance active employees
Office of Human Resources Montgomery County Government
Legal InformationThe County reserves the right at any time and for any reason to amend the Program subject to the Countys collective bargainingagreements The County expects to continue the Program but it is the Countys position that there is no implied contract between individual employees and the County to do so
The County may amend the Program prospectively or retroactively to comply with applicable law
In the event of a conflict between this presentation the County Code andor the Summary Description the County Code then the Summary Description will govern
Office of Human Resources Montgomery County Government
Thank YouWe hope you enjoyed learning about 2021 Open Enrollment
~Your OHR Health Insurance Team
2021 Open Enrollment Benefits Bonanza
What Is Open Enrollment
What Changes Can be Made
Open Enrollment Dates
MCG Continues to Make Generous Employer Contributions
New for 2021
Special 2021 Plan Rates Announcement
Employee Rate Changes for Calendar Year 2021
Planning Ahead Minimizing Future Rate Increases
New for 2021
Open Enrollment Communications
Itrsquos a New Frontier
2021 Open Enrollment Checklist
Open Enrollment Website Resources
Attend a Virtual Open Enrollment Event
Make Changes Online
Paper Enrollment Form Permitted for Only Two Reasons
Dependent Eligibility
Proof of Dependent Eligibility
Marriage Certificate Example Required Documentation (Contd)
Benefits Refresher
Medical amp Rx
Medical Plan Options
Medical Benefits at-a-Glance
Medical Benefits at-a-Glance (contd)
Prescription Plans Caremark
Prescription Drug Plan Comparison
Prescription Drug Cost Comparison
Dental
Slide Number 30
Vision
Vision Insurance
Optional Life amp Dependent Life
Optional Life Insurance ADampD
Optional Life Insurance Rates
Dependent Life Insurance
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs)Why You Should Enroll
Health Care FSA
Child Care FSA
Commuter Choice Transit FSA
Using Your FSA Funds
AFLAC Voluntary Plans
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Carrier Resources amp Cost-Saving Tips
Lower Your Out-of-Pocket Costs
Built-in Wellness Support
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You Go
Making Changes
Make Changes Online
Questions
Open Enrollment Assistance
Online Resources
Legal Information
Thank You
Cigna Dental Comparison
DHMO
PPO
CIGNA NETWORK
Care-Access PlusDHMO
Total CIGNA PPOPPO
Required to Use An Assigned Provider
Yes In-network only Primary Dental Office will be assigned based on home address
No
Out of Network Benefits Available
No
Yes
Balance Billing for Covered Services
No
Yes if you go out-of-network
Referral Required
Yes
No
Orthodontia Benefits Available
Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime)
Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person)
Unlimited
$200000
Deductible (singlefamily)
None
$50 $ 150 waived for preventive care
1Claim submission would be required and balance billing may occur when visiting a nonparticipating provider2Deductible does not apply to Class I ndash Diagnostic and Preventive Services
Coverage for dependents would cease on the day which the child turns 26Benefit Maximum and Deductibles are for the period of January 01 through December 31
All services listed on this benefit summary are subject to the contractSchedules of Benefits and current Exclusions and Limitations
Office of Human Resources Montgomery County Government
Prescription Drug Cost Comparison Cost
High Option $48Only MCGEOIAFF employees
can enroll in this High plan
High Option $510Only FOPNON-REP employees
can enroll in this High plan
Standard Option All employees can enroll in this
Standard plan
Self Only
Bi-Weekly $11339Monthly $24568Yearly $294814
Bi-Weekly $11100Monthly $24050Yearly $288600
Bi-Weekly $2413Monthly $5258Yearly $62738
Self + 1
Bi-Weekly $20979Monthly $45455Yearly $545454
Bi-Weekly $20536Monthly $44495Yearly $533936
Bi-Weekly $4463Monthly $9670
Yearly $116038
Self + Family
Bi-Weekly $32511Monthly $70441Yearly $845286
Bi-Weekly $31824Monthly $68952Yearly $827424
Bi-Weekly $6916Monthly $14985Yearly $179816
Office of Human Resources Montgomery County Government
Dental
Office of Human Resources Montgomery County Government
Dental Comparison Cigna
For a list of HMO covered services and assigned costs (copays) view the HMO benefit summary
Required to Use An Assigned Provider Yes In-network only Primary Dental Office will be
assigned based on home address
No
Out of Network Benefits Available No Yes
Balance Billing for Covered Services No Yes if you go out-of-network
Referral Required Yes No
Orthodontia Benefits Available Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime) Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person) Unlimited $200000
Deductible (singlefamily) None $50 $ 150 waived for preventive care
Table 1
Office of Human Resources Montgomery County Government
Vision
Office of Human Resources Montgomery County Government
Vision Insurancebull The Countyrsquos Vision carrier is EyeMedbull Benefits payable for exams lenses and contacts (elective or necessary) every
calendar year frames every two calendar yearsbull In-network or out-of-network benefits available bull Enhanced Hearing Benefit through EyeMedrsquos partner Amplifon40 off hearing examDiscounted pricing on thousands of hearing aids including latest technologyOne-year free follow-up care with unlimited appointmentsFree batteries for two years with initial purchase Three-year warranty and loss and damage coverage
Visit OHRrsquos Health Insurance webpage to view vision summary
Office of Human Resources Montgomery County Government
Optional Life amp Dependent Life
Office of Human Resources Montgomery County Government
Optional Life Insurance ADampDbull You may elect Optional Life ADampD coverage for yourself in increments of 1 to 8 times
your basic annual earnings ($1 million maximum)
bull NOTE Coverage is not guaranteed issue for any level You must complete an online Statement of Health no matter what level of coverage you elect Later this fall after Open Enrollment ends you will receive an email from MetLife with a link to complete the Statement of Health online
bull An eligible dependent is defined as 1) your opposite or same sex spouse or 2) your unmarried children under age 26 (natural adopted or stepchildrenfoster children who depend on your support)
Office of Human Resources Montgomery County Government
Optional Life Insurance RatesHow to estimate your Optional Life Insurance bi-weekly rate
Example 40-year-old applying for 2 x salary Salary is $49300
Steps Example Calculate for Yourself
A Find your age-based rate on the rate sheet (left) $ 0037 $_________________
B Choose how much coverage you are applying for
$99000 (2 x salary rounded to the nearest $1000 ) $_________________
C Divide that coverage amount by 100099 ($99000 1000) $_________________
D Multiply A x C for estimated bi-weekly cost$366 ($037 x 99) $_________________
Office of Human Resources Montgomery County Government
Dependent Life InsuranceYou may also purchase Dependent Optional Life insurance forbull Your opposite or same sex spouse bull Your unmarried children under age 26
ndash Natural adoptedndash Stepchildrenfoster childrenNote you do not need to supply marriage certificatesbirth certificates for dependent optional life
You may electbull $2000 Spouse$1000 Childbull $4000 Spouse $2000 Childbull $10000 Spouse $5000 Child
The bi-weekly rate is not based on salary
Office of Human Resources Montgomery County Government
Flexible Spending Accounts
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Visit the Open Enrollment website to watch a recorded FSA presentation from MCGrsquos FSA vendor Benefit Strategies
bull What is an FSA It is an IRS-approved tax-free account that saves onQualified out-of-pocket medical and dependent care expensesFederal and State Income taxSocial Security Tax
bull 3 Account Options Health Care FSA Child Care FSA and Commuter Choice Transit bull FSA accounts are administered through Benefit Strategies bull FSAs are ldquouse-it or lose-itrdquo accounts claims must be incurred during the 2021 plan year (January 1
2021 ndash March 15 2022) and submitted by April 30 2022
IMPORTANT You must re-enroll in an FSA every Open Enrollment if you want to participate in the upcoming plan year
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Why You Should EnrollGive yourself a raise by reducing your taxesbull Elect the annual amount you want to place in your FSA(s) for the upcoming plan year during Open Enrollmentbull That amount is divided by 26 and taken from your biweekly paychecks on a pre-tax basis (21 paychecks for
10-month employees)bull Then use your pre-tax FSA dollars to pay for eligible out-of-pocket health care child-care or transit
expenses
Office of Human Resources Montgomery County Government
Health Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull Claims must be submitted by April 30 of the following yearbull You may elect to contribute up to $2750 Your total annual election amount is available to spend on the first
day of the new plan year bull FSA debit card allows you to pay for expenses at the time of servicebull Examples of IRS qualified eligible expenses
bull Copays (medical prescription dental vision) deductibles and coinsurance amounts over reasonable and customary charge
bull Hearing aids bull Acupuncture bull Orthopedic shoes bull Over-the-counter (OTC) drugs (no longer require doctorrsquos prescription)
Office of Human Resources Montgomery County Government
Child Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull $5000 annual maximum per household ($2500 for married filing separately)bull Funds are available to spend as they are accumulated through payroll deductionsbull Reimbursable expenses
bull day care centersbull elder carebull beforeafter school carebull babysitter fees that allow you and your spouse to work or go to school (no child support payments)
bull Qualifying dependentsbull Children under the age of 13 and are a tax dependent of the employeebull Spouse or tax dependent that is physically or mentally incapable of self-care
bull Must coordinate between filing a tax credit with IRS and your Dependent Care FSA plan
Office of Human Resources Montgomery County Government
Commuter Choice Transit FSAbull $230 per month maximum for MCGEO staff $260 per month maximum for Unrepresented staffbull Applies to employee commuting expenses only (not spouses or dependents)bull Can enroll throughout the year (not limited to Open Enrollment election)bull Eligible expenses include Metro Marc Vanpool Lyft Line Uber Poolbull Debit card ndash may be used for some expenses (not Metro)Metro riders will have to submit claim forms for reimbursement
bull Funds must be used within 180 days of election bull If retiring or leaving the County will need to coordinate use all available funds
Office of Human Resources Montgomery County Government
Using Your FSA FundsHealth Care FSA Your full annual election amount is available on the first day of the plan yearChild Care FSA Your funds are available as they accumulate through payroll deductionsCommuterTransit FSA Your funds are available as they accumulate through payroll deductions
The FSA Debit Card bull Your FSA debit card is the same card for your Health Care Child Care and TransitCommuter FSA accountsbull The card is pre-loaded with your full annual Health Care FSA election amount You can use the card to pay for IRS qualified expenses at
the time of service or when paying a bill Receipt notifications will be mailed to you monthly by Benefit Strategies Your response to receipt notifications is necessary under the provisions of the plan No response my result in the ineligibility of the purchase and as a result your card may be temporarily deactivated
bull If you are enrolled in the Child Care FSA the card can also be used in child-care settings Just remember that the card will only work for an amount that does not exceed the available balance in your Child Care FSA account on that day
bull The card can also be used to pay for your commutertransit expenses however it does not work for WMATA metro Metro riders will have to submit manual claims for reimbursement from your CommuterTransit FSA
bull Cards are re-loaded each year after you make your new annual election Please keep your cards You will only receive a new card if your old card is about to expire
Office of Human Resources Montgomery County Government
AFLAC Voluntary Plans
Office of Human Resources Montgomery County Government
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Short-Term Disabilitybull Provides short-term cash benefits in the event of disabilitybull Monthly benefit amounts available from $500 - $6000 (subject to income requirements)bull Benefit options of 3 6 12 18 or 24 months with a variety of elimination periods
Critical Illness Insurancebull Provides a lump sum cash benefit in the event of critical illnessbull Benefit amounts available in $5000 increments from $10000 - $30000
Participants pay 100 through payroll deduction for Short-Term Disability and Critical Illness Insurance
To ENROLL Text SETAPPTrdquo to 41411orCall 920-420-8861 orEmail susan_mcdanielusAflaccom
Office of Human Resources Montgomery County Government
Carrier Resources amp Cost-Saving Tips
Office of Human Resources Montgomery County Government
Lower Your Out-of-Pocket CostsChoose the plan thatrsquos right for youbull See the medical benefits chart for options bull Stay in network Use the provider search engines on your carrier website or mobile app to find in-network providersSeek preventive carebull Check-ups immunizations and screenings are an important part of staying healthy They can detect or prevent serious diseases and keep you healthyKnow where to go for carebull You have many options of places to go when you need care If your medical condition isnrsquot serious or life threatening you can save money by connecting
with a doctor online through a virtual visit or going to an urgent care center or convenience care clinic instead of a hospital emergency roomReview your prescription drug plan optionsbull Decide which Caremark prescription plan is best for you Note that the Kaiser HMO includes prescription drug coverage Both the Standard and High
Option Caremark plans cover the same prescription drugs but have different copay and deductiblesUse generic and long-term prescriptions bull Opt for lower-cost generic drugs whenever possible bull Ask your doctor to write a 90-day prescription instead of a 30-day prescription to participate in the mail order prescription programTake advantage of tax savings by participating in Flexible Spending Accountsbull Use pre-tax dollars for eligible out of pocket services and items
Office of Human Resources Montgomery County Government
Built-in Wellness Support Take advantage of the free programs available to you through your medical carrier Each of MCGrsquos medical carriers (Kaiser UHC amp CareFirst) offer valuable programs to help you manage your health
Disease Management Programsbull Help manage your chronic condition through personalized coaching support and encouragement and online education materialsEmotional Wellness amp Stress Management Support bull Help manage stress through mobile apps and other self-care resources Maternity Programsbull Support healthy moms and healthy babiesWeight-loss Programs bull Offers telephonic coaching support and web-based tools to help ensure long-term weight managementbull See the next slide for an example of an MCG success storySmoking Cessation Programsbull Supportive coaching to make quitting more successfulDiscounts bull Gym memberships weight loss programs and moreFor more information about the programs available to you please see the Open Enrollment Guide and contact your medical carrier
Office of Human Resources Montgomery County Government
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You GoAll of MCGrsquos health insurance carriers offer a simple-to-use tool that can help make your life easier while yoursquore on the go Download your carrierrsquos Mobile App to help you personalize organize and access your important plan information on your phone or tablet
bull Schedule Virtual Visitsbull Manage and track claimsbull View ID card informationbull Find doctor and compare costs and quality ratingsbull Review your coveragebull Track your account balances and deductiblesbull Access a variety of health and wellness tools
Visit Google Play or the Apple App Store to download your carrierrsquos App
Office of Human Resources Montgomery County Government
Making Changes
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Questions
Office of Human Resources Montgomery County Government
Open Enrollment AssistanceFollow these steps (in this order)1 Review the frequently asked questions (FAQs) on the Open Enrollment website at wwwmontgomerycountymdgovoe
(available beginning September 21) You can enter key words into the interactive search bar to quickly locate the answer to your question
2 Visit the MC311 website at wwwmontgomerycountymdgovmc311 and search key words for your question The search results contain various knowledge-based articles with information related to your search words Simply click on the corresponding link and the detailed answer is revealed
3 Attend one of OHRrsquos Virtual Office Hours via Microsoft Teams Members of OHRs Health Insurance Team will be on hand to address employee questions by video or via the chat box View the schedule and access the sessions through the Open Enrollment website at wwwmontgomerycountymdgovoe (available beginning September 21)
4 If you have tried all the methods above and still have Open Enrollment-related questions please contact OHRs MC311 Customer Service Center at 240-773-6471 (Mon-Fri 8 am - 5 pm) to open a service request A member of the health insurance team will respond to service requests in the order they are received Tip Please provide an email address at the time you place your Service Request This will ensure the fastest response possible
Office of Human Resources Montgomery County Government
Online ResourcesVisit the 2021 Open Enrollment Webpage
wwwmontgomerycountymdgovOE
Visit OHRrsquos WebpagewwwmontgomerycountymdgovHR
Health Insurance active employees
Office of Human Resources Montgomery County Government
Legal InformationThe County reserves the right at any time and for any reason to amend the Program subject to the Countys collective bargainingagreements The County expects to continue the Program but it is the Countys position that there is no implied contract between individual employees and the County to do so
The County may amend the Program prospectively or retroactively to comply with applicable law
In the event of a conflict between this presentation the County Code andor the Summary Description the County Code then the Summary Description will govern
Office of Human Resources Montgomery County Government
Thank YouWe hope you enjoyed learning about 2021 Open Enrollment
~Your OHR Health Insurance Team
2021 Open Enrollment Benefits Bonanza
What Is Open Enrollment
What Changes Can be Made
Open Enrollment Dates
MCG Continues to Make Generous Employer Contributions
New for 2021
Special 2021 Plan Rates Announcement
Employee Rate Changes for Calendar Year 2021
Planning Ahead Minimizing Future Rate Increases
New for 2021
Open Enrollment Communications
Itrsquos a New Frontier
2021 Open Enrollment Checklist
Open Enrollment Website Resources
Attend a Virtual Open Enrollment Event
Make Changes Online
Paper Enrollment Form Permitted for Only Two Reasons
Dependent Eligibility
Proof of Dependent Eligibility
Marriage Certificate Example Required Documentation (Contd)
Benefits Refresher
Medical amp Rx
Medical Plan Options
Medical Benefits at-a-Glance
Medical Benefits at-a-Glance (contd)
Prescription Plans Caremark
Prescription Drug Plan Comparison
Prescription Drug Cost Comparison
Dental
Slide Number 30
Vision
Vision Insurance
Optional Life amp Dependent Life
Optional Life Insurance ADampD
Optional Life Insurance Rates
Dependent Life Insurance
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs)Why You Should Enroll
Health Care FSA
Child Care FSA
Commuter Choice Transit FSA
Using Your FSA Funds
AFLAC Voluntary Plans
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Carrier Resources amp Cost-Saving Tips
Lower Your Out-of-Pocket Costs
Built-in Wellness Support
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You Go
Making Changes
Make Changes Online
Questions
Open Enrollment Assistance
Online Resources
Legal Information
Thank You
Cigna Dental Comparison
DHMO
PPO
CIGNA NETWORK
Care-Access PlusDHMO
Total CIGNA PPOPPO
Required to Use An Assigned Provider
Yes In-network only Primary Dental Office will be assigned based on home address
No
Out of Network Benefits Available
No
Yes
Balance Billing for Covered Services
No
Yes if you go out-of-network
Referral Required
Yes
No
Orthodontia Benefits Available
Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime)
Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person)
Unlimited
$200000
Deductible (singlefamily)
None
$50 $ 150 waived for preventive care
1Claim submission would be required and balance billing may occur when visiting a nonparticipating provider2Deductible does not apply to Class I ndash Diagnostic and Preventive Services
Coverage for dependents would cease on the day which the child turns 26Benefit Maximum and Deductibles are for the period of January 01 through December 31
All services listed on this benefit summary are subject to the contractSchedules of Benefits and current Exclusions and Limitations
Office of Human Resources Montgomery County Government
Dental
Office of Human Resources Montgomery County Government
Dental Comparison Cigna
For a list of HMO covered services and assigned costs (copays) view the HMO benefit summary
Required to Use An Assigned Provider Yes In-network only Primary Dental Office will be
assigned based on home address
No
Out of Network Benefits Available No Yes
Balance Billing for Covered Services No Yes if you go out-of-network
Referral Required Yes No
Orthodontia Benefits Available Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime) Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person) Unlimited $200000
Deductible (singlefamily) None $50 $ 150 waived for preventive care
Table 1
Office of Human Resources Montgomery County Government
Vision
Office of Human Resources Montgomery County Government
Vision Insurancebull The Countyrsquos Vision carrier is EyeMedbull Benefits payable for exams lenses and contacts (elective or necessary) every
calendar year frames every two calendar yearsbull In-network or out-of-network benefits available bull Enhanced Hearing Benefit through EyeMedrsquos partner Amplifon40 off hearing examDiscounted pricing on thousands of hearing aids including latest technologyOne-year free follow-up care with unlimited appointmentsFree batteries for two years with initial purchase Three-year warranty and loss and damage coverage
Visit OHRrsquos Health Insurance webpage to view vision summary
Office of Human Resources Montgomery County Government
Optional Life amp Dependent Life
Office of Human Resources Montgomery County Government
Optional Life Insurance ADampDbull You may elect Optional Life ADampD coverage for yourself in increments of 1 to 8 times
your basic annual earnings ($1 million maximum)
bull NOTE Coverage is not guaranteed issue for any level You must complete an online Statement of Health no matter what level of coverage you elect Later this fall after Open Enrollment ends you will receive an email from MetLife with a link to complete the Statement of Health online
bull An eligible dependent is defined as 1) your opposite or same sex spouse or 2) your unmarried children under age 26 (natural adopted or stepchildrenfoster children who depend on your support)
Office of Human Resources Montgomery County Government
Optional Life Insurance RatesHow to estimate your Optional Life Insurance bi-weekly rate
Example 40-year-old applying for 2 x salary Salary is $49300
Steps Example Calculate for Yourself
A Find your age-based rate on the rate sheet (left) $ 0037 $_________________
B Choose how much coverage you are applying for
$99000 (2 x salary rounded to the nearest $1000 ) $_________________
C Divide that coverage amount by 100099 ($99000 1000) $_________________
D Multiply A x C for estimated bi-weekly cost$366 ($037 x 99) $_________________
Office of Human Resources Montgomery County Government
Dependent Life InsuranceYou may also purchase Dependent Optional Life insurance forbull Your opposite or same sex spouse bull Your unmarried children under age 26
ndash Natural adoptedndash Stepchildrenfoster childrenNote you do not need to supply marriage certificatesbirth certificates for dependent optional life
You may electbull $2000 Spouse$1000 Childbull $4000 Spouse $2000 Childbull $10000 Spouse $5000 Child
The bi-weekly rate is not based on salary
Office of Human Resources Montgomery County Government
Flexible Spending Accounts
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Visit the Open Enrollment website to watch a recorded FSA presentation from MCGrsquos FSA vendor Benefit Strategies
bull What is an FSA It is an IRS-approved tax-free account that saves onQualified out-of-pocket medical and dependent care expensesFederal and State Income taxSocial Security Tax
bull 3 Account Options Health Care FSA Child Care FSA and Commuter Choice Transit bull FSA accounts are administered through Benefit Strategies bull FSAs are ldquouse-it or lose-itrdquo accounts claims must be incurred during the 2021 plan year (January 1
2021 ndash March 15 2022) and submitted by April 30 2022
IMPORTANT You must re-enroll in an FSA every Open Enrollment if you want to participate in the upcoming plan year
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Why You Should EnrollGive yourself a raise by reducing your taxesbull Elect the annual amount you want to place in your FSA(s) for the upcoming plan year during Open Enrollmentbull That amount is divided by 26 and taken from your biweekly paychecks on a pre-tax basis (21 paychecks for
10-month employees)bull Then use your pre-tax FSA dollars to pay for eligible out-of-pocket health care child-care or transit
expenses
Office of Human Resources Montgomery County Government
Health Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull Claims must be submitted by April 30 of the following yearbull You may elect to contribute up to $2750 Your total annual election amount is available to spend on the first
day of the new plan year bull FSA debit card allows you to pay for expenses at the time of servicebull Examples of IRS qualified eligible expenses
bull Copays (medical prescription dental vision) deductibles and coinsurance amounts over reasonable and customary charge
bull Hearing aids bull Acupuncture bull Orthopedic shoes bull Over-the-counter (OTC) drugs (no longer require doctorrsquos prescription)
Office of Human Resources Montgomery County Government
Child Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull $5000 annual maximum per household ($2500 for married filing separately)bull Funds are available to spend as they are accumulated through payroll deductionsbull Reimbursable expenses
bull day care centersbull elder carebull beforeafter school carebull babysitter fees that allow you and your spouse to work or go to school (no child support payments)
bull Qualifying dependentsbull Children under the age of 13 and are a tax dependent of the employeebull Spouse or tax dependent that is physically or mentally incapable of self-care
bull Must coordinate between filing a tax credit with IRS and your Dependent Care FSA plan
Office of Human Resources Montgomery County Government
Commuter Choice Transit FSAbull $230 per month maximum for MCGEO staff $260 per month maximum for Unrepresented staffbull Applies to employee commuting expenses only (not spouses or dependents)bull Can enroll throughout the year (not limited to Open Enrollment election)bull Eligible expenses include Metro Marc Vanpool Lyft Line Uber Poolbull Debit card ndash may be used for some expenses (not Metro)Metro riders will have to submit claim forms for reimbursement
bull Funds must be used within 180 days of election bull If retiring or leaving the County will need to coordinate use all available funds
Office of Human Resources Montgomery County Government
Using Your FSA FundsHealth Care FSA Your full annual election amount is available on the first day of the plan yearChild Care FSA Your funds are available as they accumulate through payroll deductionsCommuterTransit FSA Your funds are available as they accumulate through payroll deductions
The FSA Debit Card bull Your FSA debit card is the same card for your Health Care Child Care and TransitCommuter FSA accountsbull The card is pre-loaded with your full annual Health Care FSA election amount You can use the card to pay for IRS qualified expenses at
the time of service or when paying a bill Receipt notifications will be mailed to you monthly by Benefit Strategies Your response to receipt notifications is necessary under the provisions of the plan No response my result in the ineligibility of the purchase and as a result your card may be temporarily deactivated
bull If you are enrolled in the Child Care FSA the card can also be used in child-care settings Just remember that the card will only work for an amount that does not exceed the available balance in your Child Care FSA account on that day
bull The card can also be used to pay for your commutertransit expenses however it does not work for WMATA metro Metro riders will have to submit manual claims for reimbursement from your CommuterTransit FSA
bull Cards are re-loaded each year after you make your new annual election Please keep your cards You will only receive a new card if your old card is about to expire
Office of Human Resources Montgomery County Government
AFLAC Voluntary Plans
Office of Human Resources Montgomery County Government
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Short-Term Disabilitybull Provides short-term cash benefits in the event of disabilitybull Monthly benefit amounts available from $500 - $6000 (subject to income requirements)bull Benefit options of 3 6 12 18 or 24 months with a variety of elimination periods
Critical Illness Insurancebull Provides a lump sum cash benefit in the event of critical illnessbull Benefit amounts available in $5000 increments from $10000 - $30000
Participants pay 100 through payroll deduction for Short-Term Disability and Critical Illness Insurance
To ENROLL Text SETAPPTrdquo to 41411orCall 920-420-8861 orEmail susan_mcdanielusAflaccom
Office of Human Resources Montgomery County Government
Carrier Resources amp Cost-Saving Tips
Office of Human Resources Montgomery County Government
Lower Your Out-of-Pocket CostsChoose the plan thatrsquos right for youbull See the medical benefits chart for options bull Stay in network Use the provider search engines on your carrier website or mobile app to find in-network providersSeek preventive carebull Check-ups immunizations and screenings are an important part of staying healthy They can detect or prevent serious diseases and keep you healthyKnow where to go for carebull You have many options of places to go when you need care If your medical condition isnrsquot serious or life threatening you can save money by connecting
with a doctor online through a virtual visit or going to an urgent care center or convenience care clinic instead of a hospital emergency roomReview your prescription drug plan optionsbull Decide which Caremark prescription plan is best for you Note that the Kaiser HMO includes prescription drug coverage Both the Standard and High
Option Caremark plans cover the same prescription drugs but have different copay and deductiblesUse generic and long-term prescriptions bull Opt for lower-cost generic drugs whenever possible bull Ask your doctor to write a 90-day prescription instead of a 30-day prescription to participate in the mail order prescription programTake advantage of tax savings by participating in Flexible Spending Accountsbull Use pre-tax dollars for eligible out of pocket services and items
Office of Human Resources Montgomery County Government
Built-in Wellness Support Take advantage of the free programs available to you through your medical carrier Each of MCGrsquos medical carriers (Kaiser UHC amp CareFirst) offer valuable programs to help you manage your health
Disease Management Programsbull Help manage your chronic condition through personalized coaching support and encouragement and online education materialsEmotional Wellness amp Stress Management Support bull Help manage stress through mobile apps and other self-care resources Maternity Programsbull Support healthy moms and healthy babiesWeight-loss Programs bull Offers telephonic coaching support and web-based tools to help ensure long-term weight managementbull See the next slide for an example of an MCG success storySmoking Cessation Programsbull Supportive coaching to make quitting more successfulDiscounts bull Gym memberships weight loss programs and moreFor more information about the programs available to you please see the Open Enrollment Guide and contact your medical carrier
Office of Human Resources Montgomery County Government
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You GoAll of MCGrsquos health insurance carriers offer a simple-to-use tool that can help make your life easier while yoursquore on the go Download your carrierrsquos Mobile App to help you personalize organize and access your important plan information on your phone or tablet
bull Schedule Virtual Visitsbull Manage and track claimsbull View ID card informationbull Find doctor and compare costs and quality ratingsbull Review your coveragebull Track your account balances and deductiblesbull Access a variety of health and wellness tools
Visit Google Play or the Apple App Store to download your carrierrsquos App
Office of Human Resources Montgomery County Government
Making Changes
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Questions
Office of Human Resources Montgomery County Government
Open Enrollment AssistanceFollow these steps (in this order)1 Review the frequently asked questions (FAQs) on the Open Enrollment website at wwwmontgomerycountymdgovoe
(available beginning September 21) You can enter key words into the interactive search bar to quickly locate the answer to your question
2 Visit the MC311 website at wwwmontgomerycountymdgovmc311 and search key words for your question The search results contain various knowledge-based articles with information related to your search words Simply click on the corresponding link and the detailed answer is revealed
3 Attend one of OHRrsquos Virtual Office Hours via Microsoft Teams Members of OHRs Health Insurance Team will be on hand to address employee questions by video or via the chat box View the schedule and access the sessions through the Open Enrollment website at wwwmontgomerycountymdgovoe (available beginning September 21)
4 If you have tried all the methods above and still have Open Enrollment-related questions please contact OHRs MC311 Customer Service Center at 240-773-6471 (Mon-Fri 8 am - 5 pm) to open a service request A member of the health insurance team will respond to service requests in the order they are received Tip Please provide an email address at the time you place your Service Request This will ensure the fastest response possible
Office of Human Resources Montgomery County Government
Online ResourcesVisit the 2021 Open Enrollment Webpage
wwwmontgomerycountymdgovOE
Visit OHRrsquos WebpagewwwmontgomerycountymdgovHR
Health Insurance active employees
Office of Human Resources Montgomery County Government
Legal InformationThe County reserves the right at any time and for any reason to amend the Program subject to the Countys collective bargainingagreements The County expects to continue the Program but it is the Countys position that there is no implied contract between individual employees and the County to do so
The County may amend the Program prospectively or retroactively to comply with applicable law
In the event of a conflict between this presentation the County Code andor the Summary Description the County Code then the Summary Description will govern
Office of Human Resources Montgomery County Government
Thank YouWe hope you enjoyed learning about 2021 Open Enrollment
~Your OHR Health Insurance Team
2021 Open Enrollment Benefits Bonanza
What Is Open Enrollment
What Changes Can be Made
Open Enrollment Dates
MCG Continues to Make Generous Employer Contributions
New for 2021
Special 2021 Plan Rates Announcement
Employee Rate Changes for Calendar Year 2021
Planning Ahead Minimizing Future Rate Increases
New for 2021
Open Enrollment Communications
Itrsquos a New Frontier
2021 Open Enrollment Checklist
Open Enrollment Website Resources
Attend a Virtual Open Enrollment Event
Make Changes Online
Paper Enrollment Form Permitted for Only Two Reasons
Dependent Eligibility
Proof of Dependent Eligibility
Marriage Certificate Example Required Documentation (Contd)
Benefits Refresher
Medical amp Rx
Medical Plan Options
Medical Benefits at-a-Glance
Medical Benefits at-a-Glance (contd)
Prescription Plans Caremark
Prescription Drug Plan Comparison
Prescription Drug Cost Comparison
Dental
Slide Number 30
Vision
Vision Insurance
Optional Life amp Dependent Life
Optional Life Insurance ADampD
Optional Life Insurance Rates
Dependent Life Insurance
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs)Why You Should Enroll
Health Care FSA
Child Care FSA
Commuter Choice Transit FSA
Using Your FSA Funds
AFLAC Voluntary Plans
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Carrier Resources amp Cost-Saving Tips
Lower Your Out-of-Pocket Costs
Built-in Wellness Support
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You Go
Making Changes
Make Changes Online
Questions
Open Enrollment Assistance
Online Resources
Legal Information
Thank You
Cigna Dental Comparison
DHMO
PPO
CIGNA NETWORK
Care-Access PlusDHMO
Total CIGNA PPOPPO
Required to Use An Assigned Provider
Yes In-network only Primary Dental Office will be assigned based on home address
No
Out of Network Benefits Available
No
Yes
Balance Billing for Covered Services
No
Yes if you go out-of-network
Referral Required
Yes
No
Orthodontia Benefits Available
Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime)
Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person)
Unlimited
$200000
Deductible (singlefamily)
None
$50 $ 150 waived for preventive care
1Claim submission would be required and balance billing may occur when visiting a nonparticipating provider2Deductible does not apply to Class I ndash Diagnostic and Preventive Services
Coverage for dependents would cease on the day which the child turns 26Benefit Maximum and Deductibles are for the period of January 01 through December 31
All services listed on this benefit summary are subject to the contractSchedules of Benefits and current Exclusions and Limitations
Office of Human Resources Montgomery County Government
Dental Comparison Cigna
For a list of HMO covered services and assigned costs (copays) view the HMO benefit summary
Required to Use An Assigned Provider Yes In-network only Primary Dental Office will be
assigned based on home address
No
Out of Network Benefits Available No Yes
Balance Billing for Covered Services No Yes if you go out-of-network
Referral Required Yes No
Orthodontia Benefits Available Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime) Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person) Unlimited $200000
Deductible (singlefamily) None $50 $ 150 waived for preventive care
Table 1
Office of Human Resources Montgomery County Government
Vision
Office of Human Resources Montgomery County Government
Vision Insurancebull The Countyrsquos Vision carrier is EyeMedbull Benefits payable for exams lenses and contacts (elective or necessary) every
calendar year frames every two calendar yearsbull In-network or out-of-network benefits available bull Enhanced Hearing Benefit through EyeMedrsquos partner Amplifon40 off hearing examDiscounted pricing on thousands of hearing aids including latest technologyOne-year free follow-up care with unlimited appointmentsFree batteries for two years with initial purchase Three-year warranty and loss and damage coverage
Visit OHRrsquos Health Insurance webpage to view vision summary
Office of Human Resources Montgomery County Government
Optional Life amp Dependent Life
Office of Human Resources Montgomery County Government
Optional Life Insurance ADampDbull You may elect Optional Life ADampD coverage for yourself in increments of 1 to 8 times
your basic annual earnings ($1 million maximum)
bull NOTE Coverage is not guaranteed issue for any level You must complete an online Statement of Health no matter what level of coverage you elect Later this fall after Open Enrollment ends you will receive an email from MetLife with a link to complete the Statement of Health online
bull An eligible dependent is defined as 1) your opposite or same sex spouse or 2) your unmarried children under age 26 (natural adopted or stepchildrenfoster children who depend on your support)
Office of Human Resources Montgomery County Government
Optional Life Insurance RatesHow to estimate your Optional Life Insurance bi-weekly rate
Example 40-year-old applying for 2 x salary Salary is $49300
Steps Example Calculate for Yourself
A Find your age-based rate on the rate sheet (left) $ 0037 $_________________
B Choose how much coverage you are applying for
$99000 (2 x salary rounded to the nearest $1000 ) $_________________
C Divide that coverage amount by 100099 ($99000 1000) $_________________
D Multiply A x C for estimated bi-weekly cost$366 ($037 x 99) $_________________
Office of Human Resources Montgomery County Government
Dependent Life InsuranceYou may also purchase Dependent Optional Life insurance forbull Your opposite or same sex spouse bull Your unmarried children under age 26
ndash Natural adoptedndash Stepchildrenfoster childrenNote you do not need to supply marriage certificatesbirth certificates for dependent optional life
You may electbull $2000 Spouse$1000 Childbull $4000 Spouse $2000 Childbull $10000 Spouse $5000 Child
The bi-weekly rate is not based on salary
Office of Human Resources Montgomery County Government
Flexible Spending Accounts
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Visit the Open Enrollment website to watch a recorded FSA presentation from MCGrsquos FSA vendor Benefit Strategies
bull What is an FSA It is an IRS-approved tax-free account that saves onQualified out-of-pocket medical and dependent care expensesFederal and State Income taxSocial Security Tax
bull 3 Account Options Health Care FSA Child Care FSA and Commuter Choice Transit bull FSA accounts are administered through Benefit Strategies bull FSAs are ldquouse-it or lose-itrdquo accounts claims must be incurred during the 2021 plan year (January 1
2021 ndash March 15 2022) and submitted by April 30 2022
IMPORTANT You must re-enroll in an FSA every Open Enrollment if you want to participate in the upcoming plan year
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Why You Should EnrollGive yourself a raise by reducing your taxesbull Elect the annual amount you want to place in your FSA(s) for the upcoming plan year during Open Enrollmentbull That amount is divided by 26 and taken from your biweekly paychecks on a pre-tax basis (21 paychecks for
10-month employees)bull Then use your pre-tax FSA dollars to pay for eligible out-of-pocket health care child-care or transit
expenses
Office of Human Resources Montgomery County Government
Health Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull Claims must be submitted by April 30 of the following yearbull You may elect to contribute up to $2750 Your total annual election amount is available to spend on the first
day of the new plan year bull FSA debit card allows you to pay for expenses at the time of servicebull Examples of IRS qualified eligible expenses
bull Copays (medical prescription dental vision) deductibles and coinsurance amounts over reasonable and customary charge
bull Hearing aids bull Acupuncture bull Orthopedic shoes bull Over-the-counter (OTC) drugs (no longer require doctorrsquos prescription)
Office of Human Resources Montgomery County Government
Child Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull $5000 annual maximum per household ($2500 for married filing separately)bull Funds are available to spend as they are accumulated through payroll deductionsbull Reimbursable expenses
bull day care centersbull elder carebull beforeafter school carebull babysitter fees that allow you and your spouse to work or go to school (no child support payments)
bull Qualifying dependentsbull Children under the age of 13 and are a tax dependent of the employeebull Spouse or tax dependent that is physically or mentally incapable of self-care
bull Must coordinate between filing a tax credit with IRS and your Dependent Care FSA plan
Office of Human Resources Montgomery County Government
Commuter Choice Transit FSAbull $230 per month maximum for MCGEO staff $260 per month maximum for Unrepresented staffbull Applies to employee commuting expenses only (not spouses or dependents)bull Can enroll throughout the year (not limited to Open Enrollment election)bull Eligible expenses include Metro Marc Vanpool Lyft Line Uber Poolbull Debit card ndash may be used for some expenses (not Metro)Metro riders will have to submit claim forms for reimbursement
bull Funds must be used within 180 days of election bull If retiring or leaving the County will need to coordinate use all available funds
Office of Human Resources Montgomery County Government
Using Your FSA FundsHealth Care FSA Your full annual election amount is available on the first day of the plan yearChild Care FSA Your funds are available as they accumulate through payroll deductionsCommuterTransit FSA Your funds are available as they accumulate through payroll deductions
The FSA Debit Card bull Your FSA debit card is the same card for your Health Care Child Care and TransitCommuter FSA accountsbull The card is pre-loaded with your full annual Health Care FSA election amount You can use the card to pay for IRS qualified expenses at
the time of service or when paying a bill Receipt notifications will be mailed to you monthly by Benefit Strategies Your response to receipt notifications is necessary under the provisions of the plan No response my result in the ineligibility of the purchase and as a result your card may be temporarily deactivated
bull If you are enrolled in the Child Care FSA the card can also be used in child-care settings Just remember that the card will only work for an amount that does not exceed the available balance in your Child Care FSA account on that day
bull The card can also be used to pay for your commutertransit expenses however it does not work for WMATA metro Metro riders will have to submit manual claims for reimbursement from your CommuterTransit FSA
bull Cards are re-loaded each year after you make your new annual election Please keep your cards You will only receive a new card if your old card is about to expire
Office of Human Resources Montgomery County Government
AFLAC Voluntary Plans
Office of Human Resources Montgomery County Government
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Short-Term Disabilitybull Provides short-term cash benefits in the event of disabilitybull Monthly benefit amounts available from $500 - $6000 (subject to income requirements)bull Benefit options of 3 6 12 18 or 24 months with a variety of elimination periods
Critical Illness Insurancebull Provides a lump sum cash benefit in the event of critical illnessbull Benefit amounts available in $5000 increments from $10000 - $30000
Participants pay 100 through payroll deduction for Short-Term Disability and Critical Illness Insurance
To ENROLL Text SETAPPTrdquo to 41411orCall 920-420-8861 orEmail susan_mcdanielusAflaccom
Office of Human Resources Montgomery County Government
Carrier Resources amp Cost-Saving Tips
Office of Human Resources Montgomery County Government
Lower Your Out-of-Pocket CostsChoose the plan thatrsquos right for youbull See the medical benefits chart for options bull Stay in network Use the provider search engines on your carrier website or mobile app to find in-network providersSeek preventive carebull Check-ups immunizations and screenings are an important part of staying healthy They can detect or prevent serious diseases and keep you healthyKnow where to go for carebull You have many options of places to go when you need care If your medical condition isnrsquot serious or life threatening you can save money by connecting
with a doctor online through a virtual visit or going to an urgent care center or convenience care clinic instead of a hospital emergency roomReview your prescription drug plan optionsbull Decide which Caremark prescription plan is best for you Note that the Kaiser HMO includes prescription drug coverage Both the Standard and High
Option Caremark plans cover the same prescription drugs but have different copay and deductiblesUse generic and long-term prescriptions bull Opt for lower-cost generic drugs whenever possible bull Ask your doctor to write a 90-day prescription instead of a 30-day prescription to participate in the mail order prescription programTake advantage of tax savings by participating in Flexible Spending Accountsbull Use pre-tax dollars for eligible out of pocket services and items
Office of Human Resources Montgomery County Government
Built-in Wellness Support Take advantage of the free programs available to you through your medical carrier Each of MCGrsquos medical carriers (Kaiser UHC amp CareFirst) offer valuable programs to help you manage your health
Disease Management Programsbull Help manage your chronic condition through personalized coaching support and encouragement and online education materialsEmotional Wellness amp Stress Management Support bull Help manage stress through mobile apps and other self-care resources Maternity Programsbull Support healthy moms and healthy babiesWeight-loss Programs bull Offers telephonic coaching support and web-based tools to help ensure long-term weight managementbull See the next slide for an example of an MCG success storySmoking Cessation Programsbull Supportive coaching to make quitting more successfulDiscounts bull Gym memberships weight loss programs and moreFor more information about the programs available to you please see the Open Enrollment Guide and contact your medical carrier
Office of Human Resources Montgomery County Government
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You GoAll of MCGrsquos health insurance carriers offer a simple-to-use tool that can help make your life easier while yoursquore on the go Download your carrierrsquos Mobile App to help you personalize organize and access your important plan information on your phone or tablet
bull Schedule Virtual Visitsbull Manage and track claimsbull View ID card informationbull Find doctor and compare costs and quality ratingsbull Review your coveragebull Track your account balances and deductiblesbull Access a variety of health and wellness tools
Visit Google Play or the Apple App Store to download your carrierrsquos App
Office of Human Resources Montgomery County Government
Making Changes
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Questions
Office of Human Resources Montgomery County Government
Open Enrollment AssistanceFollow these steps (in this order)1 Review the frequently asked questions (FAQs) on the Open Enrollment website at wwwmontgomerycountymdgovoe
(available beginning September 21) You can enter key words into the interactive search bar to quickly locate the answer to your question
2 Visit the MC311 website at wwwmontgomerycountymdgovmc311 and search key words for your question The search results contain various knowledge-based articles with information related to your search words Simply click on the corresponding link and the detailed answer is revealed
3 Attend one of OHRrsquos Virtual Office Hours via Microsoft Teams Members of OHRs Health Insurance Team will be on hand to address employee questions by video or via the chat box View the schedule and access the sessions through the Open Enrollment website at wwwmontgomerycountymdgovoe (available beginning September 21)
4 If you have tried all the methods above and still have Open Enrollment-related questions please contact OHRs MC311 Customer Service Center at 240-773-6471 (Mon-Fri 8 am - 5 pm) to open a service request A member of the health insurance team will respond to service requests in the order they are received Tip Please provide an email address at the time you place your Service Request This will ensure the fastest response possible
Office of Human Resources Montgomery County Government
Online ResourcesVisit the 2021 Open Enrollment Webpage
wwwmontgomerycountymdgovOE
Visit OHRrsquos WebpagewwwmontgomerycountymdgovHR
Health Insurance active employees
Office of Human Resources Montgomery County Government
Legal InformationThe County reserves the right at any time and for any reason to amend the Program subject to the Countys collective bargainingagreements The County expects to continue the Program but it is the Countys position that there is no implied contract between individual employees and the County to do so
The County may amend the Program prospectively or retroactively to comply with applicable law
In the event of a conflict between this presentation the County Code andor the Summary Description the County Code then the Summary Description will govern
Office of Human Resources Montgomery County Government
Thank YouWe hope you enjoyed learning about 2021 Open Enrollment
~Your OHR Health Insurance Team
2021 Open Enrollment Benefits Bonanza
What Is Open Enrollment
What Changes Can be Made
Open Enrollment Dates
MCG Continues to Make Generous Employer Contributions
New for 2021
Special 2021 Plan Rates Announcement
Employee Rate Changes for Calendar Year 2021
Planning Ahead Minimizing Future Rate Increases
New for 2021
Open Enrollment Communications
Itrsquos a New Frontier
2021 Open Enrollment Checklist
Open Enrollment Website Resources
Attend a Virtual Open Enrollment Event
Make Changes Online
Paper Enrollment Form Permitted for Only Two Reasons
Dependent Eligibility
Proof of Dependent Eligibility
Marriage Certificate Example Required Documentation (Contd)
Benefits Refresher
Medical amp Rx
Medical Plan Options
Medical Benefits at-a-Glance
Medical Benefits at-a-Glance (contd)
Prescription Plans Caremark
Prescription Drug Plan Comparison
Prescription Drug Cost Comparison
Dental
Slide Number 30
Vision
Vision Insurance
Optional Life amp Dependent Life
Optional Life Insurance ADampD
Optional Life Insurance Rates
Dependent Life Insurance
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs)Why You Should Enroll
Health Care FSA
Child Care FSA
Commuter Choice Transit FSA
Using Your FSA Funds
AFLAC Voluntary Plans
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Carrier Resources amp Cost-Saving Tips
Lower Your Out-of-Pocket Costs
Built-in Wellness Support
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You Go
Making Changes
Make Changes Online
Questions
Open Enrollment Assistance
Online Resources
Legal Information
Thank You
Cigna Dental Comparison
DHMO
PPO
CIGNA NETWORK
Care-Access PlusDHMO
Total CIGNA PPOPPO
Required to Use An Assigned Provider
Yes In-network only Primary Dental Office will be assigned based on home address
No
Out of Network Benefits Available
No
Yes
Balance Billing for Covered Services
No
Yes if you go out-of-network
Referral Required
Yes
No
Orthodontia Benefits Available
Yes(ANY AGE)
Yes(ANY AGE)
Orthodontia Maximum (Lifetime)
Unlimited Amount treatment limited to 24 months
$100000
Annual Maximum (per person)
Unlimited
$200000
Deductible (singlefamily)
None
$50 $ 150 waived for preventive care
1Claim submission would be required and balance billing may occur when visiting a nonparticipating provider2Deductible does not apply to Class I ndash Diagnostic and Preventive Services
Coverage for dependents would cease on the day which the child turns 26Benefit Maximum and Deductibles are for the period of January 01 through December 31
All services listed on this benefit summary are subject to the contractSchedules of Benefits and current Exclusions and Limitations
Office of Human Resources Montgomery County Government
Vision
Office of Human Resources Montgomery County Government
Vision Insurancebull The Countyrsquos Vision carrier is EyeMedbull Benefits payable for exams lenses and contacts (elective or necessary) every
calendar year frames every two calendar yearsbull In-network or out-of-network benefits available bull Enhanced Hearing Benefit through EyeMedrsquos partner Amplifon40 off hearing examDiscounted pricing on thousands of hearing aids including latest technologyOne-year free follow-up care with unlimited appointmentsFree batteries for two years with initial purchase Three-year warranty and loss and damage coverage
Visit OHRrsquos Health Insurance webpage to view vision summary
Office of Human Resources Montgomery County Government
Optional Life amp Dependent Life
Office of Human Resources Montgomery County Government
Optional Life Insurance ADampDbull You may elect Optional Life ADampD coverage for yourself in increments of 1 to 8 times
your basic annual earnings ($1 million maximum)
bull NOTE Coverage is not guaranteed issue for any level You must complete an online Statement of Health no matter what level of coverage you elect Later this fall after Open Enrollment ends you will receive an email from MetLife with a link to complete the Statement of Health online
bull An eligible dependent is defined as 1) your opposite or same sex spouse or 2) your unmarried children under age 26 (natural adopted or stepchildrenfoster children who depend on your support)
Office of Human Resources Montgomery County Government
Optional Life Insurance RatesHow to estimate your Optional Life Insurance bi-weekly rate
Example 40-year-old applying for 2 x salary Salary is $49300
Steps Example Calculate for Yourself
A Find your age-based rate on the rate sheet (left) $ 0037 $_________________
B Choose how much coverage you are applying for
$99000 (2 x salary rounded to the nearest $1000 ) $_________________
C Divide that coverage amount by 100099 ($99000 1000) $_________________
D Multiply A x C for estimated bi-weekly cost$366 ($037 x 99) $_________________
Office of Human Resources Montgomery County Government
Dependent Life InsuranceYou may also purchase Dependent Optional Life insurance forbull Your opposite or same sex spouse bull Your unmarried children under age 26
ndash Natural adoptedndash Stepchildrenfoster childrenNote you do not need to supply marriage certificatesbirth certificates for dependent optional life
You may electbull $2000 Spouse$1000 Childbull $4000 Spouse $2000 Childbull $10000 Spouse $5000 Child
The bi-weekly rate is not based on salary
Office of Human Resources Montgomery County Government
Flexible Spending Accounts
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Visit the Open Enrollment website to watch a recorded FSA presentation from MCGrsquos FSA vendor Benefit Strategies
bull What is an FSA It is an IRS-approved tax-free account that saves onQualified out-of-pocket medical and dependent care expensesFederal and State Income taxSocial Security Tax
bull 3 Account Options Health Care FSA Child Care FSA and Commuter Choice Transit bull FSA accounts are administered through Benefit Strategies bull FSAs are ldquouse-it or lose-itrdquo accounts claims must be incurred during the 2021 plan year (January 1
2021 ndash March 15 2022) and submitted by April 30 2022
IMPORTANT You must re-enroll in an FSA every Open Enrollment if you want to participate in the upcoming plan year
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Why You Should EnrollGive yourself a raise by reducing your taxesbull Elect the annual amount you want to place in your FSA(s) for the upcoming plan year during Open Enrollmentbull That amount is divided by 26 and taken from your biweekly paychecks on a pre-tax basis (21 paychecks for
10-month employees)bull Then use your pre-tax FSA dollars to pay for eligible out-of-pocket health care child-care or transit
expenses
Office of Human Resources Montgomery County Government
Health Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull Claims must be submitted by April 30 of the following yearbull You may elect to contribute up to $2750 Your total annual election amount is available to spend on the first
day of the new plan year bull FSA debit card allows you to pay for expenses at the time of servicebull Examples of IRS qualified eligible expenses
bull Copays (medical prescription dental vision) deductibles and coinsurance amounts over reasonable and customary charge
bull Hearing aids bull Acupuncture bull Orthopedic shoes bull Over-the-counter (OTC) drugs (no longer require doctorrsquos prescription)
Office of Human Resources Montgomery County Government
Child Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull $5000 annual maximum per household ($2500 for married filing separately)bull Funds are available to spend as they are accumulated through payroll deductionsbull Reimbursable expenses
bull day care centersbull elder carebull beforeafter school carebull babysitter fees that allow you and your spouse to work or go to school (no child support payments)
bull Qualifying dependentsbull Children under the age of 13 and are a tax dependent of the employeebull Spouse or tax dependent that is physically or mentally incapable of self-care
bull Must coordinate between filing a tax credit with IRS and your Dependent Care FSA plan
Office of Human Resources Montgomery County Government
Commuter Choice Transit FSAbull $230 per month maximum for MCGEO staff $260 per month maximum for Unrepresented staffbull Applies to employee commuting expenses only (not spouses or dependents)bull Can enroll throughout the year (not limited to Open Enrollment election)bull Eligible expenses include Metro Marc Vanpool Lyft Line Uber Poolbull Debit card ndash may be used for some expenses (not Metro)Metro riders will have to submit claim forms for reimbursement
bull Funds must be used within 180 days of election bull If retiring or leaving the County will need to coordinate use all available funds
Office of Human Resources Montgomery County Government
Using Your FSA FundsHealth Care FSA Your full annual election amount is available on the first day of the plan yearChild Care FSA Your funds are available as they accumulate through payroll deductionsCommuterTransit FSA Your funds are available as they accumulate through payroll deductions
The FSA Debit Card bull Your FSA debit card is the same card for your Health Care Child Care and TransitCommuter FSA accountsbull The card is pre-loaded with your full annual Health Care FSA election amount You can use the card to pay for IRS qualified expenses at
the time of service or when paying a bill Receipt notifications will be mailed to you monthly by Benefit Strategies Your response to receipt notifications is necessary under the provisions of the plan No response my result in the ineligibility of the purchase and as a result your card may be temporarily deactivated
bull If you are enrolled in the Child Care FSA the card can also be used in child-care settings Just remember that the card will only work for an amount that does not exceed the available balance in your Child Care FSA account on that day
bull The card can also be used to pay for your commutertransit expenses however it does not work for WMATA metro Metro riders will have to submit manual claims for reimbursement from your CommuterTransit FSA
bull Cards are re-loaded each year after you make your new annual election Please keep your cards You will only receive a new card if your old card is about to expire
Office of Human Resources Montgomery County Government
AFLAC Voluntary Plans
Office of Human Resources Montgomery County Government
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Short-Term Disabilitybull Provides short-term cash benefits in the event of disabilitybull Monthly benefit amounts available from $500 - $6000 (subject to income requirements)bull Benefit options of 3 6 12 18 or 24 months with a variety of elimination periods
Critical Illness Insurancebull Provides a lump sum cash benefit in the event of critical illnessbull Benefit amounts available in $5000 increments from $10000 - $30000
Participants pay 100 through payroll deduction for Short-Term Disability and Critical Illness Insurance
To ENROLL Text SETAPPTrdquo to 41411orCall 920-420-8861 orEmail susan_mcdanielusAflaccom
Office of Human Resources Montgomery County Government
Carrier Resources amp Cost-Saving Tips
Office of Human Resources Montgomery County Government
Lower Your Out-of-Pocket CostsChoose the plan thatrsquos right for youbull See the medical benefits chart for options bull Stay in network Use the provider search engines on your carrier website or mobile app to find in-network providersSeek preventive carebull Check-ups immunizations and screenings are an important part of staying healthy They can detect or prevent serious diseases and keep you healthyKnow where to go for carebull You have many options of places to go when you need care If your medical condition isnrsquot serious or life threatening you can save money by connecting
with a doctor online through a virtual visit or going to an urgent care center or convenience care clinic instead of a hospital emergency roomReview your prescription drug plan optionsbull Decide which Caremark prescription plan is best for you Note that the Kaiser HMO includes prescription drug coverage Both the Standard and High
Option Caremark plans cover the same prescription drugs but have different copay and deductiblesUse generic and long-term prescriptions bull Opt for lower-cost generic drugs whenever possible bull Ask your doctor to write a 90-day prescription instead of a 30-day prescription to participate in the mail order prescription programTake advantage of tax savings by participating in Flexible Spending Accountsbull Use pre-tax dollars for eligible out of pocket services and items
Office of Human Resources Montgomery County Government
Built-in Wellness Support Take advantage of the free programs available to you through your medical carrier Each of MCGrsquos medical carriers (Kaiser UHC amp CareFirst) offer valuable programs to help you manage your health
Disease Management Programsbull Help manage your chronic condition through personalized coaching support and encouragement and online education materialsEmotional Wellness amp Stress Management Support bull Help manage stress through mobile apps and other self-care resources Maternity Programsbull Support healthy moms and healthy babiesWeight-loss Programs bull Offers telephonic coaching support and web-based tools to help ensure long-term weight managementbull See the next slide for an example of an MCG success storySmoking Cessation Programsbull Supportive coaching to make quitting more successfulDiscounts bull Gym memberships weight loss programs and moreFor more information about the programs available to you please see the Open Enrollment Guide and contact your medical carrier
Office of Human Resources Montgomery County Government
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You GoAll of MCGrsquos health insurance carriers offer a simple-to-use tool that can help make your life easier while yoursquore on the go Download your carrierrsquos Mobile App to help you personalize organize and access your important plan information on your phone or tablet
bull Schedule Virtual Visitsbull Manage and track claimsbull View ID card informationbull Find doctor and compare costs and quality ratingsbull Review your coveragebull Track your account balances and deductiblesbull Access a variety of health and wellness tools
Visit Google Play or the Apple App Store to download your carrierrsquos App
Office of Human Resources Montgomery County Government
Making Changes
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Questions
Office of Human Resources Montgomery County Government
Open Enrollment AssistanceFollow these steps (in this order)1 Review the frequently asked questions (FAQs) on the Open Enrollment website at wwwmontgomerycountymdgovoe
(available beginning September 21) You can enter key words into the interactive search bar to quickly locate the answer to your question
2 Visit the MC311 website at wwwmontgomerycountymdgovmc311 and search key words for your question The search results contain various knowledge-based articles with information related to your search words Simply click on the corresponding link and the detailed answer is revealed
3 Attend one of OHRrsquos Virtual Office Hours via Microsoft Teams Members of OHRs Health Insurance Team will be on hand to address employee questions by video or via the chat box View the schedule and access the sessions through the Open Enrollment website at wwwmontgomerycountymdgovoe (available beginning September 21)
4 If you have tried all the methods above and still have Open Enrollment-related questions please contact OHRs MC311 Customer Service Center at 240-773-6471 (Mon-Fri 8 am - 5 pm) to open a service request A member of the health insurance team will respond to service requests in the order they are received Tip Please provide an email address at the time you place your Service Request This will ensure the fastest response possible
Office of Human Resources Montgomery County Government
Online ResourcesVisit the 2021 Open Enrollment Webpage
wwwmontgomerycountymdgovOE
Visit OHRrsquos WebpagewwwmontgomerycountymdgovHR
Health Insurance active employees
Office of Human Resources Montgomery County Government
Legal InformationThe County reserves the right at any time and for any reason to amend the Program subject to the Countys collective bargainingagreements The County expects to continue the Program but it is the Countys position that there is no implied contract between individual employees and the County to do so
The County may amend the Program prospectively or retroactively to comply with applicable law
In the event of a conflict between this presentation the County Code andor the Summary Description the County Code then the Summary Description will govern
Office of Human Resources Montgomery County Government
Thank YouWe hope you enjoyed learning about 2021 Open Enrollment
~Your OHR Health Insurance Team
2021 Open Enrollment Benefits Bonanza
What Is Open Enrollment
What Changes Can be Made
Open Enrollment Dates
MCG Continues to Make Generous Employer Contributions
New for 2021
Special 2021 Plan Rates Announcement
Employee Rate Changes for Calendar Year 2021
Planning Ahead Minimizing Future Rate Increases
New for 2021
Open Enrollment Communications
Itrsquos a New Frontier
2021 Open Enrollment Checklist
Open Enrollment Website Resources
Attend a Virtual Open Enrollment Event
Make Changes Online
Paper Enrollment Form Permitted for Only Two Reasons
Dependent Eligibility
Proof of Dependent Eligibility
Marriage Certificate Example Required Documentation (Contd)
Benefits Refresher
Medical amp Rx
Medical Plan Options
Medical Benefits at-a-Glance
Medical Benefits at-a-Glance (contd)
Prescription Plans Caremark
Prescription Drug Plan Comparison
Prescription Drug Cost Comparison
Dental
Slide Number 30
Vision
Vision Insurance
Optional Life amp Dependent Life
Optional Life Insurance ADampD
Optional Life Insurance Rates
Dependent Life Insurance
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs)Why You Should Enroll
Health Care FSA
Child Care FSA
Commuter Choice Transit FSA
Using Your FSA Funds
AFLAC Voluntary Plans
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Carrier Resources amp Cost-Saving Tips
Lower Your Out-of-Pocket Costs
Built-in Wellness Support
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You Go
Making Changes
Make Changes Online
Questions
Open Enrollment Assistance
Online Resources
Legal Information
Thank You
Office of Human Resources Montgomery County Government
Vision Insurancebull The Countyrsquos Vision carrier is EyeMedbull Benefits payable for exams lenses and contacts (elective or necessary) every
calendar year frames every two calendar yearsbull In-network or out-of-network benefits available bull Enhanced Hearing Benefit through EyeMedrsquos partner Amplifon40 off hearing examDiscounted pricing on thousands of hearing aids including latest technologyOne-year free follow-up care with unlimited appointmentsFree batteries for two years with initial purchase Three-year warranty and loss and damage coverage
Visit OHRrsquos Health Insurance webpage to view vision summary
Office of Human Resources Montgomery County Government
Optional Life amp Dependent Life
Office of Human Resources Montgomery County Government
Optional Life Insurance ADampDbull You may elect Optional Life ADampD coverage for yourself in increments of 1 to 8 times
your basic annual earnings ($1 million maximum)
bull NOTE Coverage is not guaranteed issue for any level You must complete an online Statement of Health no matter what level of coverage you elect Later this fall after Open Enrollment ends you will receive an email from MetLife with a link to complete the Statement of Health online
bull An eligible dependent is defined as 1) your opposite or same sex spouse or 2) your unmarried children under age 26 (natural adopted or stepchildrenfoster children who depend on your support)
Office of Human Resources Montgomery County Government
Optional Life Insurance RatesHow to estimate your Optional Life Insurance bi-weekly rate
Example 40-year-old applying for 2 x salary Salary is $49300
Steps Example Calculate for Yourself
A Find your age-based rate on the rate sheet (left) $ 0037 $_________________
B Choose how much coverage you are applying for
$99000 (2 x salary rounded to the nearest $1000 ) $_________________
C Divide that coverage amount by 100099 ($99000 1000) $_________________
D Multiply A x C for estimated bi-weekly cost$366 ($037 x 99) $_________________
Office of Human Resources Montgomery County Government
Dependent Life InsuranceYou may also purchase Dependent Optional Life insurance forbull Your opposite or same sex spouse bull Your unmarried children under age 26
ndash Natural adoptedndash Stepchildrenfoster childrenNote you do not need to supply marriage certificatesbirth certificates for dependent optional life
You may electbull $2000 Spouse$1000 Childbull $4000 Spouse $2000 Childbull $10000 Spouse $5000 Child
The bi-weekly rate is not based on salary
Office of Human Resources Montgomery County Government
Flexible Spending Accounts
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Visit the Open Enrollment website to watch a recorded FSA presentation from MCGrsquos FSA vendor Benefit Strategies
bull What is an FSA It is an IRS-approved tax-free account that saves onQualified out-of-pocket medical and dependent care expensesFederal and State Income taxSocial Security Tax
bull 3 Account Options Health Care FSA Child Care FSA and Commuter Choice Transit bull FSA accounts are administered through Benefit Strategies bull FSAs are ldquouse-it or lose-itrdquo accounts claims must be incurred during the 2021 plan year (January 1
2021 ndash March 15 2022) and submitted by April 30 2022
IMPORTANT You must re-enroll in an FSA every Open Enrollment if you want to participate in the upcoming plan year
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Why You Should EnrollGive yourself a raise by reducing your taxesbull Elect the annual amount you want to place in your FSA(s) for the upcoming plan year during Open Enrollmentbull That amount is divided by 26 and taken from your biweekly paychecks on a pre-tax basis (21 paychecks for
10-month employees)bull Then use your pre-tax FSA dollars to pay for eligible out-of-pocket health care child-care or transit
expenses
Office of Human Resources Montgomery County Government
Health Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull Claims must be submitted by April 30 of the following yearbull You may elect to contribute up to $2750 Your total annual election amount is available to spend on the first
day of the new plan year bull FSA debit card allows you to pay for expenses at the time of servicebull Examples of IRS qualified eligible expenses
bull Copays (medical prescription dental vision) deductibles and coinsurance amounts over reasonable and customary charge
bull Hearing aids bull Acupuncture bull Orthopedic shoes bull Over-the-counter (OTC) drugs (no longer require doctorrsquos prescription)
Office of Human Resources Montgomery County Government
Child Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull $5000 annual maximum per household ($2500 for married filing separately)bull Funds are available to spend as they are accumulated through payroll deductionsbull Reimbursable expenses
bull day care centersbull elder carebull beforeafter school carebull babysitter fees that allow you and your spouse to work or go to school (no child support payments)
bull Qualifying dependentsbull Children under the age of 13 and are a tax dependent of the employeebull Spouse or tax dependent that is physically or mentally incapable of self-care
bull Must coordinate between filing a tax credit with IRS and your Dependent Care FSA plan
Office of Human Resources Montgomery County Government
Commuter Choice Transit FSAbull $230 per month maximum for MCGEO staff $260 per month maximum for Unrepresented staffbull Applies to employee commuting expenses only (not spouses or dependents)bull Can enroll throughout the year (not limited to Open Enrollment election)bull Eligible expenses include Metro Marc Vanpool Lyft Line Uber Poolbull Debit card ndash may be used for some expenses (not Metro)Metro riders will have to submit claim forms for reimbursement
bull Funds must be used within 180 days of election bull If retiring or leaving the County will need to coordinate use all available funds
Office of Human Resources Montgomery County Government
Using Your FSA FundsHealth Care FSA Your full annual election amount is available on the first day of the plan yearChild Care FSA Your funds are available as they accumulate through payroll deductionsCommuterTransit FSA Your funds are available as they accumulate through payroll deductions
The FSA Debit Card bull Your FSA debit card is the same card for your Health Care Child Care and TransitCommuter FSA accountsbull The card is pre-loaded with your full annual Health Care FSA election amount You can use the card to pay for IRS qualified expenses at
the time of service or when paying a bill Receipt notifications will be mailed to you monthly by Benefit Strategies Your response to receipt notifications is necessary under the provisions of the plan No response my result in the ineligibility of the purchase and as a result your card may be temporarily deactivated
bull If you are enrolled in the Child Care FSA the card can also be used in child-care settings Just remember that the card will only work for an amount that does not exceed the available balance in your Child Care FSA account on that day
bull The card can also be used to pay for your commutertransit expenses however it does not work for WMATA metro Metro riders will have to submit manual claims for reimbursement from your CommuterTransit FSA
bull Cards are re-loaded each year after you make your new annual election Please keep your cards You will only receive a new card if your old card is about to expire
Office of Human Resources Montgomery County Government
AFLAC Voluntary Plans
Office of Human Resources Montgomery County Government
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Short-Term Disabilitybull Provides short-term cash benefits in the event of disabilitybull Monthly benefit amounts available from $500 - $6000 (subject to income requirements)bull Benefit options of 3 6 12 18 or 24 months with a variety of elimination periods
Critical Illness Insurancebull Provides a lump sum cash benefit in the event of critical illnessbull Benefit amounts available in $5000 increments from $10000 - $30000
Participants pay 100 through payroll deduction for Short-Term Disability and Critical Illness Insurance
To ENROLL Text SETAPPTrdquo to 41411orCall 920-420-8861 orEmail susan_mcdanielusAflaccom
Office of Human Resources Montgomery County Government
Carrier Resources amp Cost-Saving Tips
Office of Human Resources Montgomery County Government
Lower Your Out-of-Pocket CostsChoose the plan thatrsquos right for youbull See the medical benefits chart for options bull Stay in network Use the provider search engines on your carrier website or mobile app to find in-network providersSeek preventive carebull Check-ups immunizations and screenings are an important part of staying healthy They can detect or prevent serious diseases and keep you healthyKnow where to go for carebull You have many options of places to go when you need care If your medical condition isnrsquot serious or life threatening you can save money by connecting
with a doctor online through a virtual visit or going to an urgent care center or convenience care clinic instead of a hospital emergency roomReview your prescription drug plan optionsbull Decide which Caremark prescription plan is best for you Note that the Kaiser HMO includes prescription drug coverage Both the Standard and High
Option Caremark plans cover the same prescription drugs but have different copay and deductiblesUse generic and long-term prescriptions bull Opt for lower-cost generic drugs whenever possible bull Ask your doctor to write a 90-day prescription instead of a 30-day prescription to participate in the mail order prescription programTake advantage of tax savings by participating in Flexible Spending Accountsbull Use pre-tax dollars for eligible out of pocket services and items
Office of Human Resources Montgomery County Government
Built-in Wellness Support Take advantage of the free programs available to you through your medical carrier Each of MCGrsquos medical carriers (Kaiser UHC amp CareFirst) offer valuable programs to help you manage your health
Disease Management Programsbull Help manage your chronic condition through personalized coaching support and encouragement and online education materialsEmotional Wellness amp Stress Management Support bull Help manage stress through mobile apps and other self-care resources Maternity Programsbull Support healthy moms and healthy babiesWeight-loss Programs bull Offers telephonic coaching support and web-based tools to help ensure long-term weight managementbull See the next slide for an example of an MCG success storySmoking Cessation Programsbull Supportive coaching to make quitting more successfulDiscounts bull Gym memberships weight loss programs and moreFor more information about the programs available to you please see the Open Enrollment Guide and contact your medical carrier
Office of Human Resources Montgomery County Government
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You GoAll of MCGrsquos health insurance carriers offer a simple-to-use tool that can help make your life easier while yoursquore on the go Download your carrierrsquos Mobile App to help you personalize organize and access your important plan information on your phone or tablet
bull Schedule Virtual Visitsbull Manage and track claimsbull View ID card informationbull Find doctor and compare costs and quality ratingsbull Review your coveragebull Track your account balances and deductiblesbull Access a variety of health and wellness tools
Visit Google Play or the Apple App Store to download your carrierrsquos App
Office of Human Resources Montgomery County Government
Making Changes
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Questions
Office of Human Resources Montgomery County Government
Open Enrollment AssistanceFollow these steps (in this order)1 Review the frequently asked questions (FAQs) on the Open Enrollment website at wwwmontgomerycountymdgovoe
(available beginning September 21) You can enter key words into the interactive search bar to quickly locate the answer to your question
2 Visit the MC311 website at wwwmontgomerycountymdgovmc311 and search key words for your question The search results contain various knowledge-based articles with information related to your search words Simply click on the corresponding link and the detailed answer is revealed
3 Attend one of OHRrsquos Virtual Office Hours via Microsoft Teams Members of OHRs Health Insurance Team will be on hand to address employee questions by video or via the chat box View the schedule and access the sessions through the Open Enrollment website at wwwmontgomerycountymdgovoe (available beginning September 21)
4 If you have tried all the methods above and still have Open Enrollment-related questions please contact OHRs MC311 Customer Service Center at 240-773-6471 (Mon-Fri 8 am - 5 pm) to open a service request A member of the health insurance team will respond to service requests in the order they are received Tip Please provide an email address at the time you place your Service Request This will ensure the fastest response possible
Office of Human Resources Montgomery County Government
Online ResourcesVisit the 2021 Open Enrollment Webpage
wwwmontgomerycountymdgovOE
Visit OHRrsquos WebpagewwwmontgomerycountymdgovHR
Health Insurance active employees
Office of Human Resources Montgomery County Government
Legal InformationThe County reserves the right at any time and for any reason to amend the Program subject to the Countys collective bargainingagreements The County expects to continue the Program but it is the Countys position that there is no implied contract between individual employees and the County to do so
The County may amend the Program prospectively or retroactively to comply with applicable law
In the event of a conflict between this presentation the County Code andor the Summary Description the County Code then the Summary Description will govern
Office of Human Resources Montgomery County Government
Thank YouWe hope you enjoyed learning about 2021 Open Enrollment
~Your OHR Health Insurance Team
2021 Open Enrollment Benefits Bonanza
What Is Open Enrollment
What Changes Can be Made
Open Enrollment Dates
MCG Continues to Make Generous Employer Contributions
New for 2021
Special 2021 Plan Rates Announcement
Employee Rate Changes for Calendar Year 2021
Planning Ahead Minimizing Future Rate Increases
New for 2021
Open Enrollment Communications
Itrsquos a New Frontier
2021 Open Enrollment Checklist
Open Enrollment Website Resources
Attend a Virtual Open Enrollment Event
Make Changes Online
Paper Enrollment Form Permitted for Only Two Reasons
Dependent Eligibility
Proof of Dependent Eligibility
Marriage Certificate Example Required Documentation (Contd)
Benefits Refresher
Medical amp Rx
Medical Plan Options
Medical Benefits at-a-Glance
Medical Benefits at-a-Glance (contd)
Prescription Plans Caremark
Prescription Drug Plan Comparison
Prescription Drug Cost Comparison
Dental
Slide Number 30
Vision
Vision Insurance
Optional Life amp Dependent Life
Optional Life Insurance ADampD
Optional Life Insurance Rates
Dependent Life Insurance
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs)Why You Should Enroll
Health Care FSA
Child Care FSA
Commuter Choice Transit FSA
Using Your FSA Funds
AFLAC Voluntary Plans
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Carrier Resources amp Cost-Saving Tips
Lower Your Out-of-Pocket Costs
Built-in Wellness Support
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You Go
Making Changes
Make Changes Online
Questions
Open Enrollment Assistance
Online Resources
Legal Information
Thank You
Office of Human Resources Montgomery County Government
Optional Life amp Dependent Life
Office of Human Resources Montgomery County Government
Optional Life Insurance ADampDbull You may elect Optional Life ADampD coverage for yourself in increments of 1 to 8 times
your basic annual earnings ($1 million maximum)
bull NOTE Coverage is not guaranteed issue for any level You must complete an online Statement of Health no matter what level of coverage you elect Later this fall after Open Enrollment ends you will receive an email from MetLife with a link to complete the Statement of Health online
bull An eligible dependent is defined as 1) your opposite or same sex spouse or 2) your unmarried children under age 26 (natural adopted or stepchildrenfoster children who depend on your support)
Office of Human Resources Montgomery County Government
Optional Life Insurance RatesHow to estimate your Optional Life Insurance bi-weekly rate
Example 40-year-old applying for 2 x salary Salary is $49300
Steps Example Calculate for Yourself
A Find your age-based rate on the rate sheet (left) $ 0037 $_________________
B Choose how much coverage you are applying for
$99000 (2 x salary rounded to the nearest $1000 ) $_________________
C Divide that coverage amount by 100099 ($99000 1000) $_________________
D Multiply A x C for estimated bi-weekly cost$366 ($037 x 99) $_________________
Office of Human Resources Montgomery County Government
Dependent Life InsuranceYou may also purchase Dependent Optional Life insurance forbull Your opposite or same sex spouse bull Your unmarried children under age 26
ndash Natural adoptedndash Stepchildrenfoster childrenNote you do not need to supply marriage certificatesbirth certificates for dependent optional life
You may electbull $2000 Spouse$1000 Childbull $4000 Spouse $2000 Childbull $10000 Spouse $5000 Child
The bi-weekly rate is not based on salary
Office of Human Resources Montgomery County Government
Flexible Spending Accounts
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Visit the Open Enrollment website to watch a recorded FSA presentation from MCGrsquos FSA vendor Benefit Strategies
bull What is an FSA It is an IRS-approved tax-free account that saves onQualified out-of-pocket medical and dependent care expensesFederal and State Income taxSocial Security Tax
bull 3 Account Options Health Care FSA Child Care FSA and Commuter Choice Transit bull FSA accounts are administered through Benefit Strategies bull FSAs are ldquouse-it or lose-itrdquo accounts claims must be incurred during the 2021 plan year (January 1
2021 ndash March 15 2022) and submitted by April 30 2022
IMPORTANT You must re-enroll in an FSA every Open Enrollment if you want to participate in the upcoming plan year
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Why You Should EnrollGive yourself a raise by reducing your taxesbull Elect the annual amount you want to place in your FSA(s) for the upcoming plan year during Open Enrollmentbull That amount is divided by 26 and taken from your biweekly paychecks on a pre-tax basis (21 paychecks for
10-month employees)bull Then use your pre-tax FSA dollars to pay for eligible out-of-pocket health care child-care or transit
expenses
Office of Human Resources Montgomery County Government
Health Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull Claims must be submitted by April 30 of the following yearbull You may elect to contribute up to $2750 Your total annual election amount is available to spend on the first
day of the new plan year bull FSA debit card allows you to pay for expenses at the time of servicebull Examples of IRS qualified eligible expenses
bull Copays (medical prescription dental vision) deductibles and coinsurance amounts over reasonable and customary charge
bull Hearing aids bull Acupuncture bull Orthopedic shoes bull Over-the-counter (OTC) drugs (no longer require doctorrsquos prescription)
Office of Human Resources Montgomery County Government
Child Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull $5000 annual maximum per household ($2500 for married filing separately)bull Funds are available to spend as they are accumulated through payroll deductionsbull Reimbursable expenses
bull day care centersbull elder carebull beforeafter school carebull babysitter fees that allow you and your spouse to work or go to school (no child support payments)
bull Qualifying dependentsbull Children under the age of 13 and are a tax dependent of the employeebull Spouse or tax dependent that is physically or mentally incapable of self-care
bull Must coordinate between filing a tax credit with IRS and your Dependent Care FSA plan
Office of Human Resources Montgomery County Government
Commuter Choice Transit FSAbull $230 per month maximum for MCGEO staff $260 per month maximum for Unrepresented staffbull Applies to employee commuting expenses only (not spouses or dependents)bull Can enroll throughout the year (not limited to Open Enrollment election)bull Eligible expenses include Metro Marc Vanpool Lyft Line Uber Poolbull Debit card ndash may be used for some expenses (not Metro)Metro riders will have to submit claim forms for reimbursement
bull Funds must be used within 180 days of election bull If retiring or leaving the County will need to coordinate use all available funds
Office of Human Resources Montgomery County Government
Using Your FSA FundsHealth Care FSA Your full annual election amount is available on the first day of the plan yearChild Care FSA Your funds are available as they accumulate through payroll deductionsCommuterTransit FSA Your funds are available as they accumulate through payroll deductions
The FSA Debit Card bull Your FSA debit card is the same card for your Health Care Child Care and TransitCommuter FSA accountsbull The card is pre-loaded with your full annual Health Care FSA election amount You can use the card to pay for IRS qualified expenses at
the time of service or when paying a bill Receipt notifications will be mailed to you monthly by Benefit Strategies Your response to receipt notifications is necessary under the provisions of the plan No response my result in the ineligibility of the purchase and as a result your card may be temporarily deactivated
bull If you are enrolled in the Child Care FSA the card can also be used in child-care settings Just remember that the card will only work for an amount that does not exceed the available balance in your Child Care FSA account on that day
bull The card can also be used to pay for your commutertransit expenses however it does not work for WMATA metro Metro riders will have to submit manual claims for reimbursement from your CommuterTransit FSA
bull Cards are re-loaded each year after you make your new annual election Please keep your cards You will only receive a new card if your old card is about to expire
Office of Human Resources Montgomery County Government
AFLAC Voluntary Plans
Office of Human Resources Montgomery County Government
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Short-Term Disabilitybull Provides short-term cash benefits in the event of disabilitybull Monthly benefit amounts available from $500 - $6000 (subject to income requirements)bull Benefit options of 3 6 12 18 or 24 months with a variety of elimination periods
Critical Illness Insurancebull Provides a lump sum cash benefit in the event of critical illnessbull Benefit amounts available in $5000 increments from $10000 - $30000
Participants pay 100 through payroll deduction for Short-Term Disability and Critical Illness Insurance
To ENROLL Text SETAPPTrdquo to 41411orCall 920-420-8861 orEmail susan_mcdanielusAflaccom
Office of Human Resources Montgomery County Government
Carrier Resources amp Cost-Saving Tips
Office of Human Resources Montgomery County Government
Lower Your Out-of-Pocket CostsChoose the plan thatrsquos right for youbull See the medical benefits chart for options bull Stay in network Use the provider search engines on your carrier website or mobile app to find in-network providersSeek preventive carebull Check-ups immunizations and screenings are an important part of staying healthy They can detect or prevent serious diseases and keep you healthyKnow where to go for carebull You have many options of places to go when you need care If your medical condition isnrsquot serious or life threatening you can save money by connecting
with a doctor online through a virtual visit or going to an urgent care center or convenience care clinic instead of a hospital emergency roomReview your prescription drug plan optionsbull Decide which Caremark prescription plan is best for you Note that the Kaiser HMO includes prescription drug coverage Both the Standard and High
Option Caremark plans cover the same prescription drugs but have different copay and deductiblesUse generic and long-term prescriptions bull Opt for lower-cost generic drugs whenever possible bull Ask your doctor to write a 90-day prescription instead of a 30-day prescription to participate in the mail order prescription programTake advantage of tax savings by participating in Flexible Spending Accountsbull Use pre-tax dollars for eligible out of pocket services and items
Office of Human Resources Montgomery County Government
Built-in Wellness Support Take advantage of the free programs available to you through your medical carrier Each of MCGrsquos medical carriers (Kaiser UHC amp CareFirst) offer valuable programs to help you manage your health
Disease Management Programsbull Help manage your chronic condition through personalized coaching support and encouragement and online education materialsEmotional Wellness amp Stress Management Support bull Help manage stress through mobile apps and other self-care resources Maternity Programsbull Support healthy moms and healthy babiesWeight-loss Programs bull Offers telephonic coaching support and web-based tools to help ensure long-term weight managementbull See the next slide for an example of an MCG success storySmoking Cessation Programsbull Supportive coaching to make quitting more successfulDiscounts bull Gym memberships weight loss programs and moreFor more information about the programs available to you please see the Open Enrollment Guide and contact your medical carrier
Office of Human Resources Montgomery County Government
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You GoAll of MCGrsquos health insurance carriers offer a simple-to-use tool that can help make your life easier while yoursquore on the go Download your carrierrsquos Mobile App to help you personalize organize and access your important plan information on your phone or tablet
bull Schedule Virtual Visitsbull Manage and track claimsbull View ID card informationbull Find doctor and compare costs and quality ratingsbull Review your coveragebull Track your account balances and deductiblesbull Access a variety of health and wellness tools
Visit Google Play or the Apple App Store to download your carrierrsquos App
Office of Human Resources Montgomery County Government
Making Changes
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Questions
Office of Human Resources Montgomery County Government
Open Enrollment AssistanceFollow these steps (in this order)1 Review the frequently asked questions (FAQs) on the Open Enrollment website at wwwmontgomerycountymdgovoe
(available beginning September 21) You can enter key words into the interactive search bar to quickly locate the answer to your question
2 Visit the MC311 website at wwwmontgomerycountymdgovmc311 and search key words for your question The search results contain various knowledge-based articles with information related to your search words Simply click on the corresponding link and the detailed answer is revealed
3 Attend one of OHRrsquos Virtual Office Hours via Microsoft Teams Members of OHRs Health Insurance Team will be on hand to address employee questions by video or via the chat box View the schedule and access the sessions through the Open Enrollment website at wwwmontgomerycountymdgovoe (available beginning September 21)
4 If you have tried all the methods above and still have Open Enrollment-related questions please contact OHRs MC311 Customer Service Center at 240-773-6471 (Mon-Fri 8 am - 5 pm) to open a service request A member of the health insurance team will respond to service requests in the order they are received Tip Please provide an email address at the time you place your Service Request This will ensure the fastest response possible
Office of Human Resources Montgomery County Government
Online ResourcesVisit the 2021 Open Enrollment Webpage
wwwmontgomerycountymdgovOE
Visit OHRrsquos WebpagewwwmontgomerycountymdgovHR
Health Insurance active employees
Office of Human Resources Montgomery County Government
Legal InformationThe County reserves the right at any time and for any reason to amend the Program subject to the Countys collective bargainingagreements The County expects to continue the Program but it is the Countys position that there is no implied contract between individual employees and the County to do so
The County may amend the Program prospectively or retroactively to comply with applicable law
In the event of a conflict between this presentation the County Code andor the Summary Description the County Code then the Summary Description will govern
Office of Human Resources Montgomery County Government
Thank YouWe hope you enjoyed learning about 2021 Open Enrollment
~Your OHR Health Insurance Team
2021 Open Enrollment Benefits Bonanza
What Is Open Enrollment
What Changes Can be Made
Open Enrollment Dates
MCG Continues to Make Generous Employer Contributions
New for 2021
Special 2021 Plan Rates Announcement
Employee Rate Changes for Calendar Year 2021
Planning Ahead Minimizing Future Rate Increases
New for 2021
Open Enrollment Communications
Itrsquos a New Frontier
2021 Open Enrollment Checklist
Open Enrollment Website Resources
Attend a Virtual Open Enrollment Event
Make Changes Online
Paper Enrollment Form Permitted for Only Two Reasons
Dependent Eligibility
Proof of Dependent Eligibility
Marriage Certificate Example Required Documentation (Contd)
Benefits Refresher
Medical amp Rx
Medical Plan Options
Medical Benefits at-a-Glance
Medical Benefits at-a-Glance (contd)
Prescription Plans Caremark
Prescription Drug Plan Comparison
Prescription Drug Cost Comparison
Dental
Slide Number 30
Vision
Vision Insurance
Optional Life amp Dependent Life
Optional Life Insurance ADampD
Optional Life Insurance Rates
Dependent Life Insurance
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs)Why You Should Enroll
Health Care FSA
Child Care FSA
Commuter Choice Transit FSA
Using Your FSA Funds
AFLAC Voluntary Plans
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Carrier Resources amp Cost-Saving Tips
Lower Your Out-of-Pocket Costs
Built-in Wellness Support
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You Go
Making Changes
Make Changes Online
Questions
Open Enrollment Assistance
Online Resources
Legal Information
Thank You
Office of Human Resources Montgomery County Government
Optional Life Insurance ADampDbull You may elect Optional Life ADampD coverage for yourself in increments of 1 to 8 times
your basic annual earnings ($1 million maximum)
bull NOTE Coverage is not guaranteed issue for any level You must complete an online Statement of Health no matter what level of coverage you elect Later this fall after Open Enrollment ends you will receive an email from MetLife with a link to complete the Statement of Health online
bull An eligible dependent is defined as 1) your opposite or same sex spouse or 2) your unmarried children under age 26 (natural adopted or stepchildrenfoster children who depend on your support)
Office of Human Resources Montgomery County Government
Optional Life Insurance RatesHow to estimate your Optional Life Insurance bi-weekly rate
Example 40-year-old applying for 2 x salary Salary is $49300
Steps Example Calculate for Yourself
A Find your age-based rate on the rate sheet (left) $ 0037 $_________________
B Choose how much coverage you are applying for
$99000 (2 x salary rounded to the nearest $1000 ) $_________________
C Divide that coverage amount by 100099 ($99000 1000) $_________________
D Multiply A x C for estimated bi-weekly cost$366 ($037 x 99) $_________________
Office of Human Resources Montgomery County Government
Dependent Life InsuranceYou may also purchase Dependent Optional Life insurance forbull Your opposite or same sex spouse bull Your unmarried children under age 26
ndash Natural adoptedndash Stepchildrenfoster childrenNote you do not need to supply marriage certificatesbirth certificates for dependent optional life
You may electbull $2000 Spouse$1000 Childbull $4000 Spouse $2000 Childbull $10000 Spouse $5000 Child
The bi-weekly rate is not based on salary
Office of Human Resources Montgomery County Government
Flexible Spending Accounts
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Visit the Open Enrollment website to watch a recorded FSA presentation from MCGrsquos FSA vendor Benefit Strategies
bull What is an FSA It is an IRS-approved tax-free account that saves onQualified out-of-pocket medical and dependent care expensesFederal and State Income taxSocial Security Tax
bull 3 Account Options Health Care FSA Child Care FSA and Commuter Choice Transit bull FSA accounts are administered through Benefit Strategies bull FSAs are ldquouse-it or lose-itrdquo accounts claims must be incurred during the 2021 plan year (January 1
2021 ndash March 15 2022) and submitted by April 30 2022
IMPORTANT You must re-enroll in an FSA every Open Enrollment if you want to participate in the upcoming plan year
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Why You Should EnrollGive yourself a raise by reducing your taxesbull Elect the annual amount you want to place in your FSA(s) for the upcoming plan year during Open Enrollmentbull That amount is divided by 26 and taken from your biweekly paychecks on a pre-tax basis (21 paychecks for
10-month employees)bull Then use your pre-tax FSA dollars to pay for eligible out-of-pocket health care child-care or transit
expenses
Office of Human Resources Montgomery County Government
Health Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull Claims must be submitted by April 30 of the following yearbull You may elect to contribute up to $2750 Your total annual election amount is available to spend on the first
day of the new plan year bull FSA debit card allows you to pay for expenses at the time of servicebull Examples of IRS qualified eligible expenses
bull Copays (medical prescription dental vision) deductibles and coinsurance amounts over reasonable and customary charge
bull Hearing aids bull Acupuncture bull Orthopedic shoes bull Over-the-counter (OTC) drugs (no longer require doctorrsquos prescription)
Office of Human Resources Montgomery County Government
Child Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull $5000 annual maximum per household ($2500 for married filing separately)bull Funds are available to spend as they are accumulated through payroll deductionsbull Reimbursable expenses
bull day care centersbull elder carebull beforeafter school carebull babysitter fees that allow you and your spouse to work or go to school (no child support payments)
bull Qualifying dependentsbull Children under the age of 13 and are a tax dependent of the employeebull Spouse or tax dependent that is physically or mentally incapable of self-care
bull Must coordinate between filing a tax credit with IRS and your Dependent Care FSA plan
Office of Human Resources Montgomery County Government
Commuter Choice Transit FSAbull $230 per month maximum for MCGEO staff $260 per month maximum for Unrepresented staffbull Applies to employee commuting expenses only (not spouses or dependents)bull Can enroll throughout the year (not limited to Open Enrollment election)bull Eligible expenses include Metro Marc Vanpool Lyft Line Uber Poolbull Debit card ndash may be used for some expenses (not Metro)Metro riders will have to submit claim forms for reimbursement
bull Funds must be used within 180 days of election bull If retiring or leaving the County will need to coordinate use all available funds
Office of Human Resources Montgomery County Government
Using Your FSA FundsHealth Care FSA Your full annual election amount is available on the first day of the plan yearChild Care FSA Your funds are available as they accumulate through payroll deductionsCommuterTransit FSA Your funds are available as they accumulate through payroll deductions
The FSA Debit Card bull Your FSA debit card is the same card for your Health Care Child Care and TransitCommuter FSA accountsbull The card is pre-loaded with your full annual Health Care FSA election amount You can use the card to pay for IRS qualified expenses at
the time of service or when paying a bill Receipt notifications will be mailed to you monthly by Benefit Strategies Your response to receipt notifications is necessary under the provisions of the plan No response my result in the ineligibility of the purchase and as a result your card may be temporarily deactivated
bull If you are enrolled in the Child Care FSA the card can also be used in child-care settings Just remember that the card will only work for an amount that does not exceed the available balance in your Child Care FSA account on that day
bull The card can also be used to pay for your commutertransit expenses however it does not work for WMATA metro Metro riders will have to submit manual claims for reimbursement from your CommuterTransit FSA
bull Cards are re-loaded each year after you make your new annual election Please keep your cards You will only receive a new card if your old card is about to expire
Office of Human Resources Montgomery County Government
AFLAC Voluntary Plans
Office of Human Resources Montgomery County Government
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Short-Term Disabilitybull Provides short-term cash benefits in the event of disabilitybull Monthly benefit amounts available from $500 - $6000 (subject to income requirements)bull Benefit options of 3 6 12 18 or 24 months with a variety of elimination periods
Critical Illness Insurancebull Provides a lump sum cash benefit in the event of critical illnessbull Benefit amounts available in $5000 increments from $10000 - $30000
Participants pay 100 through payroll deduction for Short-Term Disability and Critical Illness Insurance
To ENROLL Text SETAPPTrdquo to 41411orCall 920-420-8861 orEmail susan_mcdanielusAflaccom
Office of Human Resources Montgomery County Government
Carrier Resources amp Cost-Saving Tips
Office of Human Resources Montgomery County Government
Lower Your Out-of-Pocket CostsChoose the plan thatrsquos right for youbull See the medical benefits chart for options bull Stay in network Use the provider search engines on your carrier website or mobile app to find in-network providersSeek preventive carebull Check-ups immunizations and screenings are an important part of staying healthy They can detect or prevent serious diseases and keep you healthyKnow where to go for carebull You have many options of places to go when you need care If your medical condition isnrsquot serious or life threatening you can save money by connecting
with a doctor online through a virtual visit or going to an urgent care center or convenience care clinic instead of a hospital emergency roomReview your prescription drug plan optionsbull Decide which Caremark prescription plan is best for you Note that the Kaiser HMO includes prescription drug coverage Both the Standard and High
Option Caremark plans cover the same prescription drugs but have different copay and deductiblesUse generic and long-term prescriptions bull Opt for lower-cost generic drugs whenever possible bull Ask your doctor to write a 90-day prescription instead of a 30-day prescription to participate in the mail order prescription programTake advantage of tax savings by participating in Flexible Spending Accountsbull Use pre-tax dollars for eligible out of pocket services and items
Office of Human Resources Montgomery County Government
Built-in Wellness Support Take advantage of the free programs available to you through your medical carrier Each of MCGrsquos medical carriers (Kaiser UHC amp CareFirst) offer valuable programs to help you manage your health
Disease Management Programsbull Help manage your chronic condition through personalized coaching support and encouragement and online education materialsEmotional Wellness amp Stress Management Support bull Help manage stress through mobile apps and other self-care resources Maternity Programsbull Support healthy moms and healthy babiesWeight-loss Programs bull Offers telephonic coaching support and web-based tools to help ensure long-term weight managementbull See the next slide for an example of an MCG success storySmoking Cessation Programsbull Supportive coaching to make quitting more successfulDiscounts bull Gym memberships weight loss programs and moreFor more information about the programs available to you please see the Open Enrollment Guide and contact your medical carrier
Office of Human Resources Montgomery County Government
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You GoAll of MCGrsquos health insurance carriers offer a simple-to-use tool that can help make your life easier while yoursquore on the go Download your carrierrsquos Mobile App to help you personalize organize and access your important plan information on your phone or tablet
bull Schedule Virtual Visitsbull Manage and track claimsbull View ID card informationbull Find doctor and compare costs and quality ratingsbull Review your coveragebull Track your account balances and deductiblesbull Access a variety of health and wellness tools
Visit Google Play or the Apple App Store to download your carrierrsquos App
Office of Human Resources Montgomery County Government
Making Changes
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Questions
Office of Human Resources Montgomery County Government
Open Enrollment AssistanceFollow these steps (in this order)1 Review the frequently asked questions (FAQs) on the Open Enrollment website at wwwmontgomerycountymdgovoe
(available beginning September 21) You can enter key words into the interactive search bar to quickly locate the answer to your question
2 Visit the MC311 website at wwwmontgomerycountymdgovmc311 and search key words for your question The search results contain various knowledge-based articles with information related to your search words Simply click on the corresponding link and the detailed answer is revealed
3 Attend one of OHRrsquos Virtual Office Hours via Microsoft Teams Members of OHRs Health Insurance Team will be on hand to address employee questions by video or via the chat box View the schedule and access the sessions through the Open Enrollment website at wwwmontgomerycountymdgovoe (available beginning September 21)
4 If you have tried all the methods above and still have Open Enrollment-related questions please contact OHRs MC311 Customer Service Center at 240-773-6471 (Mon-Fri 8 am - 5 pm) to open a service request A member of the health insurance team will respond to service requests in the order they are received Tip Please provide an email address at the time you place your Service Request This will ensure the fastest response possible
Office of Human Resources Montgomery County Government
Online ResourcesVisit the 2021 Open Enrollment Webpage
wwwmontgomerycountymdgovOE
Visit OHRrsquos WebpagewwwmontgomerycountymdgovHR
Health Insurance active employees
Office of Human Resources Montgomery County Government
Legal InformationThe County reserves the right at any time and for any reason to amend the Program subject to the Countys collective bargainingagreements The County expects to continue the Program but it is the Countys position that there is no implied contract between individual employees and the County to do so
The County may amend the Program prospectively or retroactively to comply with applicable law
In the event of a conflict between this presentation the County Code andor the Summary Description the County Code then the Summary Description will govern
Office of Human Resources Montgomery County Government
Thank YouWe hope you enjoyed learning about 2021 Open Enrollment
~Your OHR Health Insurance Team
2021 Open Enrollment Benefits Bonanza
What Is Open Enrollment
What Changes Can be Made
Open Enrollment Dates
MCG Continues to Make Generous Employer Contributions
New for 2021
Special 2021 Plan Rates Announcement
Employee Rate Changes for Calendar Year 2021
Planning Ahead Minimizing Future Rate Increases
New for 2021
Open Enrollment Communications
Itrsquos a New Frontier
2021 Open Enrollment Checklist
Open Enrollment Website Resources
Attend a Virtual Open Enrollment Event
Make Changes Online
Paper Enrollment Form Permitted for Only Two Reasons
Dependent Eligibility
Proof of Dependent Eligibility
Marriage Certificate Example Required Documentation (Contd)
Benefits Refresher
Medical amp Rx
Medical Plan Options
Medical Benefits at-a-Glance
Medical Benefits at-a-Glance (contd)
Prescription Plans Caremark
Prescription Drug Plan Comparison
Prescription Drug Cost Comparison
Dental
Slide Number 30
Vision
Vision Insurance
Optional Life amp Dependent Life
Optional Life Insurance ADampD
Optional Life Insurance Rates
Dependent Life Insurance
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs)Why You Should Enroll
Health Care FSA
Child Care FSA
Commuter Choice Transit FSA
Using Your FSA Funds
AFLAC Voluntary Plans
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Carrier Resources amp Cost-Saving Tips
Lower Your Out-of-Pocket Costs
Built-in Wellness Support
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You Go
Making Changes
Make Changes Online
Questions
Open Enrollment Assistance
Online Resources
Legal Information
Thank You
Office of Human Resources Montgomery County Government
Optional Life Insurance RatesHow to estimate your Optional Life Insurance bi-weekly rate
Example 40-year-old applying for 2 x salary Salary is $49300
Steps Example Calculate for Yourself
A Find your age-based rate on the rate sheet (left) $ 0037 $_________________
B Choose how much coverage you are applying for
$99000 (2 x salary rounded to the nearest $1000 ) $_________________
C Divide that coverage amount by 100099 ($99000 1000) $_________________
D Multiply A x C for estimated bi-weekly cost$366 ($037 x 99) $_________________
Office of Human Resources Montgomery County Government
Dependent Life InsuranceYou may also purchase Dependent Optional Life insurance forbull Your opposite or same sex spouse bull Your unmarried children under age 26
ndash Natural adoptedndash Stepchildrenfoster childrenNote you do not need to supply marriage certificatesbirth certificates for dependent optional life
You may electbull $2000 Spouse$1000 Childbull $4000 Spouse $2000 Childbull $10000 Spouse $5000 Child
The bi-weekly rate is not based on salary
Office of Human Resources Montgomery County Government
Flexible Spending Accounts
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Visit the Open Enrollment website to watch a recorded FSA presentation from MCGrsquos FSA vendor Benefit Strategies
bull What is an FSA It is an IRS-approved tax-free account that saves onQualified out-of-pocket medical and dependent care expensesFederal and State Income taxSocial Security Tax
bull 3 Account Options Health Care FSA Child Care FSA and Commuter Choice Transit bull FSA accounts are administered through Benefit Strategies bull FSAs are ldquouse-it or lose-itrdquo accounts claims must be incurred during the 2021 plan year (January 1
2021 ndash March 15 2022) and submitted by April 30 2022
IMPORTANT You must re-enroll in an FSA every Open Enrollment if you want to participate in the upcoming plan year
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Why You Should EnrollGive yourself a raise by reducing your taxesbull Elect the annual amount you want to place in your FSA(s) for the upcoming plan year during Open Enrollmentbull That amount is divided by 26 and taken from your biweekly paychecks on a pre-tax basis (21 paychecks for
10-month employees)bull Then use your pre-tax FSA dollars to pay for eligible out-of-pocket health care child-care or transit
expenses
Office of Human Resources Montgomery County Government
Health Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull Claims must be submitted by April 30 of the following yearbull You may elect to contribute up to $2750 Your total annual election amount is available to spend on the first
day of the new plan year bull FSA debit card allows you to pay for expenses at the time of servicebull Examples of IRS qualified eligible expenses
bull Copays (medical prescription dental vision) deductibles and coinsurance amounts over reasonable and customary charge
bull Hearing aids bull Acupuncture bull Orthopedic shoes bull Over-the-counter (OTC) drugs (no longer require doctorrsquos prescription)
Office of Human Resources Montgomery County Government
Child Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull $5000 annual maximum per household ($2500 for married filing separately)bull Funds are available to spend as they are accumulated through payroll deductionsbull Reimbursable expenses
bull day care centersbull elder carebull beforeafter school carebull babysitter fees that allow you and your spouse to work or go to school (no child support payments)
bull Qualifying dependentsbull Children under the age of 13 and are a tax dependent of the employeebull Spouse or tax dependent that is physically or mentally incapable of self-care
bull Must coordinate between filing a tax credit with IRS and your Dependent Care FSA plan
Office of Human Resources Montgomery County Government
Commuter Choice Transit FSAbull $230 per month maximum for MCGEO staff $260 per month maximum for Unrepresented staffbull Applies to employee commuting expenses only (not spouses or dependents)bull Can enroll throughout the year (not limited to Open Enrollment election)bull Eligible expenses include Metro Marc Vanpool Lyft Line Uber Poolbull Debit card ndash may be used for some expenses (not Metro)Metro riders will have to submit claim forms for reimbursement
bull Funds must be used within 180 days of election bull If retiring or leaving the County will need to coordinate use all available funds
Office of Human Resources Montgomery County Government
Using Your FSA FundsHealth Care FSA Your full annual election amount is available on the first day of the plan yearChild Care FSA Your funds are available as they accumulate through payroll deductionsCommuterTransit FSA Your funds are available as they accumulate through payroll deductions
The FSA Debit Card bull Your FSA debit card is the same card for your Health Care Child Care and TransitCommuter FSA accountsbull The card is pre-loaded with your full annual Health Care FSA election amount You can use the card to pay for IRS qualified expenses at
the time of service or when paying a bill Receipt notifications will be mailed to you monthly by Benefit Strategies Your response to receipt notifications is necessary under the provisions of the plan No response my result in the ineligibility of the purchase and as a result your card may be temporarily deactivated
bull If you are enrolled in the Child Care FSA the card can also be used in child-care settings Just remember that the card will only work for an amount that does not exceed the available balance in your Child Care FSA account on that day
bull The card can also be used to pay for your commutertransit expenses however it does not work for WMATA metro Metro riders will have to submit manual claims for reimbursement from your CommuterTransit FSA
bull Cards are re-loaded each year after you make your new annual election Please keep your cards You will only receive a new card if your old card is about to expire
Office of Human Resources Montgomery County Government
AFLAC Voluntary Plans
Office of Human Resources Montgomery County Government
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Short-Term Disabilitybull Provides short-term cash benefits in the event of disabilitybull Monthly benefit amounts available from $500 - $6000 (subject to income requirements)bull Benefit options of 3 6 12 18 or 24 months with a variety of elimination periods
Critical Illness Insurancebull Provides a lump sum cash benefit in the event of critical illnessbull Benefit amounts available in $5000 increments from $10000 - $30000
Participants pay 100 through payroll deduction for Short-Term Disability and Critical Illness Insurance
To ENROLL Text SETAPPTrdquo to 41411orCall 920-420-8861 orEmail susan_mcdanielusAflaccom
Office of Human Resources Montgomery County Government
Carrier Resources amp Cost-Saving Tips
Office of Human Resources Montgomery County Government
Lower Your Out-of-Pocket CostsChoose the plan thatrsquos right for youbull See the medical benefits chart for options bull Stay in network Use the provider search engines on your carrier website or mobile app to find in-network providersSeek preventive carebull Check-ups immunizations and screenings are an important part of staying healthy They can detect or prevent serious diseases and keep you healthyKnow where to go for carebull You have many options of places to go when you need care If your medical condition isnrsquot serious or life threatening you can save money by connecting
with a doctor online through a virtual visit or going to an urgent care center or convenience care clinic instead of a hospital emergency roomReview your prescription drug plan optionsbull Decide which Caremark prescription plan is best for you Note that the Kaiser HMO includes prescription drug coverage Both the Standard and High
Option Caremark plans cover the same prescription drugs but have different copay and deductiblesUse generic and long-term prescriptions bull Opt for lower-cost generic drugs whenever possible bull Ask your doctor to write a 90-day prescription instead of a 30-day prescription to participate in the mail order prescription programTake advantage of tax savings by participating in Flexible Spending Accountsbull Use pre-tax dollars for eligible out of pocket services and items
Office of Human Resources Montgomery County Government
Built-in Wellness Support Take advantage of the free programs available to you through your medical carrier Each of MCGrsquos medical carriers (Kaiser UHC amp CareFirst) offer valuable programs to help you manage your health
Disease Management Programsbull Help manage your chronic condition through personalized coaching support and encouragement and online education materialsEmotional Wellness amp Stress Management Support bull Help manage stress through mobile apps and other self-care resources Maternity Programsbull Support healthy moms and healthy babiesWeight-loss Programs bull Offers telephonic coaching support and web-based tools to help ensure long-term weight managementbull See the next slide for an example of an MCG success storySmoking Cessation Programsbull Supportive coaching to make quitting more successfulDiscounts bull Gym memberships weight loss programs and moreFor more information about the programs available to you please see the Open Enrollment Guide and contact your medical carrier
Office of Human Resources Montgomery County Government
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You GoAll of MCGrsquos health insurance carriers offer a simple-to-use tool that can help make your life easier while yoursquore on the go Download your carrierrsquos Mobile App to help you personalize organize and access your important plan information on your phone or tablet
bull Schedule Virtual Visitsbull Manage and track claimsbull View ID card informationbull Find doctor and compare costs and quality ratingsbull Review your coveragebull Track your account balances and deductiblesbull Access a variety of health and wellness tools
Visit Google Play or the Apple App Store to download your carrierrsquos App
Office of Human Resources Montgomery County Government
Making Changes
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Questions
Office of Human Resources Montgomery County Government
Open Enrollment AssistanceFollow these steps (in this order)1 Review the frequently asked questions (FAQs) on the Open Enrollment website at wwwmontgomerycountymdgovoe
(available beginning September 21) You can enter key words into the interactive search bar to quickly locate the answer to your question
2 Visit the MC311 website at wwwmontgomerycountymdgovmc311 and search key words for your question The search results contain various knowledge-based articles with information related to your search words Simply click on the corresponding link and the detailed answer is revealed
3 Attend one of OHRrsquos Virtual Office Hours via Microsoft Teams Members of OHRs Health Insurance Team will be on hand to address employee questions by video or via the chat box View the schedule and access the sessions through the Open Enrollment website at wwwmontgomerycountymdgovoe (available beginning September 21)
4 If you have tried all the methods above and still have Open Enrollment-related questions please contact OHRs MC311 Customer Service Center at 240-773-6471 (Mon-Fri 8 am - 5 pm) to open a service request A member of the health insurance team will respond to service requests in the order they are received Tip Please provide an email address at the time you place your Service Request This will ensure the fastest response possible
Office of Human Resources Montgomery County Government
Online ResourcesVisit the 2021 Open Enrollment Webpage
wwwmontgomerycountymdgovOE
Visit OHRrsquos WebpagewwwmontgomerycountymdgovHR
Health Insurance active employees
Office of Human Resources Montgomery County Government
Legal InformationThe County reserves the right at any time and for any reason to amend the Program subject to the Countys collective bargainingagreements The County expects to continue the Program but it is the Countys position that there is no implied contract between individual employees and the County to do so
The County may amend the Program prospectively or retroactively to comply with applicable law
In the event of a conflict between this presentation the County Code andor the Summary Description the County Code then the Summary Description will govern
Office of Human Resources Montgomery County Government
Thank YouWe hope you enjoyed learning about 2021 Open Enrollment
~Your OHR Health Insurance Team
2021 Open Enrollment Benefits Bonanza
What Is Open Enrollment
What Changes Can be Made
Open Enrollment Dates
MCG Continues to Make Generous Employer Contributions
New for 2021
Special 2021 Plan Rates Announcement
Employee Rate Changes for Calendar Year 2021
Planning Ahead Minimizing Future Rate Increases
New for 2021
Open Enrollment Communications
Itrsquos a New Frontier
2021 Open Enrollment Checklist
Open Enrollment Website Resources
Attend a Virtual Open Enrollment Event
Make Changes Online
Paper Enrollment Form Permitted for Only Two Reasons
Dependent Eligibility
Proof of Dependent Eligibility
Marriage Certificate Example Required Documentation (Contd)
Benefits Refresher
Medical amp Rx
Medical Plan Options
Medical Benefits at-a-Glance
Medical Benefits at-a-Glance (contd)
Prescription Plans Caremark
Prescription Drug Plan Comparison
Prescription Drug Cost Comparison
Dental
Slide Number 30
Vision
Vision Insurance
Optional Life amp Dependent Life
Optional Life Insurance ADampD
Optional Life Insurance Rates
Dependent Life Insurance
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs)Why You Should Enroll
Health Care FSA
Child Care FSA
Commuter Choice Transit FSA
Using Your FSA Funds
AFLAC Voluntary Plans
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Carrier Resources amp Cost-Saving Tips
Lower Your Out-of-Pocket Costs
Built-in Wellness Support
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You Go
Making Changes
Make Changes Online
Questions
Open Enrollment Assistance
Online Resources
Legal Information
Thank You
Office of Human Resources Montgomery County Government
Dependent Life InsuranceYou may also purchase Dependent Optional Life insurance forbull Your opposite or same sex spouse bull Your unmarried children under age 26
ndash Natural adoptedndash Stepchildrenfoster childrenNote you do not need to supply marriage certificatesbirth certificates for dependent optional life
You may electbull $2000 Spouse$1000 Childbull $4000 Spouse $2000 Childbull $10000 Spouse $5000 Child
The bi-weekly rate is not based on salary
Office of Human Resources Montgomery County Government
Flexible Spending Accounts
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Visit the Open Enrollment website to watch a recorded FSA presentation from MCGrsquos FSA vendor Benefit Strategies
bull What is an FSA It is an IRS-approved tax-free account that saves onQualified out-of-pocket medical and dependent care expensesFederal and State Income taxSocial Security Tax
bull 3 Account Options Health Care FSA Child Care FSA and Commuter Choice Transit bull FSA accounts are administered through Benefit Strategies bull FSAs are ldquouse-it or lose-itrdquo accounts claims must be incurred during the 2021 plan year (January 1
2021 ndash March 15 2022) and submitted by April 30 2022
IMPORTANT You must re-enroll in an FSA every Open Enrollment if you want to participate in the upcoming plan year
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Why You Should EnrollGive yourself a raise by reducing your taxesbull Elect the annual amount you want to place in your FSA(s) for the upcoming plan year during Open Enrollmentbull That amount is divided by 26 and taken from your biweekly paychecks on a pre-tax basis (21 paychecks for
10-month employees)bull Then use your pre-tax FSA dollars to pay for eligible out-of-pocket health care child-care or transit
expenses
Office of Human Resources Montgomery County Government
Health Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull Claims must be submitted by April 30 of the following yearbull You may elect to contribute up to $2750 Your total annual election amount is available to spend on the first
day of the new plan year bull FSA debit card allows you to pay for expenses at the time of servicebull Examples of IRS qualified eligible expenses
bull Copays (medical prescription dental vision) deductibles and coinsurance amounts over reasonable and customary charge
bull Hearing aids bull Acupuncture bull Orthopedic shoes bull Over-the-counter (OTC) drugs (no longer require doctorrsquos prescription)
Office of Human Resources Montgomery County Government
Child Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull $5000 annual maximum per household ($2500 for married filing separately)bull Funds are available to spend as they are accumulated through payroll deductionsbull Reimbursable expenses
bull day care centersbull elder carebull beforeafter school carebull babysitter fees that allow you and your spouse to work or go to school (no child support payments)
bull Qualifying dependentsbull Children under the age of 13 and are a tax dependent of the employeebull Spouse or tax dependent that is physically or mentally incapable of self-care
bull Must coordinate between filing a tax credit with IRS and your Dependent Care FSA plan
Office of Human Resources Montgomery County Government
Commuter Choice Transit FSAbull $230 per month maximum for MCGEO staff $260 per month maximum for Unrepresented staffbull Applies to employee commuting expenses only (not spouses or dependents)bull Can enroll throughout the year (not limited to Open Enrollment election)bull Eligible expenses include Metro Marc Vanpool Lyft Line Uber Poolbull Debit card ndash may be used for some expenses (not Metro)Metro riders will have to submit claim forms for reimbursement
bull Funds must be used within 180 days of election bull If retiring or leaving the County will need to coordinate use all available funds
Office of Human Resources Montgomery County Government
Using Your FSA FundsHealth Care FSA Your full annual election amount is available on the first day of the plan yearChild Care FSA Your funds are available as they accumulate through payroll deductionsCommuterTransit FSA Your funds are available as they accumulate through payroll deductions
The FSA Debit Card bull Your FSA debit card is the same card for your Health Care Child Care and TransitCommuter FSA accountsbull The card is pre-loaded with your full annual Health Care FSA election amount You can use the card to pay for IRS qualified expenses at
the time of service or when paying a bill Receipt notifications will be mailed to you monthly by Benefit Strategies Your response to receipt notifications is necessary under the provisions of the plan No response my result in the ineligibility of the purchase and as a result your card may be temporarily deactivated
bull If you are enrolled in the Child Care FSA the card can also be used in child-care settings Just remember that the card will only work for an amount that does not exceed the available balance in your Child Care FSA account on that day
bull The card can also be used to pay for your commutertransit expenses however it does not work for WMATA metro Metro riders will have to submit manual claims for reimbursement from your CommuterTransit FSA
bull Cards are re-loaded each year after you make your new annual election Please keep your cards You will only receive a new card if your old card is about to expire
Office of Human Resources Montgomery County Government
AFLAC Voluntary Plans
Office of Human Resources Montgomery County Government
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Short-Term Disabilitybull Provides short-term cash benefits in the event of disabilitybull Monthly benefit amounts available from $500 - $6000 (subject to income requirements)bull Benefit options of 3 6 12 18 or 24 months with a variety of elimination periods
Critical Illness Insurancebull Provides a lump sum cash benefit in the event of critical illnessbull Benefit amounts available in $5000 increments from $10000 - $30000
Participants pay 100 through payroll deduction for Short-Term Disability and Critical Illness Insurance
To ENROLL Text SETAPPTrdquo to 41411orCall 920-420-8861 orEmail susan_mcdanielusAflaccom
Office of Human Resources Montgomery County Government
Carrier Resources amp Cost-Saving Tips
Office of Human Resources Montgomery County Government
Lower Your Out-of-Pocket CostsChoose the plan thatrsquos right for youbull See the medical benefits chart for options bull Stay in network Use the provider search engines on your carrier website or mobile app to find in-network providersSeek preventive carebull Check-ups immunizations and screenings are an important part of staying healthy They can detect or prevent serious diseases and keep you healthyKnow where to go for carebull You have many options of places to go when you need care If your medical condition isnrsquot serious or life threatening you can save money by connecting
with a doctor online through a virtual visit or going to an urgent care center or convenience care clinic instead of a hospital emergency roomReview your prescription drug plan optionsbull Decide which Caremark prescription plan is best for you Note that the Kaiser HMO includes prescription drug coverage Both the Standard and High
Option Caremark plans cover the same prescription drugs but have different copay and deductiblesUse generic and long-term prescriptions bull Opt for lower-cost generic drugs whenever possible bull Ask your doctor to write a 90-day prescription instead of a 30-day prescription to participate in the mail order prescription programTake advantage of tax savings by participating in Flexible Spending Accountsbull Use pre-tax dollars for eligible out of pocket services and items
Office of Human Resources Montgomery County Government
Built-in Wellness Support Take advantage of the free programs available to you through your medical carrier Each of MCGrsquos medical carriers (Kaiser UHC amp CareFirst) offer valuable programs to help you manage your health
Disease Management Programsbull Help manage your chronic condition through personalized coaching support and encouragement and online education materialsEmotional Wellness amp Stress Management Support bull Help manage stress through mobile apps and other self-care resources Maternity Programsbull Support healthy moms and healthy babiesWeight-loss Programs bull Offers telephonic coaching support and web-based tools to help ensure long-term weight managementbull See the next slide for an example of an MCG success storySmoking Cessation Programsbull Supportive coaching to make quitting more successfulDiscounts bull Gym memberships weight loss programs and moreFor more information about the programs available to you please see the Open Enrollment Guide and contact your medical carrier
Office of Human Resources Montgomery County Government
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You GoAll of MCGrsquos health insurance carriers offer a simple-to-use tool that can help make your life easier while yoursquore on the go Download your carrierrsquos Mobile App to help you personalize organize and access your important plan information on your phone or tablet
bull Schedule Virtual Visitsbull Manage and track claimsbull View ID card informationbull Find doctor and compare costs and quality ratingsbull Review your coveragebull Track your account balances and deductiblesbull Access a variety of health and wellness tools
Visit Google Play or the Apple App Store to download your carrierrsquos App
Office of Human Resources Montgomery County Government
Making Changes
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Questions
Office of Human Resources Montgomery County Government
Open Enrollment AssistanceFollow these steps (in this order)1 Review the frequently asked questions (FAQs) on the Open Enrollment website at wwwmontgomerycountymdgovoe
(available beginning September 21) You can enter key words into the interactive search bar to quickly locate the answer to your question
2 Visit the MC311 website at wwwmontgomerycountymdgovmc311 and search key words for your question The search results contain various knowledge-based articles with information related to your search words Simply click on the corresponding link and the detailed answer is revealed
3 Attend one of OHRrsquos Virtual Office Hours via Microsoft Teams Members of OHRs Health Insurance Team will be on hand to address employee questions by video or via the chat box View the schedule and access the sessions through the Open Enrollment website at wwwmontgomerycountymdgovoe (available beginning September 21)
4 If you have tried all the methods above and still have Open Enrollment-related questions please contact OHRs MC311 Customer Service Center at 240-773-6471 (Mon-Fri 8 am - 5 pm) to open a service request A member of the health insurance team will respond to service requests in the order they are received Tip Please provide an email address at the time you place your Service Request This will ensure the fastest response possible
Office of Human Resources Montgomery County Government
Online ResourcesVisit the 2021 Open Enrollment Webpage
wwwmontgomerycountymdgovOE
Visit OHRrsquos WebpagewwwmontgomerycountymdgovHR
Health Insurance active employees
Office of Human Resources Montgomery County Government
Legal InformationThe County reserves the right at any time and for any reason to amend the Program subject to the Countys collective bargainingagreements The County expects to continue the Program but it is the Countys position that there is no implied contract between individual employees and the County to do so
The County may amend the Program prospectively or retroactively to comply with applicable law
In the event of a conflict between this presentation the County Code andor the Summary Description the County Code then the Summary Description will govern
Office of Human Resources Montgomery County Government
Thank YouWe hope you enjoyed learning about 2021 Open Enrollment
~Your OHR Health Insurance Team
2021 Open Enrollment Benefits Bonanza
What Is Open Enrollment
What Changes Can be Made
Open Enrollment Dates
MCG Continues to Make Generous Employer Contributions
New for 2021
Special 2021 Plan Rates Announcement
Employee Rate Changes for Calendar Year 2021
Planning Ahead Minimizing Future Rate Increases
New for 2021
Open Enrollment Communications
Itrsquos a New Frontier
2021 Open Enrollment Checklist
Open Enrollment Website Resources
Attend a Virtual Open Enrollment Event
Make Changes Online
Paper Enrollment Form Permitted for Only Two Reasons
Dependent Eligibility
Proof of Dependent Eligibility
Marriage Certificate Example Required Documentation (Contd)
Benefits Refresher
Medical amp Rx
Medical Plan Options
Medical Benefits at-a-Glance
Medical Benefits at-a-Glance (contd)
Prescription Plans Caremark
Prescription Drug Plan Comparison
Prescription Drug Cost Comparison
Dental
Slide Number 30
Vision
Vision Insurance
Optional Life amp Dependent Life
Optional Life Insurance ADampD
Optional Life Insurance Rates
Dependent Life Insurance
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs)Why You Should Enroll
Health Care FSA
Child Care FSA
Commuter Choice Transit FSA
Using Your FSA Funds
AFLAC Voluntary Plans
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Carrier Resources amp Cost-Saving Tips
Lower Your Out-of-Pocket Costs
Built-in Wellness Support
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You Go
Making Changes
Make Changes Online
Questions
Open Enrollment Assistance
Online Resources
Legal Information
Thank You
Office of Human Resources Montgomery County Government
Flexible Spending Accounts
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Visit the Open Enrollment website to watch a recorded FSA presentation from MCGrsquos FSA vendor Benefit Strategies
bull What is an FSA It is an IRS-approved tax-free account that saves onQualified out-of-pocket medical and dependent care expensesFederal and State Income taxSocial Security Tax
bull 3 Account Options Health Care FSA Child Care FSA and Commuter Choice Transit bull FSA accounts are administered through Benefit Strategies bull FSAs are ldquouse-it or lose-itrdquo accounts claims must be incurred during the 2021 plan year (January 1
2021 ndash March 15 2022) and submitted by April 30 2022
IMPORTANT You must re-enroll in an FSA every Open Enrollment if you want to participate in the upcoming plan year
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Why You Should EnrollGive yourself a raise by reducing your taxesbull Elect the annual amount you want to place in your FSA(s) for the upcoming plan year during Open Enrollmentbull That amount is divided by 26 and taken from your biweekly paychecks on a pre-tax basis (21 paychecks for
10-month employees)bull Then use your pre-tax FSA dollars to pay for eligible out-of-pocket health care child-care or transit
expenses
Office of Human Resources Montgomery County Government
Health Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull Claims must be submitted by April 30 of the following yearbull You may elect to contribute up to $2750 Your total annual election amount is available to spend on the first
day of the new plan year bull FSA debit card allows you to pay for expenses at the time of servicebull Examples of IRS qualified eligible expenses
bull Copays (medical prescription dental vision) deductibles and coinsurance amounts over reasonable and customary charge
bull Hearing aids bull Acupuncture bull Orthopedic shoes bull Over-the-counter (OTC) drugs (no longer require doctorrsquos prescription)
Office of Human Resources Montgomery County Government
Child Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull $5000 annual maximum per household ($2500 for married filing separately)bull Funds are available to spend as they are accumulated through payroll deductionsbull Reimbursable expenses
bull day care centersbull elder carebull beforeafter school carebull babysitter fees that allow you and your spouse to work or go to school (no child support payments)
bull Qualifying dependentsbull Children under the age of 13 and are a tax dependent of the employeebull Spouse or tax dependent that is physically or mentally incapable of self-care
bull Must coordinate between filing a tax credit with IRS and your Dependent Care FSA plan
Office of Human Resources Montgomery County Government
Commuter Choice Transit FSAbull $230 per month maximum for MCGEO staff $260 per month maximum for Unrepresented staffbull Applies to employee commuting expenses only (not spouses or dependents)bull Can enroll throughout the year (not limited to Open Enrollment election)bull Eligible expenses include Metro Marc Vanpool Lyft Line Uber Poolbull Debit card ndash may be used for some expenses (not Metro)Metro riders will have to submit claim forms for reimbursement
bull Funds must be used within 180 days of election bull If retiring or leaving the County will need to coordinate use all available funds
Office of Human Resources Montgomery County Government
Using Your FSA FundsHealth Care FSA Your full annual election amount is available on the first day of the plan yearChild Care FSA Your funds are available as they accumulate through payroll deductionsCommuterTransit FSA Your funds are available as they accumulate through payroll deductions
The FSA Debit Card bull Your FSA debit card is the same card for your Health Care Child Care and TransitCommuter FSA accountsbull The card is pre-loaded with your full annual Health Care FSA election amount You can use the card to pay for IRS qualified expenses at
the time of service or when paying a bill Receipt notifications will be mailed to you monthly by Benefit Strategies Your response to receipt notifications is necessary under the provisions of the plan No response my result in the ineligibility of the purchase and as a result your card may be temporarily deactivated
bull If you are enrolled in the Child Care FSA the card can also be used in child-care settings Just remember that the card will only work for an amount that does not exceed the available balance in your Child Care FSA account on that day
bull The card can also be used to pay for your commutertransit expenses however it does not work for WMATA metro Metro riders will have to submit manual claims for reimbursement from your CommuterTransit FSA
bull Cards are re-loaded each year after you make your new annual election Please keep your cards You will only receive a new card if your old card is about to expire
Office of Human Resources Montgomery County Government
AFLAC Voluntary Plans
Office of Human Resources Montgomery County Government
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Short-Term Disabilitybull Provides short-term cash benefits in the event of disabilitybull Monthly benefit amounts available from $500 - $6000 (subject to income requirements)bull Benefit options of 3 6 12 18 or 24 months with a variety of elimination periods
Critical Illness Insurancebull Provides a lump sum cash benefit in the event of critical illnessbull Benefit amounts available in $5000 increments from $10000 - $30000
Participants pay 100 through payroll deduction for Short-Term Disability and Critical Illness Insurance
To ENROLL Text SETAPPTrdquo to 41411orCall 920-420-8861 orEmail susan_mcdanielusAflaccom
Office of Human Resources Montgomery County Government
Carrier Resources amp Cost-Saving Tips
Office of Human Resources Montgomery County Government
Lower Your Out-of-Pocket CostsChoose the plan thatrsquos right for youbull See the medical benefits chart for options bull Stay in network Use the provider search engines on your carrier website or mobile app to find in-network providersSeek preventive carebull Check-ups immunizations and screenings are an important part of staying healthy They can detect or prevent serious diseases and keep you healthyKnow where to go for carebull You have many options of places to go when you need care If your medical condition isnrsquot serious or life threatening you can save money by connecting
with a doctor online through a virtual visit or going to an urgent care center or convenience care clinic instead of a hospital emergency roomReview your prescription drug plan optionsbull Decide which Caremark prescription plan is best for you Note that the Kaiser HMO includes prescription drug coverage Both the Standard and High
Option Caremark plans cover the same prescription drugs but have different copay and deductiblesUse generic and long-term prescriptions bull Opt for lower-cost generic drugs whenever possible bull Ask your doctor to write a 90-day prescription instead of a 30-day prescription to participate in the mail order prescription programTake advantage of tax savings by participating in Flexible Spending Accountsbull Use pre-tax dollars for eligible out of pocket services and items
Office of Human Resources Montgomery County Government
Built-in Wellness Support Take advantage of the free programs available to you through your medical carrier Each of MCGrsquos medical carriers (Kaiser UHC amp CareFirst) offer valuable programs to help you manage your health
Disease Management Programsbull Help manage your chronic condition through personalized coaching support and encouragement and online education materialsEmotional Wellness amp Stress Management Support bull Help manage stress through mobile apps and other self-care resources Maternity Programsbull Support healthy moms and healthy babiesWeight-loss Programs bull Offers telephonic coaching support and web-based tools to help ensure long-term weight managementbull See the next slide for an example of an MCG success storySmoking Cessation Programsbull Supportive coaching to make quitting more successfulDiscounts bull Gym memberships weight loss programs and moreFor more information about the programs available to you please see the Open Enrollment Guide and contact your medical carrier
Office of Human Resources Montgomery County Government
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You GoAll of MCGrsquos health insurance carriers offer a simple-to-use tool that can help make your life easier while yoursquore on the go Download your carrierrsquos Mobile App to help you personalize organize and access your important plan information on your phone or tablet
bull Schedule Virtual Visitsbull Manage and track claimsbull View ID card informationbull Find doctor and compare costs and quality ratingsbull Review your coveragebull Track your account balances and deductiblesbull Access a variety of health and wellness tools
Visit Google Play or the Apple App Store to download your carrierrsquos App
Office of Human Resources Montgomery County Government
Making Changes
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Questions
Office of Human Resources Montgomery County Government
Open Enrollment AssistanceFollow these steps (in this order)1 Review the frequently asked questions (FAQs) on the Open Enrollment website at wwwmontgomerycountymdgovoe
(available beginning September 21) You can enter key words into the interactive search bar to quickly locate the answer to your question
2 Visit the MC311 website at wwwmontgomerycountymdgovmc311 and search key words for your question The search results contain various knowledge-based articles with information related to your search words Simply click on the corresponding link and the detailed answer is revealed
3 Attend one of OHRrsquos Virtual Office Hours via Microsoft Teams Members of OHRs Health Insurance Team will be on hand to address employee questions by video or via the chat box View the schedule and access the sessions through the Open Enrollment website at wwwmontgomerycountymdgovoe (available beginning September 21)
4 If you have tried all the methods above and still have Open Enrollment-related questions please contact OHRs MC311 Customer Service Center at 240-773-6471 (Mon-Fri 8 am - 5 pm) to open a service request A member of the health insurance team will respond to service requests in the order they are received Tip Please provide an email address at the time you place your Service Request This will ensure the fastest response possible
Office of Human Resources Montgomery County Government
Online ResourcesVisit the 2021 Open Enrollment Webpage
wwwmontgomerycountymdgovOE
Visit OHRrsquos WebpagewwwmontgomerycountymdgovHR
Health Insurance active employees
Office of Human Resources Montgomery County Government
Legal InformationThe County reserves the right at any time and for any reason to amend the Program subject to the Countys collective bargainingagreements The County expects to continue the Program but it is the Countys position that there is no implied contract between individual employees and the County to do so
The County may amend the Program prospectively or retroactively to comply with applicable law
In the event of a conflict between this presentation the County Code andor the Summary Description the County Code then the Summary Description will govern
Office of Human Resources Montgomery County Government
Thank YouWe hope you enjoyed learning about 2021 Open Enrollment
~Your OHR Health Insurance Team
2021 Open Enrollment Benefits Bonanza
What Is Open Enrollment
What Changes Can be Made
Open Enrollment Dates
MCG Continues to Make Generous Employer Contributions
New for 2021
Special 2021 Plan Rates Announcement
Employee Rate Changes for Calendar Year 2021
Planning Ahead Minimizing Future Rate Increases
New for 2021
Open Enrollment Communications
Itrsquos a New Frontier
2021 Open Enrollment Checklist
Open Enrollment Website Resources
Attend a Virtual Open Enrollment Event
Make Changes Online
Paper Enrollment Form Permitted for Only Two Reasons
Dependent Eligibility
Proof of Dependent Eligibility
Marriage Certificate Example Required Documentation (Contd)
Benefits Refresher
Medical amp Rx
Medical Plan Options
Medical Benefits at-a-Glance
Medical Benefits at-a-Glance (contd)
Prescription Plans Caremark
Prescription Drug Plan Comparison
Prescription Drug Cost Comparison
Dental
Slide Number 30
Vision
Vision Insurance
Optional Life amp Dependent Life
Optional Life Insurance ADampD
Optional Life Insurance Rates
Dependent Life Insurance
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs)Why You Should Enroll
Health Care FSA
Child Care FSA
Commuter Choice Transit FSA
Using Your FSA Funds
AFLAC Voluntary Plans
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Carrier Resources amp Cost-Saving Tips
Lower Your Out-of-Pocket Costs
Built-in Wellness Support
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You Go
Making Changes
Make Changes Online
Questions
Open Enrollment Assistance
Online Resources
Legal Information
Thank You
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Visit the Open Enrollment website to watch a recorded FSA presentation from MCGrsquos FSA vendor Benefit Strategies
bull What is an FSA It is an IRS-approved tax-free account that saves onQualified out-of-pocket medical and dependent care expensesFederal and State Income taxSocial Security Tax
bull 3 Account Options Health Care FSA Child Care FSA and Commuter Choice Transit bull FSA accounts are administered through Benefit Strategies bull FSAs are ldquouse-it or lose-itrdquo accounts claims must be incurred during the 2021 plan year (January 1
2021 ndash March 15 2022) and submitted by April 30 2022
IMPORTANT You must re-enroll in an FSA every Open Enrollment if you want to participate in the upcoming plan year
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Why You Should EnrollGive yourself a raise by reducing your taxesbull Elect the annual amount you want to place in your FSA(s) for the upcoming plan year during Open Enrollmentbull That amount is divided by 26 and taken from your biweekly paychecks on a pre-tax basis (21 paychecks for
10-month employees)bull Then use your pre-tax FSA dollars to pay for eligible out-of-pocket health care child-care or transit
expenses
Office of Human Resources Montgomery County Government
Health Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull Claims must be submitted by April 30 of the following yearbull You may elect to contribute up to $2750 Your total annual election amount is available to spend on the first
day of the new plan year bull FSA debit card allows you to pay for expenses at the time of servicebull Examples of IRS qualified eligible expenses
bull Copays (medical prescription dental vision) deductibles and coinsurance amounts over reasonable and customary charge
bull Hearing aids bull Acupuncture bull Orthopedic shoes bull Over-the-counter (OTC) drugs (no longer require doctorrsquos prescription)
Office of Human Resources Montgomery County Government
Child Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull $5000 annual maximum per household ($2500 for married filing separately)bull Funds are available to spend as they are accumulated through payroll deductionsbull Reimbursable expenses
bull day care centersbull elder carebull beforeafter school carebull babysitter fees that allow you and your spouse to work or go to school (no child support payments)
bull Qualifying dependentsbull Children under the age of 13 and are a tax dependent of the employeebull Spouse or tax dependent that is physically or mentally incapable of self-care
bull Must coordinate between filing a tax credit with IRS and your Dependent Care FSA plan
Office of Human Resources Montgomery County Government
Commuter Choice Transit FSAbull $230 per month maximum for MCGEO staff $260 per month maximum for Unrepresented staffbull Applies to employee commuting expenses only (not spouses or dependents)bull Can enroll throughout the year (not limited to Open Enrollment election)bull Eligible expenses include Metro Marc Vanpool Lyft Line Uber Poolbull Debit card ndash may be used for some expenses (not Metro)Metro riders will have to submit claim forms for reimbursement
bull Funds must be used within 180 days of election bull If retiring or leaving the County will need to coordinate use all available funds
Office of Human Resources Montgomery County Government
Using Your FSA FundsHealth Care FSA Your full annual election amount is available on the first day of the plan yearChild Care FSA Your funds are available as they accumulate through payroll deductionsCommuterTransit FSA Your funds are available as they accumulate through payroll deductions
The FSA Debit Card bull Your FSA debit card is the same card for your Health Care Child Care and TransitCommuter FSA accountsbull The card is pre-loaded with your full annual Health Care FSA election amount You can use the card to pay for IRS qualified expenses at
the time of service or when paying a bill Receipt notifications will be mailed to you monthly by Benefit Strategies Your response to receipt notifications is necessary under the provisions of the plan No response my result in the ineligibility of the purchase and as a result your card may be temporarily deactivated
bull If you are enrolled in the Child Care FSA the card can also be used in child-care settings Just remember that the card will only work for an amount that does not exceed the available balance in your Child Care FSA account on that day
bull The card can also be used to pay for your commutertransit expenses however it does not work for WMATA metro Metro riders will have to submit manual claims for reimbursement from your CommuterTransit FSA
bull Cards are re-loaded each year after you make your new annual election Please keep your cards You will only receive a new card if your old card is about to expire
Office of Human Resources Montgomery County Government
AFLAC Voluntary Plans
Office of Human Resources Montgomery County Government
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Short-Term Disabilitybull Provides short-term cash benefits in the event of disabilitybull Monthly benefit amounts available from $500 - $6000 (subject to income requirements)bull Benefit options of 3 6 12 18 or 24 months with a variety of elimination periods
Critical Illness Insurancebull Provides a lump sum cash benefit in the event of critical illnessbull Benefit amounts available in $5000 increments from $10000 - $30000
Participants pay 100 through payroll deduction for Short-Term Disability and Critical Illness Insurance
To ENROLL Text SETAPPTrdquo to 41411orCall 920-420-8861 orEmail susan_mcdanielusAflaccom
Office of Human Resources Montgomery County Government
Carrier Resources amp Cost-Saving Tips
Office of Human Resources Montgomery County Government
Lower Your Out-of-Pocket CostsChoose the plan thatrsquos right for youbull See the medical benefits chart for options bull Stay in network Use the provider search engines on your carrier website or mobile app to find in-network providersSeek preventive carebull Check-ups immunizations and screenings are an important part of staying healthy They can detect or prevent serious diseases and keep you healthyKnow where to go for carebull You have many options of places to go when you need care If your medical condition isnrsquot serious or life threatening you can save money by connecting
with a doctor online through a virtual visit or going to an urgent care center or convenience care clinic instead of a hospital emergency roomReview your prescription drug plan optionsbull Decide which Caremark prescription plan is best for you Note that the Kaiser HMO includes prescription drug coverage Both the Standard and High
Option Caremark plans cover the same prescription drugs but have different copay and deductiblesUse generic and long-term prescriptions bull Opt for lower-cost generic drugs whenever possible bull Ask your doctor to write a 90-day prescription instead of a 30-day prescription to participate in the mail order prescription programTake advantage of tax savings by participating in Flexible Spending Accountsbull Use pre-tax dollars for eligible out of pocket services and items
Office of Human Resources Montgomery County Government
Built-in Wellness Support Take advantage of the free programs available to you through your medical carrier Each of MCGrsquos medical carriers (Kaiser UHC amp CareFirst) offer valuable programs to help you manage your health
Disease Management Programsbull Help manage your chronic condition through personalized coaching support and encouragement and online education materialsEmotional Wellness amp Stress Management Support bull Help manage stress through mobile apps and other self-care resources Maternity Programsbull Support healthy moms and healthy babiesWeight-loss Programs bull Offers telephonic coaching support and web-based tools to help ensure long-term weight managementbull See the next slide for an example of an MCG success storySmoking Cessation Programsbull Supportive coaching to make quitting more successfulDiscounts bull Gym memberships weight loss programs and moreFor more information about the programs available to you please see the Open Enrollment Guide and contact your medical carrier
Office of Human Resources Montgomery County Government
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You GoAll of MCGrsquos health insurance carriers offer a simple-to-use tool that can help make your life easier while yoursquore on the go Download your carrierrsquos Mobile App to help you personalize organize and access your important plan information on your phone or tablet
bull Schedule Virtual Visitsbull Manage and track claimsbull View ID card informationbull Find doctor and compare costs and quality ratingsbull Review your coveragebull Track your account balances and deductiblesbull Access a variety of health and wellness tools
Visit Google Play or the Apple App Store to download your carrierrsquos App
Office of Human Resources Montgomery County Government
Making Changes
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Questions
Office of Human Resources Montgomery County Government
Open Enrollment AssistanceFollow these steps (in this order)1 Review the frequently asked questions (FAQs) on the Open Enrollment website at wwwmontgomerycountymdgovoe
(available beginning September 21) You can enter key words into the interactive search bar to quickly locate the answer to your question
2 Visit the MC311 website at wwwmontgomerycountymdgovmc311 and search key words for your question The search results contain various knowledge-based articles with information related to your search words Simply click on the corresponding link and the detailed answer is revealed
3 Attend one of OHRrsquos Virtual Office Hours via Microsoft Teams Members of OHRs Health Insurance Team will be on hand to address employee questions by video or via the chat box View the schedule and access the sessions through the Open Enrollment website at wwwmontgomerycountymdgovoe (available beginning September 21)
4 If you have tried all the methods above and still have Open Enrollment-related questions please contact OHRs MC311 Customer Service Center at 240-773-6471 (Mon-Fri 8 am - 5 pm) to open a service request A member of the health insurance team will respond to service requests in the order they are received Tip Please provide an email address at the time you place your Service Request This will ensure the fastest response possible
Office of Human Resources Montgomery County Government
Online ResourcesVisit the 2021 Open Enrollment Webpage
wwwmontgomerycountymdgovOE
Visit OHRrsquos WebpagewwwmontgomerycountymdgovHR
Health Insurance active employees
Office of Human Resources Montgomery County Government
Legal InformationThe County reserves the right at any time and for any reason to amend the Program subject to the Countys collective bargainingagreements The County expects to continue the Program but it is the Countys position that there is no implied contract between individual employees and the County to do so
The County may amend the Program prospectively or retroactively to comply with applicable law
In the event of a conflict between this presentation the County Code andor the Summary Description the County Code then the Summary Description will govern
Office of Human Resources Montgomery County Government
Thank YouWe hope you enjoyed learning about 2021 Open Enrollment
~Your OHR Health Insurance Team
2021 Open Enrollment Benefits Bonanza
What Is Open Enrollment
What Changes Can be Made
Open Enrollment Dates
MCG Continues to Make Generous Employer Contributions
New for 2021
Special 2021 Plan Rates Announcement
Employee Rate Changes for Calendar Year 2021
Planning Ahead Minimizing Future Rate Increases
New for 2021
Open Enrollment Communications
Itrsquos a New Frontier
2021 Open Enrollment Checklist
Open Enrollment Website Resources
Attend a Virtual Open Enrollment Event
Make Changes Online
Paper Enrollment Form Permitted for Only Two Reasons
Dependent Eligibility
Proof of Dependent Eligibility
Marriage Certificate Example Required Documentation (Contd)
Benefits Refresher
Medical amp Rx
Medical Plan Options
Medical Benefits at-a-Glance
Medical Benefits at-a-Glance (contd)
Prescription Plans Caremark
Prescription Drug Plan Comparison
Prescription Drug Cost Comparison
Dental
Slide Number 30
Vision
Vision Insurance
Optional Life amp Dependent Life
Optional Life Insurance ADampD
Optional Life Insurance Rates
Dependent Life Insurance
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs)Why You Should Enroll
Health Care FSA
Child Care FSA
Commuter Choice Transit FSA
Using Your FSA Funds
AFLAC Voluntary Plans
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Carrier Resources amp Cost-Saving Tips
Lower Your Out-of-Pocket Costs
Built-in Wellness Support
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You Go
Making Changes
Make Changes Online
Questions
Open Enrollment Assistance
Online Resources
Legal Information
Thank You
Office of Human Resources Montgomery County Government
Flexible Spending Accounts (FSAs)Why You Should EnrollGive yourself a raise by reducing your taxesbull Elect the annual amount you want to place in your FSA(s) for the upcoming plan year during Open Enrollmentbull That amount is divided by 26 and taken from your biweekly paychecks on a pre-tax basis (21 paychecks for
10-month employees)bull Then use your pre-tax FSA dollars to pay for eligible out-of-pocket health care child-care or transit
expenses
Office of Human Resources Montgomery County Government
Health Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull Claims must be submitted by April 30 of the following yearbull You may elect to contribute up to $2750 Your total annual election amount is available to spend on the first
day of the new plan year bull FSA debit card allows you to pay for expenses at the time of servicebull Examples of IRS qualified eligible expenses
bull Copays (medical prescription dental vision) deductibles and coinsurance amounts over reasonable and customary charge
bull Hearing aids bull Acupuncture bull Orthopedic shoes bull Over-the-counter (OTC) drugs (no longer require doctorrsquos prescription)
Office of Human Resources Montgomery County Government
Child Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull $5000 annual maximum per household ($2500 for married filing separately)bull Funds are available to spend as they are accumulated through payroll deductionsbull Reimbursable expenses
bull day care centersbull elder carebull beforeafter school carebull babysitter fees that allow you and your spouse to work or go to school (no child support payments)
bull Qualifying dependentsbull Children under the age of 13 and are a tax dependent of the employeebull Spouse or tax dependent that is physically or mentally incapable of self-care
bull Must coordinate between filing a tax credit with IRS and your Dependent Care FSA plan
Office of Human Resources Montgomery County Government
Commuter Choice Transit FSAbull $230 per month maximum for MCGEO staff $260 per month maximum for Unrepresented staffbull Applies to employee commuting expenses only (not spouses or dependents)bull Can enroll throughout the year (not limited to Open Enrollment election)bull Eligible expenses include Metro Marc Vanpool Lyft Line Uber Poolbull Debit card ndash may be used for some expenses (not Metro)Metro riders will have to submit claim forms for reimbursement
bull Funds must be used within 180 days of election bull If retiring or leaving the County will need to coordinate use all available funds
Office of Human Resources Montgomery County Government
Using Your FSA FundsHealth Care FSA Your full annual election amount is available on the first day of the plan yearChild Care FSA Your funds are available as they accumulate through payroll deductionsCommuterTransit FSA Your funds are available as they accumulate through payroll deductions
The FSA Debit Card bull Your FSA debit card is the same card for your Health Care Child Care and TransitCommuter FSA accountsbull The card is pre-loaded with your full annual Health Care FSA election amount You can use the card to pay for IRS qualified expenses at
the time of service or when paying a bill Receipt notifications will be mailed to you monthly by Benefit Strategies Your response to receipt notifications is necessary under the provisions of the plan No response my result in the ineligibility of the purchase and as a result your card may be temporarily deactivated
bull If you are enrolled in the Child Care FSA the card can also be used in child-care settings Just remember that the card will only work for an amount that does not exceed the available balance in your Child Care FSA account on that day
bull The card can also be used to pay for your commutertransit expenses however it does not work for WMATA metro Metro riders will have to submit manual claims for reimbursement from your CommuterTransit FSA
bull Cards are re-loaded each year after you make your new annual election Please keep your cards You will only receive a new card if your old card is about to expire
Office of Human Resources Montgomery County Government
AFLAC Voluntary Plans
Office of Human Resources Montgomery County Government
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Short-Term Disabilitybull Provides short-term cash benefits in the event of disabilitybull Monthly benefit amounts available from $500 - $6000 (subject to income requirements)bull Benefit options of 3 6 12 18 or 24 months with a variety of elimination periods
Critical Illness Insurancebull Provides a lump sum cash benefit in the event of critical illnessbull Benefit amounts available in $5000 increments from $10000 - $30000
Participants pay 100 through payroll deduction for Short-Term Disability and Critical Illness Insurance
To ENROLL Text SETAPPTrdquo to 41411orCall 920-420-8861 orEmail susan_mcdanielusAflaccom
Office of Human Resources Montgomery County Government
Carrier Resources amp Cost-Saving Tips
Office of Human Resources Montgomery County Government
Lower Your Out-of-Pocket CostsChoose the plan thatrsquos right for youbull See the medical benefits chart for options bull Stay in network Use the provider search engines on your carrier website or mobile app to find in-network providersSeek preventive carebull Check-ups immunizations and screenings are an important part of staying healthy They can detect or prevent serious diseases and keep you healthyKnow where to go for carebull You have many options of places to go when you need care If your medical condition isnrsquot serious or life threatening you can save money by connecting
with a doctor online through a virtual visit or going to an urgent care center or convenience care clinic instead of a hospital emergency roomReview your prescription drug plan optionsbull Decide which Caremark prescription plan is best for you Note that the Kaiser HMO includes prescription drug coverage Both the Standard and High
Option Caremark plans cover the same prescription drugs but have different copay and deductiblesUse generic and long-term prescriptions bull Opt for lower-cost generic drugs whenever possible bull Ask your doctor to write a 90-day prescription instead of a 30-day prescription to participate in the mail order prescription programTake advantage of tax savings by participating in Flexible Spending Accountsbull Use pre-tax dollars for eligible out of pocket services and items
Office of Human Resources Montgomery County Government
Built-in Wellness Support Take advantage of the free programs available to you through your medical carrier Each of MCGrsquos medical carriers (Kaiser UHC amp CareFirst) offer valuable programs to help you manage your health
Disease Management Programsbull Help manage your chronic condition through personalized coaching support and encouragement and online education materialsEmotional Wellness amp Stress Management Support bull Help manage stress through mobile apps and other self-care resources Maternity Programsbull Support healthy moms and healthy babiesWeight-loss Programs bull Offers telephonic coaching support and web-based tools to help ensure long-term weight managementbull See the next slide for an example of an MCG success storySmoking Cessation Programsbull Supportive coaching to make quitting more successfulDiscounts bull Gym memberships weight loss programs and moreFor more information about the programs available to you please see the Open Enrollment Guide and contact your medical carrier
Office of Human Resources Montgomery County Government
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You GoAll of MCGrsquos health insurance carriers offer a simple-to-use tool that can help make your life easier while yoursquore on the go Download your carrierrsquos Mobile App to help you personalize organize and access your important plan information on your phone or tablet
bull Schedule Virtual Visitsbull Manage and track claimsbull View ID card informationbull Find doctor and compare costs and quality ratingsbull Review your coveragebull Track your account balances and deductiblesbull Access a variety of health and wellness tools
Visit Google Play or the Apple App Store to download your carrierrsquos App
Office of Human Resources Montgomery County Government
Making Changes
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Questions
Office of Human Resources Montgomery County Government
Open Enrollment AssistanceFollow these steps (in this order)1 Review the frequently asked questions (FAQs) on the Open Enrollment website at wwwmontgomerycountymdgovoe
(available beginning September 21) You can enter key words into the interactive search bar to quickly locate the answer to your question
2 Visit the MC311 website at wwwmontgomerycountymdgovmc311 and search key words for your question The search results contain various knowledge-based articles with information related to your search words Simply click on the corresponding link and the detailed answer is revealed
3 Attend one of OHRrsquos Virtual Office Hours via Microsoft Teams Members of OHRs Health Insurance Team will be on hand to address employee questions by video or via the chat box View the schedule and access the sessions through the Open Enrollment website at wwwmontgomerycountymdgovoe (available beginning September 21)
4 If you have tried all the methods above and still have Open Enrollment-related questions please contact OHRs MC311 Customer Service Center at 240-773-6471 (Mon-Fri 8 am - 5 pm) to open a service request A member of the health insurance team will respond to service requests in the order they are received Tip Please provide an email address at the time you place your Service Request This will ensure the fastest response possible
Office of Human Resources Montgomery County Government
Online ResourcesVisit the 2021 Open Enrollment Webpage
wwwmontgomerycountymdgovOE
Visit OHRrsquos WebpagewwwmontgomerycountymdgovHR
Health Insurance active employees
Office of Human Resources Montgomery County Government
Legal InformationThe County reserves the right at any time and for any reason to amend the Program subject to the Countys collective bargainingagreements The County expects to continue the Program but it is the Countys position that there is no implied contract between individual employees and the County to do so
The County may amend the Program prospectively or retroactively to comply with applicable law
In the event of a conflict between this presentation the County Code andor the Summary Description the County Code then the Summary Description will govern
Office of Human Resources Montgomery County Government
Thank YouWe hope you enjoyed learning about 2021 Open Enrollment
~Your OHR Health Insurance Team
2021 Open Enrollment Benefits Bonanza
What Is Open Enrollment
What Changes Can be Made
Open Enrollment Dates
MCG Continues to Make Generous Employer Contributions
New for 2021
Special 2021 Plan Rates Announcement
Employee Rate Changes for Calendar Year 2021
Planning Ahead Minimizing Future Rate Increases
New for 2021
Open Enrollment Communications
Itrsquos a New Frontier
2021 Open Enrollment Checklist
Open Enrollment Website Resources
Attend a Virtual Open Enrollment Event
Make Changes Online
Paper Enrollment Form Permitted for Only Two Reasons
Dependent Eligibility
Proof of Dependent Eligibility
Marriage Certificate Example Required Documentation (Contd)
Benefits Refresher
Medical amp Rx
Medical Plan Options
Medical Benefits at-a-Glance
Medical Benefits at-a-Glance (contd)
Prescription Plans Caremark
Prescription Drug Plan Comparison
Prescription Drug Cost Comparison
Dental
Slide Number 30
Vision
Vision Insurance
Optional Life amp Dependent Life
Optional Life Insurance ADampD
Optional Life Insurance Rates
Dependent Life Insurance
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs)Why You Should Enroll
Health Care FSA
Child Care FSA
Commuter Choice Transit FSA
Using Your FSA Funds
AFLAC Voluntary Plans
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Carrier Resources amp Cost-Saving Tips
Lower Your Out-of-Pocket Costs
Built-in Wellness Support
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You Go
Making Changes
Make Changes Online
Questions
Open Enrollment Assistance
Online Resources
Legal Information
Thank You
Office of Human Resources Montgomery County Government
Health Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull Claims must be submitted by April 30 of the following yearbull You may elect to contribute up to $2750 Your total annual election amount is available to spend on the first
day of the new plan year bull FSA debit card allows you to pay for expenses at the time of servicebull Examples of IRS qualified eligible expenses
bull Copays (medical prescription dental vision) deductibles and coinsurance amounts over reasonable and customary charge
bull Hearing aids bull Acupuncture bull Orthopedic shoes bull Over-the-counter (OTC) drugs (no longer require doctorrsquos prescription)
Office of Human Resources Montgomery County Government
Child Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull $5000 annual maximum per household ($2500 for married filing separately)bull Funds are available to spend as they are accumulated through payroll deductionsbull Reimbursable expenses
bull day care centersbull elder carebull beforeafter school carebull babysitter fees that allow you and your spouse to work or go to school (no child support payments)
bull Qualifying dependentsbull Children under the age of 13 and are a tax dependent of the employeebull Spouse or tax dependent that is physically or mentally incapable of self-care
bull Must coordinate between filing a tax credit with IRS and your Dependent Care FSA plan
Office of Human Resources Montgomery County Government
Commuter Choice Transit FSAbull $230 per month maximum for MCGEO staff $260 per month maximum for Unrepresented staffbull Applies to employee commuting expenses only (not spouses or dependents)bull Can enroll throughout the year (not limited to Open Enrollment election)bull Eligible expenses include Metro Marc Vanpool Lyft Line Uber Poolbull Debit card ndash may be used for some expenses (not Metro)Metro riders will have to submit claim forms for reimbursement
bull Funds must be used within 180 days of election bull If retiring or leaving the County will need to coordinate use all available funds
Office of Human Resources Montgomery County Government
Using Your FSA FundsHealth Care FSA Your full annual election amount is available on the first day of the plan yearChild Care FSA Your funds are available as they accumulate through payroll deductionsCommuterTransit FSA Your funds are available as they accumulate through payroll deductions
The FSA Debit Card bull Your FSA debit card is the same card for your Health Care Child Care and TransitCommuter FSA accountsbull The card is pre-loaded with your full annual Health Care FSA election amount You can use the card to pay for IRS qualified expenses at
the time of service or when paying a bill Receipt notifications will be mailed to you monthly by Benefit Strategies Your response to receipt notifications is necessary under the provisions of the plan No response my result in the ineligibility of the purchase and as a result your card may be temporarily deactivated
bull If you are enrolled in the Child Care FSA the card can also be used in child-care settings Just remember that the card will only work for an amount that does not exceed the available balance in your Child Care FSA account on that day
bull The card can also be used to pay for your commutertransit expenses however it does not work for WMATA metro Metro riders will have to submit manual claims for reimbursement from your CommuterTransit FSA
bull Cards are re-loaded each year after you make your new annual election Please keep your cards You will only receive a new card if your old card is about to expire
Office of Human Resources Montgomery County Government
AFLAC Voluntary Plans
Office of Human Resources Montgomery County Government
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Short-Term Disabilitybull Provides short-term cash benefits in the event of disabilitybull Monthly benefit amounts available from $500 - $6000 (subject to income requirements)bull Benefit options of 3 6 12 18 or 24 months with a variety of elimination periods
Critical Illness Insurancebull Provides a lump sum cash benefit in the event of critical illnessbull Benefit amounts available in $5000 increments from $10000 - $30000
Participants pay 100 through payroll deduction for Short-Term Disability and Critical Illness Insurance
To ENROLL Text SETAPPTrdquo to 41411orCall 920-420-8861 orEmail susan_mcdanielusAflaccom
Office of Human Resources Montgomery County Government
Carrier Resources amp Cost-Saving Tips
Office of Human Resources Montgomery County Government
Lower Your Out-of-Pocket CostsChoose the plan thatrsquos right for youbull See the medical benefits chart for options bull Stay in network Use the provider search engines on your carrier website or mobile app to find in-network providersSeek preventive carebull Check-ups immunizations and screenings are an important part of staying healthy They can detect or prevent serious diseases and keep you healthyKnow where to go for carebull You have many options of places to go when you need care If your medical condition isnrsquot serious or life threatening you can save money by connecting
with a doctor online through a virtual visit or going to an urgent care center or convenience care clinic instead of a hospital emergency roomReview your prescription drug plan optionsbull Decide which Caremark prescription plan is best for you Note that the Kaiser HMO includes prescription drug coverage Both the Standard and High
Option Caremark plans cover the same prescription drugs but have different copay and deductiblesUse generic and long-term prescriptions bull Opt for lower-cost generic drugs whenever possible bull Ask your doctor to write a 90-day prescription instead of a 30-day prescription to participate in the mail order prescription programTake advantage of tax savings by participating in Flexible Spending Accountsbull Use pre-tax dollars for eligible out of pocket services and items
Office of Human Resources Montgomery County Government
Built-in Wellness Support Take advantage of the free programs available to you through your medical carrier Each of MCGrsquos medical carriers (Kaiser UHC amp CareFirst) offer valuable programs to help you manage your health
Disease Management Programsbull Help manage your chronic condition through personalized coaching support and encouragement and online education materialsEmotional Wellness amp Stress Management Support bull Help manage stress through mobile apps and other self-care resources Maternity Programsbull Support healthy moms and healthy babiesWeight-loss Programs bull Offers telephonic coaching support and web-based tools to help ensure long-term weight managementbull See the next slide for an example of an MCG success storySmoking Cessation Programsbull Supportive coaching to make quitting more successfulDiscounts bull Gym memberships weight loss programs and moreFor more information about the programs available to you please see the Open Enrollment Guide and contact your medical carrier
Office of Human Resources Montgomery County Government
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You GoAll of MCGrsquos health insurance carriers offer a simple-to-use tool that can help make your life easier while yoursquore on the go Download your carrierrsquos Mobile App to help you personalize organize and access your important plan information on your phone or tablet
bull Schedule Virtual Visitsbull Manage and track claimsbull View ID card informationbull Find doctor and compare costs and quality ratingsbull Review your coveragebull Track your account balances and deductiblesbull Access a variety of health and wellness tools
Visit Google Play or the Apple App Store to download your carrierrsquos App
Office of Human Resources Montgomery County Government
Making Changes
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Questions
Office of Human Resources Montgomery County Government
Open Enrollment AssistanceFollow these steps (in this order)1 Review the frequently asked questions (FAQs) on the Open Enrollment website at wwwmontgomerycountymdgovoe
(available beginning September 21) You can enter key words into the interactive search bar to quickly locate the answer to your question
2 Visit the MC311 website at wwwmontgomerycountymdgovmc311 and search key words for your question The search results contain various knowledge-based articles with information related to your search words Simply click on the corresponding link and the detailed answer is revealed
3 Attend one of OHRrsquos Virtual Office Hours via Microsoft Teams Members of OHRs Health Insurance Team will be on hand to address employee questions by video or via the chat box View the schedule and access the sessions through the Open Enrollment website at wwwmontgomerycountymdgovoe (available beginning September 21)
4 If you have tried all the methods above and still have Open Enrollment-related questions please contact OHRs MC311 Customer Service Center at 240-773-6471 (Mon-Fri 8 am - 5 pm) to open a service request A member of the health insurance team will respond to service requests in the order they are received Tip Please provide an email address at the time you place your Service Request This will ensure the fastest response possible
Office of Human Resources Montgomery County Government
Online ResourcesVisit the 2021 Open Enrollment Webpage
wwwmontgomerycountymdgovOE
Visit OHRrsquos WebpagewwwmontgomerycountymdgovHR
Health Insurance active employees
Office of Human Resources Montgomery County Government
Legal InformationThe County reserves the right at any time and for any reason to amend the Program subject to the Countys collective bargainingagreements The County expects to continue the Program but it is the Countys position that there is no implied contract between individual employees and the County to do so
The County may amend the Program prospectively or retroactively to comply with applicable law
In the event of a conflict between this presentation the County Code andor the Summary Description the County Code then the Summary Description will govern
Office of Human Resources Montgomery County Government
Thank YouWe hope you enjoyed learning about 2021 Open Enrollment
~Your OHR Health Insurance Team
2021 Open Enrollment Benefits Bonanza
What Is Open Enrollment
What Changes Can be Made
Open Enrollment Dates
MCG Continues to Make Generous Employer Contributions
New for 2021
Special 2021 Plan Rates Announcement
Employee Rate Changes for Calendar Year 2021
Planning Ahead Minimizing Future Rate Increases
New for 2021
Open Enrollment Communications
Itrsquos a New Frontier
2021 Open Enrollment Checklist
Open Enrollment Website Resources
Attend a Virtual Open Enrollment Event
Make Changes Online
Paper Enrollment Form Permitted for Only Two Reasons
Dependent Eligibility
Proof of Dependent Eligibility
Marriage Certificate Example Required Documentation (Contd)
Benefits Refresher
Medical amp Rx
Medical Plan Options
Medical Benefits at-a-Glance
Medical Benefits at-a-Glance (contd)
Prescription Plans Caremark
Prescription Drug Plan Comparison
Prescription Drug Cost Comparison
Dental
Slide Number 30
Vision
Vision Insurance
Optional Life amp Dependent Life
Optional Life Insurance ADampD
Optional Life Insurance Rates
Dependent Life Insurance
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs)Why You Should Enroll
Health Care FSA
Child Care FSA
Commuter Choice Transit FSA
Using Your FSA Funds
AFLAC Voluntary Plans
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Carrier Resources amp Cost-Saving Tips
Lower Your Out-of-Pocket Costs
Built-in Wellness Support
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You Go
Making Changes
Make Changes Online
Questions
Open Enrollment Assistance
Online Resources
Legal Information
Thank You
Office of Human Resources Montgomery County Government
Child Care FSAbull Contributions are ldquouse it or lose itrdquobull Expenses must be incurred between January 1 ndash March 15bull $5000 annual maximum per household ($2500 for married filing separately)bull Funds are available to spend as they are accumulated through payroll deductionsbull Reimbursable expenses
bull day care centersbull elder carebull beforeafter school carebull babysitter fees that allow you and your spouse to work or go to school (no child support payments)
bull Qualifying dependentsbull Children under the age of 13 and are a tax dependent of the employeebull Spouse or tax dependent that is physically or mentally incapable of self-care
bull Must coordinate between filing a tax credit with IRS and your Dependent Care FSA plan
Office of Human Resources Montgomery County Government
Commuter Choice Transit FSAbull $230 per month maximum for MCGEO staff $260 per month maximum for Unrepresented staffbull Applies to employee commuting expenses only (not spouses or dependents)bull Can enroll throughout the year (not limited to Open Enrollment election)bull Eligible expenses include Metro Marc Vanpool Lyft Line Uber Poolbull Debit card ndash may be used for some expenses (not Metro)Metro riders will have to submit claim forms for reimbursement
bull Funds must be used within 180 days of election bull If retiring or leaving the County will need to coordinate use all available funds
Office of Human Resources Montgomery County Government
Using Your FSA FundsHealth Care FSA Your full annual election amount is available on the first day of the plan yearChild Care FSA Your funds are available as they accumulate through payroll deductionsCommuterTransit FSA Your funds are available as they accumulate through payroll deductions
The FSA Debit Card bull Your FSA debit card is the same card for your Health Care Child Care and TransitCommuter FSA accountsbull The card is pre-loaded with your full annual Health Care FSA election amount You can use the card to pay for IRS qualified expenses at
the time of service or when paying a bill Receipt notifications will be mailed to you monthly by Benefit Strategies Your response to receipt notifications is necessary under the provisions of the plan No response my result in the ineligibility of the purchase and as a result your card may be temporarily deactivated
bull If you are enrolled in the Child Care FSA the card can also be used in child-care settings Just remember that the card will only work for an amount that does not exceed the available balance in your Child Care FSA account on that day
bull The card can also be used to pay for your commutertransit expenses however it does not work for WMATA metro Metro riders will have to submit manual claims for reimbursement from your CommuterTransit FSA
bull Cards are re-loaded each year after you make your new annual election Please keep your cards You will only receive a new card if your old card is about to expire
Office of Human Resources Montgomery County Government
AFLAC Voluntary Plans
Office of Human Resources Montgomery County Government
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Short-Term Disabilitybull Provides short-term cash benefits in the event of disabilitybull Monthly benefit amounts available from $500 - $6000 (subject to income requirements)bull Benefit options of 3 6 12 18 or 24 months with a variety of elimination periods
Critical Illness Insurancebull Provides a lump sum cash benefit in the event of critical illnessbull Benefit amounts available in $5000 increments from $10000 - $30000
Participants pay 100 through payroll deduction for Short-Term Disability and Critical Illness Insurance
To ENROLL Text SETAPPTrdquo to 41411orCall 920-420-8861 orEmail susan_mcdanielusAflaccom
Office of Human Resources Montgomery County Government
Carrier Resources amp Cost-Saving Tips
Office of Human Resources Montgomery County Government
Lower Your Out-of-Pocket CostsChoose the plan thatrsquos right for youbull See the medical benefits chart for options bull Stay in network Use the provider search engines on your carrier website or mobile app to find in-network providersSeek preventive carebull Check-ups immunizations and screenings are an important part of staying healthy They can detect or prevent serious diseases and keep you healthyKnow where to go for carebull You have many options of places to go when you need care If your medical condition isnrsquot serious or life threatening you can save money by connecting
with a doctor online through a virtual visit or going to an urgent care center or convenience care clinic instead of a hospital emergency roomReview your prescription drug plan optionsbull Decide which Caremark prescription plan is best for you Note that the Kaiser HMO includes prescription drug coverage Both the Standard and High
Option Caremark plans cover the same prescription drugs but have different copay and deductiblesUse generic and long-term prescriptions bull Opt for lower-cost generic drugs whenever possible bull Ask your doctor to write a 90-day prescription instead of a 30-day prescription to participate in the mail order prescription programTake advantage of tax savings by participating in Flexible Spending Accountsbull Use pre-tax dollars for eligible out of pocket services and items
Office of Human Resources Montgomery County Government
Built-in Wellness Support Take advantage of the free programs available to you through your medical carrier Each of MCGrsquos medical carriers (Kaiser UHC amp CareFirst) offer valuable programs to help you manage your health
Disease Management Programsbull Help manage your chronic condition through personalized coaching support and encouragement and online education materialsEmotional Wellness amp Stress Management Support bull Help manage stress through mobile apps and other self-care resources Maternity Programsbull Support healthy moms and healthy babiesWeight-loss Programs bull Offers telephonic coaching support and web-based tools to help ensure long-term weight managementbull See the next slide for an example of an MCG success storySmoking Cessation Programsbull Supportive coaching to make quitting more successfulDiscounts bull Gym memberships weight loss programs and moreFor more information about the programs available to you please see the Open Enrollment Guide and contact your medical carrier
Office of Human Resources Montgomery County Government
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You GoAll of MCGrsquos health insurance carriers offer a simple-to-use tool that can help make your life easier while yoursquore on the go Download your carrierrsquos Mobile App to help you personalize organize and access your important plan information on your phone or tablet
bull Schedule Virtual Visitsbull Manage and track claimsbull View ID card informationbull Find doctor and compare costs and quality ratingsbull Review your coveragebull Track your account balances and deductiblesbull Access a variety of health and wellness tools
Visit Google Play or the Apple App Store to download your carrierrsquos App
Office of Human Resources Montgomery County Government
Making Changes
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Questions
Office of Human Resources Montgomery County Government
Open Enrollment AssistanceFollow these steps (in this order)1 Review the frequently asked questions (FAQs) on the Open Enrollment website at wwwmontgomerycountymdgovoe
(available beginning September 21) You can enter key words into the interactive search bar to quickly locate the answer to your question
2 Visit the MC311 website at wwwmontgomerycountymdgovmc311 and search key words for your question The search results contain various knowledge-based articles with information related to your search words Simply click on the corresponding link and the detailed answer is revealed
3 Attend one of OHRrsquos Virtual Office Hours via Microsoft Teams Members of OHRs Health Insurance Team will be on hand to address employee questions by video or via the chat box View the schedule and access the sessions through the Open Enrollment website at wwwmontgomerycountymdgovoe (available beginning September 21)
4 If you have tried all the methods above and still have Open Enrollment-related questions please contact OHRs MC311 Customer Service Center at 240-773-6471 (Mon-Fri 8 am - 5 pm) to open a service request A member of the health insurance team will respond to service requests in the order they are received Tip Please provide an email address at the time you place your Service Request This will ensure the fastest response possible
Office of Human Resources Montgomery County Government
Online ResourcesVisit the 2021 Open Enrollment Webpage
wwwmontgomerycountymdgovOE
Visit OHRrsquos WebpagewwwmontgomerycountymdgovHR
Health Insurance active employees
Office of Human Resources Montgomery County Government
Legal InformationThe County reserves the right at any time and for any reason to amend the Program subject to the Countys collective bargainingagreements The County expects to continue the Program but it is the Countys position that there is no implied contract between individual employees and the County to do so
The County may amend the Program prospectively or retroactively to comply with applicable law
In the event of a conflict between this presentation the County Code andor the Summary Description the County Code then the Summary Description will govern
Office of Human Resources Montgomery County Government
Thank YouWe hope you enjoyed learning about 2021 Open Enrollment
~Your OHR Health Insurance Team
2021 Open Enrollment Benefits Bonanza
What Is Open Enrollment
What Changes Can be Made
Open Enrollment Dates
MCG Continues to Make Generous Employer Contributions
New for 2021
Special 2021 Plan Rates Announcement
Employee Rate Changes for Calendar Year 2021
Planning Ahead Minimizing Future Rate Increases
New for 2021
Open Enrollment Communications
Itrsquos a New Frontier
2021 Open Enrollment Checklist
Open Enrollment Website Resources
Attend a Virtual Open Enrollment Event
Make Changes Online
Paper Enrollment Form Permitted for Only Two Reasons
Dependent Eligibility
Proof of Dependent Eligibility
Marriage Certificate Example Required Documentation (Contd)
Benefits Refresher
Medical amp Rx
Medical Plan Options
Medical Benefits at-a-Glance
Medical Benefits at-a-Glance (contd)
Prescription Plans Caremark
Prescription Drug Plan Comparison
Prescription Drug Cost Comparison
Dental
Slide Number 30
Vision
Vision Insurance
Optional Life amp Dependent Life
Optional Life Insurance ADampD
Optional Life Insurance Rates
Dependent Life Insurance
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs)Why You Should Enroll
Health Care FSA
Child Care FSA
Commuter Choice Transit FSA
Using Your FSA Funds
AFLAC Voluntary Plans
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Carrier Resources amp Cost-Saving Tips
Lower Your Out-of-Pocket Costs
Built-in Wellness Support
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You Go
Making Changes
Make Changes Online
Questions
Open Enrollment Assistance
Online Resources
Legal Information
Thank You
Office of Human Resources Montgomery County Government
Commuter Choice Transit FSAbull $230 per month maximum for MCGEO staff $260 per month maximum for Unrepresented staffbull Applies to employee commuting expenses only (not spouses or dependents)bull Can enroll throughout the year (not limited to Open Enrollment election)bull Eligible expenses include Metro Marc Vanpool Lyft Line Uber Poolbull Debit card ndash may be used for some expenses (not Metro)Metro riders will have to submit claim forms for reimbursement
bull Funds must be used within 180 days of election bull If retiring or leaving the County will need to coordinate use all available funds
Office of Human Resources Montgomery County Government
Using Your FSA FundsHealth Care FSA Your full annual election amount is available on the first day of the plan yearChild Care FSA Your funds are available as they accumulate through payroll deductionsCommuterTransit FSA Your funds are available as they accumulate through payroll deductions
The FSA Debit Card bull Your FSA debit card is the same card for your Health Care Child Care and TransitCommuter FSA accountsbull The card is pre-loaded with your full annual Health Care FSA election amount You can use the card to pay for IRS qualified expenses at
the time of service or when paying a bill Receipt notifications will be mailed to you monthly by Benefit Strategies Your response to receipt notifications is necessary under the provisions of the plan No response my result in the ineligibility of the purchase and as a result your card may be temporarily deactivated
bull If you are enrolled in the Child Care FSA the card can also be used in child-care settings Just remember that the card will only work for an amount that does not exceed the available balance in your Child Care FSA account on that day
bull The card can also be used to pay for your commutertransit expenses however it does not work for WMATA metro Metro riders will have to submit manual claims for reimbursement from your CommuterTransit FSA
bull Cards are re-loaded each year after you make your new annual election Please keep your cards You will only receive a new card if your old card is about to expire
Office of Human Resources Montgomery County Government
AFLAC Voluntary Plans
Office of Human Resources Montgomery County Government
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Short-Term Disabilitybull Provides short-term cash benefits in the event of disabilitybull Monthly benefit amounts available from $500 - $6000 (subject to income requirements)bull Benefit options of 3 6 12 18 or 24 months with a variety of elimination periods
Critical Illness Insurancebull Provides a lump sum cash benefit in the event of critical illnessbull Benefit amounts available in $5000 increments from $10000 - $30000
Participants pay 100 through payroll deduction for Short-Term Disability and Critical Illness Insurance
To ENROLL Text SETAPPTrdquo to 41411orCall 920-420-8861 orEmail susan_mcdanielusAflaccom
Office of Human Resources Montgomery County Government
Carrier Resources amp Cost-Saving Tips
Office of Human Resources Montgomery County Government
Lower Your Out-of-Pocket CostsChoose the plan thatrsquos right for youbull See the medical benefits chart for options bull Stay in network Use the provider search engines on your carrier website or mobile app to find in-network providersSeek preventive carebull Check-ups immunizations and screenings are an important part of staying healthy They can detect or prevent serious diseases and keep you healthyKnow where to go for carebull You have many options of places to go when you need care If your medical condition isnrsquot serious or life threatening you can save money by connecting
with a doctor online through a virtual visit or going to an urgent care center or convenience care clinic instead of a hospital emergency roomReview your prescription drug plan optionsbull Decide which Caremark prescription plan is best for you Note that the Kaiser HMO includes prescription drug coverage Both the Standard and High
Option Caremark plans cover the same prescription drugs but have different copay and deductiblesUse generic and long-term prescriptions bull Opt for lower-cost generic drugs whenever possible bull Ask your doctor to write a 90-day prescription instead of a 30-day prescription to participate in the mail order prescription programTake advantage of tax savings by participating in Flexible Spending Accountsbull Use pre-tax dollars for eligible out of pocket services and items
Office of Human Resources Montgomery County Government
Built-in Wellness Support Take advantage of the free programs available to you through your medical carrier Each of MCGrsquos medical carriers (Kaiser UHC amp CareFirst) offer valuable programs to help you manage your health
Disease Management Programsbull Help manage your chronic condition through personalized coaching support and encouragement and online education materialsEmotional Wellness amp Stress Management Support bull Help manage stress through mobile apps and other self-care resources Maternity Programsbull Support healthy moms and healthy babiesWeight-loss Programs bull Offers telephonic coaching support and web-based tools to help ensure long-term weight managementbull See the next slide for an example of an MCG success storySmoking Cessation Programsbull Supportive coaching to make quitting more successfulDiscounts bull Gym memberships weight loss programs and moreFor more information about the programs available to you please see the Open Enrollment Guide and contact your medical carrier
Office of Human Resources Montgomery County Government
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You GoAll of MCGrsquos health insurance carriers offer a simple-to-use tool that can help make your life easier while yoursquore on the go Download your carrierrsquos Mobile App to help you personalize organize and access your important plan information on your phone or tablet
bull Schedule Virtual Visitsbull Manage and track claimsbull View ID card informationbull Find doctor and compare costs and quality ratingsbull Review your coveragebull Track your account balances and deductiblesbull Access a variety of health and wellness tools
Visit Google Play or the Apple App Store to download your carrierrsquos App
Office of Human Resources Montgomery County Government
Making Changes
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Questions
Office of Human Resources Montgomery County Government
Open Enrollment AssistanceFollow these steps (in this order)1 Review the frequently asked questions (FAQs) on the Open Enrollment website at wwwmontgomerycountymdgovoe
(available beginning September 21) You can enter key words into the interactive search bar to quickly locate the answer to your question
2 Visit the MC311 website at wwwmontgomerycountymdgovmc311 and search key words for your question The search results contain various knowledge-based articles with information related to your search words Simply click on the corresponding link and the detailed answer is revealed
3 Attend one of OHRrsquos Virtual Office Hours via Microsoft Teams Members of OHRs Health Insurance Team will be on hand to address employee questions by video or via the chat box View the schedule and access the sessions through the Open Enrollment website at wwwmontgomerycountymdgovoe (available beginning September 21)
4 If you have tried all the methods above and still have Open Enrollment-related questions please contact OHRs MC311 Customer Service Center at 240-773-6471 (Mon-Fri 8 am - 5 pm) to open a service request A member of the health insurance team will respond to service requests in the order they are received Tip Please provide an email address at the time you place your Service Request This will ensure the fastest response possible
Office of Human Resources Montgomery County Government
Online ResourcesVisit the 2021 Open Enrollment Webpage
wwwmontgomerycountymdgovOE
Visit OHRrsquos WebpagewwwmontgomerycountymdgovHR
Health Insurance active employees
Office of Human Resources Montgomery County Government
Legal InformationThe County reserves the right at any time and for any reason to amend the Program subject to the Countys collective bargainingagreements The County expects to continue the Program but it is the Countys position that there is no implied contract between individual employees and the County to do so
The County may amend the Program prospectively or retroactively to comply with applicable law
In the event of a conflict between this presentation the County Code andor the Summary Description the County Code then the Summary Description will govern
Office of Human Resources Montgomery County Government
Thank YouWe hope you enjoyed learning about 2021 Open Enrollment
~Your OHR Health Insurance Team
2021 Open Enrollment Benefits Bonanza
What Is Open Enrollment
What Changes Can be Made
Open Enrollment Dates
MCG Continues to Make Generous Employer Contributions
New for 2021
Special 2021 Plan Rates Announcement
Employee Rate Changes for Calendar Year 2021
Planning Ahead Minimizing Future Rate Increases
New for 2021
Open Enrollment Communications
Itrsquos a New Frontier
2021 Open Enrollment Checklist
Open Enrollment Website Resources
Attend a Virtual Open Enrollment Event
Make Changes Online
Paper Enrollment Form Permitted for Only Two Reasons
Dependent Eligibility
Proof of Dependent Eligibility
Marriage Certificate Example Required Documentation (Contd)
Benefits Refresher
Medical amp Rx
Medical Plan Options
Medical Benefits at-a-Glance
Medical Benefits at-a-Glance (contd)
Prescription Plans Caremark
Prescription Drug Plan Comparison
Prescription Drug Cost Comparison
Dental
Slide Number 30
Vision
Vision Insurance
Optional Life amp Dependent Life
Optional Life Insurance ADampD
Optional Life Insurance Rates
Dependent Life Insurance
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs)Why You Should Enroll
Health Care FSA
Child Care FSA
Commuter Choice Transit FSA
Using Your FSA Funds
AFLAC Voluntary Plans
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Carrier Resources amp Cost-Saving Tips
Lower Your Out-of-Pocket Costs
Built-in Wellness Support
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You Go
Making Changes
Make Changes Online
Questions
Open Enrollment Assistance
Online Resources
Legal Information
Thank You
Office of Human Resources Montgomery County Government
Using Your FSA FundsHealth Care FSA Your full annual election amount is available on the first day of the plan yearChild Care FSA Your funds are available as they accumulate through payroll deductionsCommuterTransit FSA Your funds are available as they accumulate through payroll deductions
The FSA Debit Card bull Your FSA debit card is the same card for your Health Care Child Care and TransitCommuter FSA accountsbull The card is pre-loaded with your full annual Health Care FSA election amount You can use the card to pay for IRS qualified expenses at
the time of service or when paying a bill Receipt notifications will be mailed to you monthly by Benefit Strategies Your response to receipt notifications is necessary under the provisions of the plan No response my result in the ineligibility of the purchase and as a result your card may be temporarily deactivated
bull If you are enrolled in the Child Care FSA the card can also be used in child-care settings Just remember that the card will only work for an amount that does not exceed the available balance in your Child Care FSA account on that day
bull The card can also be used to pay for your commutertransit expenses however it does not work for WMATA metro Metro riders will have to submit manual claims for reimbursement from your CommuterTransit FSA
bull Cards are re-loaded each year after you make your new annual election Please keep your cards You will only receive a new card if your old card is about to expire
Office of Human Resources Montgomery County Government
AFLAC Voluntary Plans
Office of Human Resources Montgomery County Government
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Short-Term Disabilitybull Provides short-term cash benefits in the event of disabilitybull Monthly benefit amounts available from $500 - $6000 (subject to income requirements)bull Benefit options of 3 6 12 18 or 24 months with a variety of elimination periods
Critical Illness Insurancebull Provides a lump sum cash benefit in the event of critical illnessbull Benefit amounts available in $5000 increments from $10000 - $30000
Participants pay 100 through payroll deduction for Short-Term Disability and Critical Illness Insurance
To ENROLL Text SETAPPTrdquo to 41411orCall 920-420-8861 orEmail susan_mcdanielusAflaccom
Office of Human Resources Montgomery County Government
Carrier Resources amp Cost-Saving Tips
Office of Human Resources Montgomery County Government
Lower Your Out-of-Pocket CostsChoose the plan thatrsquos right for youbull See the medical benefits chart for options bull Stay in network Use the provider search engines on your carrier website or mobile app to find in-network providersSeek preventive carebull Check-ups immunizations and screenings are an important part of staying healthy They can detect or prevent serious diseases and keep you healthyKnow where to go for carebull You have many options of places to go when you need care If your medical condition isnrsquot serious or life threatening you can save money by connecting
with a doctor online through a virtual visit or going to an urgent care center or convenience care clinic instead of a hospital emergency roomReview your prescription drug plan optionsbull Decide which Caremark prescription plan is best for you Note that the Kaiser HMO includes prescription drug coverage Both the Standard and High
Option Caremark plans cover the same prescription drugs but have different copay and deductiblesUse generic and long-term prescriptions bull Opt for lower-cost generic drugs whenever possible bull Ask your doctor to write a 90-day prescription instead of a 30-day prescription to participate in the mail order prescription programTake advantage of tax savings by participating in Flexible Spending Accountsbull Use pre-tax dollars for eligible out of pocket services and items
Office of Human Resources Montgomery County Government
Built-in Wellness Support Take advantage of the free programs available to you through your medical carrier Each of MCGrsquos medical carriers (Kaiser UHC amp CareFirst) offer valuable programs to help you manage your health
Disease Management Programsbull Help manage your chronic condition through personalized coaching support and encouragement and online education materialsEmotional Wellness amp Stress Management Support bull Help manage stress through mobile apps and other self-care resources Maternity Programsbull Support healthy moms and healthy babiesWeight-loss Programs bull Offers telephonic coaching support and web-based tools to help ensure long-term weight managementbull See the next slide for an example of an MCG success storySmoking Cessation Programsbull Supportive coaching to make quitting more successfulDiscounts bull Gym memberships weight loss programs and moreFor more information about the programs available to you please see the Open Enrollment Guide and contact your medical carrier
Office of Human Resources Montgomery County Government
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You GoAll of MCGrsquos health insurance carriers offer a simple-to-use tool that can help make your life easier while yoursquore on the go Download your carrierrsquos Mobile App to help you personalize organize and access your important plan information on your phone or tablet
bull Schedule Virtual Visitsbull Manage and track claimsbull View ID card informationbull Find doctor and compare costs and quality ratingsbull Review your coveragebull Track your account balances and deductiblesbull Access a variety of health and wellness tools
Visit Google Play or the Apple App Store to download your carrierrsquos App
Office of Human Resources Montgomery County Government
Making Changes
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Questions
Office of Human Resources Montgomery County Government
Open Enrollment AssistanceFollow these steps (in this order)1 Review the frequently asked questions (FAQs) on the Open Enrollment website at wwwmontgomerycountymdgovoe
(available beginning September 21) You can enter key words into the interactive search bar to quickly locate the answer to your question
2 Visit the MC311 website at wwwmontgomerycountymdgovmc311 and search key words for your question The search results contain various knowledge-based articles with information related to your search words Simply click on the corresponding link and the detailed answer is revealed
3 Attend one of OHRrsquos Virtual Office Hours via Microsoft Teams Members of OHRs Health Insurance Team will be on hand to address employee questions by video or via the chat box View the schedule and access the sessions through the Open Enrollment website at wwwmontgomerycountymdgovoe (available beginning September 21)
4 If you have tried all the methods above and still have Open Enrollment-related questions please contact OHRs MC311 Customer Service Center at 240-773-6471 (Mon-Fri 8 am - 5 pm) to open a service request A member of the health insurance team will respond to service requests in the order they are received Tip Please provide an email address at the time you place your Service Request This will ensure the fastest response possible
Office of Human Resources Montgomery County Government
Online ResourcesVisit the 2021 Open Enrollment Webpage
wwwmontgomerycountymdgovOE
Visit OHRrsquos WebpagewwwmontgomerycountymdgovHR
Health Insurance active employees
Office of Human Resources Montgomery County Government
Legal InformationThe County reserves the right at any time and for any reason to amend the Program subject to the Countys collective bargainingagreements The County expects to continue the Program but it is the Countys position that there is no implied contract between individual employees and the County to do so
The County may amend the Program prospectively or retroactively to comply with applicable law
In the event of a conflict between this presentation the County Code andor the Summary Description the County Code then the Summary Description will govern
Office of Human Resources Montgomery County Government
Thank YouWe hope you enjoyed learning about 2021 Open Enrollment
~Your OHR Health Insurance Team
2021 Open Enrollment Benefits Bonanza
What Is Open Enrollment
What Changes Can be Made
Open Enrollment Dates
MCG Continues to Make Generous Employer Contributions
New for 2021
Special 2021 Plan Rates Announcement
Employee Rate Changes for Calendar Year 2021
Planning Ahead Minimizing Future Rate Increases
New for 2021
Open Enrollment Communications
Itrsquos a New Frontier
2021 Open Enrollment Checklist
Open Enrollment Website Resources
Attend a Virtual Open Enrollment Event
Make Changes Online
Paper Enrollment Form Permitted for Only Two Reasons
Dependent Eligibility
Proof of Dependent Eligibility
Marriage Certificate Example Required Documentation (Contd)
Benefits Refresher
Medical amp Rx
Medical Plan Options
Medical Benefits at-a-Glance
Medical Benefits at-a-Glance (contd)
Prescription Plans Caremark
Prescription Drug Plan Comparison
Prescription Drug Cost Comparison
Dental
Slide Number 30
Vision
Vision Insurance
Optional Life amp Dependent Life
Optional Life Insurance ADampD
Optional Life Insurance Rates
Dependent Life Insurance
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs)Why You Should Enroll
Health Care FSA
Child Care FSA
Commuter Choice Transit FSA
Using Your FSA Funds
AFLAC Voluntary Plans
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Carrier Resources amp Cost-Saving Tips
Lower Your Out-of-Pocket Costs
Built-in Wellness Support
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You Go
Making Changes
Make Changes Online
Questions
Open Enrollment Assistance
Online Resources
Legal Information
Thank You
Office of Human Resources Montgomery County Government
AFLAC Voluntary Plans
Office of Human Resources Montgomery County Government
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Short-Term Disabilitybull Provides short-term cash benefits in the event of disabilitybull Monthly benefit amounts available from $500 - $6000 (subject to income requirements)bull Benefit options of 3 6 12 18 or 24 months with a variety of elimination periods
Critical Illness Insurancebull Provides a lump sum cash benefit in the event of critical illnessbull Benefit amounts available in $5000 increments from $10000 - $30000
Participants pay 100 through payroll deduction for Short-Term Disability and Critical Illness Insurance
To ENROLL Text SETAPPTrdquo to 41411orCall 920-420-8861 orEmail susan_mcdanielusAflaccom
Office of Human Resources Montgomery County Government
Carrier Resources amp Cost-Saving Tips
Office of Human Resources Montgomery County Government
Lower Your Out-of-Pocket CostsChoose the plan thatrsquos right for youbull See the medical benefits chart for options bull Stay in network Use the provider search engines on your carrier website or mobile app to find in-network providersSeek preventive carebull Check-ups immunizations and screenings are an important part of staying healthy They can detect or prevent serious diseases and keep you healthyKnow where to go for carebull You have many options of places to go when you need care If your medical condition isnrsquot serious or life threatening you can save money by connecting
with a doctor online through a virtual visit or going to an urgent care center or convenience care clinic instead of a hospital emergency roomReview your prescription drug plan optionsbull Decide which Caremark prescription plan is best for you Note that the Kaiser HMO includes prescription drug coverage Both the Standard and High
Option Caremark plans cover the same prescription drugs but have different copay and deductiblesUse generic and long-term prescriptions bull Opt for lower-cost generic drugs whenever possible bull Ask your doctor to write a 90-day prescription instead of a 30-day prescription to participate in the mail order prescription programTake advantage of tax savings by participating in Flexible Spending Accountsbull Use pre-tax dollars for eligible out of pocket services and items
Office of Human Resources Montgomery County Government
Built-in Wellness Support Take advantage of the free programs available to you through your medical carrier Each of MCGrsquos medical carriers (Kaiser UHC amp CareFirst) offer valuable programs to help you manage your health
Disease Management Programsbull Help manage your chronic condition through personalized coaching support and encouragement and online education materialsEmotional Wellness amp Stress Management Support bull Help manage stress through mobile apps and other self-care resources Maternity Programsbull Support healthy moms and healthy babiesWeight-loss Programs bull Offers telephonic coaching support and web-based tools to help ensure long-term weight managementbull See the next slide for an example of an MCG success storySmoking Cessation Programsbull Supportive coaching to make quitting more successfulDiscounts bull Gym memberships weight loss programs and moreFor more information about the programs available to you please see the Open Enrollment Guide and contact your medical carrier
Office of Human Resources Montgomery County Government
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You GoAll of MCGrsquos health insurance carriers offer a simple-to-use tool that can help make your life easier while yoursquore on the go Download your carrierrsquos Mobile App to help you personalize organize and access your important plan information on your phone or tablet
bull Schedule Virtual Visitsbull Manage and track claimsbull View ID card informationbull Find doctor and compare costs and quality ratingsbull Review your coveragebull Track your account balances and deductiblesbull Access a variety of health and wellness tools
Visit Google Play or the Apple App Store to download your carrierrsquos App
Office of Human Resources Montgomery County Government
Making Changes
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Questions
Office of Human Resources Montgomery County Government
Open Enrollment AssistanceFollow these steps (in this order)1 Review the frequently asked questions (FAQs) on the Open Enrollment website at wwwmontgomerycountymdgovoe
(available beginning September 21) You can enter key words into the interactive search bar to quickly locate the answer to your question
2 Visit the MC311 website at wwwmontgomerycountymdgovmc311 and search key words for your question The search results contain various knowledge-based articles with information related to your search words Simply click on the corresponding link and the detailed answer is revealed
3 Attend one of OHRrsquos Virtual Office Hours via Microsoft Teams Members of OHRs Health Insurance Team will be on hand to address employee questions by video or via the chat box View the schedule and access the sessions through the Open Enrollment website at wwwmontgomerycountymdgovoe (available beginning September 21)
4 If you have tried all the methods above and still have Open Enrollment-related questions please contact OHRs MC311 Customer Service Center at 240-773-6471 (Mon-Fri 8 am - 5 pm) to open a service request A member of the health insurance team will respond to service requests in the order they are received Tip Please provide an email address at the time you place your Service Request This will ensure the fastest response possible
Office of Human Resources Montgomery County Government
Online ResourcesVisit the 2021 Open Enrollment Webpage
wwwmontgomerycountymdgovOE
Visit OHRrsquos WebpagewwwmontgomerycountymdgovHR
Health Insurance active employees
Office of Human Resources Montgomery County Government
Legal InformationThe County reserves the right at any time and for any reason to amend the Program subject to the Countys collective bargainingagreements The County expects to continue the Program but it is the Countys position that there is no implied contract between individual employees and the County to do so
The County may amend the Program prospectively or retroactively to comply with applicable law
In the event of a conflict between this presentation the County Code andor the Summary Description the County Code then the Summary Description will govern
Office of Human Resources Montgomery County Government
Thank YouWe hope you enjoyed learning about 2021 Open Enrollment
~Your OHR Health Insurance Team
2021 Open Enrollment Benefits Bonanza
What Is Open Enrollment
What Changes Can be Made
Open Enrollment Dates
MCG Continues to Make Generous Employer Contributions
New for 2021
Special 2021 Plan Rates Announcement
Employee Rate Changes for Calendar Year 2021
Planning Ahead Minimizing Future Rate Increases
New for 2021
Open Enrollment Communications
Itrsquos a New Frontier
2021 Open Enrollment Checklist
Open Enrollment Website Resources
Attend a Virtual Open Enrollment Event
Make Changes Online
Paper Enrollment Form Permitted for Only Two Reasons
Dependent Eligibility
Proof of Dependent Eligibility
Marriage Certificate Example Required Documentation (Contd)
Benefits Refresher
Medical amp Rx
Medical Plan Options
Medical Benefits at-a-Glance
Medical Benefits at-a-Glance (contd)
Prescription Plans Caremark
Prescription Drug Plan Comparison
Prescription Drug Cost Comparison
Dental
Slide Number 30
Vision
Vision Insurance
Optional Life amp Dependent Life
Optional Life Insurance ADampD
Optional Life Insurance Rates
Dependent Life Insurance
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs)Why You Should Enroll
Health Care FSA
Child Care FSA
Commuter Choice Transit FSA
Using Your FSA Funds
AFLAC Voluntary Plans
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Carrier Resources amp Cost-Saving Tips
Lower Your Out-of-Pocket Costs
Built-in Wellness Support
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You Go
Making Changes
Make Changes Online
Questions
Open Enrollment Assistance
Online Resources
Legal Information
Thank You
Office of Human Resources Montgomery County Government
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Short-Term Disabilitybull Provides short-term cash benefits in the event of disabilitybull Monthly benefit amounts available from $500 - $6000 (subject to income requirements)bull Benefit options of 3 6 12 18 or 24 months with a variety of elimination periods
Critical Illness Insurancebull Provides a lump sum cash benefit in the event of critical illnessbull Benefit amounts available in $5000 increments from $10000 - $30000
Participants pay 100 through payroll deduction for Short-Term Disability and Critical Illness Insurance
To ENROLL Text SETAPPTrdquo to 41411orCall 920-420-8861 orEmail susan_mcdanielusAflaccom
Office of Human Resources Montgomery County Government
Carrier Resources amp Cost-Saving Tips
Office of Human Resources Montgomery County Government
Lower Your Out-of-Pocket CostsChoose the plan thatrsquos right for youbull See the medical benefits chart for options bull Stay in network Use the provider search engines on your carrier website or mobile app to find in-network providersSeek preventive carebull Check-ups immunizations and screenings are an important part of staying healthy They can detect or prevent serious diseases and keep you healthyKnow where to go for carebull You have many options of places to go when you need care If your medical condition isnrsquot serious or life threatening you can save money by connecting
with a doctor online through a virtual visit or going to an urgent care center or convenience care clinic instead of a hospital emergency roomReview your prescription drug plan optionsbull Decide which Caremark prescription plan is best for you Note that the Kaiser HMO includes prescription drug coverage Both the Standard and High
Option Caremark plans cover the same prescription drugs but have different copay and deductiblesUse generic and long-term prescriptions bull Opt for lower-cost generic drugs whenever possible bull Ask your doctor to write a 90-day prescription instead of a 30-day prescription to participate in the mail order prescription programTake advantage of tax savings by participating in Flexible Spending Accountsbull Use pre-tax dollars for eligible out of pocket services and items
Office of Human Resources Montgomery County Government
Built-in Wellness Support Take advantage of the free programs available to you through your medical carrier Each of MCGrsquos medical carriers (Kaiser UHC amp CareFirst) offer valuable programs to help you manage your health
Disease Management Programsbull Help manage your chronic condition through personalized coaching support and encouragement and online education materialsEmotional Wellness amp Stress Management Support bull Help manage stress through mobile apps and other self-care resources Maternity Programsbull Support healthy moms and healthy babiesWeight-loss Programs bull Offers telephonic coaching support and web-based tools to help ensure long-term weight managementbull See the next slide for an example of an MCG success storySmoking Cessation Programsbull Supportive coaching to make quitting more successfulDiscounts bull Gym memberships weight loss programs and moreFor more information about the programs available to you please see the Open Enrollment Guide and contact your medical carrier
Office of Human Resources Montgomery County Government
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You GoAll of MCGrsquos health insurance carriers offer a simple-to-use tool that can help make your life easier while yoursquore on the go Download your carrierrsquos Mobile App to help you personalize organize and access your important plan information on your phone or tablet
bull Schedule Virtual Visitsbull Manage and track claimsbull View ID card informationbull Find doctor and compare costs and quality ratingsbull Review your coveragebull Track your account balances and deductiblesbull Access a variety of health and wellness tools
Visit Google Play or the Apple App Store to download your carrierrsquos App
Office of Human Resources Montgomery County Government
Making Changes
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Questions
Office of Human Resources Montgomery County Government
Open Enrollment AssistanceFollow these steps (in this order)1 Review the frequently asked questions (FAQs) on the Open Enrollment website at wwwmontgomerycountymdgovoe
(available beginning September 21) You can enter key words into the interactive search bar to quickly locate the answer to your question
2 Visit the MC311 website at wwwmontgomerycountymdgovmc311 and search key words for your question The search results contain various knowledge-based articles with information related to your search words Simply click on the corresponding link and the detailed answer is revealed
3 Attend one of OHRrsquos Virtual Office Hours via Microsoft Teams Members of OHRs Health Insurance Team will be on hand to address employee questions by video or via the chat box View the schedule and access the sessions through the Open Enrollment website at wwwmontgomerycountymdgovoe (available beginning September 21)
4 If you have tried all the methods above and still have Open Enrollment-related questions please contact OHRs MC311 Customer Service Center at 240-773-6471 (Mon-Fri 8 am - 5 pm) to open a service request A member of the health insurance team will respond to service requests in the order they are received Tip Please provide an email address at the time you place your Service Request This will ensure the fastest response possible
Office of Human Resources Montgomery County Government
Online ResourcesVisit the 2021 Open Enrollment Webpage
wwwmontgomerycountymdgovOE
Visit OHRrsquos WebpagewwwmontgomerycountymdgovHR
Health Insurance active employees
Office of Human Resources Montgomery County Government
Legal InformationThe County reserves the right at any time and for any reason to amend the Program subject to the Countys collective bargainingagreements The County expects to continue the Program but it is the Countys position that there is no implied contract between individual employees and the County to do so
The County may amend the Program prospectively or retroactively to comply with applicable law
In the event of a conflict between this presentation the County Code andor the Summary Description the County Code then the Summary Description will govern
Office of Human Resources Montgomery County Government
Thank YouWe hope you enjoyed learning about 2021 Open Enrollment
~Your OHR Health Insurance Team
2021 Open Enrollment Benefits Bonanza
What Is Open Enrollment
What Changes Can be Made
Open Enrollment Dates
MCG Continues to Make Generous Employer Contributions
New for 2021
Special 2021 Plan Rates Announcement
Employee Rate Changes for Calendar Year 2021
Planning Ahead Minimizing Future Rate Increases
New for 2021
Open Enrollment Communications
Itrsquos a New Frontier
2021 Open Enrollment Checklist
Open Enrollment Website Resources
Attend a Virtual Open Enrollment Event
Make Changes Online
Paper Enrollment Form Permitted for Only Two Reasons
Dependent Eligibility
Proof of Dependent Eligibility
Marriage Certificate Example Required Documentation (Contd)
Benefits Refresher
Medical amp Rx
Medical Plan Options
Medical Benefits at-a-Glance
Medical Benefits at-a-Glance (contd)
Prescription Plans Caremark
Prescription Drug Plan Comparison
Prescription Drug Cost Comparison
Dental
Slide Number 30
Vision
Vision Insurance
Optional Life amp Dependent Life
Optional Life Insurance ADampD
Optional Life Insurance Rates
Dependent Life Insurance
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs)Why You Should Enroll
Health Care FSA
Child Care FSA
Commuter Choice Transit FSA
Using Your FSA Funds
AFLAC Voluntary Plans
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Carrier Resources amp Cost-Saving Tips
Lower Your Out-of-Pocket Costs
Built-in Wellness Support
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You Go
Making Changes
Make Changes Online
Questions
Open Enrollment Assistance
Online Resources
Legal Information
Thank You
Office of Human Resources Montgomery County Government
Carrier Resources amp Cost-Saving Tips
Office of Human Resources Montgomery County Government
Lower Your Out-of-Pocket CostsChoose the plan thatrsquos right for youbull See the medical benefits chart for options bull Stay in network Use the provider search engines on your carrier website or mobile app to find in-network providersSeek preventive carebull Check-ups immunizations and screenings are an important part of staying healthy They can detect or prevent serious diseases and keep you healthyKnow where to go for carebull You have many options of places to go when you need care If your medical condition isnrsquot serious or life threatening you can save money by connecting
with a doctor online through a virtual visit or going to an urgent care center or convenience care clinic instead of a hospital emergency roomReview your prescription drug plan optionsbull Decide which Caremark prescription plan is best for you Note that the Kaiser HMO includes prescription drug coverage Both the Standard and High
Option Caremark plans cover the same prescription drugs but have different copay and deductiblesUse generic and long-term prescriptions bull Opt for lower-cost generic drugs whenever possible bull Ask your doctor to write a 90-day prescription instead of a 30-day prescription to participate in the mail order prescription programTake advantage of tax savings by participating in Flexible Spending Accountsbull Use pre-tax dollars for eligible out of pocket services and items
Office of Human Resources Montgomery County Government
Built-in Wellness Support Take advantage of the free programs available to you through your medical carrier Each of MCGrsquos medical carriers (Kaiser UHC amp CareFirst) offer valuable programs to help you manage your health
Disease Management Programsbull Help manage your chronic condition through personalized coaching support and encouragement and online education materialsEmotional Wellness amp Stress Management Support bull Help manage stress through mobile apps and other self-care resources Maternity Programsbull Support healthy moms and healthy babiesWeight-loss Programs bull Offers telephonic coaching support and web-based tools to help ensure long-term weight managementbull See the next slide for an example of an MCG success storySmoking Cessation Programsbull Supportive coaching to make quitting more successfulDiscounts bull Gym memberships weight loss programs and moreFor more information about the programs available to you please see the Open Enrollment Guide and contact your medical carrier
Office of Human Resources Montgomery County Government
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You GoAll of MCGrsquos health insurance carriers offer a simple-to-use tool that can help make your life easier while yoursquore on the go Download your carrierrsquos Mobile App to help you personalize organize and access your important plan information on your phone or tablet
bull Schedule Virtual Visitsbull Manage and track claimsbull View ID card informationbull Find doctor and compare costs and quality ratingsbull Review your coveragebull Track your account balances and deductiblesbull Access a variety of health and wellness tools
Visit Google Play or the Apple App Store to download your carrierrsquos App
Office of Human Resources Montgomery County Government
Making Changes
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Questions
Office of Human Resources Montgomery County Government
Open Enrollment AssistanceFollow these steps (in this order)1 Review the frequently asked questions (FAQs) on the Open Enrollment website at wwwmontgomerycountymdgovoe
(available beginning September 21) You can enter key words into the interactive search bar to quickly locate the answer to your question
2 Visit the MC311 website at wwwmontgomerycountymdgovmc311 and search key words for your question The search results contain various knowledge-based articles with information related to your search words Simply click on the corresponding link and the detailed answer is revealed
3 Attend one of OHRrsquos Virtual Office Hours via Microsoft Teams Members of OHRs Health Insurance Team will be on hand to address employee questions by video or via the chat box View the schedule and access the sessions through the Open Enrollment website at wwwmontgomerycountymdgovoe (available beginning September 21)
4 If you have tried all the methods above and still have Open Enrollment-related questions please contact OHRs MC311 Customer Service Center at 240-773-6471 (Mon-Fri 8 am - 5 pm) to open a service request A member of the health insurance team will respond to service requests in the order they are received Tip Please provide an email address at the time you place your Service Request This will ensure the fastest response possible
Office of Human Resources Montgomery County Government
Online ResourcesVisit the 2021 Open Enrollment Webpage
wwwmontgomerycountymdgovOE
Visit OHRrsquos WebpagewwwmontgomerycountymdgovHR
Health Insurance active employees
Office of Human Resources Montgomery County Government
Legal InformationThe County reserves the right at any time and for any reason to amend the Program subject to the Countys collective bargainingagreements The County expects to continue the Program but it is the Countys position that there is no implied contract between individual employees and the County to do so
The County may amend the Program prospectively or retroactively to comply with applicable law
In the event of a conflict between this presentation the County Code andor the Summary Description the County Code then the Summary Description will govern
Office of Human Resources Montgomery County Government
Thank YouWe hope you enjoyed learning about 2021 Open Enrollment
~Your OHR Health Insurance Team
2021 Open Enrollment Benefits Bonanza
What Is Open Enrollment
What Changes Can be Made
Open Enrollment Dates
MCG Continues to Make Generous Employer Contributions
New for 2021
Special 2021 Plan Rates Announcement
Employee Rate Changes for Calendar Year 2021
Planning Ahead Minimizing Future Rate Increases
New for 2021
Open Enrollment Communications
Itrsquos a New Frontier
2021 Open Enrollment Checklist
Open Enrollment Website Resources
Attend a Virtual Open Enrollment Event
Make Changes Online
Paper Enrollment Form Permitted for Only Two Reasons
Dependent Eligibility
Proof of Dependent Eligibility
Marriage Certificate Example Required Documentation (Contd)
Benefits Refresher
Medical amp Rx
Medical Plan Options
Medical Benefits at-a-Glance
Medical Benefits at-a-Glance (contd)
Prescription Plans Caremark
Prescription Drug Plan Comparison
Prescription Drug Cost Comparison
Dental
Slide Number 30
Vision
Vision Insurance
Optional Life amp Dependent Life
Optional Life Insurance ADampD
Optional Life Insurance Rates
Dependent Life Insurance
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs)Why You Should Enroll
Health Care FSA
Child Care FSA
Commuter Choice Transit FSA
Using Your FSA Funds
AFLAC Voluntary Plans
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Carrier Resources amp Cost-Saving Tips
Lower Your Out-of-Pocket Costs
Built-in Wellness Support
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You Go
Making Changes
Make Changes Online
Questions
Open Enrollment Assistance
Online Resources
Legal Information
Thank You
Office of Human Resources Montgomery County Government
Lower Your Out-of-Pocket CostsChoose the plan thatrsquos right for youbull See the medical benefits chart for options bull Stay in network Use the provider search engines on your carrier website or mobile app to find in-network providersSeek preventive carebull Check-ups immunizations and screenings are an important part of staying healthy They can detect or prevent serious diseases and keep you healthyKnow where to go for carebull You have many options of places to go when you need care If your medical condition isnrsquot serious or life threatening you can save money by connecting
with a doctor online through a virtual visit or going to an urgent care center or convenience care clinic instead of a hospital emergency roomReview your prescription drug plan optionsbull Decide which Caremark prescription plan is best for you Note that the Kaiser HMO includes prescription drug coverage Both the Standard and High
Option Caremark plans cover the same prescription drugs but have different copay and deductiblesUse generic and long-term prescriptions bull Opt for lower-cost generic drugs whenever possible bull Ask your doctor to write a 90-day prescription instead of a 30-day prescription to participate in the mail order prescription programTake advantage of tax savings by participating in Flexible Spending Accountsbull Use pre-tax dollars for eligible out of pocket services and items
Office of Human Resources Montgomery County Government
Built-in Wellness Support Take advantage of the free programs available to you through your medical carrier Each of MCGrsquos medical carriers (Kaiser UHC amp CareFirst) offer valuable programs to help you manage your health
Disease Management Programsbull Help manage your chronic condition through personalized coaching support and encouragement and online education materialsEmotional Wellness amp Stress Management Support bull Help manage stress through mobile apps and other self-care resources Maternity Programsbull Support healthy moms and healthy babiesWeight-loss Programs bull Offers telephonic coaching support and web-based tools to help ensure long-term weight managementbull See the next slide for an example of an MCG success storySmoking Cessation Programsbull Supportive coaching to make quitting more successfulDiscounts bull Gym memberships weight loss programs and moreFor more information about the programs available to you please see the Open Enrollment Guide and contact your medical carrier
Office of Human Resources Montgomery County Government
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You GoAll of MCGrsquos health insurance carriers offer a simple-to-use tool that can help make your life easier while yoursquore on the go Download your carrierrsquos Mobile App to help you personalize organize and access your important plan information on your phone or tablet
bull Schedule Virtual Visitsbull Manage and track claimsbull View ID card informationbull Find doctor and compare costs and quality ratingsbull Review your coveragebull Track your account balances and deductiblesbull Access a variety of health and wellness tools
Visit Google Play or the Apple App Store to download your carrierrsquos App
Office of Human Resources Montgomery County Government
Making Changes
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Questions
Office of Human Resources Montgomery County Government
Open Enrollment AssistanceFollow these steps (in this order)1 Review the frequently asked questions (FAQs) on the Open Enrollment website at wwwmontgomerycountymdgovoe
(available beginning September 21) You can enter key words into the interactive search bar to quickly locate the answer to your question
2 Visit the MC311 website at wwwmontgomerycountymdgovmc311 and search key words for your question The search results contain various knowledge-based articles with information related to your search words Simply click on the corresponding link and the detailed answer is revealed
3 Attend one of OHRrsquos Virtual Office Hours via Microsoft Teams Members of OHRs Health Insurance Team will be on hand to address employee questions by video or via the chat box View the schedule and access the sessions through the Open Enrollment website at wwwmontgomerycountymdgovoe (available beginning September 21)
4 If you have tried all the methods above and still have Open Enrollment-related questions please contact OHRs MC311 Customer Service Center at 240-773-6471 (Mon-Fri 8 am - 5 pm) to open a service request A member of the health insurance team will respond to service requests in the order they are received Tip Please provide an email address at the time you place your Service Request This will ensure the fastest response possible
Office of Human Resources Montgomery County Government
Online ResourcesVisit the 2021 Open Enrollment Webpage
wwwmontgomerycountymdgovOE
Visit OHRrsquos WebpagewwwmontgomerycountymdgovHR
Health Insurance active employees
Office of Human Resources Montgomery County Government
Legal InformationThe County reserves the right at any time and for any reason to amend the Program subject to the Countys collective bargainingagreements The County expects to continue the Program but it is the Countys position that there is no implied contract between individual employees and the County to do so
The County may amend the Program prospectively or retroactively to comply with applicable law
In the event of a conflict between this presentation the County Code andor the Summary Description the County Code then the Summary Description will govern
Office of Human Resources Montgomery County Government
Thank YouWe hope you enjoyed learning about 2021 Open Enrollment
~Your OHR Health Insurance Team
2021 Open Enrollment Benefits Bonanza
What Is Open Enrollment
What Changes Can be Made
Open Enrollment Dates
MCG Continues to Make Generous Employer Contributions
New for 2021
Special 2021 Plan Rates Announcement
Employee Rate Changes for Calendar Year 2021
Planning Ahead Minimizing Future Rate Increases
New for 2021
Open Enrollment Communications
Itrsquos a New Frontier
2021 Open Enrollment Checklist
Open Enrollment Website Resources
Attend a Virtual Open Enrollment Event
Make Changes Online
Paper Enrollment Form Permitted for Only Two Reasons
Dependent Eligibility
Proof of Dependent Eligibility
Marriage Certificate Example Required Documentation (Contd)
Benefits Refresher
Medical amp Rx
Medical Plan Options
Medical Benefits at-a-Glance
Medical Benefits at-a-Glance (contd)
Prescription Plans Caremark
Prescription Drug Plan Comparison
Prescription Drug Cost Comparison
Dental
Slide Number 30
Vision
Vision Insurance
Optional Life amp Dependent Life
Optional Life Insurance ADampD
Optional Life Insurance Rates
Dependent Life Insurance
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs)Why You Should Enroll
Health Care FSA
Child Care FSA
Commuter Choice Transit FSA
Using Your FSA Funds
AFLAC Voluntary Plans
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Carrier Resources amp Cost-Saving Tips
Lower Your Out-of-Pocket Costs
Built-in Wellness Support
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You Go
Making Changes
Make Changes Online
Questions
Open Enrollment Assistance
Online Resources
Legal Information
Thank You
Office of Human Resources Montgomery County Government
Built-in Wellness Support Take advantage of the free programs available to you through your medical carrier Each of MCGrsquos medical carriers (Kaiser UHC amp CareFirst) offer valuable programs to help you manage your health
Disease Management Programsbull Help manage your chronic condition through personalized coaching support and encouragement and online education materialsEmotional Wellness amp Stress Management Support bull Help manage stress through mobile apps and other self-care resources Maternity Programsbull Support healthy moms and healthy babiesWeight-loss Programs bull Offers telephonic coaching support and web-based tools to help ensure long-term weight managementbull See the next slide for an example of an MCG success storySmoking Cessation Programsbull Supportive coaching to make quitting more successfulDiscounts bull Gym memberships weight loss programs and moreFor more information about the programs available to you please see the Open Enrollment Guide and contact your medical carrier
Office of Human Resources Montgomery County Government
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You GoAll of MCGrsquos health insurance carriers offer a simple-to-use tool that can help make your life easier while yoursquore on the go Download your carrierrsquos Mobile App to help you personalize organize and access your important plan information on your phone or tablet
bull Schedule Virtual Visitsbull Manage and track claimsbull View ID card informationbull Find doctor and compare costs and quality ratingsbull Review your coveragebull Track your account balances and deductiblesbull Access a variety of health and wellness tools
Visit Google Play or the Apple App Store to download your carrierrsquos App
Office of Human Resources Montgomery County Government
Making Changes
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Questions
Office of Human Resources Montgomery County Government
Open Enrollment AssistanceFollow these steps (in this order)1 Review the frequently asked questions (FAQs) on the Open Enrollment website at wwwmontgomerycountymdgovoe
(available beginning September 21) You can enter key words into the interactive search bar to quickly locate the answer to your question
2 Visit the MC311 website at wwwmontgomerycountymdgovmc311 and search key words for your question The search results contain various knowledge-based articles with information related to your search words Simply click on the corresponding link and the detailed answer is revealed
3 Attend one of OHRrsquos Virtual Office Hours via Microsoft Teams Members of OHRs Health Insurance Team will be on hand to address employee questions by video or via the chat box View the schedule and access the sessions through the Open Enrollment website at wwwmontgomerycountymdgovoe (available beginning September 21)
4 If you have tried all the methods above and still have Open Enrollment-related questions please contact OHRs MC311 Customer Service Center at 240-773-6471 (Mon-Fri 8 am - 5 pm) to open a service request A member of the health insurance team will respond to service requests in the order they are received Tip Please provide an email address at the time you place your Service Request This will ensure the fastest response possible
Office of Human Resources Montgomery County Government
Online ResourcesVisit the 2021 Open Enrollment Webpage
wwwmontgomerycountymdgovOE
Visit OHRrsquos WebpagewwwmontgomerycountymdgovHR
Health Insurance active employees
Office of Human Resources Montgomery County Government
Legal InformationThe County reserves the right at any time and for any reason to amend the Program subject to the Countys collective bargainingagreements The County expects to continue the Program but it is the Countys position that there is no implied contract between individual employees and the County to do so
The County may amend the Program prospectively or retroactively to comply with applicable law
In the event of a conflict between this presentation the County Code andor the Summary Description the County Code then the Summary Description will govern
Office of Human Resources Montgomery County Government
Thank YouWe hope you enjoyed learning about 2021 Open Enrollment
~Your OHR Health Insurance Team
2021 Open Enrollment Benefits Bonanza
What Is Open Enrollment
What Changes Can be Made
Open Enrollment Dates
MCG Continues to Make Generous Employer Contributions
New for 2021
Special 2021 Plan Rates Announcement
Employee Rate Changes for Calendar Year 2021
Planning Ahead Minimizing Future Rate Increases
New for 2021
Open Enrollment Communications
Itrsquos a New Frontier
2021 Open Enrollment Checklist
Open Enrollment Website Resources
Attend a Virtual Open Enrollment Event
Make Changes Online
Paper Enrollment Form Permitted for Only Two Reasons
Dependent Eligibility
Proof of Dependent Eligibility
Marriage Certificate Example Required Documentation (Contd)
Benefits Refresher
Medical amp Rx
Medical Plan Options
Medical Benefits at-a-Glance
Medical Benefits at-a-Glance (contd)
Prescription Plans Caremark
Prescription Drug Plan Comparison
Prescription Drug Cost Comparison
Dental
Slide Number 30
Vision
Vision Insurance
Optional Life amp Dependent Life
Optional Life Insurance ADampD
Optional Life Insurance Rates
Dependent Life Insurance
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs)Why You Should Enroll
Health Care FSA
Child Care FSA
Commuter Choice Transit FSA
Using Your FSA Funds
AFLAC Voluntary Plans
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Carrier Resources amp Cost-Saving Tips
Lower Your Out-of-Pocket Costs
Built-in Wellness Support
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You Go
Making Changes
Make Changes Online
Questions
Open Enrollment Assistance
Online Resources
Legal Information
Thank You
Office of Human Resources Montgomery County Government
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You GoAll of MCGrsquos health insurance carriers offer a simple-to-use tool that can help make your life easier while yoursquore on the go Download your carrierrsquos Mobile App to help you personalize organize and access your important plan information on your phone or tablet
bull Schedule Virtual Visitsbull Manage and track claimsbull View ID card informationbull Find doctor and compare costs and quality ratingsbull Review your coveragebull Track your account balances and deductiblesbull Access a variety of health and wellness tools
Visit Google Play or the Apple App Store to download your carrierrsquos App
Office of Human Resources Montgomery County Government
Making Changes
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Questions
Office of Human Resources Montgomery County Government
Open Enrollment AssistanceFollow these steps (in this order)1 Review the frequently asked questions (FAQs) on the Open Enrollment website at wwwmontgomerycountymdgovoe
(available beginning September 21) You can enter key words into the interactive search bar to quickly locate the answer to your question
2 Visit the MC311 website at wwwmontgomerycountymdgovmc311 and search key words for your question The search results contain various knowledge-based articles with information related to your search words Simply click on the corresponding link and the detailed answer is revealed
3 Attend one of OHRrsquos Virtual Office Hours via Microsoft Teams Members of OHRs Health Insurance Team will be on hand to address employee questions by video or via the chat box View the schedule and access the sessions through the Open Enrollment website at wwwmontgomerycountymdgovoe (available beginning September 21)
4 If you have tried all the methods above and still have Open Enrollment-related questions please contact OHRs MC311 Customer Service Center at 240-773-6471 (Mon-Fri 8 am - 5 pm) to open a service request A member of the health insurance team will respond to service requests in the order they are received Tip Please provide an email address at the time you place your Service Request This will ensure the fastest response possible
Office of Human Resources Montgomery County Government
Online ResourcesVisit the 2021 Open Enrollment Webpage
wwwmontgomerycountymdgovOE
Visit OHRrsquos WebpagewwwmontgomerycountymdgovHR
Health Insurance active employees
Office of Human Resources Montgomery County Government
Legal InformationThe County reserves the right at any time and for any reason to amend the Program subject to the Countys collective bargainingagreements The County expects to continue the Program but it is the Countys position that there is no implied contract between individual employees and the County to do so
The County may amend the Program prospectively or retroactively to comply with applicable law
In the event of a conflict between this presentation the County Code andor the Summary Description the County Code then the Summary Description will govern
Office of Human Resources Montgomery County Government
Thank YouWe hope you enjoyed learning about 2021 Open Enrollment
~Your OHR Health Insurance Team
2021 Open Enrollment Benefits Bonanza
What Is Open Enrollment
What Changes Can be Made
Open Enrollment Dates
MCG Continues to Make Generous Employer Contributions
New for 2021
Special 2021 Plan Rates Announcement
Employee Rate Changes for Calendar Year 2021
Planning Ahead Minimizing Future Rate Increases
New for 2021
Open Enrollment Communications
Itrsquos a New Frontier
2021 Open Enrollment Checklist
Open Enrollment Website Resources
Attend a Virtual Open Enrollment Event
Make Changes Online
Paper Enrollment Form Permitted for Only Two Reasons
Dependent Eligibility
Proof of Dependent Eligibility
Marriage Certificate Example Required Documentation (Contd)
Benefits Refresher
Medical amp Rx
Medical Plan Options
Medical Benefits at-a-Glance
Medical Benefits at-a-Glance (contd)
Prescription Plans Caremark
Prescription Drug Plan Comparison
Prescription Drug Cost Comparison
Dental
Slide Number 30
Vision
Vision Insurance
Optional Life amp Dependent Life
Optional Life Insurance ADampD
Optional Life Insurance Rates
Dependent Life Insurance
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs)Why You Should Enroll
Health Care FSA
Child Care FSA
Commuter Choice Transit FSA
Using Your FSA Funds
AFLAC Voluntary Plans
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Carrier Resources amp Cost-Saving Tips
Lower Your Out-of-Pocket Costs
Built-in Wellness Support
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You Go
Making Changes
Make Changes Online
Questions
Open Enrollment Assistance
Online Resources
Legal Information
Thank You
Office of Human Resources Montgomery County Government
Making Changes
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Questions
Office of Human Resources Montgomery County Government
Open Enrollment AssistanceFollow these steps (in this order)1 Review the frequently asked questions (FAQs) on the Open Enrollment website at wwwmontgomerycountymdgovoe
(available beginning September 21) You can enter key words into the interactive search bar to quickly locate the answer to your question
2 Visit the MC311 website at wwwmontgomerycountymdgovmc311 and search key words for your question The search results contain various knowledge-based articles with information related to your search words Simply click on the corresponding link and the detailed answer is revealed
3 Attend one of OHRrsquos Virtual Office Hours via Microsoft Teams Members of OHRs Health Insurance Team will be on hand to address employee questions by video or via the chat box View the schedule and access the sessions through the Open Enrollment website at wwwmontgomerycountymdgovoe (available beginning September 21)
4 If you have tried all the methods above and still have Open Enrollment-related questions please contact OHRs MC311 Customer Service Center at 240-773-6471 (Mon-Fri 8 am - 5 pm) to open a service request A member of the health insurance team will respond to service requests in the order they are received Tip Please provide an email address at the time you place your Service Request This will ensure the fastest response possible
Office of Human Resources Montgomery County Government
Online ResourcesVisit the 2021 Open Enrollment Webpage
wwwmontgomerycountymdgovOE
Visit OHRrsquos WebpagewwwmontgomerycountymdgovHR
Health Insurance active employees
Office of Human Resources Montgomery County Government
Legal InformationThe County reserves the right at any time and for any reason to amend the Program subject to the Countys collective bargainingagreements The County expects to continue the Program but it is the Countys position that there is no implied contract between individual employees and the County to do so
The County may amend the Program prospectively or retroactively to comply with applicable law
In the event of a conflict between this presentation the County Code andor the Summary Description the County Code then the Summary Description will govern
Office of Human Resources Montgomery County Government
Thank YouWe hope you enjoyed learning about 2021 Open Enrollment
~Your OHR Health Insurance Team
2021 Open Enrollment Benefits Bonanza
What Is Open Enrollment
What Changes Can be Made
Open Enrollment Dates
MCG Continues to Make Generous Employer Contributions
New for 2021
Special 2021 Plan Rates Announcement
Employee Rate Changes for Calendar Year 2021
Planning Ahead Minimizing Future Rate Increases
New for 2021
Open Enrollment Communications
Itrsquos a New Frontier
2021 Open Enrollment Checklist
Open Enrollment Website Resources
Attend a Virtual Open Enrollment Event
Make Changes Online
Paper Enrollment Form Permitted for Only Two Reasons
Dependent Eligibility
Proof of Dependent Eligibility
Marriage Certificate Example Required Documentation (Contd)
Benefits Refresher
Medical amp Rx
Medical Plan Options
Medical Benefits at-a-Glance
Medical Benefits at-a-Glance (contd)
Prescription Plans Caremark
Prescription Drug Plan Comparison
Prescription Drug Cost Comparison
Dental
Slide Number 30
Vision
Vision Insurance
Optional Life amp Dependent Life
Optional Life Insurance ADampD
Optional Life Insurance Rates
Dependent Life Insurance
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs)Why You Should Enroll
Health Care FSA
Child Care FSA
Commuter Choice Transit FSA
Using Your FSA Funds
AFLAC Voluntary Plans
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Carrier Resources amp Cost-Saving Tips
Lower Your Out-of-Pocket Costs
Built-in Wellness Support
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You Go
Making Changes
Make Changes Online
Questions
Open Enrollment Assistance
Online Resources
Legal Information
Thank You
Office of Human Resources Montgomery County Government
Make Changes OnlineMCG HR Employee Self Service Benefits
bull All Open Enrollment changes should be made online via Employee Self-Service (ESS)
bull Visit wwwmontgomerycountymdgovoe for step-by-step ESS instruction videos
bull Print your 2021 confirmation statement before exiting ESS This is your receipt for your 2021 elections If there is any discrepancy with your enrollment you will be required to provide your confirmation statement as proof of your open enrollment activity Without proof no changes will be permitted after Open Enrollment ends
Contact the IT Help Desk at 240-777-2828 option 2 for login assistance
Office of Human Resources Montgomery County Government
Questions
Office of Human Resources Montgomery County Government
Open Enrollment AssistanceFollow these steps (in this order)1 Review the frequently asked questions (FAQs) on the Open Enrollment website at wwwmontgomerycountymdgovoe
(available beginning September 21) You can enter key words into the interactive search bar to quickly locate the answer to your question
2 Visit the MC311 website at wwwmontgomerycountymdgovmc311 and search key words for your question The search results contain various knowledge-based articles with information related to your search words Simply click on the corresponding link and the detailed answer is revealed
3 Attend one of OHRrsquos Virtual Office Hours via Microsoft Teams Members of OHRs Health Insurance Team will be on hand to address employee questions by video or via the chat box View the schedule and access the sessions through the Open Enrollment website at wwwmontgomerycountymdgovoe (available beginning September 21)
4 If you have tried all the methods above and still have Open Enrollment-related questions please contact OHRs MC311 Customer Service Center at 240-773-6471 (Mon-Fri 8 am - 5 pm) to open a service request A member of the health insurance team will respond to service requests in the order they are received Tip Please provide an email address at the time you place your Service Request This will ensure the fastest response possible
Office of Human Resources Montgomery County Government
Online ResourcesVisit the 2021 Open Enrollment Webpage
wwwmontgomerycountymdgovOE
Visit OHRrsquos WebpagewwwmontgomerycountymdgovHR
Health Insurance active employees
Office of Human Resources Montgomery County Government
Legal InformationThe County reserves the right at any time and for any reason to amend the Program subject to the Countys collective bargainingagreements The County expects to continue the Program but it is the Countys position that there is no implied contract between individual employees and the County to do so
The County may amend the Program prospectively or retroactively to comply with applicable law
In the event of a conflict between this presentation the County Code andor the Summary Description the County Code then the Summary Description will govern
Office of Human Resources Montgomery County Government
Thank YouWe hope you enjoyed learning about 2021 Open Enrollment
~Your OHR Health Insurance Team
2021 Open Enrollment Benefits Bonanza
What Is Open Enrollment
What Changes Can be Made
Open Enrollment Dates
MCG Continues to Make Generous Employer Contributions
New for 2021
Special 2021 Plan Rates Announcement
Employee Rate Changes for Calendar Year 2021
Planning Ahead Minimizing Future Rate Increases
New for 2021
Open Enrollment Communications
Itrsquos a New Frontier
2021 Open Enrollment Checklist
Open Enrollment Website Resources
Attend a Virtual Open Enrollment Event
Make Changes Online
Paper Enrollment Form Permitted for Only Two Reasons
Dependent Eligibility
Proof of Dependent Eligibility
Marriage Certificate Example Required Documentation (Contd)
Benefits Refresher
Medical amp Rx
Medical Plan Options
Medical Benefits at-a-Glance
Medical Benefits at-a-Glance (contd)
Prescription Plans Caremark
Prescription Drug Plan Comparison
Prescription Drug Cost Comparison
Dental
Slide Number 30
Vision
Vision Insurance
Optional Life amp Dependent Life
Optional Life Insurance ADampD
Optional Life Insurance Rates
Dependent Life Insurance
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs)Why You Should Enroll
Health Care FSA
Child Care FSA
Commuter Choice Transit FSA
Using Your FSA Funds
AFLAC Voluntary Plans
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Carrier Resources amp Cost-Saving Tips
Lower Your Out-of-Pocket Costs
Built-in Wellness Support
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You Go
Making Changes
Make Changes Online
Questions
Open Enrollment Assistance
Online Resources
Legal Information
Thank You
Office of Human Resources Montgomery County Government
Questions
Office of Human Resources Montgomery County Government
Open Enrollment AssistanceFollow these steps (in this order)1 Review the frequently asked questions (FAQs) on the Open Enrollment website at wwwmontgomerycountymdgovoe
(available beginning September 21) You can enter key words into the interactive search bar to quickly locate the answer to your question
2 Visit the MC311 website at wwwmontgomerycountymdgovmc311 and search key words for your question The search results contain various knowledge-based articles with information related to your search words Simply click on the corresponding link and the detailed answer is revealed
3 Attend one of OHRrsquos Virtual Office Hours via Microsoft Teams Members of OHRs Health Insurance Team will be on hand to address employee questions by video or via the chat box View the schedule and access the sessions through the Open Enrollment website at wwwmontgomerycountymdgovoe (available beginning September 21)
4 If you have tried all the methods above and still have Open Enrollment-related questions please contact OHRs MC311 Customer Service Center at 240-773-6471 (Mon-Fri 8 am - 5 pm) to open a service request A member of the health insurance team will respond to service requests in the order they are received Tip Please provide an email address at the time you place your Service Request This will ensure the fastest response possible
Office of Human Resources Montgomery County Government
Online ResourcesVisit the 2021 Open Enrollment Webpage
wwwmontgomerycountymdgovOE
Visit OHRrsquos WebpagewwwmontgomerycountymdgovHR
Health Insurance active employees
Office of Human Resources Montgomery County Government
Legal InformationThe County reserves the right at any time and for any reason to amend the Program subject to the Countys collective bargainingagreements The County expects to continue the Program but it is the Countys position that there is no implied contract between individual employees and the County to do so
The County may amend the Program prospectively or retroactively to comply with applicable law
In the event of a conflict between this presentation the County Code andor the Summary Description the County Code then the Summary Description will govern
Office of Human Resources Montgomery County Government
Thank YouWe hope you enjoyed learning about 2021 Open Enrollment
~Your OHR Health Insurance Team
2021 Open Enrollment Benefits Bonanza
What Is Open Enrollment
What Changes Can be Made
Open Enrollment Dates
MCG Continues to Make Generous Employer Contributions
New for 2021
Special 2021 Plan Rates Announcement
Employee Rate Changes for Calendar Year 2021
Planning Ahead Minimizing Future Rate Increases
New for 2021
Open Enrollment Communications
Itrsquos a New Frontier
2021 Open Enrollment Checklist
Open Enrollment Website Resources
Attend a Virtual Open Enrollment Event
Make Changes Online
Paper Enrollment Form Permitted for Only Two Reasons
Dependent Eligibility
Proof of Dependent Eligibility
Marriage Certificate Example Required Documentation (Contd)
Benefits Refresher
Medical amp Rx
Medical Plan Options
Medical Benefits at-a-Glance
Medical Benefits at-a-Glance (contd)
Prescription Plans Caremark
Prescription Drug Plan Comparison
Prescription Drug Cost Comparison
Dental
Slide Number 30
Vision
Vision Insurance
Optional Life amp Dependent Life
Optional Life Insurance ADampD
Optional Life Insurance Rates
Dependent Life Insurance
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs)Why You Should Enroll
Health Care FSA
Child Care FSA
Commuter Choice Transit FSA
Using Your FSA Funds
AFLAC Voluntary Plans
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Carrier Resources amp Cost-Saving Tips
Lower Your Out-of-Pocket Costs
Built-in Wellness Support
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You Go
Making Changes
Make Changes Online
Questions
Open Enrollment Assistance
Online Resources
Legal Information
Thank You
Office of Human Resources Montgomery County Government
Open Enrollment AssistanceFollow these steps (in this order)1 Review the frequently asked questions (FAQs) on the Open Enrollment website at wwwmontgomerycountymdgovoe
(available beginning September 21) You can enter key words into the interactive search bar to quickly locate the answer to your question
2 Visit the MC311 website at wwwmontgomerycountymdgovmc311 and search key words for your question The search results contain various knowledge-based articles with information related to your search words Simply click on the corresponding link and the detailed answer is revealed
3 Attend one of OHRrsquos Virtual Office Hours via Microsoft Teams Members of OHRs Health Insurance Team will be on hand to address employee questions by video or via the chat box View the schedule and access the sessions through the Open Enrollment website at wwwmontgomerycountymdgovoe (available beginning September 21)
4 If you have tried all the methods above and still have Open Enrollment-related questions please contact OHRs MC311 Customer Service Center at 240-773-6471 (Mon-Fri 8 am - 5 pm) to open a service request A member of the health insurance team will respond to service requests in the order they are received Tip Please provide an email address at the time you place your Service Request This will ensure the fastest response possible
Office of Human Resources Montgomery County Government
Online ResourcesVisit the 2021 Open Enrollment Webpage
wwwmontgomerycountymdgovOE
Visit OHRrsquos WebpagewwwmontgomerycountymdgovHR
Health Insurance active employees
Office of Human Resources Montgomery County Government
Legal InformationThe County reserves the right at any time and for any reason to amend the Program subject to the Countys collective bargainingagreements The County expects to continue the Program but it is the Countys position that there is no implied contract between individual employees and the County to do so
The County may amend the Program prospectively or retroactively to comply with applicable law
In the event of a conflict between this presentation the County Code andor the Summary Description the County Code then the Summary Description will govern
Office of Human Resources Montgomery County Government
Thank YouWe hope you enjoyed learning about 2021 Open Enrollment
~Your OHR Health Insurance Team
2021 Open Enrollment Benefits Bonanza
What Is Open Enrollment
What Changes Can be Made
Open Enrollment Dates
MCG Continues to Make Generous Employer Contributions
New for 2021
Special 2021 Plan Rates Announcement
Employee Rate Changes for Calendar Year 2021
Planning Ahead Minimizing Future Rate Increases
New for 2021
Open Enrollment Communications
Itrsquos a New Frontier
2021 Open Enrollment Checklist
Open Enrollment Website Resources
Attend a Virtual Open Enrollment Event
Make Changes Online
Paper Enrollment Form Permitted for Only Two Reasons
Dependent Eligibility
Proof of Dependent Eligibility
Marriage Certificate Example Required Documentation (Contd)
Benefits Refresher
Medical amp Rx
Medical Plan Options
Medical Benefits at-a-Glance
Medical Benefits at-a-Glance (contd)
Prescription Plans Caremark
Prescription Drug Plan Comparison
Prescription Drug Cost Comparison
Dental
Slide Number 30
Vision
Vision Insurance
Optional Life amp Dependent Life
Optional Life Insurance ADampD
Optional Life Insurance Rates
Dependent Life Insurance
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs)Why You Should Enroll
Health Care FSA
Child Care FSA
Commuter Choice Transit FSA
Using Your FSA Funds
AFLAC Voluntary Plans
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Carrier Resources amp Cost-Saving Tips
Lower Your Out-of-Pocket Costs
Built-in Wellness Support
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You Go
Making Changes
Make Changes Online
Questions
Open Enrollment Assistance
Online Resources
Legal Information
Thank You
Office of Human Resources Montgomery County Government
Online ResourcesVisit the 2021 Open Enrollment Webpage
wwwmontgomerycountymdgovOE
Visit OHRrsquos WebpagewwwmontgomerycountymdgovHR
Health Insurance active employees
Office of Human Resources Montgomery County Government
Legal InformationThe County reserves the right at any time and for any reason to amend the Program subject to the Countys collective bargainingagreements The County expects to continue the Program but it is the Countys position that there is no implied contract between individual employees and the County to do so
The County may amend the Program prospectively or retroactively to comply with applicable law
In the event of a conflict between this presentation the County Code andor the Summary Description the County Code then the Summary Description will govern
Office of Human Resources Montgomery County Government
Thank YouWe hope you enjoyed learning about 2021 Open Enrollment
~Your OHR Health Insurance Team
2021 Open Enrollment Benefits Bonanza
What Is Open Enrollment
What Changes Can be Made
Open Enrollment Dates
MCG Continues to Make Generous Employer Contributions
New for 2021
Special 2021 Plan Rates Announcement
Employee Rate Changes for Calendar Year 2021
Planning Ahead Minimizing Future Rate Increases
New for 2021
Open Enrollment Communications
Itrsquos a New Frontier
2021 Open Enrollment Checklist
Open Enrollment Website Resources
Attend a Virtual Open Enrollment Event
Make Changes Online
Paper Enrollment Form Permitted for Only Two Reasons
Dependent Eligibility
Proof of Dependent Eligibility
Marriage Certificate Example Required Documentation (Contd)
Benefits Refresher
Medical amp Rx
Medical Plan Options
Medical Benefits at-a-Glance
Medical Benefits at-a-Glance (contd)
Prescription Plans Caremark
Prescription Drug Plan Comparison
Prescription Drug Cost Comparison
Dental
Slide Number 30
Vision
Vision Insurance
Optional Life amp Dependent Life
Optional Life Insurance ADampD
Optional Life Insurance Rates
Dependent Life Insurance
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs)Why You Should Enroll
Health Care FSA
Child Care FSA
Commuter Choice Transit FSA
Using Your FSA Funds
AFLAC Voluntary Plans
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Carrier Resources amp Cost-Saving Tips
Lower Your Out-of-Pocket Costs
Built-in Wellness Support
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You Go
Making Changes
Make Changes Online
Questions
Open Enrollment Assistance
Online Resources
Legal Information
Thank You
Office of Human Resources Montgomery County Government
Legal InformationThe County reserves the right at any time and for any reason to amend the Program subject to the Countys collective bargainingagreements The County expects to continue the Program but it is the Countys position that there is no implied contract between individual employees and the County to do so
The County may amend the Program prospectively or retroactively to comply with applicable law
In the event of a conflict between this presentation the County Code andor the Summary Description the County Code then the Summary Description will govern
Office of Human Resources Montgomery County Government
Thank YouWe hope you enjoyed learning about 2021 Open Enrollment
~Your OHR Health Insurance Team
2021 Open Enrollment Benefits Bonanza
What Is Open Enrollment
What Changes Can be Made
Open Enrollment Dates
MCG Continues to Make Generous Employer Contributions
New for 2021
Special 2021 Plan Rates Announcement
Employee Rate Changes for Calendar Year 2021
Planning Ahead Minimizing Future Rate Increases
New for 2021
Open Enrollment Communications
Itrsquos a New Frontier
2021 Open Enrollment Checklist
Open Enrollment Website Resources
Attend a Virtual Open Enrollment Event
Make Changes Online
Paper Enrollment Form Permitted for Only Two Reasons
Dependent Eligibility
Proof of Dependent Eligibility
Marriage Certificate Example Required Documentation (Contd)
Benefits Refresher
Medical amp Rx
Medical Plan Options
Medical Benefits at-a-Glance
Medical Benefits at-a-Glance (contd)
Prescription Plans Caremark
Prescription Drug Plan Comparison
Prescription Drug Cost Comparison
Dental
Slide Number 30
Vision
Vision Insurance
Optional Life amp Dependent Life
Optional Life Insurance ADampD
Optional Life Insurance Rates
Dependent Life Insurance
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs)Why You Should Enroll
Health Care FSA
Child Care FSA
Commuter Choice Transit FSA
Using Your FSA Funds
AFLAC Voluntary Plans
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Carrier Resources amp Cost-Saving Tips
Lower Your Out-of-Pocket Costs
Built-in Wellness Support
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You Go
Making Changes
Make Changes Online
Questions
Open Enrollment Assistance
Online Resources
Legal Information
Thank You
Office of Human Resources Montgomery County Government
Thank YouWe hope you enjoyed learning about 2021 Open Enrollment
~Your OHR Health Insurance Team
2021 Open Enrollment Benefits Bonanza
What Is Open Enrollment
What Changes Can be Made
Open Enrollment Dates
MCG Continues to Make Generous Employer Contributions
New for 2021
Special 2021 Plan Rates Announcement
Employee Rate Changes for Calendar Year 2021
Planning Ahead Minimizing Future Rate Increases
New for 2021
Open Enrollment Communications
Itrsquos a New Frontier
2021 Open Enrollment Checklist
Open Enrollment Website Resources
Attend a Virtual Open Enrollment Event
Make Changes Online
Paper Enrollment Form Permitted for Only Two Reasons
Dependent Eligibility
Proof of Dependent Eligibility
Marriage Certificate Example Required Documentation (Contd)
Benefits Refresher
Medical amp Rx
Medical Plan Options
Medical Benefits at-a-Glance
Medical Benefits at-a-Glance (contd)
Prescription Plans Caremark
Prescription Drug Plan Comparison
Prescription Drug Cost Comparison
Dental
Slide Number 30
Vision
Vision Insurance
Optional Life amp Dependent Life
Optional Life Insurance ADampD
Optional Life Insurance Rates
Dependent Life Insurance
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs)Why You Should Enroll
Health Care FSA
Child Care FSA
Commuter Choice Transit FSA
Using Your FSA Funds
AFLAC Voluntary Plans
Other Voluntary Benefits Aflac (only available to unrepresented and IAFF employees)
Carrier Resources amp Cost-Saving Tips
Lower Your Out-of-Pocket Costs
Built-in Wellness Support
Carrier Mobile Apps Access Your Benefits Anytime and Anywhere You Go
