Benefits Plan Overview

Pre-Tax Benefits

 Flexible Spending Accounts*

• Medical Reimbursement Maximum $2,750/year
• Dependent Care Reimbursement Maximum $5,000/year

*You will need to re-sign for the Spending Accounts if you want them to continue next year.

IF YOU DO NOT RE-SIGN, YOUR CONTRIBUTION WILL STOP EFFECTIVE JUNE 30, 2021.

Health Insurance: Anthem

 Cancer Benefits: Colonial Life

Accident Benefits: Colonial Life

 Medical Bridge Benefits: Colonial Life

 Dental Insurance: Delta

 Vision Insurance: Superior

Post-Tax Benefits

 Disability Benefits: Colonial Life

 Critical Illness Benefits: Colonial Life

 Life Insurance

• Term Life Insurance: Colonial Life
• Whole Life Insurance: Colonial Life

Accident Benefits – Gunshot Wound Policy: Colonial Life (Henry CG/PSA employees only)

ENROLLMENT PERIOD: APRIL 12, 2021 – APRIL 23, 2021

EFFECTIVE DATES: JULY 1, 2021 – JUNE 30, 2022

QUALIFICATIONS:

• Henry County Government monthly and semi-monthly employees working 35 hours or more per week are eligible for all benefits.

• Henry County Public Service Authority (PSA) employees are eligible for all benefits. PSA employees: if you have questions about your current dental plan, please see HR.

• Henry-Martinsville SS (HMSS) Employees who work more than 30 hours per week are eligible for all benefits.

IMPORTANT FACTS:

• The plan year for Anthem Health, Delta Dental, Superior Vision, Spending Accounts and Colonial Insurance products lasts from July 1, 2021 through June 30, 2022.

• Deductions for Anthem Health, Delta Dental and Superior Vision will begin June 2021. Deductions for Spending Accounts and Colonial Insurance products will begin July 2021.

• Please visit www.piercegroupbenefits.com/henrycounty to review plan summaries and other required health plan notices.

• If signing up for any coverage on your spouse and/or children, please have their dates of birth and social security numbers available when meeting with the Benefits Representative.

• If you will be receiving a new debit card, whether you are a new participant or to replace your expired card, please be aware that it may take up to 30 days following your plan effective date for your card to arrive. Your card will be delivered by mail in a plain white envelope. During this time you may use manual claim forms for eligible expenses. Please note that your debit card is good through the expiration date printed on the card.

• Elections made during this enrollment period CANNOT BE CHANGED AFTER THE ENROLLMENT PERIOD unless there is a family status change as defined by the Internal Revenue Code. Examples of a family status change are: marriage, divorce, death of a spouse or child, birth or adoption of a child, termination or commencement of a spouse’s employment, or the transition of spouse’s employment from full-time to part-time, or vice-versa.

• Once a family status change has occurred, an employee has 30 days to notify the Pierce Group Benefits Service Center at 1-800-387-5955 to request a change in elections.

• Flexible Spending Account expenses must be incurred during the Plan Year in order to be eligible for reimbursement.

• An employee has 90 days after the plan year ends to submit claims for spending account expenses that were incurred during the plan year. Please note that if employment terminates during the plan year, that employee’s plan year ends the day employment ends. The employee has 90 days after the termination date to submit claims.

• With Dependent Care Flexible Spending Accounts, the maximum reimbursement you can request is equal to the current account balance in your Dependent Care account. You cannot be reimbursed more than has actually been deducted from your pay.

• As a married couple, one spouse cannot be enrolled in an FSA at the same time the other is contributing to an HSA.

• The Colonial Medical Bridge plan has a 30-day waiting period for new enrollees. Coverage, therefore, will not begin until July 31, 2021.

• Additionally, some policies may include a pre-existing condition clause. Please read your policy carefully for full details.

• Please be aware there are certain coverages that may be subject to federal and state tax when premium is paid by pretax deduction or employee contribution.

• An employee taking a leave of absence, other than under the Family & Medical Leave Act, may not be eligible to re-enter the Flexible Benefits Program until the next plan year. Please contact your Benefit Administrator for more information.