Benefits Plan Overview

Pre-Tax Benefits

Health Insurance: The Local Choice — Anthem

 Dental Insurance: The Local Choice – Delta Dental of VA

 Vision Insurance: The Local Choice — Blue View Vision

Flexible Spending Accounts*

• Medical Reimbursement FSA Maximum $2,750/year | Minimum $100/year
• Limited Purposed FSA+Maximum: $2,750/year | Minimum $100/year
• Dependent Care Reimbursement Maximum $10,500/year |  Minimum $100/year

+Limited Purpose FSA funds can only be used for qualifying vision, dental and orthodontia expenses.

 Health Savings Accounts*

• Employee Maximum $3,600/year | Minimum $100/year
• Family Maximum $7,200/year | Minimum $100/year

HSA plans can only be established in conjunction with a qualified High-Deductible Health Plan (HDHP).

Louisa County Government and Schools will contribute $550 annually into your HSA account. The $550 is divided among the pay periods and not contributed as a lump sum.

 Dental Insurance: Delta Dental of VA (Stand-Alone Policy)

 Cancer Benefits: Colonial Life

 Accident Benefits: Colonial Life

*You will need to re-sign for the Health Savings Account and Flexible Spending Accounts if you want them to continue.

PLEASE NOTE: Employees will have until 9/30/2021 to file claims with your previous Plan Administrator, Total Administrative Services Corporation (TASC) for expenses incurred during the 2020-2021 plan year. All claims with a date of service after 7/1/2021 should be filed with Ameriflex.

Post-Tax Benefits

 Medical Bridge Benefits: Colonial Life

 Disability Benefits:

• Short-Term Disability: Colonial Life
• Long-Term Disability: The Standard (Employer-Paid)

 Critical Illness Benefits: Colonial Life

 Life Insurance

• Term Life Insurance: Colonial Life
• Universal Life Insurance: Trustmark

ENROLLMENT PERIOD: APRIL 15, 2021 – MAY 14, 2021

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

QUALIFICATIONS:

• Employees must work full-time in order to participate in benefits.

• Group premiums included in the booklet are for Louisa County Government and Louisa County School employees. Water Authority Employees will need to speak with their Administration Contact for premium information.

• All employees are eligible for the Colonial Short-Term Disability plan (Educator Plan) included in the booklet.

IMPORTANT FACTS:

• The plan year for The Local Choice Benefits (Anthem Health, Delta Dental and Blue View Vision), Health Savings Accounts, Flexible Spending Accounts, Delta Dental (Stand-Alone policy), Trustmark Universal Life and Colonial Insurance products lasts from July 1, 2021 through June 30, 2022.

• Deductions for The Local Choice Benefits (Anthem Health, Delta Dental and Blue View Vision) and Delta Dental (Stand-Alone policy) will begin June 2021. Deductions for Health Savings Accounts, Flexible Spending Accounts, Trustmark Universal Life and Colonial Insurance products will begin July 2021.

• Please visit www.piercegroupbenefits.com/client/louisa-county-government-schools to review plan summaries and other required health plan notices.

• Health FSA Rollover Provision: Your employer provides the rollover option for your FSA plan. Please see the Flexible Spending Account section of your benefit booklet for more information on this provision.

• 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, 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 Health Screening Rider on 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.

Wellness Plan

Employees will have an extra year to complete their wellness exam. In FY22, ALL employees will receive the wellness rate, but everyone must complete a wellness exam in either FY21 or in FY22, to receive the lower rate in FY23. For those that did their exam in FY21, they are ahead of the game and will not be required to complete the exam in FY22 to receive the better rate in FY23. We still recommend annual checkups, but with the pandemic, we understand employee concerns and want everyone to feel safe.