Canaveral Port Authority (Full time employees working 40 hours per week)
2015
2 
 
Introduction Canaveral Port Authority is committed to providing its employees with a comprehensive benefits program to help you stay healthy and feel secure. This booklet will describe those benefits which include group medical, dental, vision, life, and disability. For a detailed description of these benefits please refer to the applicable Certificates of Coverage.
The group insurance plan year is January 1st through December 31st. Full time employees are eligible for benefits on the 1st of the month following date of hire.
In order to get the most out of your medical, dental, and vision plans you should seek care at an in network provider. These providers have agreed to discount their prices, so you will pay less out of pocket. You can locate an in network provider by accessing the carrier’s website listed in the back of this booklet.
Your coverage termination will end at the end of the month in which you are terminating. Following your termination, you will receive a letter providing you with information on how to sign up for COBRA benefits.
3 
Dependent Eligibility Medical
Through the month in which you turn age 26 with no eligibility requirements.
Age 27 to the end of the calendar year in which they turn 30 if they are:
Unmarried with no dependents Not enrolled in any other health plan Florida resident or a full / part time student
Dental & Vision Through the end of the calendar year in which they turn 25
Life Through the month in which you turn age 20 (24 if a full time student) Cannot be married
Flexible Spending Account Through the end of the calendar year in which they turn 26
Qualifying Events The premiums you pay toward you and your dependents’ coverage will be deducted from your pay check pre-tax through an IRS Section 125 Plan. Coverage elections made at Open Enrollment cannot be changed until the next annual Open Enrollment period. The only exception to this IRS Section 125 Rule is if you experience a “Qualifying Event.” A Qualifying Event allows you to make a change to your benefit elections within 30 days of the Event.
Examples of Qualifying Events include: Marriage Birth, adoption, or legal custody of a dependent child Divorce or legal separation Involuntary loss of other group coverage
Death
If you experience a Qualifying Event, you must contact Human Resources within
30 days to change your benefit elections.
 
Current Monthly Premium
Employee + 1 $1,267.80 $557.86 $27.28 95.34%
Employee + Family $1,871.50 $815.45 $48.32 94.41%
Medical Insurance - OAP (High Plan)
2015 - Based on 26 pay periods
Current Monthly Premium
Employee + 1 $1,429.15 $582.78 $76.82 88%
Employee + Family $2,109.70 $851.58 $122.13 87%
5 
12 
13 
Current Monthly Premium
CPA Bi-Weekly Cost
Employee % of CPA
Family $72.53 $9.42 $24.06 28.13%
Dental Insurance Option 2 (High Plan)
2015 - Based on 26 pay periods
Current Monthly Premium
CPA Bi-Weekly Cost
Employee % of CPA
Family $107.52 $13.40 $36.22 27.01%
Vision Insurance
Current Monthly Premium
CPA Bi-Weekly Cost
Employee % of CPA
Family $19.24 $3.35 $5.53 38.87%
18 
 
Routine Exam
(1 in 12 months)
Restorative Amalgams
Restorative Composites
Endodontics (nonsurgical)
Endodontics (surgical)
Periodontics (nonsurgical)
Simple Extractions
Complex Extractions
Crown Repair
Periodontics (surgical)
Denture Repair
plete/partial dentures)
 
Routine Exam
(1 in 12 months)
Restorative Amalgams
Restorative Composites
Endodontics (nonsurgical)
Endodontics (surgical)
Periodontics (nonsurgical)
Simple Extractions
Complex Extractions
Crown Repair
Periodontics (surgical)
Denture Repair
plete/partial dentures)
Basic Life and AD&D
Canaveral Port Authority pays for 1 x your annual earnings up to $250,000 in Life and Accidental Death & Dismemberment Insurance.
Voluntary Additional Life Insurance
You may purchase additional life insurance in increments of $10,000 up to a maximum of $300,000 (not to exceed 5 times your annual salary) through payroll deduction. The guarantee issue limit is $150,000 which means you do not have to provide evidence of good health and cannot be turned down for any reason during your initial enrollment period. If you would like to increase your voluntary life insurance during open enrollment, you may elect or increase your coverage up to 2 increments ($20,000) without evidence of insurability.
Voluntary Dependent Life Insurance
You may purchase life insurance for your spouse in increments of $5,000 up to a maximum of $150,000, but not to exceed 50% of your additional life coverage. The guarantee issue limit is $30,000 which means you do not have to provide evidence of good health and cannot be turned down for any reason during your initial enrollment period. If you would like to increase your spousal life insurance during open enrollment, you may elect or increase up to 2 increments ($10,000) without evidence of insurability.
You may elect $10,000 of dependents life insurance for your eligible children. All late applications will be subject to medical underwriting approval. The monthly premium is $2 regardless of the number of eligible children covered.
**You must purchase voluntary life insurance for yourself before you can purchase life insurance for your spouse or child(ren).
Age Reduction Schedule
Under this plan, coverage reduces by 35% at age 65, an additional 15% of the original amount at age 70, and an additional 15% of the original amount at age 75. Benefits terminate at retirement.
25 
Short Term Disability
Short term disability is provided in the event that a covered illness or injury leaves you unable to work for a short period of time. Your income replacement benefit is payable weekly and is equal to 60% of your weekly earnings minus any deductible income.
Benefit Highlight
Maximum Weekly Benefit $1,000
Minimum Weekly Benefit $15
Elimination Period 14 Days
28 
Long Term Disability
Long term disability is provided in the event that a covered illness or injury leaves you unable to work for a long period of time. Your income replacement benefit is payable monthly and is equal to 60% of your monthly earnings minus any deductible income.
Benefit Highlight
Maximum Monthly Benefit $6,000
Elimination Period 90 Days
To Social Security Normal Retirement Age
Pre-Existing Condition Limitation
You may not be eligible for benefits if you have received treatment for a con- dition within 3 months prior to your ef- fective date under this policy until you have been covered under the policy for
12 months
Other Plan Features:
Family Care Expenses — If you have a qualified disability and have a loss of 2 or more Activities of Daily Living, you will receive an additional benefit of 10% to a maximum of $5,000
Partial Disability —You are considered partially disabled if you are unable, due to an injury or illness, to perform the main duties of your regular occupation on a full-time basis. Partial Disability benefits may be payable if you are earning at least 20% of the income you earned prior to becoming disabled, but not more than 99%. Partial disability benefits allow you to work and earn income from your employer as well as continue to receive benefits, which may enable you to receive 100% of your income during your time of disability.
29 
 Employee Assistance Program (EAP)
There are times when we all need a little help. No matter what the issue,
EmployeeConnect services are available 24 hours a day, seven days a week with confidential support, guidance, and resources.
Assistance for you or an immediate household family member.
4 In-person sessions for short-term problem resolution. **
24 x 7 x 365 telephone and Web access.
Telephone access to legal counsel.
A 25% discount for services resulting from an attorney referral.
Work/life services for assistance with:
Parenting and childcare
Financial
**If you need to continue services after your 4 in person sessions, you can use your Cigna Health Plan. See a network of provider listings under Mental Health at www.cigna.com.
To learn more about the Lincoln Financial Employee Connect program visit
www.Lincoln4Benefits.com (password = connect) or www.GuidanceResouces.com or talk with a specialist at 1-888-628-4824.
30 
A valuable pre-tax benefit with innovative services!
FlexSystem FSA increases your take-home pay by reducing your taxable income. A Flexible Spending
Account (FSA) allows you to save up to 30% on your eligible healthcare and/or dependent care expenses every year by using pre-tax dollars.
Consider how much you spend on healthcare and/or dependent care expenses for you and your qualified dependents in one year.:
Prescription drugs
Daycare tuition
How FlexSystem Works
When you choose to enroll in the FSA, you choose the dollar amount that you want to contribute based on your estimated expenses for the upcoming plan year. Your contributions will be deducted in equal amounts from each paycheck. The maximum amount you can contribute into the medical reimbursement FSA is $2,500 and the maximum for the dependent care FSA is $5,000.
Reimbursement and the TASC Card
As you incur eligible expenses, simply submit a request for reimbursement to TASC up to the amount of your annual contribution. There are multiple methods for requesting reimbursement: MyTASC Mobile App, text message, fax, online, or mail.
For additional convenience, you will be issued a TASC Card to directly access your FSA funds when paying for eligible expenses at the point of purchase, which eliminates the need for requesting reimbursement.
New this year. You have a carryover provision of $500 for your Medical FSA. The $500 carryover is available after the run out period ends on 3/31/2015.
PreTax Savings Example 
PreTax Contributions     
TOTAL:  $0  $600 
Taxes (federal, state, FICA)  $968  $802 
Outofpocket Expenses:  $600  $0 
Monthly Takehome Pay:  $1,932  $2,098 
Net Increase in TakeHome Pay = $166 
For Illustration only. Actual dollar amounts may vary. 
31 
Summary of AFLAC Plans
Protect your family and yourself from your insurance deductibles, co-pays, lost wages and other out-of-pocket expenses with affordable AFLAC protection plans. All AFLAC plans pay all benefits in cash directly to you as the policy holder, for you to use in any way you see fit….
Personal Short-term Disability: NOW GUARANTEED ISSUE! Use the AFLAC plan to supplement your employer provided disability coverage. AFLAC’s short term disability plan provides replacement income for you when you are disabled from an illness or an off-the-job accident and unable to work. You choose your level of benefits, you choose your elimination period (how long you can wait until you need replacement income to begin), and you choose the benefit period (how long you will need benefits to be paid). And remember…Disability benefits paid by AFLAC are non-taxable. Personal Accident Plan: Protect yourself and your family 24/7, on the job or off the job from the out of pocket expenses associated with any accident. Benefits are paid directly to you for emergency treatments, hospitalization, specific injuries and/or treatments, major diagnostics, medical appliances and much, much more. This extremely affordable plan also includes an accidental death and dismemberment benefit. Best part about it, all benefits are paid directly to you. Hospital Protector: When you or a family member are hospitalized for any reason, AFLAC provides cash directly to you to help with increasing hospital deductibles, or co- pays. Helps keep your funds in your HSA! Policy pays $500 or $600 per day for the first 5 days of hospital admissions, plus $100 per day for days 6 through 365! Personal Cancer Policy: More than 65% of the expenses associated with battling cancer are non-medical expenses NOT covered by medical Insurance!! AFLAC will pay you cash benefits for hospitalization, surgeries, cancer treatments, travel & lodging, second opinions, experimental treatments, home health care, bone marrow transplants, and much, much more. And…. Most of the benefits have no lifetime limitations Critical Care and Recovery: Formerly known as “Specified Health Event”, this policy provides the much needed financial help in the event of critical Illnesses such as a Heart Attack, Stroke, Coma, Paralysis, Coronary Artery Bypass Surgery, End Stage Renal Failure, Major Human Organ Transplant and more. Benefits include a First Occurrence Benefit, Hospitalization, Ambulance and much more. Best of all….You own and you control your AFLAC plans. You can keep them in force even if you leave work. You decide how the cash benefits are to be spent. …and the premium rates never increase on any plan you keep.
32 
Choosing the right benefits
can be critical. That’s why
Colonial Life is committed to
making benefits count by
from life’s unexpected turns.
These coverages may not be available in all states; product benefits vary by state. Policies have exclusions and limitations that may affect benefits payable. For cost and complete details, please see your Colonial Life benefits counselor.
Disability Insurance – Replaces a portion of your income to help make ends meet if you become disabled from a covered accident or covered sickness.
Accident Insurance – Helps offset the unexpected medical expenses, such as emergency room fees, deductibles and copayments, that can result from a fracture, dislocation or other covered accidental injury.
Cancer Insurance – Helps offset the out-of-pocket medical and indirect, non-medical expenses related to cancer that most medical plans don’t cover. This coverage also provides a benefit for specified cancer-screening tests.
Critical Illness Insurance – Complements your major medical coverage by providing a lump-sum benefit that you can use to pay the direct and indirect costs related to a covered critical illness, which can often be expensive and lengthy.
Hospital Confinement Insurance – Provides a lump-sum benefit for a covered hospital confinement and a covered outpatient surgery to help offset the gaps caused by copayments and deductibles that are not covered by most major medical plans.
See your Colonial Life benefits counselor to find out how you can apply for these valuable coverages.
Colonial Life 1200 Colonial Life Boulevard Columbia, South Carolina 29210 © 2011 Colonial Life & Accident Insurance Company coloniallife.com Colonial Life products are underwritten by Colonial Life & Accident
Insurance Company, for which Colonial Life is the marketing brand.
4/11 42868-29
Reminder:
If you purchase supplemental benefits through AFLAC or Colonial, the premiums you pay will be deducted from your pay check pre-tax through an IRS Section 125
Plan. Coverage elections made at Open Enrollment cannot be changed until the next annual Open Enrollment period. The only exception to this IRS Section 125 Rule is if you experience a “Qualifying Event.” A Qualifying Event allows you to make a
change to your benefit elections within 30 days of the Event.
Examples of Qualifying Events include: Marriage Birth, adoption, or legal custody of a dependent child Divorce or legal separation Involuntary loss of other group coverage
Death
If you experience a Qualifying Event, you must contact Human Resources within 30 days to change your benefit elections.
34 
 
HIPAA Special Enrollment Rights – If you are declining enrollment for yourself or your dependents (including you spouse) because of other health insurance coverage, you may in the future be able to enroll yourself or your dependents in this plan, provided that you request enrollment within 30 days after your other coverage ends. In additional, if you have a new dependent as a result of marriage, birth, adoption, or placement for adoption, you may be able to enroll yourself and your dependents, provided that you request enrollment within 30 days after the marriage, birth, adoption, or placement for adoption.
Effective April 1, 2009, a special enrollment period provision is added to comply with the requirements of the Children’s Health Insurance Program Reauthorization Act (CHIPRA) of 2009. If you or a dependent is covered under a Medicaid or CHIP plan and coverage is terminated as a result of the loss of eligibility for Medicaid or CHIP coverage, you may be able to enroll yourself and/or your dependent(s). However, you must enroll within 60 days after the date eligibility is lost. If you or a dependent becomes eligible for premium assistance under an applicable State Medicaid or CHIP plan to purchase coverage under the group health plan, you may be able to enroll yourself and/or your dependent(s). However, you must enroll within 60 days after you or your dependent is determined to be eligible for State premium assistance. Please note that premium assistance is not available in all states.
Medicaid and the Children’s Health Insurance Program - If you are eligible for health coverage from your employer, but are unable to afford the premiums, some States have premium assistance programs that can help pay for coverage. These States use funds from their Medicaid or CHIP programs to help people who are eligible for employer-sponsored health coverage, but need assistance in paying their premiums. If you or your dependents are already enrolled in Medicaid or CHIP, you can contact your State Medicaid or CHIP office to find out if premium assistance is available.
If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, you can contact your State Medicaid or CHIP office or dial 1-877-KIDS NOW or www.insurekidsnow.gov to find out how to apply. If you qualify, you can ask the State if it has a program that might help you pay the premiums for an employer-sponsored plan.
Once it is determined that you or your dependents are eligible for premium assistance under Medicaid or CHIP, your employer’s health plan is required to permit you and your dependents to enroll in the plan—as long as you and your dependents are eligible, but
not already enrolled in the employer’s plan. This is a called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance.
Michelle’s Law – The law allows for continued coverage for dependent children who are covered under your group health plan as a student if they lose their student status because of a medically necessary leave of absence from school. This law applies to medically necessary leaves of absence that begin on or after January 1, 2010.
If your child is no longer a student, as defined in your Certificate of Coverage, because he or she is on a medically necessary leave of absence, your child may continue to be covered under the plan for up to one year from the beginning of the leave of absence. This continued coverage applies if your child was (1) covered under the plan and (2) enrolled as a student at a post-secondary educational institution (includes colleges, universities, some trade schools and certain other post-secondary institutions).
Your employer will require a written certification from the child's physician that states that the child is suffering from a serious illness or injury and that the leave of absence is medically necessary.
Pre-existing Conditions Limitations Notice – If you or your family members are enrolling for the first time and have a break in medical coverage more than 63 days over the last 12 months, pre-existing condition limitations may apply to the health plan. A more detailed explanation of pre-existing condition provisions is available in the carrier’s Member Certificate of Coverage or by calling Member Services.
Section 111 – Effective January 1, 2009 Group Health Plans are required by Federal government to comply with Section 111 of the Medicare, Medicaid, and SCHIP Extension of 2007’s new Medicare Secondary Payer regulations. The mandate is designed to assist in establishing financial liability of claim assignments. In other words, it will help establish who pays first. The mandate requires Group Health Plans to collect additional information, more specifically Social Security Numbers for all enrollees, including dependents six months of age or older. Please be prepared to provide this information on your Benefit Enrollment Form when enrolling into benefits.
Women’s Health and Cancer Rights Act of 1998 – The medical plans provide benefits for mastectomy-related services including all stages of reconstruction and surgery to achieve symmetry between the breasts, prosthesis, and complications resulting from a mastectomy, including lymph edema.
Important Notices for Plan Participants
35 
  Key Contact Information
Please refer to this list when you need to contact one of your benefits vendors. For general information, contact your Human Resources Department.
Company Name Customer Service Website Address
Health Insurance
1-866-494-2111 www.myCigna.com
rriley@bbpria.com
www.pria.com
This Benefits at a Glance handbook is designed to provide basic information to employees on employee benefit plans