2015-2016Employee Benefits Guide

Table of Contents Welcome................................................................................................ 1About Your Benefits .............................................................................. 2Important Contact Information............................................................. 4Benefit Rate Summary........................................................................... 5Free Health Resources Harnett County Employee Health Clinic ...................................... 6

24-Hour Nurse Hotline (Health Line Blue) – BCBSNC.................. 7 Employee Assistance Plan (EAP) – HMSA..................................... 8 Health Plan – BCBSNC........................................................................... 10Dental Plan – Delta Dental .................................................................... 14 Network Savings – Delta ............................................................. 16Vision Plan – Blue 20/20 – BCBSNC / EyeMed ..................................... 17Employer Paid Life Insurance and AD&D – Reliance Standard .............. 19Voluntary Life Insurance and AD&D – Reliance Standard ..................... 20 Voluntary Life and AD&D Rates .................................................. 22Voluntary Short Term Disability (STD) – Reliance Standard .................. 23 STD Rates .................................................................................... 24Worksite Benefits – Transamerica Accident, Cancer, Critical Illness, Hospital Indemnity ................ 25Flexible Spending Accounts (FSA) – HealthEquity Account Overview....................................................................... 26 Medical Flexible Spending Account ........................................... 27 Dependent Care Account ........................................................... 28 Account Management ................................................................ 29Holiday Schedule .................................................................................. 30Leave Policies ........................................................................................ 31Retirement Benefits

NC State Retirement ................................................................... 34Harnett County Retirement Health Insurance ............................. 35

What To Do When An Injury Occurs ..................................................... 37Harnett County Departments ............................................................ 38COBRA ................................................................................................... 40Notice of Privacy of Privacy Information Practices................................ 42Notes .................................................................................................... 43About This Guide ................................................................................... 45

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Dear County Employee:

Welcome to the Harnett County Government family. It is our pleasure to provide you with this important resource regarding benefits. This quick and easy guide has information you will need to make educated decisions that are right for you and your family as it relates to healthcare.

Your benefits make up an important part of your total compensation. Harnett County offers a comprehensive benefits package for you as an employee and your eligible dependents.

Once again, congratulations on joining the Harnett County Government family!

We look forward to working with you.

Harnett County Human Resources

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About Your Benefits Choosing Your Benefits

Some benefits, like Basic Life Insurance, are automatic. You don’t have to choose them because the County of Harnett pays the entire cost. The benefits that you pay for, you must actively choose. Your portion of the cost is automatically taken out of your paycheck. There are two ways that the money can be taken out:

PRE-TAX premiums are collected for Medical, Dental and Flexible Spending Accounts. POST-TAX premiums are collected for the following optional benefit plans: Short-Term Disability,

Supplemental Life Insurance, and Dependent Life Insurance.

Making Changes

Employee benefit elections must be made before the start of each plan year during open enrollment or as part of new hire benefits enrollment process. Your benefit selection will remain in effect through June 30, 2016. Generally, you can only change your benefits choices during the annual benefits enrollment period. However, you can change your applicable benefit plans during the year if you have a qualifying event. A list of qualifying events follows:

Marriage Divorced or legal separation Addition of certified dependent Birth, adoption, or placement for adoption of an eligible child Death of spouse or covered child Change in spouse’s or certified partner’s work status that affects benefits eligibility (e.g.,

starting a new job, leaving a job, or leave of absence) A significant change in spouse’s health coverage attributable to your spouse’s employment (e.g.,

open enrollment of spouse) A change in your child’s eligibility for benefits Becoming eligible for Medicare or Medicaid Commencement of or returning from an unpaid leave for employee/spouse

If you have a qualifying event, you must notify Human Resources with the appropriate paperwork within 30 days. Depending on the type of change, you may need to provide proof of the change (e.g., a copy of a marriage license or birth certificate). If you do not notify Human Resources within 30 days, you will have to wait until the next annual enrollment period to make benefits changes unless you have another family status change.

The IRS has strict regulations regarding changes to insurance coverage and Flexible Spending Account plans that allow payroll deductions on a pre-tax basis. Once you have elected your coverage and contribution amounts, you cannot start, change, or cancel them during the benefit period unless:

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For All Benefit Plans: You have a qualifying change in your life status For Dependent Care FSA: Your dependent care costs change significantly due to switching care

providers or changes in fees charged by the care provider.

Financial hardship is not a change in life status that qualifies for changing or stopping contributions for your insurance coverage or Flexible Spending Account.

When Coverage Ends

Health, Vision, Dental, Disability, and Life Insurance benefits terminate the last day of the month in which you terminate employment.

Flexible Spending Accounts terminate on the day that you terminate employment. All claims filed must have a date of service before the termination date and must be submitted before termination date.

If employees wish to continue coverage following termination for Life Insurance through Reliance or the USAble policies, it is the employees’ responsibility to contact the insurance carrier to make arrangements.

A dependent’s coverage will terminate because of age on the last day of the month in which the dependent’s 26th birthday falls unless that dependent is mentally or physically handicapped and incapable of self-support.

Eligibility for Health Plan Benefits

All full-time employees are eligible for Health Plan coverage beginning on the first day of the month following 30 days of employment. You may also enroll eligible dependents, which include your:

spouse; children (are eligible for coverage on the health plan until age 26, regardless of any, or a

combination of any of the following factors: financial dependency, residency with parent, student status, employment and marital status); and,

unmarried children who are mentally or physically handicapped and incapable of self-support, regardless of age.

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Important Contact Information If you have questions about your benefits or claims, please first contact the company listed below that administers the plan for the County. If you need further assistance, please contact Human Resources.

Benefit Plan Company Phone Number Website

Employee Health Clinic Harnett County 910-893-7550 www.harnett.org

Employee Assistance Plan (EAP)

Health Management Systems of America (HMSA)

800-767-5320 www.my-life-resource.com User Name: HMSA Password: myresource

Health Plan Blue Cross Blue Shield of North Carolina (BCBSNC)

877-275-9787 www.bcbsnc.com

Dental Plan Delta Dental 800-662-8856 www.deltadentalnc.com

Vision Plan EyeMed Vision Care (BCBSNC) 855-400-3641 www.eyemedvisioncare.com/bcbsnc

Flexible Spending Accounts

HealthEquity (BCBSNC) 877-713-7682 www.mybcbsnc.com

Basic Life Insurance & AD&D

Reliance Standard

Contact Human Resources about benefits and filing claims. Contact Reliance Standard at 800-351-7500 about the status of a claim or claim payment.

www.reliancestandard.com Voluntary Life Insurance & AD&D

Short-Term Disability Insurance Worksite Benefits Accident, Cancer, Critical Illness, Hospital Indemnity

Transamerica 888-763-7474 transamericaemployeebenefits.com

COBRA P&A Group 800-688-2611 www.padmin.com

North Carolina Retirement System

North Carolina State Treasurer 877-627-3287 www.myncretirement.com

457 Deferred Compensation Retirement Plan

Prudential 866-627-5267 www.prudential.com

401K Retirement Plan Prudential 866-627-5267 www.prudential.com

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Employee Benefit Rate Summary 2015/2016 Monthly Cost

Medical Enrollment Tier Total Cost Employee Cost

Employee Only $583.02 $0 Employee + 1 $815.55 $232.53

Employee + 2 or More $1081.00 $497.98

Dental Vision Enrollment Tier Employee Cost Enrollment Tier Employee Cost

Employee Only $28.09 Employee Only $8.68 Employee + 1 $55.30 Employee + Spouse $16.49

Employee + 2 or More $105.18 Employee + Child(ren) $17.36

Employee + Family $25.52

Voluntary Short Term Disability

Voluntary Life, AD&D, and Worksite Benefits

Cost is per $10 of weekly benefit. For examples, please see the HR Rate Sheet.

Please see the HR Rate Sheets for age-banded rates.

Minimum Weekly Benefit: $100 Maximum Weekly Benefit: The Lesser of $1,000 or 60% of Weekly Salary

Age-Bands Employee Cost Under age 50 $0.49

Age 50-59 $0.74

Age 60 and Over $1.25

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Harnett County Employee Health Clinic

All Harnett County employees and their dependents may use the Employee Health Clinic for sick visits, laboratory tests, and vaccines. Most services are covered at no cost to you.*

Clinic Hours: Monday – Friday 8 – 11 AM and 1 – 4 PM Call 910-893-7550 for Appointments

Located at the Harnett County Health Department Services Include: Sick visits Certain minor procedures such as stitches, wart removal, wound care, etc. Ordering imaging studies such as x-rays, ultrasounds, or CT scans as necessary Routine laboratory tests* (See below) Vaccines including Tdap, Flu, Pneumonia, etc.

Lab tests provided at no cost include: Complete blood count Basic metabolic panel Glucose Lipid panel Liver function panel Thyroid panel Hemoglobin A1c PSA Vitamin B12 Vitamin D Urinalysis Flu and strep

*Other labs can be provided at the Clinic, but insurance will be billed by LabCorp. Lab results can be faxed to your primary care doctor as long as a signed order is presented at the time of the blood draw. Otherwise, results can only be released to the patient who will then be able to take the results to their doctor.

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How to reacH

us

Whether you need tips on symptom relief at home, guidance on finding immediate medical care in urgent situations or information about your overall health – Health Line Blue is there for you.

The Health Line Blue team can answer medical questions on almost any health care issue or treatment – often helping you save time and money. And nurses offer support in either English or Spanish.

Talk to a nurse and get answers on these issues – and more. If the nurse determines you need to be seen immediately, you’ll get direction on the right place to go for medical care.

The answers you need from specially trained nurses. Get assistance fast whenever you have a health concern. Call 1-877-477-2424 and speak with a nurse immediately. From chronic conditions to cuts and sprains, get peace of mind and convenient support – all at no cost to you.

answers to your medical questions24/7 at no additional cost with Health Line BlueSM,1.

The information provided in this material has been consolidated for your convenience from various health resources. The information should not be viewed as medical advice from Blue Cross and Blue Shield of North Carolina (BCBSNC). If you have any questions concerning your medical condition or any drugs, treatment plans or new symptoms, consult your health care provider.

1 BCBSNC provides the Health Line Blue program for your convenience and is not liable in any way for the goods or services received. BCBSNC reserves the right to discontinue or change the program at any time without prior notice. Decisions regarding your care should be made with the advice of a doctor. Depending on your plan, selected programs may not be available to you at this time. Check with your benefits administrator or BCBSNC Customer Service to determine your eligibility. BCBSNC has contracted with a third-party vendor independent from BCBSNC to bring you Health Line Blue.

®, SM Marks of the Blue Cross and Blue Shield Association. Blue cross and Blue shield of North carolina is an independent licensee of the Blue cross and Blue shield association. U7815, 9/11

+ Stomachache

+ Headache

+ Minor back pain

+ Sore throat

+ Earaches

+ Cuts and scrapes

+ Insect bites

+ Skin rashes

+ Possible strains or sprains

+ Minor allergic reactions

Call Health Line Blue with your health questions, day or night: 1-877-477-2424. And scan this QR code to download the number right into your phone.

Remember, if you’re facing an issue that threatens your life or health, never hesitate to go straight to the emergency room!

Speak to a nurse 24/7

1-877-477-2424Hable con una enfermera en cualquier momento

U7815, 9/11

Visit us at bcbsnc.com/urgent

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A top priority at our Harnett County is the well-being of our employees. We realize from time to time all of us have personal problems. We may find ourselves confronted with confusing and uncomfortable situations. These might be financial or marital difficulties, substance abuse, an aging parent, an overly rebellious teenager or an emotional problem. Sometimes we may want to talk over a situation with an outside objective person. The Employee Assistance Program (EAP) is available to provide counseling assistance or referrals to provider resources for these types of situations. Our organization has retained the services of Health Management Systems of America (HMSA) to administer the EAP program. HMSA will confidentially help employees deal with a wide range of personal problems such as marital, family, alcoholism, drug abuse, financial and psychological. Harnett County recognizes that the personal life and problems of all personnel are their own affairs. The program is confidential and is designed to help ensure the well being of all those individuals who work at Harnett County. We urge you or any household family member to take advantage of the Employee Assistance Program. If you have problems or if problems exist in your family, the EAP can be a valuable service to you and those you love. Professional counselors are available at HMSA 24-hours a day to assist you and can be reached by calling 1-800-767-5320.

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DEDICATED TOLL FREE CRISIS LINE• 24 hours a day• 7 days a week• 365 days a year

TELEPHONIC DIAGNOSTICASSESSMENT AND PROBLEM RESOLUTION SESSIONS• Employees and Family Members are

eligible to receive a telephonic assessment and up to 3 telephonic short-term problem resolution sessions per issue.

• Referral services coordinated with existing health insurance benefits if long term treatment is recommended. (deductibles and co-pay may apply)

LEGAL CONSULTATIONS• Employees / Family Members are

eligible to receive one initial 30 minute office or telephonic consultation on separate legal matters at no cost. (Employment Law excluded)

• If the attorney is retained beyond the initial consultation, a 25% discount will be applied.

FINANCIAL CONSULTATIONS• Employees / Family Members are

eligible to receive one initial telephonic consultation on separate financial issuesat no cost.

• Consultation is generally limited to between 30-60 minutes.

ONLINE WORK-LIFE EAP RESOURCES

www.my-life-resource.com

Username: hmsa Password: myresource

ONLINE RESOURCES AVAILABLE (but not limited to):• Additional Legal and Financial Tools• Financial Calculators• Childcare• Eldercare • Health and Wellness Resources• Health and Wellness Podcasts• 1,000+ Articles• Simple Will Preparation

HMSA EMPLOYEE ASSISTANCE/WORK-LIFE PROGRAM

1-800-767-5320

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U4964, 7/11

Harnett County Government

Effective Date: 7/1/2015

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Blue OptionsSM Benefit Highlights (PPO)The coinsurance amounts that appear on this benefit highlight represent Plan responsibility. The coinsurance amounts that displayin the benefit booklet represent member responsibility.Physician Office Services In-network Out-of-network1

(See "Hospital Based Clinics" for "outpatient clinic" or "hospital-based" services.)Office VisitIncludes Office Surgery, Consultation, X-rays and Labs, and a benefit period maximum of 4 office visits for the evaluation and treatment of obesityin and out-of-network. See "Inpatient and Outpatient Services".

Primary Care Provider $25 copayment 70% after deductibleSpecialist $50 copayment 70% after deductible

Preventive Care (Primary Preventative Diagnosis Only)For the most updated list of general preventive/screenings, immunizations, well-baby/well-child care and women’s preventive care services mandatedunder Federal law, see our website at bcbsnc.com/preventive.Routine eye exams are covered only In-Network as non-mandated Preventive Care.Nutritional counseling is covered and available In-Network and Out-of-Network.

Primary Care Provider 100%, no deductible Not Available*Specialist 100%, no deductible Not Available*

*Colorectal screening, bone mass measurement, newborn hearing screening, prostate specific antigen tests (PSAs),gynecological exams, cervical cancer screening, ovarian cancer screening and mammograms are state mandated and also covered Out-of-Network.TherapiesRehabilitative and Habilitative Therapies (Maximums apply to Home, Office and Outpatient Settings):Physical/Occupational: 30 visits per Benefit Period;Speech Therapy: 30 visits per Benefit Period

Primary Care $25 copayment 70% after deductibleSpecialist $50 copayment 70% after deductible

Urgent Care Centers and Emergency RoomUrgent Care Centers $50 copayment $50 copaymentEmergency Room Visit $500 copayment $500 copayment(If admitted from the ER, the copayment does not apply; instead, Inpatient Hospital benefits apply. If held for observation,outpatient benefits apply. See "Inpatient and Outpatient Hospital Services".)

Ambulatory Surgical Center 70% after deductible 50% after deductibleInpatient and Outpatient Hospital Services

Hospital and Hospital Based Services 70% after deductible 50% after deductibleHospital Based Clinics(other than preventive services above) 70% after deductible 50% after deductibleProfessional Services 70% after deductible 50% after deductibleOutpatient Diagnostic Services

Outpatient lab tests and mammography, when performed alone(Physician and Hospital-based services) 100%, no deductible 70% after deductibleOutpatient lab tests and mammography, when performed with another servicePhysician Services 100%, no deductible 70% after deductibleHospital and Hospital-based Services 70% after deductible 50% after deductibleOutpatient X-rays, ultrasounds, and other diagnostic tests such as 70% after deductible 50% after deductibleEEG's and EKG'sCT scans, MRI 's, MRA's and PET scans in any location, including 70% after deductible 50% after deductiblephysician's office

Other ServicesSkilled Nursing Facility (60 days per Benefit Period) 70% after deductible 50% after deductibleHome Health Care, Durable Medical Equipment and Hospice 70% after deductible 50% after deductibleAmbulance 70% after deductible 70% after deductibleMaternityMaternity Delivery includes Prenatal and Post-delivery care

Hospital Services (Delivery) 70% after deductible 50% after deductibleProfessional Services (Delivery) 70% after deductible 50% after deductible

TransplantsHospital Services 70% after deductible 50% after deductibleProfessional Services 70% after deductible 50% after deductible

Infertility ServicesCombined In-Network and Out-of-Network Lifetime Maximum of 3 ovulation induction cycles, with or without insemination,per Member for Infertility services, provided in all places of service.

Primary Care Provider $25 copayment 70% after deductibleSpecialist $50 copayment 70% after deductibleHospital Services 70% after deductible 50% after deductibleInpatient and Outpatient Professional Services 70% after deductible 50% after deductible

Harnett County Effective Date: 07/2015

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Blue OptionsSM Benefit Highlights (PPO)Lifetime Maximum, Deductibles & Out-of-Pocket Limits In-network Out-of-network1

The following Deductibles and Out-of-Pocket limits apply to all services unless otherwise indicated and Mental Health and Substance Abuse services below:

Lifetime Benefit Maximum Unlimited UnlimitedDeductibles

Individual (per Benefit Period) $2000 $4000Family (per Benefit Period) $4000 $8000

Out-of-Pocket Limits$6,600 $13,200

$13,200 $26,400Mental Health and Substance Abuse Services

Mental Health ServicesOffice Visit $50 copayment 70% after deductibleInpatient/Outpatient 70% after deductible 50% after deductible

Substance Abuse ServicesOffice Visit $50 copayment 70% after deductible

Inpatient/Outpatient 70% after deductible 50% after deductible

Prescription DrugsUp to 30 day supply. 31-60 day supply is two copayments and 61-90 day supply is three copayments. Mail order for Generic Drugs is 2 Copayments for a 90 Days Supply. MAC B Pricing, Brand Penalty

Generic Drugs $10 copayment $10 copaymentBrand Drugs 50% 50%

100%, no deductible

1 NOTICE: Your actual expenses for covered services may exceed the stated coinsurance percentage or co-payment amount because actualprovider charges may not be used to determine the payment obligations for BCBSNC and its members.

Harnett County Government Effective Date: 07/2015

Diabetic Supplies 100% 50% after deductibleThere is a $100 per Drug Maximum, for each 30-day supply of Brand drugsAny Out-of-Network charges over the allowed amount are not included in this maximum.You are responsible for charges over the allowed amount received from an out-of-network pharmacy. Limits apply to Infertility drugs, refer to your benefit booklet.Preventive OTC Medications and Contraceptive 100%, no deductible Drugs and Devices as listed at bcbsnc.com/preventive

Individual (per Benefit Period) Medical OOP $5,500. Rx OOP $1,100. Family (per Benefit Period) Medical OOP $11,000. Rx OOP $2,200.

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ADDITIONAL INFORMATION ABOUT BLUE OPTIONS FROM BCBSNCBenefit PeriodThe period of time, usually 12 months as stated in the groupcontract, during which charges for covered services provided toa member must be incurred in order to be eligible for paymentby BCBSNC. A charge shall be considered incurred on thedate the service or supply was provided to a member.Allowed AmountThe maximum amount that BCBSNC determines is to be paidfor covered services provided to a member.Out-of-Pocket LimitThe dollar amount you pay for covered services in a benefitperiod before BCBSNC pays 100% of covered services. Itincludes deductible, coinsurance and copayments. It does notinclude charges over the allowed amount, premiums, andcharges for non-covered services.Day and Visit MaximumsAll day and visit maximums are on a combined In- and Out-ofNetwork basis.Utilization ManagementTo make sure you have access to high quality, cost-effectivehealth care, we manage utilization through a variety ofprograms including certification, transplant management,concurrent and retrospective review.If you have a concern regarding the final determination of yourcare, you have the right to appeal the decision. If you wouldlike a copy of a benefit booklet providing more informationabout our Utilization Management programs, call the toll freenumber listed in your information packet.CertificationCertification is a program designed to make sure that your careis given in a cost effective setting and efficient manner.If you need to be hospitalized, you must obtain certification.Non-emergency and non-maternity hospital admissions mustbe certified prior to the hospitalization. If the admission is notcertified, a penalty will be applied.For maternity admissions, your provider is not required toobtain certification from BCBSNC for prescribing a length ofstay up to 48 hours for a normal vaginal delivery, or up to 96hours for delivery by cesarean section. You or your providermust request certification for coverage for additional days,which will be given by BCBSNC, if medically necessary.All inpatient and certain outpatient Mental Health andSubstance Abuse services must be certified in advance byMagellan Behavioral Health. Call Magellan Behavioral Healthat 1-800-359-2422. Office visits do not require certification.In-network providers are responsible for obtainingcertifications. The member will bear no financial penalties ifthe in-network provider fails to obtain the appropriateauthorization. The member is responsible for obtainingcertification for services rendered by an out-of-network or out-of-state provider.

Health and Wellness ProgramBecause we want to help you stay healthy, we offer a variety ofwellness benefits and services. You can take advantage ofHealthLine Blue, our 24-hour health information service, a healthtopics library, asthma and diabetes management and a prenatalprogram. You will also have access to online health and wellnessinformation at www.bcbsnc.com. With our program you can gethealth advice anytime you need it, so you can learn how to takecharge of your health.What is Not Covered?The following are summaries of some of the coverage restrictions. Afull explanation and listing of restrictions will be found in your benefitbooklet.Your health benefit plan does not cover services, supplies, drugs orcharges that are: Not medically necessary For injury or illness resulting from an act of war For personal hygiene and convenience items For inpatient admissions that are primarily for

diagnostic studies For palliative or cosmetic foot care For investigative or experimental purposes For hearing aids or tinnitus maskers, except as

specifically covered by the benefit plan For cosmetic services or cosmetic surgery For custodial care, domiciliary care or rest cures For treatment of obesity, except for surgical treatment of

morbid obesity, or as specifically covered by yourhealth benefit plan

For reversal of sterilization For treatment of sexual dysfunction not related to

organic disease For assisted reproductive technologies as defined by the

Centers for Disease Control and Prevention For self-injectable drugs in the provider's office

®, SM Registration and Service marks of the Blue Cross and Blue Shield AssociationAn Independent licensee of the Blue Cross and Blue Shield Association

Harnett County Effective Date: 07/2015

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Delta Dental PPO plus Premier Summary of Dental Plan Benefits

For Group# 0792-0001, 0002, 0003, 0099 County of Harnett

This Summary of Dental Plan Benefits should be read along with your Certificate. Your Certificate provides additional information about your Delta Dental plan, including information about plan exclusions and limitations. If a statement in this Summary conflicts with a statement in the Certificate, the statement in this Summary applies to you and you should ignore the conflicting statement in the Certificate. The percentages below are applied to Delta Dental's allowance for each service and it may vary due to the dentist's network participation.* Control Plan – Delta Dental of North Carolina Benefit Year – July 1 through June 30 Covered Services – Delta Dental

PPO Dentist Delta Dental

Premier Dentist Nonparticipating

Dentist Plan Pays Plan Pays Plan Pays*

Diagnostic & Preventive Diagnostic and Preventive Services – exams, cleanings, fluoride, and space maintainers 100% 100% 100%

Emergency Palliative Treatment – to temporarily relieve pain 100% 100% 100%

Sealants – to prevent decay of permanent teeth 100% 100% 100% Brush Biopsy – to detect oral cancer 100% 100% 100% Radiographs – X-rays 100% 100% 100%

Basic Services Minor Restorative Services – fillings and crown repair 80% 80% 80% Endodontic Services – root canals 80% 80% 80% Periodontic Services – to treat gum disease 80% 80% 80% Oral Surgery Services – extractions and dental surgery 80% 80% 80% Other Basic Services – misc. services 80% 80% 80% Relines and Repairs – to bridges, implants, and dentures 80% 80% 80%

Major Services Major Restorative Services – crowns 50% 50% 50% Prosthodontic Services – bridges, implants, and dentures 50% 50% 50%

Orthodontic Services Orthodontic Services – braces 50% 50% 50% Orthodontic Age Limit – Up to age 19 Up to age 19 Up to age 19 * When you receive services from a Nonparticipating Dentist, the percentages in this column indicate the portion of Delta Dental's Nonparticipating Dentist Fee that will be paid for those services. The Nonparticipating Dentist Fee may be less than what your dentist charges and you are responsible for that difference. Oral exams (including evaluations by a specialist) are payable twice per calendar year. Prophylaxes (cleanings) are payable twice per calendar year. Full mouth debridement is payable once per lifetime. People with specific at-risk health conditions may be eligible for additional prophylaxes (cleanings) or fluoride

treatment. The patient should talk with his or her dentist about treatment. Fluoride treatments are payable twice per calendar year for people up to age 19. Bitewing X-rays are payable once per calendar year and full mouth X-rays (which include bitewing X-rays) are

payable once in any five-year period. Sealants are payable once per tooth per lifetime for the occlusal surface of first and second permanent molars up to age

16. The surface must be free from decay and restorations.

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Composite resin (white) restorations are Covered Services on posterior teeth. Porcelain and resin facings on crowns and onlays are Covered Services on posterior teeth. Vestibuloplasty is a Covered Service. Full and partial dentures are payable once in any five-year period. Reline and rebase of dentures are payable once in

any two-year period. Implants and implant related services are payable once per tooth in any five-year period. Having Delta Dental coverage makes it easy for you to get dental care almost everywhere in the world! You can now receive expert dental care when you are outside of the United States through our Passport Dental program. This program gives you access to a worldwide network of dentists and dental clinics. English-speaking operators are available around the clock to answer questions and help you schedule care. For more information, check our Web site or contact your benefits representative to get a copy of our Passport Dental information sheet. Maximum Payment – $1,000 per person total per Benefit Year on all services except orthodontics. $1,000 per person total per lifetime on orthodontic services. Deductible – $25 Deductible per person total per Benefit Year limited to a maximum Deductible of $75 per family per Benefit Year. The Deductible does not apply to diagnostic and preventive services, emergency palliative treatment, brush biopsy, X-rays, sealants, and orthodontic services. Waiting Period – Employees who are eligible for dental benefits are covered on the first day of the month following 30 days of employment. Eligible People – All full-time employees of the Contractor working at least 30 hours per week who choose the dental plan: Active (0001), County Commissioners (0002), Pre 65 Retirees (0003) and COBRA (Consolidated Omnibus Budget Reconciliation Act of 1985) enrollees (0099). The Subscriber pays the full cost of this plan. Also eligible are your legal spouse and your children to the end of the month in which they turn 26, including your children who are married, who no longer live with you, who are not your dependents for Federal income tax purposes, and/or who are not permanently disabled. You and your eligible dependents must enroll for a minimum of 12 months. If coverage is terminated after 12 months, you may not re-enroll prior to the open enrollment that occurs at least 12 months from the date of termination. Your dependents may only enroll if you are enrolled (except under COBRA) and must be enrolled in the same plan as you. Plan changes are only allowed during open enrollment periods, except that an election may be revoked or changed at any time if the change is the result of a qualifying event as defined under Internal Revenue Code Section 125. If you and your spouse are both eligible for coverage under this Contract, you may be enrolled together on one application or separately on individual applications, but not both. Your dependent children may only be enrolled on one application. Delta Dental will not coordinate benefits if you and your spouse are both covered under this Contract. Benefits will cease on the last day of the month in which the employee is terminated.

Customer Service Toll-Free Number: (800) 662-8856 www.DeltaDentalNC.com

July 1, 2015

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The Dual Network AdvantageDelta Dental of North Carolina offers access to two Delta Dental networks nationwide: Delta Dental PPOSM and Delta Dental Premier®.

Enrollees may save the most money and receive the highest level of coverage when they visit a Delta Dental PPO dentist. Our PPO dentists have agreed to accept lower fees as full payment for covered services. If enrollees go to a dentist who doesn’t participate in Delta Dental PPO, they may still save money if the dentist participates in Delta Dental Premier. Like Delta Dental PPO dentists, Delta Dental Premier dentists agree to accept Delta Dental’s fee determination as full payment for covered services.

Delta Dental of North Carolina Network Comparison2

How It Works:3In this example, applicable deductibles have been met and the enrollee visits a dentist to have a basic service provided. If the dentist’s submitted fee of $120 is covered at 80%, the claim may be processed as follows for each network:

Visit www.DeltaDentalNC.com to find a participating dentist. PA 10/13

More choice for enrollees. Lower cost for groups.

DELTA DENTAL Delta Dental PPO n More than 207,000 office locations nationwide1 NETWORKS n Dentists file claims for enrollee n No balance billing on covered services

Delta Dental Premier n More than 292,000 office locations nationwide1 n Dentists file claims for enrollee n No balance billing on covered services

OUT-OF-NETWORK Out-of-network dentist n May need to file own claims n May be balance billed n No network discounts

SUBMITTED MAXIMUM AMOUNT DELTA AMOUNT NETWORK FEE APPROVED FEE DENTAL PAYS ENROLLEE PAYS

Delta Dental PPO $120 $84 $67.20 $16.80

Delta Dental Premier $120 $113 $90.40 $22.60

Out-of-network dentist $120 $100 $80.00 $40.00

162-NC v4

Delta Dental Premier

Delta Dental PPO

Competitor A

Competitor B

Competitor C

2,576

1,527

1,402

1,384

1,285

DELTA DENTAL OF NORTH CAROLINAUNIQUE DENTISTS LICENSED AND PRACTICING IN NORTH CAROLINA

1 National network statistics: Delta Dental Plans Association, June 2013

2 North Carolina network statistics: Delta Dental of North Carolina and Netminder, October 2013

ENROLLEE PAYMENT REFLECTS BALANCE BILLING FROM OUT-OF-NETWORK DENTIST

3 This example is for illustration purposes only. Fees and reimbursements can vary by location and dentist.

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Vision Plan Information

Vision coverage focused on you

When you choose a health plan to cover you and your family, it’s important that you consider vision care. Why? Regular eye exams do more than identify vision problems. They can also provide the earliest detection of serious health conditions such as diabetes, glaucoma, cataracts, hypertension, high blood pressure and high cholesterol.1 That’s why your employer offers Blue 20/20 vision coverage from the most trusted health insurer in North Carolina.2

Valuable coverageBlue Cross and Blue Shield of North Carolina (BCBSNC) offers affordable vision coverage for individuals and families, all powered by EyeMed Vision Care.

With Blue 20/20, you’ll pay low monthly premiums and receive valuable discounts at in-network providers,3 such as:+ 40% off complete pairs of eyewear and 15% off conventional

contact lenses after the initial benefit has been used + 20% off non-prescription sunglasses + 15% off regular pricing and 5% off promotional pricing on

laser vision correction surgery at US Laser Network locations + 20% off supplies such as contact lens solution

A plan for your lifestyleWith Blue 20/20, you’ll have access to one of the nation’s largest vision networks – more than 50,000 independent providers and national retailers. With so many locations to choose from, you’re sure to find a provider with a schedule that works for you. In fact, more than 70% of participating locations offer convenient evening and weekend appointment times.

And Blue 20/20 is easy to use. You won’t need an ID card when you visit an in-network provider, and there won’t be any claim forms to fill out.

LEARN MORE

Ask your employer how you can enroll in Blue 20/20 today!

Easy online accessYou’ll get the most out of your vision coverage when you take advantage of our member website. Any time you go online to eyemedvisioncare.com/bcbsnc, you will be able to:

+ Review your benefits

+ Find a provider

+ Check the status of a claim

+ Access eye health information

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Vision care service In-network member cost

Out-of-network reimbursement4

Comprehensive eye exam $39

Contact lens fit and follow-up5

Standard Up to $55 Not covered

Premium 90% of retail price Not covered

Frames6

Standard plastic lenses

Single vision $25 Bifocal $39 Trifocal $63 Lenticular $63 Standard progressive lens5 $39 Premium progressive lens5

Tier 1 Tier 2 Tier 3 Tier 4

$91$97

$103

$39$39$39$39

Lens options5 UV treatment $15 Not covered Tint (solid and gradient) $15 Not covered Standard plastic scratch coating $15 Not covered Standard polycarbonate $40 Not covered Standard polycarbonate for

covered dependents under age 19 $0 $28

Standard anti-reflective coating $45 Not covered Premium anti-reflective coating Tier 1 Tier 2 Tier 3

$57-$68$57$68

80% of charge

Not coveredNot coveredNot covered

Plastic photochromic $75 Not covered Polarization 80% of retail price Not covered Other lens options 80% of retail price Not covered

Contact lenses7

Conventional

Disposable

Medically necessary $0 copay $200

Laser vision correction5

LASIK or PRK from U.S. Laser Network Discount applies Not covered

Frequency Exam Once every 12 months Lenses or contact lenses Once every 12 months Frames

Rates

For costs and further details of the coverage, including exclusions and reductions or limitations and terms under which the policy may be continued in force, see your benefit administrator. This brochure contains a summary of benefits only. It is not your vision plan policy. Your policy is your vision plan contract. If there is any difference between this brochure and the policy, the provisions of the policy will control.

1 “For Overall Wellness, Don’t Overlook Your Annual Eye Exam.” American Academy of Ophthalmology, “Frequency of Ocular Examinations,” 2009. www.eyesiteonwellness.com/wellness-library/article/5. (Accessed October 2011).

2 FrederickPolls, LLC; April 2011.3 Discount does not apply to EyeMed providers’ professional services

or contact lenses; plan discounts cannot be combined with any other discounts or promotional offers.

4 Your actual expenses for covered services may exceed the stated coinsurance percentage or copayment amount because actual provider charges may not be used to determine the vision benefit plan’s and member’s payment obligations.

5 Indicates a service that is not a regular part of your vision benefit plan.

6 Certain brand name vision materials in which the manufacturer imposes a no-discount practice are excluded.

7 Discount applies to materials only and not fittings for contact lenses.

®, SM Marks of the Blue Cross and Blue Shield Association. ®1 Mark of EyeMed Vision Care. All other marks are the property of their respective owners. Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association. U7662d, 11/11

Exam Plus

Limitations & exclusionsThis is a partial list of services that are not covered by Blue 20/20. Refer to your member booklet for a full list of exclusions.

n Lost or broken lenses, frames, glasses or contact lenses

n Non-prescription lenses, contact lenses or sunglasses

n Two pairs of glasses in place of bifocalsn Medical and/or surgical treatment of the eye,

eyes or supporting structuresn Vision training, orthoptic services, aniseikonic

lenses, subnormal vision aids or any associated supplemental testing

n Services required by any governmental agency or program, or as a result of any workers’ compensation law or similar legislation

n Any eye or vision examination or corrective eyewear ordered by a member’s employer, including safety eyewear

n Services or materials provided by any other group benefit plan providing vision care

n Services rendered after the last date of coverage, unless materials are ordered before the end of coverage and services are rendered within 31 days of the order

n Benefit allowances provide no remaining balance for future use within the same benefit frequency

$10 copay

80% of balance over $130 allowance

$65

$10 copay$10 copay $10 copay $10 copay

$10 copay plus $91-$103$10 copay plus $65

$75, 80% of charge less $120 allowance

85% of balance over $130 allowance

$104

100% of balance over $130 allowance

$104

Once every 24 months

Valid from 7/1/2013-6/30/2016

Subscriber $8.68Subscriber + spouse $16.49Subscriber + children $17.36Subscriber + family $25.52

Harnett County

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Harnett County

ELIGIBILITYEmployees: Each Active, Full-time employee working 30 or more hours per week, except any person working on a temporary or seasonal basis.

Dependents: You must be insured in order for Dependents to be covered.Dependents are:

A person may not have coverage as both an Employee and Dependent.

Only one insured spouse may cover Dependent children.

your legal spouse not legally separated or divorced from you

your unmarried financially dependent children* age 14 days to 20 years (to 26 years if full-time student).*natural and adopted children; stepchildren and fosterchildren in your custody.Age limit does not apply to handicapped children.

BENEFIT AMOUNTBasic Life1 times Earnings, rounded to the next higher $1,000, subject to a maximum of $125,000

Dependent LifeSpouse $2,500(spouse amount may not exceed 50% of employee amount)

Dependent Child(ren)14 days but less than 6 months : $5006 months through Age 19 : $2,500(up to age 26 if a full-time student)VALUE ADDED SERVICES

Bereavement Counseling Service

Travel Assistance Service

Employee Assistance Program

CONTRIBUTION REQUIREMENTS

Basic Life:Coverage is 100% employer paid.

Dependent Life:

Spouse: Coverage is 100% employee paid.

Dependent Child(ren): Coverage is 100% employee paid.

BENEFIT REDUCTION DUE TO AGE(applicable to employee/spouse coverage)

Age Original Benefit Reduced To65 65%70 40%75 20%

FEATURESLiving Benefit Rider(expressed as Accelerated Death

Benefit in some states and Imminent Death Benefit in PA) Air Bag Benefit Conversion Privilege FMLA/MSLA Continuation Seat Belt Benefit Waiver of Premium with Critical Illness

EXCLUSIONSAD&D EXCLUSIONS:AD&D benefits will not be payable for a loss: caused by suicide or intentionally self-inflicted injuries; caused by or resulting from war or any act of war, declared or undeclared; to which sickness, disease or myocardial infarction, including medical or surgical treatment thereof, is a contributing factor;sustained during an insured’s commission or attempted commission of an assault or felony; to which the insured’sacute or chronic intoxication is a contributing factor; or to which the insured’s voluntary consumption of an illegal or controlled substance or a non-prescribed narcotic or drug is acontributing factor.For a comprehensive list of exclusions and limitations, pleaserefer to the Certificate of Insurance. The Certificate also provides all requirements necessary to be eligible for coverage and benefits.

This Plan Highlights is a brief description of the key features of the RSL insurance plan. The availability of the benefits and features described may vary by state. It is not a certificate of insurance or evidence of coverage. Insurance isprovided under group policy form LRS-6422, et al.

Plan Highlights

Group Basic Life and AD&D,and Dependent Life Insurance

  www.RelianceStandard.com

 

  

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Harnett County

ELIGIBILITYEmployees: Each Active, Full-time employee working 30 ormore hours per week, except any person working on atemporary or seasonal basis.

Dependents: You must be insured in order for Dependentsto be covered.Dependents are:

A person may not have coverage as both an Employee andDependent.

Only one insured spouse may cover Dependent children.

your legal spouse not legally separated or divorced fromyou

your unmarried financially dependent children* age 14days to 20 years (to 26 years if full-time student).*natural and adopted children; stepchildren and fosterchildren in your custody.Age limit does not apply to handicapped children.

BENEFIT AMOUNTVoluntary Life:Choose from a minimum of $10,000 to a maximum of$500,000 in $10,000 increments

Flat amounts of life insurance equal to $150,000 or moremay be subject to an earnings cap.Dependent LifeSpouseChoose from a minimum of $10,000 to a maximum of$250,000 in $10,000 increments(spouse amount may not exceed 50% of employee amount)

Dependent Child(ren)14 days but less than 6 months : $1,000 6 months through Age 19: $5,000 or $10,000 (up to age 26 if a full-time student)

GUARANTEED ISSUE (INITIAL ELIGIBILITY PERIOD ONLY)

Employee: $150,000Spouse: $30,000Child: all child amounts are guaranteed issue

AD&D SCHEDULE

For Accidental Loss of: Amount Payable:Life 100%Both hands or both feet 100%Sight of both eyes 100%One hand and one foot 100%One hand and sight of one eye 100%One foot and sight of one eye 100%Speech and hearing 100%One hand or One foot 50%Sight of one eye 50%Speech or Hearing 50%

BENEFIT REDUCTION DUE TO AGE(applicable to employee/spouse coverage)

Age Original Benefit Reduced To65 65%70 40%75 20%

FEATURESLiving Benefit Rider(expressed as Accelerated Death

Benefit in some states and Imminent Death Benefit in PA)FMLA/MSLA ContinuationPortability

CONTRIBUTION REQUIREMENTS

Employee:

Coverage is 100% employee paid.

Spouse: Coverage is 100% employee paid.

Dependent Child(ren): Coverage is 100% employee paid.

EXCLUSIONSFor a comprehensive list of exclusions and limitations, pleaserefer to the Certificate of Insurance. The Certificate alsoprovides all requirements necessary to be eligible forcoverage and benefits.

This Plan Highlights is a brief description of the key featuresof the RSL insurance plan. The availability of the benefitsand features described may vary by state. It is not acertificate of insurance or evidence of coverage. Insurance isprovided under group policy form LRS-6422, et al.

Plan Highlights

Group Voluntary andDependent Life Insurance

www.RelianceStandard.com

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Harnett County

ELIGIBILITY  Employees: Each Active, Full‐time employee working 30 or more hours per week, except any person working on a temporary or seasonal basis.

BENEFIT AMOUNT  Employee: Choose from a minimum of $10,000 to a maximum of $500,000 in $10,000 increments (not to exceed 10 times Earnings for amounts over $150,000) Spouse and Child(ren): Spouse: Choose from a minimum of $10,000 to a maximum of $150,000 in $5,000 increments (spouse amount may not exceed 50% of employee amount) Child(ren): Choose from a minimum of $5,000 to a maximum of $10,000 in $5,000 increments Dependents: You must be insured in order for Dependents to be covered. Dependents are:

your legal spouse not legally separated or divorced from you. your unmarried financially dependent children* 14 days to 20

years (to 26 years if full‐time student) *natural and adopted children; stepchildren and foster children in your custody. A person may not have coverage as both an Employee and Dependent. Only one insured spouse may cover Dependent children.

AD&D SCHEDULE For Accidental Loss of: Amount Payable:

Life 100% Two or more Members 100%

Speech and hearing 100% One Member 50%*

Speech or Hearing 50%* Thumb & Index Finger of Same Hand

25% “Member” means hand, foot or eye.

CONTRIBUTION REQUIREMENTS

 

Coverage is 100% employee paid.

BENEFIT REDUCTION DUE TO AGE

 

Age Original Benefit Reduced to:

75 50%

80 25%

FEATURES  Conversion Privilege

Exposure & Disappearance

Seat Belt & Air Bag Benefit

VALUE ADDED SERVICES   Travel Assistance Service

EXCLUSIONS  Benefits will not be payable for any loss: to which sickness, disease, or myocardial infarction, including medical or surgical treatment thereof, is a contributing factor; caused by suicide, or intentionally self‐inflicted injuries; caused by or resulting from war; caused by an accident that occurs while in the armed forces of any country; caused by or resulting from: piloting any aircraft; or riding in or getting into or out of any non civilian aircraft or any aircraft owned, leased or operated by you or any of your employers; sustained during the insured’scommission or attempted commission of an assault or felony; to which the insured’s acute or chronic alcoholic intoxication is a contributing factor; or, to which the insured’s voluntary consumption of an illegal or controlled substance or a non‐prescribed narcotic is a contributing factor. For a comprehensive list of exclusions and limitations, please refer to the Certificate of Insurance. The Certificate also provides all requirements necessary to be eligible for coverage and benefits. This Plan Highlights is a brief description of the key features ofthe RSL insurance plan. The availability of the benefits and features described may vary by state. It is not a certificate of insurance or evidence of coverage. Insurance is provided under group policy form LRS‐8604, et al.

Plan Highlights

Voluntary Group Accidental Death & Dismemberment Insurance

  www.RelianceStandard.com

 

  

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$10,000 $20,000 $30,000 $40,000 $50,000 $60,000 $70,000 $80,000 $90,000 $100,000 $110,000 $120,000 $130,000 $140,000 $150,000

Under 34 $0.76 $1.52 $2.28 $3.04 $3.80 $4.56 $5.32 $6.08 $6.84 $7.60 $8.36 $9.12 $9.88 $10.64 $11.40

35-39 $1.14 $2.28 $3.42 $4.56 $5.70 $6.84 $7.98 $9.12 $10.26 $11.40 $12.54 $13.68 $14.82 $15.96 $17.10

40-44 $1.90 $3.80 $5.70 $7.60 $9.50 $11.40 $13.30 $15.20 $17.10 $19.00 $20.90 $22.80 $24.70 $26.60 $28.50

45-49 $2.75 $5.50 $8.25 $11.00 $13.75 $16.50 $19.25 $22.00 $24.75 $27.50 $30.25 $33.00 $35.75 $38.50 $41.25

50-54 $4.65 $9.30 $13.95 $18.60 $23.25 $27.90 $32.55 $37.20 $41.85 $46.50 $51.15 $55.80 $60.45 $65.10 $69.75

55-59 $7.50 $15.00 $22.50 $30.00 $37.50 $45.00 $52.50 $60.00 $67.50 $75.00 $82.50 $90.00 $97.50 $105.00 $112.50

60-64 $11.78 $23.56 $35.34 $47.12 $58.90 $70.68 $82.46 $94.24 $106.02 $117.80 $129.58 $141.36 $153.14 $164.92 $176.70

65-69 $18.90 $37.80 $56.70 $75.60 $94.50 $113.40 $132.30 $151.20 $170.10 $189.00 $207.90 $226.80 $245.70 $264.60 $283.50

70-74 $29.45 $58.90 $88.35 $117.80 $147.25 $176.70 $206.15 $235.60 $265.05 $294.50 $323.95 $353.40 $382.85 $412.30 $441.75

75+ $52.54 $105.08 $157.62 $210.16 $262.70 $315.24 $367.78 $420.32 $472.86 $525.40 $577.94 $630.48 $683.02 $735.56 $788.10

$10,000 $20,000 $30,000 $40,000 $50,000 $60,000 $70,000 $80,000 $90,000 $100,000 $110,000 $120,000 $130,000 $140,000 $150,000

$0.30 $0.60 $0.90 $1.20 $1.50 $1.80 $2.10 $2.40 $2.70 $3.00 $3.30 $3.60 $3.90 $4.20 $4.50

$5,000 $10,000

$0.95 $1.90

$0.14 $0.27

AD&D Benefit Amounts

All Ages

Post-Tax Monthly Paycheck Deductions for Children

Coverage Amount

AD&D Benefit

Employee benefits reduce to 65% at age 65, to 50% at age 70, and terminate at retirement.

Rates change as employees or spouses age into higher age brackets.

An employee must elect at least $10,000 coverage in order for a spouse to be eligible for any coverage.

Children are eligible for coverage from birth to age 26 as long as they qualify as dependents of the employee.

The employee's age determines the rate for both the employee and the spouse.

Life Insurance

All eligible children are covered for one premium.

An employee must elect at least $10,000 coverage in order for children to be eligible for any coverage.

Reliance StandardVoluntary Life Insurance & AD&D Coverage Cost

Post-Tax Monthly Paycheck Deductions for Employees & Spouses

Age of Employee

Life Insurance Coverage Amounts (Guarantee Issue: $150,000 for Employee and $30,000 for Spouse)

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Harnett County

COVERAGE  Disability income protection insurance provides a benefit for “short term” disability resulting from a covered injury or sickness. Benefits begin at the end of the elimination period and continue while you are disabled up to the maximum benefit duration.

ELIGIBILITY Each Active, Full‐time employee working 30 or more hours per week,  and earning an annual salary of at least $15,000, except any person working on a temporary or seasonal basis.

BENEFIT AMOUNT You may elect a weekly benefit in increments of $25, from a minimum of $100 up to a maximum benefit of $1,000 per week, not to exceed 60% of your covered earnings (rounded to the next lower increment).

DAY BENEFITS BEGIN Injury (accident) and Sickness (illness): benefits begin on the 15th consecutive day of disability; or the day immediately following the number of accumulated paid time off days applicable to the employee.

MAXIMUM BENEFIT DURATION Benefits for one period of disability, will be paid up to a maximum of 26 weeks.

CONTRIBUTION REQUIREMENTSCoverage is 100% employee paid.

FEATURES  Maternity covered as any other illness Non‐occupational coverage Partial Disability benefit included Transfer of Coverage provision

LIMITATIONS  Pre‐Existing Condition Limitation – 3/12

Please note‐ pre‐ex limitations also apply to benefit increases

EXCLUSIONS Benefits will not be payable for any disability caused by: an intentionally self‐inflicted injury; an act of war (declared or undeclared); commission of a felony; sickness covered by workers’ compensation or other workers’ disability law; injury occurring out of or in the course of work for wage or profit. For a comprehensive list of exclusions, limitations, and any applicable benefit offsets, please refer to the Certificate of Insurance. TheCertificate also provides all requirements necessary to be eligible for coverage and benefits. This Plan Highlights is a brief description of the key features of the RSL insurance plan. The availability of the benefits and features described may vary by state. It is not a certificate of insurance or evidence of coverage. Insurance is provided under group policy form LRS‐6451, et al.

Plan Highlights

Voluntary Group Short Term Disability Insurance

  www.RelianceStandard.com

 

  

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Under Age 50 Ages 50-59 Ages 60+$100 $4.90 $7.40 $12.50$125 $6.13 $9.25 $15.63$150 $7.35 $11.10 $18.75$175 $8.58 $12.95 $21.88$200 $9.80 $14.80 $25.00$225 $11.03 $16.65 $28.13$250 $12.25 $18.50 $31.25$275 $13.48 $20.35 $34.38$300 $14.70 $22.20 $37.50$325 $15.93 $24.05 $40.63$350 $17.15 $25.90 $43.75$375 $18.38 $27.75 $46.88$400 $19.60 $29.60 $50.00$425 $20.83 $31.45 $53.13$450 $22.05 $33.30 $56.25$475 $23.28 $35.15 $59.38$500 $24.50 $37.00 $62.50$525 $25.73 $38.85 $65.63$550 $26.95 $40.70 $68.75$575 $28.18 $42.55 $71.88$600 $29.40 $44.40 $75.00$625 $30.63 $46.25 $78.13$650 $31.85 $48.10 $81.25$675 $33.08 $49.95 $84.38$700 $34.30 $51.80 $87.50$725 $35.53 $53.65 $90.63$750 $36.75 $55.50 $93.75$775 $37.98 $57.35 $96.88$800 $39.20 $59.20 $100.00$825 $40.43 $61.05 $103.13$850 $41.65 $62.90 $106.25$875 $42.88 $64.75 $109.38$900 $44.10 $66.60 $112.50$925 $45.33 $68.45 $115.63$950 $46.55 $70.30 $118.75$975 $47.78 $72.15 $121.88

$1000 $49.00 $74.00 $125.00

Reliance Standard Life Insurance

Annual salaries of $88,667 or more are limited to the maximum $1,000 weekly benefit.

Voluntary Short-Term Disability Insurance (STD) Cost

Weekly BenefitPost-Tax Monthly Paycheck Deduction

25

This flier is not complete unless it is presented with consumer brochures that include the full list of limitations and exclusions for the policies listed.

This is a brief summary of benefits. Forms and form numbers may vary. Coverage may not be available in all jurisdictions. Limitations and exclusions apply. Refer to the policy, certificate and riders for complete details.

Up to date information regarding our compensation practices can be found in the Disclosures section of our website at: www.tebcs.com.

Policies underwritten by Transamerica Life Insurance Company, Cedar Rapids, Iowa.

CHOEMMP(HC)-0315

CriticalAssistance AdvanceSM - critical illness insurance Policy form series CPCI0400 and CCCI0400.Critical illness insurance is designed to come to the rescue of those budget-conscious families by helping pay the costs associated with the initial occurrence of a heart attack, stroke, cancer or other serious illness as defined in the policy. You choose your benefit amount. Benefits are also available for your spouse and eligible children. Their benefit amount will be 50% of your elected benefit.

It pays a lump sum benefit equal to the amount you choose multiplied by the applicable percentage shown in the Schedule of Benefits upon the occurrence of a covered critical illness within each category. If the benefit payment is less than 100% of the selected benefit amount, the policy pays another lump sum benefit amount upon the diagnosis of a different type of critical illness within the same category up to the limit per category. There is a lifetime maximum of three times the benefit amount you choose.

CancerSelect® Plus - cancer-only insurance Policy form series CPCAN200 and CCCAN200.Anyone can develop cancer, but can you help protect yourself and your family from the out-of-pocket

costs associated with cancer treatment? Good medical coverage helps, but is it enough?

CancerSelect® Plus is designed to provide you and your eligible family members with benefits for costs associated with cancer treatment. Coverage is 100% portable. Benefits are paid directly to you --

or anyone you choose. CancerSelect Plus offers benefits for Hospital Benefits, Cancer Maintenance Ther-apy, Wellness and Miscellaneous Benefits, Surgery Benefits, Radiation and Chemotherapy Benefits.

Benefits Open Enrollment

HospitalSelectSM II - hospital indemnity insurance Policy form series CPGHI400

Are you financially prepared if an unexpected illness or accident causes you or one of your family mem-bers to spend one day, two days or longer in the hospital? Recovering from a serious illness or accident is

difficult enough without having to worry about the added financial stress of being in the hospital.

That’s why you can help protect yourself with a product that pays benefits to help you manage the ex-penses that arise if you or an eligible family member ends up in the hospital. It’s called Hospital Select II, Hospital Indemnity Insurance. Hospital Select II can help reduce this financial stress with real dollars that

are paid to you so you can focus on recovery. Money when you need it most, peace of mind when you don’t. Plus, benefits are paid in addition to any other benefits you may have and you can get this protection

at a competitive cost.

AccidentAdvance® - accident-only insurance Policy form series CPACC100 and CCACC100. Accidents are a part of everyday life, but are you prepared for the added financial burden? If you have a serious accident, you’ll want extra cash to help pay your increased expenses. Accident insurance pays benefits you can use for medical bills and other out-of-pocket expenses – or for any other purpose, including paying your mortgage or other bills. Your medical coverage may not take care of all of the added expenses you’ll have after an accident.

You’ll want your family protected. This policy helps provide protection for you and your insured family every day of the year for covered accidents. These benefits are paid directly to you, not to your doctor or hospital. You can use this money for anything you need. The extra cash can really help you and your family during a difficult time.

County of Harnett

26

Flexible Spending Accounts Flexible Spending Accounts (FSA) allow you to avoid federal, state and Social Security (FICA) taxes on the money you pay for eligible out-of-pocket medical, dental, and dependent care expenses. You choose an amount to be withheld from your paycheck before taxes are applied. The withholdings are placed in your FSA accounts. There are two kinds of FSA accounts:

Medical Expense Reimbursement Account Dependent Care Reimbursement Account

Covers medical, dental and vision expenses that are only partially covered or not covered at all by your insurance. Some examples include: Deductibles Coinsurance Dental Care Orthodontia Drug Copays Lasik

Maximum Annual Contribution $2,500

$500 Rollover Benefit

FSA balances up to $500 that are not used by June 30, 2015, will automatically rollover to the next year. Any balance over $500 that remains in your account at the end of the plan year is forfeited.

Covers amounts you pay to daycare centers, babysitters, caregivers or after school programs that allow you and your spouse to work.

Maximum Annual Contribution $5,000

No Rollover Benefit

Account Maintenance Fee Employees pay one total fee of $4.25 per month for Medical Expense FSA, Dependent Care FSA, or both. More Information Please see the following pages for more details about the accounts and how to manage them.

27

Save money with an FSA

Flexible Spending Accounts

Save money on health care expenses Did you know that you can save money on your health care costs when you choose to enroll in your employer’s Flexible Spending Account (FSA) plan? An FSA is an account that allows you to set aside a portion of your income each year on a pre-tax basis – so you can pay for qualified health care expenses with tax-free dollars. Because the money you contribute is deducted from your paycheck before taxes and the withdrawals are tax-free, your FSA can mean significant savings.1

Save on qualified medical expensesYou can use the tax-free dollars in your FSA for any qualified medical expense, for example:

+ Copayments for doctor visits

+ Health plan deductibles and coinsurance

+ Prescriptions

+ Dental and orthodontic care

+ Hearing aids

+ Eyeglasses, contact lenses, laser eye surgery

With a medical FSA, your contribution is deducted from your paycheck in equal amounts over the course of the year, but your full year’s contribution is available to you from day one. So you know you’ll have the money when you need it. What’s more, employers can now, with certain restrictions, allow employees to carryover unused FSA balances up to a maximum IRS-prescribed amount. Please consult with your benefits administrator for additional details.

Save on dependent care, tooYour employer may also offer a separate FSA for dependent care. With a dependent care FSA, your contribution is deducted from your paycheck in equal amounts over the course of the year. You can contribute pre-tax dollars to this FSA to help pay the costs of day care for a child or elder care for a parent – and as with a medical FSA, withdrawals are tax-free.1 However, only the funds actually on deposit are available for withdrawal.

To learn more about the details of your employer’s FSA plan – and to sign up – contact your group benefits administrator.

NEED MORE INFO?

Taxed dollars in your checking account

Pre-tax dollars in your FSA

Your contribution

$1,000

Your contribution

$1,000

Taxes

$300

Taxes

$0

Available for medical expenses$700

Available for medical expenses$1000

Your money goes further in an FSAA $1,000 contribution to your FSA could save you as much as $300 or more.2

PAGE 1 of 2

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A tax-saving solution for dependent care

Dependent Care Reimbursement Account

Eligible expenses*+ Babysitter inside or outside household

+ Before and after school or extended day programs

+ Custodial childcare or eldercare expenses

+ Day camps

+ Daycare centers

+ Household employee whose services include care of a qualifying person

+ Looking-for-work expenses

+ Nanny expenses

+ Preschool/nursery school for pre-kindergarten

+ Sick-child care center

+ Summer day camps

Ineligible expenses*+ Educational/tuition expenses

+ Expenses paid to child of participant

+ Field trip expenses

+ Food, clothing, education or entertainment expenses

+ Household services

+ Incidental expenses

+ Overnight camps

+ Payments for care where you are not the custodial parent

+ Payments for care while on a leave of absence, or while on maternity, or other medical leave

+ Payments for care while you are on vacation or due to illness

+ Payments for services not yet provided

*See the complete list of qualified and non-qualified expenses in IRS Publication 503 – Child and Dependent Care Expenses.

Why DCRAs?A Dependent Care Reimbursement Account (DCRA) is a great way to pay for dependent care with tax free dollars. And since you contribute to a DCRA through a payroll deduction, you also reduce your taxable income. To qualify, the dependent care must be essential for you and your spouse to work, look for work, or attend school full-time.

How it worksWith a DCRA, you are able to make pre-tax payroll contributions to pay for dependent care expenses.

+ Determine the amount you would like to contribute for the year. The maximum annual DCRA election allowed is $5,000 per household. Unlike medical flexible spending accounts, your annual DCRA funds aren’t available up-front. Funds are only accessible as they are deposited with each payroll deduction.

+ Pay dependent care costs out-of-pocket.

+ Submit expenses either through the online member portal, or by using the DCRA Reimbursement form.n Recurring dependent care claims can be scheduled for the duration of the plan year. For assistance, contact customer service at 877.713.7682.

Qualified dependentsTo be considered qualified, dependents must meet the following criteria:

+ Children under the age of 13

+ A spouse who is physically or mentally unable to care for him/herself

+ Any adult you can claim as a dependent on your tax return that is physically or mentally unable to care for him/herself

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Don’t Forget! DCRA funds do not roll over from year to year. You must use DCRA dollars within the plan year or they will be forfeited.

Be sure to save all receipts, which are required for reimbursement and validation of expenses.

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PAGE 2 of 2

24/7/365Expert support specialists are availablefor members every hour of every day

Helpful tools and support along the way Once enrolled, you’ll receive a welcome kit in the mail from HealthEquity®, BCBSNC’s partner in FSA administration. This kit contains information and instructions for accessing your account. With HealthEquity, you’ll have convenient and comprehensive tools and resources to manage your account including expert specialists who are available every hour of every day to share advice and answer your questions.

Managing your FSA You can manage both your BCBSNC health plan and your FSA account online and on-the-go. Visit mybcbsnc.com to view your health benefits and claims and to check your FSA fund balance. Click on the “Manage Your FSA” link for access to comprehensive online services. You also have on-the-go access to your FSA on your mobile device with the HealthEquity mobile application available for iPhone and Android devices.

Here’s what you can do

+ View account balance and history

+ Create new claims and view status

+ Send payments and reimbursements

+ Manage debit card transactions, if applicable

+ Archive documents on our secure servers

+ And with the new mobile app, you can do all this on the go, plus use your device’s camera to document and upload claims

1 Withdrawals are tax-free only if used for qualified medical expenses or dependent care costs. Specific regulations and a list of qualified medical expenses can be found in IRS publication 502, available at www.irs.gov.

2 Example based on a combined state and federal tax rate of 30%. Your specific tax rate and savings may differ.

Blue Cross and Blue Shield of North Carolina (BCBSNC) is the HRA/FSA administrator and contracts with HealthEquity, Inc., an independent entity, to perform certain HRA/FSA administrative services. Blue Cross® Blue Shield® and the Cross and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans. All other marks are the property of their respective owners. Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association. U7471, 12/13

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HARNETT COUNTY HOLIDAY SCHEDULE

2015 New Year’s Day Thursday - January 1 Martin Luther King, Jr Day Monday - January 19 Good Friday Friday - April 3 Memorial Day Monday - May 25 Independence Day Friday - July 3 Labor Day Monday - September 7 Veterans Day Wednesday - November 11 Thanksgiving Thursday - November 26

Friday - November 27 Christmas Wednesday - December 23

Thursday - December 24 Friday - December 25

2016 New Year’s Day Friday - January 1 Martin Luther King, Jr Day Monday - January 18 Good Friday Friday - March 25 Memorial Day Monday - May 30 Independence Day Monday - July 4 Labor Day Monday - September 5 Veterans Day Friday - November 11 Thanksgiving Thursday - November 24

Friday - November 25 Christmas Friday - December 23

Monday - December 26 Tuesday - December 27

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Employee Leave Policies Please review the Harnett County Personnel Ordinances on the Harnett County website: www.harnett.org Sick Leave Employees working 40 hours per week shall earn 8 hours per month. EMS and Sheriff’s Departments accumulate sick leave per shift hours. Sick leave may be used for: sickness, injury, medical or dental examinations or treatment, exposure to a contagious disease when presence at the worksite would jeopardize the health of others, or for the death in employee’s immediate family (not to exceed 3 days). Immediate family includes wife, husband, mother, father, brother, sister, daughter, son, grandmother, grandfather, grandson, granddaughter, aunt, and uncle. Included are the step, half, in-law, loco parentis relationship, and those living within the same household. Sick leave may also be used when the employee’s presence is required because of the illness or medical appointment of a spouse, child, parent, or parent-in-law. Requests for sick leave must be submitted to the immediate supervisor as far in advance as practical/possible, but not later than 2 hours after the start of the next scheduled workday. If an employee is incapacitated by illness and not able to report for work, they are responsible for personally contacting their immediate supervisor to request sick leave. This request must be made as soon as possible but not later than 2 hours after the start of the workday. Shared Leave Pool This program provides a means for employees to share vacation leave with employees who have exhausted all their sick and vacation leave because of a serious and prolonged medical condition. This program provides an opportunity for employees to help each other by establishing a method for donating earned time. Employees may donate leave or apply to be a recipient in accordance with the procedures outlined in the Harnett County Personnel Ordinance. Volunteer Leave Regular employees are authorized 1 ½ hours of administrative leave each week to perform volunteer work at a Harnett County school or Harnett County non-profit organization (Ex: Food Pantry or Meals-on-Wheels) of their choice. This leave may be used in conjunction with other leave and lunch periods but may not be accumulated and/or carried forward to the next week. To utilize this form of leave an employee must receive advanced approval (at least 48 hours) and is subject to workload requirements. The Supervisor, Department Head or County Manager may require documentation of use of Volunteer Leave.

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Parental Involvement Leave In compliance with NC General Statute 95-28.3, leave for Parent Involvement in Schools, an employee who is a parent, guardian, or person in standing loco parentis of a school-aged child will be allowed to use four hours per year of administrative leave to attend or otherwise be involved at that child’s school. Parent Involvement Leave must be approved by the employee’s Supervisor at least 48 hours in advance. The Supervisor, Department Head or the County Manager may require documentation of use of the employee’s school involvement. Example: An employee may use this leave to attend a parent teacher conference, or chaperon a school trip. Vacation Regular employees working the basic workweek or greater shall earn vacation leave at the following monthly rates:

Regular Employees Years Worked Hours Per Month Days Per Year

Less than 2 6.67 10 2 but less than 5 8.00 12 5 but less than 10 10.00 15 10 but less than 15 12.00 18 15 but less than 20 14.00 21 20 plus 16.00 24

EMTs (24 Hour Shift) Years Worked Hours Per Month Hours Per Year

Less than 2 8.87 106.40 2 but less than 5 10.64 127.68 5 but less than 10 13.30 159.60 10 but less than 15 15.96 191.52 15 but less than 20 18.62 223.44 20 plus 21.28 255.36

Deputies Years Worked Hours Per Month Hours Per Year

Less than 2 7.13 85.60 2 but less than 5 8.56 102.72 5 but less than 10 10.70 128.40 10 but less than 15 12.84 154.08 15 but less than 20 14.98 179.76 20 plus 17.12 205.44

During initial employment, probationary employees will not be permitted to take vacation unless denial of such leave will create an unusual hardship on the employee and may be taken only with the prior approval of the Department Head. Law Enforcement Officers shall be allowed to take accumulated vacation leave after 6 months of service. Any employee with more than 240 hours of accumulated vacation leave shall have the excess transferred to sick leave per the Personnel Ordinance. Only 240 hours may be carried forward to January of the next calendar year. Request for Leave will be submitted by the employee to their immediate supervisor as far in advance as practical and possible.

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Petty Leave Petty Leave can be used to attend to personal matters such as time lost reporting to work, medical appointments and absences due to adverse weather conditions. All full-time County employees shall be allowed fourteen (14) hours per year of petty leave with pay beginning February 1st of each calendar year. If an employee is hired after January 1st, they will receive petty leave on a prorated basis. These fourteen (14) hours are over and above any other leave an employee may accrue while in the service of the County. Petty Leave, therefore, may be used in conjunction with any other type of leave, but may only be used in increments of fifteen (15) minutes up to a maximum of three (3) hours at one time. Petty leave may only be taken with the approval of a Supervisor, Department Head, or County Manager and must be used before December 15th of each calendar year. After December 15th, any petty leave an employee may have will be terminated and will not roll over to the next year. Family and Medical Leave The Family and Medical Leave Act (FMLA) of 1993 gives eligible employees unpaid leave for a period of up to 12 work weeks for any FMLA-qualifying event. In the event of an FMLA-qualifying event, the County is responsible for designating leave as FMLA leave and providing notices to the employee of such designation. If the employee has FMLA leave available and the reason for the leave qualifies under the FMLA, the employee is required to take FMLA leave. Employees are required to use all of their accrued leave before unpaid FMLA leave is granted. When the necessity for leave is foreseeable, the employee must give the County at least 30 days advance notice of the need for leave. If the need for leave is not foreseeable, the employee needs to give the County as much notice as practical. Request for Family and Medical Leave forms will be provided by the department/division/office head. When Human Resources becomes aware that an employee is absent due to a serious health condition (or when the request involves the health condition of a family member), the department approves the employee provisionally under the FMLA. A final determination is made when the completed FMLA forms are received within 15 days. Final approval of an FMLA leave request is contingent upon the Human Resources Department’s confirmation of eligibility. Civil Leave When a County employee is called for jury duty or as a court witness for the federal or state governments or a subdivision thereof, they shall receive leave with pay for such duty during the required absence without charge to accumulated vacation, sick or petty leave. While on civil leave, benefits and leave shall accrue as though the employee were on regular duty. An employee may keep fees and travel allowances received for jury or witness duty in addition to regular compensation, except that employees must turn over to the County any witness fees or travel allowances awarded by the Court for Court appearances in connection with official duties.

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Harnett County employees are required to contribute to the NC State Retirement System at the rate of 6% of their salary until retirement, regardless of age. Contributions to the retirement system are tax-deferred. State law provides that the County as a participant in the North Carolina Local Governmental Employees Retirement System (NC LGERS) may shelter the contributions payable to the system by its employees who are members of the system. This provision enables eligible members to have state and federal income taxes o on their contributions to their retirement deferred until after retirement.

Harnett County also contributes to the retirement fund. The County’s contributions are based on an actuarial calculation so that employee benefits can be provided on a sound basis. Your retirement program offers several options. These options are discussed more fully in your North Carolina State Retirement handbook.

The ORBIT online system allows members to access their individual account information on demand. You can review your salary history and reported earnings, service credits, and dates of participation as an active member of the retirement system. There are support tools available such as the Benefit Calculator to assist you in calculation of your monthly benefit. The Member Benefits booklet, another benefit tool, provides guidance and increased understanding. Visit ORBIT and logon at www.nctreasurer.com.

Saving money for retirement can be a daunting task for those of us who are not independently wealthy. That is why the County has other savings and investment options for employees who would like to participate. Your contributions are made through payroll deductions, which may be increased or decreased monthly. Plan Name Type Tax Advantage 401(k) Supplemental Retirement Pre-Tax 457 Deferred Compensation Plan Supplemental Retirement Pre-Tax Roth 401(k) Supplemental Retirement Post-Tax Any employee interested in participating in any of the plans listed above should contact Human Resources for additional information.

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Grandfathered Retirement Health Insurance Benefits Full-time employees as of June 30, 2015 shall continue to be eligible to Harnett County Health Insurance Benefits on a pro-rated basis for years of service indicated below. The retiree must be a Harnett County employee at time of retirement to be eligible.

Group Health Plan for Retirees Under Age 65 and Not Medicare Eligible Years of Service for Eligibility Percentage of Cost Paid by the County

Until Age 65 or Medicare Eligible 30 Years – Harnett County Service 100% 29 Years – Harnett County Service 96% 28 Years – Harnett County Service 94% 27 Years – Harnett County Service 91% 26 Years – Harnett County Service 88% 25 Years – Harnett County Service 85% 24 Years – Harnett County Service 83% 23 Years – Harnett County Service 81% 22 Years – Harnett County Service 79% 21 Years – Harnett County Service 77% 20 Years – Harnett County Service 75% 19 Years – Harnett County Service 70% 18 Years – Harnett County Service 65% 17 Years – Harnett County Service 60% 16 Years – Harnett County Service 55% 15 Years – Harnett County Service 50% 30 Years – *Local Government Service (*Includes 10 Years of Harnett County Service)

50%

Medicare Supplement for Retirees Older than Age 65 and/or Medicare Eligible

Years of Service for Eligibility **Percentage of Cost Paid by the County 30 Years – Harnett County Service 100% 29 Years – Harnett County Service 96% 28 Years – Harnett County Service 94% 27 Years – Harnett County Service 91% 26 Years – Harnett County Service 88% 25 Years – Harnett County Service 85% 24 Years – Harnett County Service 83% 23 Years – Harnett County Service 81% 22 Years – Harnett County Service 79% 21 Years – Harnett County Service 77% 20 Years – Harnett County Service 75% 19 Years – Harnett County Service 70% 18 Years – Harnett County Service 65% 17 Years – Harnett County Service 60% 16 Years – Harnett County Service 55% 15 Years – Harnett County Service 50%

**Medicare Supplement standard amount to be determined by the Board of Commissioners.

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Non-Grandfathered Retirement Health Insurance Benefits Full-time employees hired on or after July 1st, 2015, or those employees who leave the employment of the County and return to work on or after July 1st, 2015, shall be eligible for Retirement Health Benefits on a pro-rated basis for years of service indicated below.

Group Health Plan for Retirees Under Age 65 and Not Medicare Eligible Minimum Consecutive Years of Service

for Harnett County Percentage of Cost Paid by the County

Until Age 65 or Medicare Eligible 20 Years 50% 25 Years 75% 30 Years 100%

Medicare Supplement for Retirees Older than Age 65 and/or Medicare Eligible

Minimum Consecutive Years of Service for Harnett County

**Percentage of Cost Paid by the County

20 Years 50% 25 Years 75% 30 Years 100%

**Medicare Supplement standard amount to be determined by the Board of Commissioners.

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What to Do When an Injury Occurs

The following instructions are for reporting work-related injuries or illness. Please read the information carefully. Failure to follow these instructions could result in loss or a delay of Worker’s Compensation benefits.

Notify your supervisor immediately (within 24 hours if possible).

Failure to inform your employer within 40 days after an injury or development of an occupational disease may deprive you of the right to compensation.

Complete “Employee’s Report of Accident/Incident” This should be filled as soon as possible following the injury/incident. Be as detailed as possible. Submit the completed form to your supervisor within 24 hours if possible. If necessary, seek medical treatment.

For an emergency, your supervisor or any other employee on the scene will call 911 for medical assistance and transport to the nearest medical facility. For non-emergencies, you must obtain treatment from the listed Credentialed Network Provider below:

Primary Care: Lillington Family Medical Center 7 East Duncan St Lillington, N.C. 27546 910 893-2641 If for any reason other than a medical emergency, you are not able to treat with Lillington Family Medical Center, please contact the Risk Management and Safety Coordinator immediately.

Prescriptions If you need to have a prescription filled, go to any major pharmacy and tell them you are covered under Modern Medical through the County’s worker’s compensation program. The pharmacy will electronically go online with modernmedical.com and get approval for the prescription. The injury report must be filed with Harnett County Human Resources Office prior to this program being available. Therefore, remember to report accidents immediately.

Please contact Harnett County Human Resources at 893-7567 with questions.

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Harnett County Departments Airport PO Box 940 (Mail) 615 Airport Road Erwin NC 28339 P: 814-2740 F: 893-8263

Animal Services PO Box 940 (Mail) 1100 McKay Place Lillington NC 27546 P: 814-2952 F: 814-0438

Board of Elections PO Box 356 (Mail) 308 W Duncan St Lillington NC 27546 P: 893-7553 F: 893-4655

Clerk of Court 301 W. Cornelius Harnett Blvd. Suite 100 Lillington NC 27546 P: 814-4600 F: 814-4560

Cooperative Extension 126 Alexander Drive Suite 300 Lillington NC 27546 P: 893-7530 F: 893-7539

County Manager’s Office/ Board of Commissioners PO Box 759 (Mail) 102 E Front St Lillington NC 27546 P: 893-7555 F: 814-2662

County Garage PO Box 2773 (Mail) 1100 E McNeill St Lillington NC 27546 P: 893-7517 F: 814-8263

Department on Aging 309 W Cornelius Harnett Blvd Lillington NC 27546 P: 893-7578 F: 814-2564

Economic Development PO Box 1270 (Mail) 102 E Front St Lillington NC 27546 P: 893-7524 F: 814-2662

Engineering/Facilities Maint P.O. Box 2773 (Mail) 200 Alexander Dr Lillington NC 27546 P: 814-6156 F: 814-8263

Emergency Medical Services PO Box 370 (Mail) 1005 Edward Brothers Dr Lillington NC 27546 P: 893-7563 F: 814-2570

Finance Office P.O. Box 760 (Mail) 102 E Front St Lillington NC 27546 P: 893-7557 F: 893-3445

Fire Marshal/Emergency Mgmt. P.O. Box 370 (Mail) 1005 Edwards Brothers Dr Lillington NC 27546 P: 893-7580 F: 893-5025

General Services P.O. Box 940 (Mail) 200 Alexander Dr. Lillington NC 27546 P: 893-7536 F: 814-8263

GIS/911/Land Records 305 W Cornelius Harnett Blvd Suite 100 Lillington NC 27546 P: 893-7523 F: 814-0183

HARTS (Transportation) P.O. Box 85 (Mail) 250 Alexander Dr Lillington NC 27546 P: 814-4019 F:814-4020

Health Department 307 W. Cornelius Harnett Blvd Lillington NC 27546 P: 893-7550 F: 893-9429 (Main) F: 814-4060 (Admin)

Human Resources & Risk Mgmt. PO Box 778 (Mail) 102 E Front St Lillington NC 27546 P: 893-7567 F: 814-0350

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Information Technology P.O. Box 1405 (Mail) 201 W Front St Lillington NC 27546 P: 814-6388 F: 814-8250

Job Link/ Workforce Development 1137 E. Cornelius Harnett Blvd Lillington NC 27546 P: 893-2191 F: 814-4011

Legal Services P.O. Box 238 (Mail) 102 E Front St Lillington NC 27546 P: 814-6009 F: 814-0350

Library PO Box 1149 (Mail) 601 S. Main St. Lillington NC 27546 P: 893-3446 F: 893-3001

Parks & Recreation PO Box 816 (Mail) 1100 E. McNeill St. Lillington NC 27546 P: 893-7518 F: 814-2662

Planning & Inspections / Central Permitting PO Box 65 (Mail) 108 E Front St Lillington NC 27546 P: 893-7525 F: 814-6459

Public Buildings P.O. Box 2773 (Mail) 200 Alexander Dr Lillington NC 27546 P: 893-7538 F: 814-4041

Public Utilities P.O. Box 1119 (Mail) 700 McKinney Parkway Lillington NC 27546 P: 893-7575 F: 893-6643 or 814-4002

Register of Deeds 305 W. Cornelius Harnett Blvd Suite 200 Lillington NC 27546 P: 893-7540 F: 814-3841

Sheriff’s Office P.O. Box 399 (Mail) 175 Bain St Lillington NC 27546 P: 893-9111 F: 893-6450

Social Services PO Box 2169 (Mail) 311 W. Cornelius Harnett Blvd. Lillington NC 27546 P: 893-7500 F: 893-6604

Soil & Water Conservation District P.O. Box 267 (Mail) 126 Alexander Dr. Suite 200 Lillington NC 27546 P: 893-7584

Solid Waste P.O. Box 2773 (Mail) 200 Alexander Dr Lillington NC 27546 P: 814-6156 F: 814-8263

Tax Department 305 W. Cornelius Harnett Blvd Suite 101 Lillington NC 27546 P: 893-7520 F: 814-4017

Veteran’s Services PO Box 232 (Mail) 102 E Front St Lillington NC 27546 P: 893-7574 F: 814-4005

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COBRA Benefits Continuing Your Health, Dental, and Vison Coverage

Under certain circumstances, you may continue your health care coverage when it would otherwise end as provided under the Public Health Services Act (PHSA) and stipulated by the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA). COBRA contains a provision giving certain former employees, retirees, spouses, and/or dependent children the right to temporary continuation of health coverage at group rates.

Health coverage for COBRA participants is usually more expensive than health coverage for active employees for two reasons:

1. The County pays a part of active employees’ insurance premiums, but does not pay any part of COBRA premiums.

2. COBRA rates include an extra 2% administration fee collected by the COBRA administrator.

COBRA continuation coverage is only available in specific instances. If you are an employee of Harnett Count Government and covered by the County’s health, dental, or vision insurance, or have a Health Care Flexible Spending Account, you have a right to choose COBRA continuation coverage for yourself and/or your covered dependents if:

You lose your coverage under the plan because of a reduction in your hours or employment. Your employment is terminated for reasons other than gross misconduct on your part.

Once notified of one of these events, the County’s COBRA administrator will notify you that you have the right to choose continuation coverage. You have 60 days from the date you receive the necessary election forms from the COBRA administrator to inform the administrator that you want continuation coverage.

If you do not choose continuation coverage, your coverage under the County’s plan will end. If you choose continuation coverage, you will receive coverage identical to the coverage currently provided by the County’s. The law requires that you be given the opportunity to maintain coverage for up to 18 months due to loss of coverage resulting from a termination of employment or reduction in hours.

If you, or a dependent on continuation coverage, become disabled for purposes for Social Security during the first 60 days of continuation coverage, the affected individual qualifies for 29 months of continuation coverage. The County must receive notification of the disability determination within 60 days (and before the expiration of the original 18 month period) in order for the affected individual to qualify for this extension. You must also notify the County within 30 days of any final determination that the individual is no longer disabled.

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Dependents

If you are the spouse of an employee covered by the Harnett County Health, Dental, or Vision plans, you have the right to choose continuation coverage, if you lose coverage under the plans for any of the following reasons:

Death of your spouse Divorce or legal separation from your spouse Termination of your spouse’s employment for reasons other than gross misconduct Reduction in your spouse’s hours of employment Your spouse becomes eligible for Medicare and chooses Medicare as the primary payer

Covered dependent children of an employee have the right to continuation coverage, if coverage under the plans is lost for any of the following reasons:

Death of parent employed by the County Parent’s divorce or legal separation Termination of the parent’s employment for reasons other than gross misconduct Reduction in parent’s hours of employment Parent employed by the County becomes eligible for Medicare and chooses Medicare as the

primary payer Under the continuation coverage law, the employee or a family member is responsible for informing the County’s Human Resources Department of a divorce, or a legal separation within 30 days after this event occurs. Once notified that one of these events has occurred, the County’s COBRA Administrator will notify you that you have the right to choose continuation coverage. You have 60 days from the date you receive the necessary election forms form the County’s COBRA administrator to inform the administrator that you want continuation coverage.

If you do not choose continuation coverage, your coverage under the plan will end. If you choose continuation coverage, you will receive coverage identical to the coverage currently provided under the plan. The law requires that you be given the opportunity to maintain coverage for between 18 and 36 months, as applicable.

If you have any questions about COBRA, please contact the County’s COBRA administrator:

P & A Group 17 Court Street, Suite 500 Buffalo, NY 14202 Phone: 800-688-2611 Website: www.padmin.com

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Notice of Privacy Information Practices Our Legal Duty: We are required by law to protect the privacy of your information, provide this Notice about our information practices, and follow the information practices that are described in this Notice. In accordance with 45 CFR Section 164.520 (c) (1) (iii), this Notice is provided to the named insured under the Group Health Plan(s). It is the responsibility of the named insured to share this Notice with his/her dependents. Should you have any questions regarding the Notice(s), you may contact the Administrative Entity for the appropriate plan. What is HIPAA? A federal regulation, the Health Insurance Portability and Accountability Act of 1996, also known as the HIPAA Privacy Rule, requires the County to provide a detailed notice in writing of its privacy practices. Uses and Disclosure of Health Insurance: The County may contract with individuals and entities (Business Associates) to perform various functions and activities on the County’s behalf and to provide certain types of services for the County. In their performance of these functions, activities and services, the County’s Business Associates may receive, create, maintain, use or dispose Protected Health Information (PHI), but only after the Business Associate has agreed in writing to contract terms designed to appropriately safeguard the information. The Administrative Entity may use PHI to ascertain, on behalf of the Group Health Plan(s), ways to improve the quality of health care and to possibly reduce health care costs. The Administrative Entity may use and disclose PHI for billing, claims management, and collection activities. The vast majority of the PHI that is received, used, and maintained by the Administrative Entity, on behalf of County’s Group Health Plan(s), is never seen by the County in its capacity as Plan Sponsor or in its capacity as the employer. Complaints Under HIPAA: If you believe that your privacy rights have been violated, you may contact the County in care of John Rankins, Human Resources and Risk Management Director, at 910-814-6401. You may also file a complaint with the Secretary of the U.S. Department of Health and Human Services, Hubert H. Humphrey Building, 200 Independence Avenue S.W., Washington, D.C. 20201. All complaints must be submitted in writing. The County will not retaliate against you for filing a complaint. Whom to Contact for More Information: If you have any questions regarding the Notice or the subjects addressed in it, you may contact John Rankins, Human Resources and Risk Management Director, at 910-814-6401.

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NOTES

44

NOTES

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About This Guide

This Guide describes the benefit plans and policies available to you as an employee of Harnett County Government. The details of these plans and policies are contained in the official plan and policy documents, including some insurance contracts. This guide is meant only to cover the major points of each plan or policy. Additional information can be obtained through the County’s Human Resources Department.

If there is ever a question about one of these plans and policies, or if there is a conflict between the information in this Guide and the formal language of the plan or policy documents, the formal wording in the plan and policy documents will govern.

Please note that the benefits described in this Guide may be changed at any time and do not represent a contractual obligation on the part of the Harnett County Government.