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Preventive Care and Wellness Benefits
Prescription Drug Benefit
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Choosing a Beneficiary
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Plan Information

Medical
The City’s comprehensive medical plan, administered by UnitedHealthcare, offers employees access to a Preferred Provider Organization (PPO) Network, whose services are discounted, saving the Employee and the City money.

PPO (Choice Plus Network)

In-Network Benefits-
Participants who choose in-network providers pay:

  1. Annual deductible of $250 for individual ($500 for family coverage) for plan year 2012
  2. Once a participant’s deductible is satisfied, the member cost drops to 20% of discounted eligible expenses to a maximum of $500 per individual or $1,500 for family coverage per year, excluding the deductible. Amounts above this annual maximum are paid by the City at 100% of eligible expense.

Out-of-Network Benefits-
Participants who choose out-of-network providers pay:

  1. Annual deductible of $500 for individual ($1,000 for family coverage) for plan year 2012
  2. Once a participant’s annual out-of-network deductible is satisfied, the member cost drops to 40% of eligible billed charges to a maximum of $1,000 per individual or $3,000 for family coverage per year, excluding the deductible.

Health Services Chart
View page five (5) of the 2012 Benefit Matters guide to compare health plans.


Preventive Care and Wellness Benefits
Preventive care services for eligible employees and covered dependents will be covered at 100% in-network, or 60% out-of-network. The deductible does not have to be met for this benefit to be paid. Other services provided at the same time as the preventive care services, including but not limited to office visit charges, will be subject to deductibles and co-insurance.

All age-appropriate immunizations recommended by a physician for employees and dependents are covered at 100% in-network or 60% out-of-network after the deductible. Other services provided at the same time as the immunizations, including but not limited to office visit charges, will be subject to deductibles and co-insurance.

Synagis administration for the prevention of respiratory syncytial virus (RSV) among high-risk infants meeting prescribing criteria set forth by American Academy of Pediatrics (AAP) will be covered at 100%, deductible waived, only if such treatment is determined to be medically necessary and prior authorization obtained on or before administration of the first injection.


Prescription Drug Benefit
The City's prescription drug benefit, administered by UnitedHealthcare, includes access to both chain and independent stores including more than 60,000 in-network retail pharmacies. Pharmacy benefits can be accessed through your UnitedHealthcare ID Card. Visit www.myuhc.com to find an in-network pharmacy near you.

Generic Prescription Drugs
Prescription drugs are placed into tiers, and each tier is assigned a cost. Tier 1 contains most generic prescription drugs, and it is usually the lowest-cost tier option. Generic prescription drugs contain the same active ingredients as brand name drugs, typically found in Tiers 2 and 3. Over 75% of brand name drugs have an available generic equivalent. To find out if your medication has an available generic equivalent, visit www.myuhc.com.

90-day and Mail Order Prescription
A 90-day supply for maintenance medications is available at any of the participating pharmacies or through the UnitedHealthcare Mail Order Pharmacy Program administered by Medco Mail Order. Medco Mail Order, a partner of UnitedHealthcare, allows you to manage your 90-day supply with reminders and easy online ordering. Contact Human Resources Customer Service to obtain mail order enrollment packets or visit UnitedHealthcare online at www.myuhc.com.

Plan

In-Network Pharmacy

Out-of-Network

                                                                            30-day Retail

Tier 1

0%

20% after deductible

Tier 2

20% co-insurance

40% after deductible

Tier 3

30% co-insurance

50% after deductible

                                                                            90-day or Mail Order

Tier 1

0%

N/A

Tier 2

10% co-insurance

N/A

Tier 3

20% co-insurance

N/A

In-network annual prescription co-insurance out-of-pocket maximum of $150 for an individual and $300 for a family.


Life Insurance
The City of San Antonio provides basic life and accidental death & dismemberment insurance with Dearborn National Life Insurance Company to help protect your family in the event of your death. 

Your Right to Continuation of Coverage
Upon termination of employment with the City, you are no longer covered for Basic Life Insurance. Your last day of employment is your last day of coverage.

If you wish to continue your basic life coverage, you have an option to convert the City’s group policy to an individual policy.  By converting, you will be responsible for the cost of this coverage.  Dearborn National Insurance Company will notify you of the cost after you submit an application for conversion.  If you are interested in converting to an individual life policy, please contact Human Resources Customer Service at (210) 207-8705. Affordable group-age bracketed rates are applicable, and will be billed on a quarterly, semi-annual or annual basis.


Choosing a Beneficiary
It is important to name a beneficiary. In the event of your death, benefits are paid by Dearborn National Life Insurance Company to your named beneficiary. A Beneficiary Designation Form is available at Human Resources Customer Service or on the COSAweb for this purpose.

You should review your beneficiary form periodically to make sure that you have listed the person(s) or organization(s) whom you want to receive benefits in the event of your death. You may name more than one beneficiary, and indicate the percentage of your death benefit each should receive. If minors are named, a guardian or trustee must be appointed on their behalf.  You may wish to consult with an attorney to make sure that benefits to a minor will be paid according to your wishes.  You may change your beneficiary designation at any time by completing a change of Beneficiary Form at the Human Resources Department, 111 Soledad, San Antonio, Texas 78205 (located in the Riverview Towers Building).


Accidental Death & Dismemberment Coverage
All full-time employees are automatically covered under the Fort Dearborn’s basic term life insurance plan. The City pays the entire cost of this coverage. If you die while covered under the basic life insurance plan, your beneficiary will receive a tax-free lump sum benefit equal to your annual base salary.  You also have accidental death and dismemberment (AD&D) coverage which pays one time your annual salary to your beneficiary in the event of your accidental death, in addition to the basic life insurance amount.