There are several changes to benefits this year that you should be aware of before enrolling. Read through these highlights, take a look at the additional information in the benefit drop-down sections below, and let the Insurance & Risk Management department know if you have any questions.

• The Emergency Room copay on the Copay plan is increasing by $200 to be $500. The copay will still be waived if admitted to the hospital.
• Name brand and generic weight management GLP-1 medications, including Zepbound, Saxenda, Foundayo, and Wegovy, will no longer be included in any medical plan's formulary. See the GLP-1 Resource page for information about TrumpRx, pharmacy discount programs, and the programs available to you through your Cigna insurance. **GLP-1 medications for Type 2 Diabetes and non-GLP-1 weight loss medications are NOT affected by this change.**
• The DPPO Option 2 Annual Maximum benefit is increasing to $1,750 per covered member.

Additionally, in accordance with federal regulations:

• In accordance with IRS guidelines, to keep the deductible embedded, the Individual deductible for the High Deductible Health Plan (HDHP) will increase by $100 to be $3,500.
• The Health Savings Account (HSA) Individual/Family contribution limits will increase to $4,500/$9,000.
• The Healthcare Flexible Spending Account (HCFSA) contribution limit will increase to $3,400.

Keep in mind that your medical plan's formulary can change periodically throughout the plan year. For more information, contact Rutherford County's dedicated Cigna liaison, Candi Turner, at [email protected] or 727-277-6565.

If you or your spouse are eligible for Medicare or will become eligible for Medicare in the next few years, it's a good idea to understand all of the benefit options available to you and how to transition from Rutherford County benefits to Medicare when you are ready. Since the Insurance & Risk Management department is not able to advise you on Medicare benefits or outside Medicare plans, we recommend that you speak with a Medicare advisor (such as a SHIP or at the St. Clair Senior Center) to discuss which options are right for you.

A few important things to know:

• Rutherford County’s medical plans will continue to provide Creditable Prescription Drug Coverage in 2027.
• Rutherford County’s medical insurance does NOT require active employees or their spouses to sign up for Medicare upon aging into Medicare eligibility. You and your spouse may remain on the County’s medical insurance for the duration of your full-time employment regardless of age. However, if you or your spouse become Medicare-eligible for other reasons, such as ESRD or ALS, please contact the Insurance & Risk Management department, as other causes for Medicare eligibility may follow different rules. 
• Medicare.gov recommends stopping your and your employer’s Health Savings Account (HSA) contributions six months before you retire, sign up for Medicare, or apply for benefits from Social Security (or the Railroad Retirement Board) in order to ensure you avoid a tax penalty, since you are not eligible to make or receive contributions to an HSA after you have Medicare. You can still withdraw money from your HSA after you sign up for Medicare to help pay your share of costs (like deductibles, premiums, coinsurance or copayments) and other qualified healthcare expenses.
  • Please note that HSA disenrollment or contribution change will NOT happen automatically through the Insurance & Risk Management department. If you are enrolled in an HSA and need to stop receiving HSA contributions, you MUST contact Insurance & Risk Management at [email protected] to drop your HSA enrollment.
  • You can disenroll from the HSA or change your HSA contribution amount at any time during the year, but you will NOT be able to switch from a High Deductible Health Plan (HDHP) enrollment to a Copay plan enrollment without a Qualifying Life Event until the next Annual Enrollment period.

To discuss Rutherford County’s medical retirement benefits and determine your eligibility, you can schedule a Retiree Insurance appointment with the Insurance & Risk Management department. Please allow at least five business days before your appointment so we can calculate your eligibility and prepare for your appointment. We recommend discussing your medical retirement eligibility and benefits at least three months before retiring.

For more information about Medicare benefits, please visit https://www.medicare.gov/basics/get-started-with-medicare/medicare-basics. For 2026 and 2027 Rutherford County medical insurance plan documents and Notices of Creditable Prescription Drug Coverage, please see https://rutherfordcountytn.gov/medical.

Summaries of Benefits and Coverage

Rutherford County's 2027 Medical Summaries of Benefits and Coverage (SBCs) are below. Keep in mind that the Grandfathered Deductible plan is only available to those who are already enrolled in it.

• Open Access Plus High Deductible Health Plan (HDHP) with HSA

• LocalPlus High Deductible Health Plan (HDHP) with HSA
• Open Access Plus High Deductible Health Plan (HDHP) without HSA
• LocalPlus High Deductible Health Plan (HDHP) without HSA
• Open Access Plus Copay Plan
• LocalPlus Copay Plan
• Open Access Plus Grandfathered Deductible Plan
• LocalPlus Grandfathered Deductible Plan

Additional Resources

• Cigna Easy Choice Tool - A great resource to help you assess which plan is right for you and your family. Just answer a few quick questions about your needs and preferences, and see plans ranked by what matters most to you. 
• Code for premiums WITH Wellness Credit: MLSR-2783 / Code for premiums WITHOUT Wellness Credit: UOBM-0926
• Digital ID Cards - Remember that your virtual medical ID cards are accessible in myCigna, but physical copies of your medical ID cards won't be mailed to you unless you request it. Follow these steps to locate your medical ID card through the myCigna.com online portal or app.
• myCigna Health Portal - Your personalized Cigna health dashboard. Find in-network providers, keep track of your claims, and view, request, or print your ID cards all from one portal or app.
• Check Your Provider's Network Status - Not currently enrolled in a network but want to check your provider's network status? You can follow these steps to make sure your doctor is in network with the Open Access Plus (OAP) and/or LocalPlus (LP) networks. The OAP network is a broad network with higher premiums, while the LocalPlus is a more selective, but still flexible, network that has lower premiums than the OAP.
• LocalPlus Away From Home Care - Have children in college out of state? Catch the flu on vacation? The LocalPlus network isn't just local. It covers you wherever you need it.
• Convenient Telehealth Options - Find virtual Primary Care, Urgent Care, Dermatology, and Behavioral Care through MDLive covered at 100% by your medical plan, all at your fingertips.

When you enroll in a High Deductible Health Plan (HDHP), you have the opportunity to open an accompanying Health Savings Account (HSA), a tax-advantaged savings account you can use for eligible healthcare expenses.

Rutherford County contributes up to $500 or $1,000 to your HSA throughout the year depending on your enrollment, and you can make additional pre-tax payroll contributions to your HSA to supplement that amount. The funds in your HSA roll over in full every year and are yours to keep, even if you retire or leave employment with Rutherford County.

Keep in mind that you can change the amount you contribute to your HSA at any time during the year by emailing the Insurance & Risk Management Department at [email protected]. 

• HSA Quick Reference Guide - Before you choose an HDHP and enroll in a Health Savings Account (HSA), make sure you understand how an HSA works and that you're eligible for one.
• HSA Overview and Eligibility - Review for a high-level overview of the eligibility requirements and contribution limits.
• HSA FAQ - Find the answers to all of your questions about having and using an HSA.
• Assigning HSA Beneficiaries - Don't forget to designate your HSA beneficiaries through the HSA Bank portal.
• Investing Your HSA - Invest the funds in your HSA to use not just for healthcare expenses now, but also for your retirement in the future.
  
• HSA or HCFSA? - Understand the differences between a Health Savings Account (HSA) and a Healthcare Flexible Spending Account (HCFSA), so you can decide which plan is right for you.

Benefit Summaries

The 2027 dental Benefit Summaries and DHMO patient charge schedule are below.

• Option 1 DPPO
• Option 2 DPPO
• DHMO Patient Charge Schedule

Additional Resources

• Digital ID Cards - Remember that your virtual dental ID cards are accessible in myCigna, but physical copies of your dental ID cards won't be mailed to you unless you request it. Follow these steps to locate your dental ID card through the myCigna.com online portal or app.
• myCigna Health Portal - Your personalized Cigna health dashboard. Find in-network providers, keep track of your claims, and view, request, or print your ID cards all from one portal or app.
• Check Your Provider's Network Status - Not currently enrolled in a network but want to check your provider's network status? You can follow these steps to make sure your dentist is in the network you want to enroll in.
  

Benefit Summary

The 2027 vision Benefit Summary is below.

• Cigna Vision PPO

Additional Resources

• Digital ID Cards - Remember that your virtual vision ID cards are accessible in myCigna, but physical copies of your vision ID cards won't be mailed to you unless you request it. Follow these steps to locate your vision ID card through the myCigna.com online portal or app.
• Find an In-Network Provider - Check your provider's network status or search for in-network providers by ZIP code.

When you enroll in a Healthcare Flexible Spending Account (HCFSA), you make pre-tax payroll contributions toward your elected annual amount over the course of the year but have access to the entire annual amount of your election on January 1. HCFSA funds may be spent on qualified healthcare expenses as determined by the IRS.

However, HCFSAs are "use it or lose it" accounts. You can only carry over a certain amount into the next plan year ($680 in 2026; 2027 limits will be released by the IRS soon) and any amount over that limit will be forfeited.

If you carry funds over into the next plan year but enroll in a Health Savings Account (HSA) instead of the HCFSA, keep in mind that the qualified expenses on which you can spend your carryover HCFSA funds will change.

Be aware that if you enroll in a HCFSA and your spouse enrolls in a Health Savings Account (HSA), you might be creating a complicated tax situation. If this applies to you, you may want to speak with a tax advisor prior to enrolling.

• HCFSA Overview - Review how HCFSAs work and the current contribution limit.
• HealthEquity Resources for Your HCFSA - Learn more about eligible medical expenses and how you can get the most out of your HCFSA.
  
• HSA or HCFSA? - Which type of tax-advantaged account is right for you? Make sure you know the differences between a Health Savings Account (HSA) and a Healthcare Flexible Spending Account (HCFSA) before you enroll.
• HealthEquity - Flexible Benefits Plan - Summary Plan Description
  

When you enroll in a Dependent Care Flexible Spending Account (DCFSA), you make pre-tax payroll contributions toward your elected annual amount of up to $5,000. Funds become available to spend on childcare and eldercare expenses as you contribute them.

It's important to remember that DCFSAs are "use it or lose it" accounts. Any amount you have left over at the end of the year will be forfeited.

• DCFSA Overview - Review how DCFSAs work, who counts as a qualifying dependent, and the current contribution limit.
• HealthEquity Resources for Your DCFSA - Learn more about getting the most from your DCFSA and how you can use funds.
  
• HealthEquity - Flexible Benefits Plan - Summary Plan Description
  

Please use this Annual Enrollment period to ensure your beneficiaries are up to date.

Rutherford County provides a $50,000 Employee Basic Life and AD&D (Accidental Death & Dismemberment) insurance policy for all benefit-eligible employees at no cost to you, through The Standard. Coverage begins reducing in increments the year after you turn 70 years old. 

Additional life insurance you can enroll in:

Employee Supplemental Life and AD&D Insurance

You can elect additional insurance for yourself up to 5 times your salary or $750,000, whichever is less. Pricing is based on employee age. For any new or increased elections made during Annual Enrollment, you'll need to submit Medical Evidence of Insurability (MEOI) to The Standard during the benefit enrollment process. Coverage is dependent on approval by The Standard.

Spouse Basic Life and AD&D Insurance

Basic life insurance is available for your spouse or domestic partner in increments of $5,000, up to $30,000. Pricing is not based on age until the employee reaches age 70. For any new or increased elections made during Annual Enrollment, you'll need to submit Medical Evidence of Insurability (MEOI) to The Standard during the benefit enrollment process. Coverage is dependent on approval by The Standard.

Spouse Supplemental Life and AD&D Insurance

If you are enrolled in Employee Supplemental Life insurance for yourself, you can elect supplemental insurance for your spouse or domestic partner up to half of your supplemental election or $250,000, whichever is less. Pricing is based on employee age. For any new or increased elections made during Annual Enrollment, you'll need to submit Medical Evidence of Insurability (MEOI) to The Standard during the benefit enrollment process. Coverage is dependent on approval by The Standard.

Child Supplemental Life Insurance

You can elect $5,000 or $10,000 in life insurance for your child or children until they turn 26*. Only one policy is needed to cover multiple children, and pricing is not based on age or number of children covered. Medical Evidence of Insurability (MEOI) is not required.

*If your child is under 26 and disabled, you may be able to continue their coverage after they reach age 26. Contact [email protected] about continuing life insurance for a disabled child.

• Life Services Toolkit - Your employer-provided life insurance policy comes with additional resources that can help you navigate life necessities or difficult times, emotionally, financially, or legally. Find out how your life insurance can help you now.
  
• The Standard Resources for Your Life Insurance - Learn more about life insurance through The Standard and take advantage of their life insurance calculator.
  
• Travel Assistance Through The Standard - Your employer-provided life insurance comes with extra security that travels with you. With Travel Assistance, you'll be prepared as you encounter unpredictable circumstances during your trip.
• Employer-Provided Life and AD&D Insurance Summary - Class 2
• Life and AD&D Insurance Certificate - Class 2

*Airport Authority, Community Care, and RCECD employees are not eligible for this benefit.*

Short term disability insurance can replace a portion of your income for up to six months if you become disabled and are not able to work. You can insure between 30-60% of your income with a 0/7-day (Option 1) or 30/30-day (Option 2) Benefit Waiting Period (accidental injury/physical disease, mental health issue, or pregnancy).

Extended Benefit Waiting Period For New or Increased Elections

If you enroll in a new election or elect to change to an option with a higher benefit amount than your current election, the increase will be subject to the 60-day Extended Benefit Waiting Period. Additionally, if you enroll in Option 1 after having been enrolled in Option 2 for at least 12 months, you will retain your 30-day waiting period for the 12-month period beginning on the effective date of the change. Thereafter, for any period of continuous coverage, only the 7-day benefit waiting period under Option 1 will apply.

How Rutherford County Works With Your Short Term Disability

It is important to know that The Standard calculates short term disability benefits to not put you over 100% of your usual weekly pay between your short term disability benefit and any other Deductible Income you’re receiving, which includes but is not limited to paid leave from Rutherford County. For more information about other types of Deductible Income that may reduce your benefit, please review the Coverage Summary and Insurance Certificate below.

For this reason, Rutherford County allows employees who are enrolled in short term disability and file short term disability claims when they are on a disability-related leave to choose to receive a reduced percentage of their salary from Rutherford County for the period in which their short term disability claims are approved and benefits are payable. If you choose to opt into the reduced pay benefit from Rutherford County, you'll receive the complementary percentage of your paid leave so that you can receive the full elected percentage of your short term disability election from The Standard during that time. For example, if you enroll in 40% short term disability, you can opt into receiving 60% of your paid leave while eligible for a reduced salary from Rutherford County. This allows you to maximize your short term disability benefit and extend your paid leave while you are out of work.

• Short Term Disability Coverage Summary - Review the way Short Term Disability insurance works, how it pays benefits, and the types of waiting periods your election may be subject to.

• The Standard Resources for Your Disability Insurance - Learn more about Short Term Disability insurance through The Standard and use their coverage calculator to estimate how much coverage is right for you.
• The Standard - Short Term Disability Insurance Certificate

Accident insurance can supplement your budget when the unexpected strikes you or your family. Benefit payments are made directly to you and can be applied to healthcare or daily life expenses, such as mortgage, rent, or groceries.

Ground and air emergency ambulance transport coverage is included in Rutherford County's Securian accident insurance, through MASA

• Accident Insurance Overview - Learn how accident insurance works, when you might use it, and the benefit amounts for covered injuries and services.
• MASA Emergency Transport Coverage - Your accident insurance comes with additional coverage for ground and air emergency ambulance transport. Learn how MASA can protect you and your family from unexpected out-of-pocket costs after an emergency.
• Securian Resources for Your Accident Insurance - Learn more about accident insurance through Securian and how to file a claim.
• Securian Financial - Accident Insurance Certificate
• MASA - Emergency Transport Protection Member Services Agreement

Critical Illness insurance can provide you with a one-time lump sum when you or a member of your family is diagnosed with a covered illness. Covered illnesses include cancer, heart attack, stroke, kidney failure, Alzheimer's disease, and more. See the Critical Illness Insurance Certificate below for a full list of covered illnesses.

Securian provides a Health and Wellness Benefit of $50 per covered individual per calendar year for completing a covered screening or prevention measure, such as an annual physical, dental cleaning, or eye exam.

• Critical Illness Insurance Overview - Learn how Critical Illness insurance works, when you could use it, and review a summary of covered illnesses and benefit amounts.
• Securian Resources for Your Critical Illness Insurance - Learn more through Securian about critical illness coverage, the Health and Wellness Benefit, and how to file a claim.
• Securian Financial - Critical Illness Insurance Certificate

You do not need to enroll in the Employee Assistance Program (EAP). Rutherford County provides an EAP service through AllOne Health for all full time, part time, and seasonal employees and their household members and dependents living out of the home. Services provided by AllOne Health are completely confidential. The County is not provided with names of individuals who use the service.

AllOne Health EAP is designed to help with problems that would otherwise hinder your day-to-day life. Stress, whether personal, familial, or financial, can affect you mentally, emotionally, and physically, and we want to provide resources to allow you to live a healthy and balanced life.

You can access AllOne Health at 800-451-1834 or through their portal or app:
https://portal.allonehealth.com/
Company Code: LS0161

Learn more about the Rutherford County's EAP here.

Annual Notices

Health Insurance Marketplace Notice

Medicare Part D Creditable Coverage Notice

Medicaid and CHIP Notice