2023 Employee Benefits Guide | Page 5

Pharmacy

Prescriptions are managed by Navitus . Navitus provides you with a large network of pharmacies throughout the nation . Mail Order is available for 90-day prescriptions and provided by Birdi . The Specialty Drug Program is provided by Lumicera . The Prescription Drug List and the Preventive Drug List are updated bi-annually and posted on our Benefits Portal .

Wellness

Our Wellness Program is called Wellness for Life . If you participate in the wellness program you receive a $ 20 discount on your biweekly premium . That ' s a savings of $ 520 per year ! The Wellness Program consists of participation in medical screenings , medical visits , educational classes , and certain activities . Please refer to the Wellness Form on our Benefits Portal for detailed information and instructions .
Employees enrolled in a Medical Plan must self-report as a tobacco user if they have used tobacco an average of four or more times per week within the past 12 months . Tobacco users pay an extra $ 25 towards their medical premium . Enrolled employees have access to $ 0 copay tobacco cessation products under the prescription program . If you participate in a Tobacco Cessation Program , you may submit documentation to stop the $ 25 surcharge . And you ’ ll also earn Wellness Points !

Dental

Dental Insurance is provided by Delta Dental . Delta Dental ' s customer service team can assist you with finding dentists , clarifying coverage and understanding your bill . The City offers three ( 3 ) plans - the DeltaCare USA DHMO , the Low Option PPO , and the High Option PPO . The DeltaCare USA DHMO Plan uses a smaller Texasbased network and requires that you select a primary dentist within the network . The PPO Plans provide you with a larger network of dental providers throughout the nation . Please see below for the Dental Plan Summary :
Key Dental Benefits
DeltaCare USA DHMO
Low Option PPO
High Option PPO
Dental Coinsurance Class A - Preventive Services
refer to fee schedule
20 %
$ 0
Class B - Basic Services
refer to fee schedule
40 % after deductible
20 % after deductible
Class C - Major Services
refer to fee schedule
50 % after deductible
50 % after deductible
Class D - Orthodontia
refer to fee schedule
none
50 %
Dental Deductibles Class A - Preventive Services
none
none
none
Class B - Basic Services
none
$ 50 per indiv . / $ 150 family max
$ 50 per indiv . / $ 150 family max
Class C - Major Services
none
$ 50 per indiv . / $ 150 family max
$ 50 per indiv . / $ 150 family max
Class D - Orthodontia
none
none
none
Dental Maximums Class A + B + C
none
$ 750 per indiv . / per plan year
$ 1,750 per indiv . / per plan year
Class D
none
none
$ 1,000 per indiv . / per lifetime
Waiting Periods Class A + B + C + D
none
none
none