FOP Miami 2023 Member Benefits and Enrollment Details

Fraternal Order of Police Miami 2023 Member Benefits

Agenda Eligibility Key Information Medical Plan Overview Enrollment Process Questions & Answers

Eligibility Full-time members working 30 or more hours per week are eligible to enroll in benefits. Eligible dependents: Spouse: to whom you are legally married Domestic Partner: of same or opposite sex Child: biological, legally adopted, a child for whom you have legal guardianship, child with a qualified medical child support order, or a child placed in anticipation of adoption Step-child: as long as you remain married or until child turns 26 Child Over Age 26: must be unable to self-support due to disability

Eligibility Retirees and Medicare Eligible Members Medicare-eligible members: You must enroll in Medicare Part A &B. Includes all members who are eligible due to age, disease, disability or any other reason. If you are not enrolled, you will be responsible for primary cost of service. Medicare Cross-Over members: Upon obtaining Medicare, you must notify Trust Office. Medicare Primary members: Do not have to obtain pre-certification for services covered by Medicare. If your dependent is currently enrolled in the Plan and you remove them from the Plan after they have reached Medicare Eligibility, they CANNOT be reenrolled in the Plan.

Eligibility Continued When coverage begins: First pay period after date of swearing in. All elections in effect for entire plan year unless you experience a qualified family status change. When you can enroll: Upon date of swearing in During annual open enrollment period Within 60 days of a qualified family status change Qualified Family Status Change: Any change that may impact you or your dependent s eligibility. Change in legal marital status (i.e. marriage, divorce, death of spouse) Change in number of dependents (i.e. birth, adoption, death of dependent) Change in employment status (spouse loses job, etc) Notification Requirement: You have 60 days from date of Qualified Family Status Change to request the changes to your benefits. Failure to request a change of status within 60 days may result in your having to wait until the next open enrollment period to make your change.

Key Information for 2023 You have 60 days from the time of a qualifying event to add or remove dependents. Your responsibilities to Meritain: To read your Explanation of Benefits (EOB) and provide any information being requested to Meritain. Failure will result in your claim not being processed. To advise Meritain whether or not you have other insurance on a yearly basis. Failure will result in claims you may incur to not be processed. For providing your insurance card for Meritain to your providers. Failure may result in delay in the processing of claims. To create an account and log into the Meritain website at www.meritain.com. The site includes important information regarding your benefits. The site also includes a Summary of Benefits and Coverage (SBC), outlining the Plan s coverages. A hard copy can be sent to you upon request. You have 180 days to appeal a denied claim. Instructions on filing an appeal are included in the explanation of benefits (EOB) provided by Meritain.

Key Information for 2023 - Continued Your responsibilities to the Trust: If you get divorced or terminate your domestic partnership, you MUST notify the Trust immediately. You are responsible to notify the Trust if a dependent is no longer eligible due to divorce, over-age dependent, a step-child is no longer the Employee s dependent, etc. It is also your responsibility to notify the Trust if a dependent turns 26 or 65. Any contributions paid for a non-eligible dependent will not be reimbursed. You are responsible for notifying the Trust if you have a change of address. If we do not have your correct address, you will not receive important insurance information. If you are an active officer and develop a condition or impairment which may have been caused by or is a result of having tuberculosis, heart disease or hypertension, you must immediately file a report of injury. Any current employee retiring on or after February 1, 2018, must have been enrolled in the health plan for at least ten years prior to separation of service. Any current employee who retires from service between February 1, 2023, and February 1, 2028, will be eligible for benefits only if they were enrolled in the health plan during open enrollment for the 2018 plan year. If at any time you have questions about your benefits, we encourage you to contact the Trust Office at 305-372-4605 or come by Room 324 in the Central Station.

Medical Plan Overview FOP INN PLAN (HMO) Restricts members to a physician or facility that is in-network. Selection of a primary care physician (PCP) is not required, and no referrals are necessary to see a specialist. Benefits for out-of-network services are limited to Life-Threatening Emergency Care only. If you go out-of-network for NON Life-Threatening Emergency Care, you will be responsible for the entire cost of the benefits. FOP POS PLAN (POS) Offers members in- and out-of-network benefits. Selection of a primary care physician (PCP) is not required, and no referrals are necessary to see a specialist. Out-of-network providers will always have a higher cost to members. IMPORTANT: THE PLAN HAS PRE-CERTIFICATION REQUIREMENTS FOR CERTAIN PROCEDURES AND ADMISSIONS, INCLUDING EMERGENCIES. IF YOU ARE A RESIDENT OF NORTH CAROLINA, BY STATE LAW, YOU CAN ONLY ENROLL IN THE POS PLAN. To find in-network providers, visit www.aetna.com or www.meritain.com YOUR NETWORK: Choice POS II Network

Rx Plan Overview The Plan s prescription provider is Caremark. Caremark s information appears on your Aetna/Meritain member identification card. ALL maintenance medications (i.e. birth control pills, thyroid medication, diabetic medication, etc.) MUST be ordered through CVS/Caremark and be delivered via mail to your home or picked up at your local CVS pharmacy. Any member prescribed a specialty medication MUST enroll in Prudent Rx. Otherwise, the member will have to pay 100% of the cost of the medication. Prudent Rx may be contacted at 800-578-4403.

Enrollment Process Complete an Enrollment Card Enrolling a dependent to the plan, you must provide the following items: Complete an Enrollment Card Provide proof of relationship (birth certificate, marriage certificate, adoption paperwork) Provide dependent s social security number (SSN) Active members will become effective at the beginning of the pay period after all documents are received. Retired members will become effective at the beginning of the month after all documents are received.

Aetna Health Inc. MEDICAL/RX

Medical/Rx Definitions Flat dollar amount member is responsible for at the time of service. The plan usually pays 100% of the remaining balance. Copay Amount member is responsible for before the plan pays for certain services. Deductible Percentage of payment shared between the member and the plan for certain services after the deductible has been met. Coinsurance Member total payments for deductible, coinsurance and copays to stated maximum per plan year. Once reached, the plan will pay 100% for eligible expenses for the rest of the plan year. Out-of-Pocket Maximum A type of health insurance plan that limits coverage to care from providers who work for or contract with the HMO. Because of the agreed-upon payment level, an HMO usually offers lower costs than other types of insurance plans. Health Maintenance Organization (HMO) A type of health insurance plan in which you pay less if you use doctors, hospitals, and other health care providers that are in-network. At each point you need healthcare service, you can decide whether to stay in-network or not. Point-of-Service (POS) Medical and pharmacy providers that have contracted with the plan to provide lower out-of-pocket costs for members. Network Provider

Medical Plan Highlights FOP Miami Insurance Trust offers medical benefits through Meritain Health, an Aetna Company. The chart below illustrates a brief description of these plans. Please refer to the Summary Plan Description (SPD) for complete plan details. To locate providers within your network, visit www.aetna.com/docfind/custom/mymeritain. INN PLAN: AETNA CHOICE POINT OF SERVICE II POS PLAN: AETNA CHOICE POINT OF SERVICE II Network FOP INN PLAN (In Network) FOP POS PLAN (In Network) $0 per individual $0 per family $0 per individual $0 per family Annual Deductible $2,000 per individual $17,400 per family $2,000 per individual $17,400 per family Annual Out-of-Pocket Maximum Plan Coinsurance 100% 100% Office Visit Covered 100% Covered 100% Independent Lab: Covered 100% after $30 copay X-Ray: Covered 100% after $100 copay Independent Lab: Covered 100% after $30 copay X-Ray: Covered 100% after $100 copay Lab & X-ray Advanced Imaging / Complex Radiology Covered 100% after $100 copay Covered 100% after $100 copay Inpatient Hospital Facility Covered 100% after $100 copay Covered 100% after $100 copay Emergency Room Covered 100% after $200 copay Covered 100% after $200 copay OUT-OF-NETWORK BENEFITS Annual Deductible $1,000,000 $0 $7,500 per individual $30,000 per family Annual Out-of-Pocket Maximum Unlimited Plan Coinsurance N/A 70%

Medical Plan Highlights PREVENTIVE CARE Covered at 100% in-network on all medical plans. This includes the office visit and any other eligible item or received at the same time, whether billed at the same time or separately. Routine preventive for Children* Appropriate screenings based on gender and age Newborn visits Tuberculosis testing Anemia testing Lead exposure Pelvic exam and pap test Development and behavior Lipid profile Depression Obesity and counseling Nutrition counseling Routine preventive for Adults Appropriate screenings based on gender and age Lipid profile Diabetes Pelvic exam and pap testing Breast exam and mammogram Bone density testing Colonoscopy Aortic aneurysm *Children to age 19

Rx Plan Highlights FOP INN PLAN (In Network) FOP POS PLAN (In Network) Rx Deductible $0 $0 Retail Prescription Drugs: 30-day supply Generic $10 copay $10 copay Formulary Drug $25 copay $25 copay Non-Formulary Drug $40 copay $40 copay Preventive Drug (as classified by HHS) $0 copay $0 copay Specialty Pharmacy Program: 30-day supply* Generic $10 copay $10 copay Formulary Drug $25 copay $25 copay Non-Formulary Drug $40 copay $40 copay CVS Maintenance Choice Mandatory / Mail-Order Prescriptions: 90-day supply Generic $20 copay $20 copay Formulary Drug $50 copay $50 copay Non-Formulary Drug $80 copay $80 copay Preventive Drug (as classified by HHS) $0 copay $0 copay *Specialty Drugs MUST be obtained directly from the specialty pharmacy after one refill at the retail pharmacy.

How do I Maximize my Benefits? Am I using in-network facilities and providers? Do I know the urgent care facilities near my home for minor emergencies? Have I asked my doctor or pharmacist for lower cost prescription alternatives or shopped around pharmacies for lower prices? Have my family and I had our annual preventive services performed? Do I know where I stand regarding my deductible and coinsurance before services are received? Have I checked my Explanation of Benefits (EOB) to compare it to provider charges?

ANCILLARY COVERAGES

Basic Life and AD&D FOP Miami Insurance Trust will continue to provide its eligible employees Basic Life and AD&D insurance through Reliance Standard. This benefit guarantees that loved ones or other designated survivor(s), receive part of an employee s benefits after a death. Please be sure to review and update your beneficiary information as needed; does not have to be done during Open Enrollment. Reliance Standard Basic Life and AD&D Benefit Description** Eligibility All Active Full-Time Employees Benefit Amount $50,000 Benefit Maximum $50,000 Benefits Will Reduce No Benefit Reductions AD&D Equal to Benefit Amount Premium Cost Employer Paid Benefit Reliance Standard Basic Life and AD&D Retirees Benefit Description** Eligibility* Benefit Amount $1,000 Increments Benefit Maximum $15,000 10% per year starting at age 61; final reduction at age 65 Benefits Will Reduce AD&D Equal to Benefit Amount Premium Cost Employee Paid Benefit * All coverage subject to Evidence of Insurability. **This chart is intended only to highlight the benefits available and should not be relied upon to fully determine your coverage. If the above illustration of benefits conflicts in any way with the Summary Plan Description (SPD), the SPD shall prevail.

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