following the date you submit the Benefits Enrollment Form not qualify to be claimed on your federal income tax return, retirement system, you must call the Employee Benefits To be eligible to participate in the HSA, you must meet all the requirements below as Current Texas law states a legally married spouse
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Medical l Vision l Dental l Life Insurance l Disability l FSA l Wellness2020
Employee Benets Guide
Contact Information ...............................................2 Bene?ts Guide Information ....................................4 Bene?ts Eligibility ...................................................5 Employee Eligibility ................................................6 Dependent Eligibility ..............................................7 Dependent Documentation .....................................8 Persons Not Eligible ................................................8 Coverage Information .............................................9 Plan Choices ............................................................11 Medical Plans ..........................................................12 Medical Rates ..........................................................12 CDHP w/HSA ........................................................13 CDHP w/HSA Schedule of Benets .......................15 PPO & HMO Schedule of Benets ........................16 PPO & HMO Vision Benets ................................18 PPO & HMO Pharmacy Benets ...........................18 How to Use Mail Order ..........................................19 Diabetic Bundling ...................................................19 Medical Programs ....................................................20 Vision Plan ..............................................................21 Dental Assistance Plan.............................................22 Group Term Life Insurance .....................................23 Employee ................................................................23 Dependent ..............................................................25 Supplemental Life Insurance Worksheet ..................26 Short Term Disability ..............................................27 Long Term Disability ..............................................28 Long Term Disability Worksheet .............................29 Flexible Spending Account (FSA) ............................30 Health Care FSA .....................................................30 Dependent Care FSA ..............................................30 Health Care FSA Worksheet ....................................32 Dependent Care FSA Worksheet .............................33 Legal Insurance Plan................................................34 Employee Wellness ...................................................35 HealthyConnections ...............................................36 Additional Bene?ts ..................................................39 Employee Assistance Program ..................................40 Employee Communications ....................................41 Tuition Reimbursement Program ............................41 Service Incentive Pay ...............................................41 Direct Deposit .........................................................41 Employee Discount Page .........................................42 Smart Commute Rewards .......................................42 Aordable Small Dollar Loans .................................42 Homebuyer Assistance Program ..............................42 Child Care Program ................................................43 Maternity & Lactation Support ...............................43 Commuter Program ................................................43 Leave Programs .......................................................44 Veterans Services Oce ...........................................47 Workers" Compensation ..........................................48 Employee Retirement Systems .................................49 Deferred Compensation Plan ..................................49 Social Security .........................................................49 Important Bene?ts Information .............................50 Summary of Benets and Coverage .........................51 ADA Compliance ....................................................51 Governing Plan .......................................................51 HIPAA ....................................................................51 Women's Health and Cancer Rights Act .................52 Patient Protection and Aordable Care Act .............52 COBRA ..................................................................52 Continuation of Coverage for Domestic Partners ....53 USERRA Continuation of Coverage .......................53 Surviving Dependent Coverage ...............................53 Surviving Family/Work-Related Coverage ...............53 Your Prescription Drug Coverage and Medicare ......54 Health Insurance Marketplace .................................55 Notice to Enrollees ..................................................57 Premium Assistance Under Medicaid and CHIP .....57 Corporate Human Resources Department ...............58 e City of Austin is committed to compliance with the Americans with Disabilities Act.Call the Human Resources Department at 512-974-3400 (Voice) or 800-735-2989 (Relay Texas TTY number) for more information.
1City of Austin
Human Resources Department
Employee Benets Division
Bene?ts sta? are available to answer questions you have about your benets.Phone Number:
512-974-3284
Outlook Email:
HRD, Benets
Email:
HRD.Benets@austintexas.gov
Fax Number: 512-974-3420
For your convenience, make an appointment before visiting our oce.Oce Hours:
7:30 a.m. to 5:00 p.m.
Oce Location:
505 Barton Springs Road, Suite 600
Online Resources
Resources are available at cityspace, the City"s intranet website, or on the Internet at austintexas.gov/benets. Scan the QR code below for easy access to the EmployeeBenets website.
BlueCross BlueShield
Medical Plans
Member Service phone number:
888-907-7880
24/7 NurseLine phone number:
800-581-0368
HSA Bank phone number:
855-731-5220
To ?nd a medical provider, visit bcbstx.com/coa.
1. Under Find a Doctor," click on View provider
information.2. Under Provider Finder," click on HMO Plan,
PPO Plan, or HSA Plan.
3. Click on Browse by Category and select the type of
medical care you are searching for: Medical Care,Urgent Care Center, or Behavioral Health.
To view the prescription formulary, Explanation of Benets, and print a temporary ID card, visit bcbstx.com/coa.To register, follow these steps:
1.Click Log in.
2.Click Register Now.
3.Follow the prompts to register.
4. Enter information from your ID card. If you do not have your ID card, you can call 888-907-7880. 2City of Austin Employees'
Retirement System (COAERS)
6836 Austin Center Blvd., Suite 190
Austin, TX 78731
Phone Number:
512-458-2551
Fax Number: 512-458-5650
Website:
coaers.orgAustin Fire Fighters Relief
and Retirement Fund (AFRS)4101 Parkstone Heights Dr.,
Suite 270, Austin, TX 78746
Phone Number:
512-454-9567
Fax Number: 512-453-7197
Website:
afrs.orgCity of Austin Police
Retirement System (PRS)
2520 South IH-35, Suite 100
Austin, TX 78704
Phone Number:
512-416-7672
Fax Number: 512-416-7138
Website:
ausprs.orgRetirement Systems
3Davis Vision
Vision Plan
Toll-Free Number:
888-445-2290
To view bene?ts, locate a provider, and check claim status, visit davisvision.com. To register, follow these steps:1. Click Member.
2. Click Register new account.
3. Enter information from your ID card.
4. Create a username, password, and security
question.5. Click Register.
For non-members, click the Member link and enter 2481 forClient Code.
CompuSys/Erisa Group Inc. (Erisa)
Dental Assistance Plan
COBRA Administration
Child Care Reimbursements
Phone Number:
512-250-9397
Toll-Free Number:
800-933-7472
Fax Number:
512-250-2937
Child Care Assistance Email: COADCAA@cserisa.com
City of Austin Dental Plan
To view claim activity, visit coadentalplan.com.
To register, follow these steps:
1. Click Sign In.
2. Enter your ID number from your ID card.
3. Leave password blank.
4. Click Sign In.
5. Follow the instructions to complete registration.
Austin Deferred Compensation Plan
457 Plan (Empower Retirement)
Toll-Free Number: 866-613-6189
Email: dcaustin@empower-retirement.com
To view and manage your account, visit dcaustin.com.To enroll, click Register.
ARAGGroup Legal Plan
Toll-Free Number: 800-247-4184
Relay Texas Number: 800-383-4184
To view covered services and to locate a participating attorney, visit ARAGlegal.com/myinfo. To register, follow these steps:1. Click Member Login.
2. Click Create account.
3. Enter your member ID number from your ID card and
your home address ZIP code and click Continue.4. Enter your email address twice and click Continue.
5. Enter the verication code sent to your email and click
Submit Code.
6. Create a password and click Login.
For non-members, enter 17886COA for Access Code.
Deer Oaks
Employee Assistance Program
Toll-Free Phone Number:
866-228-2542
Relay Texas Number:
800-735-2989
Toll-Free Teen Helpline:
866-228-2542
To view a list of free webinars and counseling services, visit deeroakseap.com. To access, follow these steps:1. Click Member Login.
2. Type austintexas.gov for the username and password.
3. Click Login.
Total Administrative Services Corporation
(TASC)Flexible Spending Accounts (FSA) & Debit Card
Phone Number:
800-422-4661
Fax Number:
608-661-9601
To view activity, visit tasconline.com. To register:1. Click Sign in to Universal Bene?t Account.
2. Under the Participants sign in, click Sign up to establish
your new account.3. Enter your email and create a password.
4. Enter the verication code sent to your email and click
Verify.
5. Conrm your name and email address and click Continue.
6. Agree to the Terms of Use.
7. Enter your mobile number. Enter the authentication code
sent to your phone and click Verify.Bene?ts Guide Information
City of Austin employees have access to benets approved by the City Council each year as part of the budget process. e
benets and services oered by the City may be changed or end at any time. ese benets are not a guarantee of your
employment with the City.is Guide is designed to help you understand your benets. Review this material carefully before making your enrollment
decisions. Your rights are governed by each Plan Instrument, which may be a plan document, evidence of coverage, certicate
of coverage or contract. If there is a conict between the provisions of the plan you selected and this Guide, the terms of the
plan govern.For detailed information about the plans, refer to each plan instrument, contact the Employee Benets Division of the Human