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Benefits Guide

Eligibility

Waiving Coverage

Benefits Eligible Employees:

Full-time employees working 30 or more hours a week.

Eligible family members may be enrolled under certain plans when elected by the employee.

Eligible family members include:

Your legally married spouse

Your unmarried children who are your natural children, stepchildren, adopted children, or children for whom you have legal custody (age restrictions may apply) up to the age of 26. Disabled children age 26 or older who meet certain criteria may continue on your health coverage

When Do Benefits Begin?

The effective date of coverage for benefits depends on your hire date. Typically, benefits will begin following 90 calendar days of employment.

For all benefits, employees must be actively at work on the effective date of coverage. New hires must complete enrollment within 90 days of hire date, prior to effective date of coverage.

Supporting documentation is required to be submitted to process qualifying life events

Employees who choose to waive/decline any benefits for themselves or their dependents will not be eligible to enroll until open enrollment for each plan without a Qualifying Life Event.

Additional Rules:

Specific employee and dependent eligibility rules are governed by each plan’s policy document/certificate; available on the employee benefits website, or by contacting Campus Benefits.

When Do Benefits End?

Upon termination of employment, the benefits end date may vary by benefit, but typically end at the end of your last month of employment coinciding with your last payroll deduction. Please consult with a Campus Benefits advisor on your specific end date and portability options for any current coverages.

Important Notes:

This guide is presented for illustrative purposes only and is not intended to offer insurance advice. It is important to review each benefit’s summary plan description (SPD), benefit summaries, and other carrier materials before making any selections.

Remember: Review the plan options and/or update beneficiaries annually for all benefits including Basic Life and Voluntary Term Life & AD&D.

Carefully review your plan options and consider which ones best meet your needs. Make elections during the assigned enrollment period to receive coverage for the coming year. Enrollment requires dependent information, including Social Security Numbers and dates of birth.

Disclaimer: The Benefits Guide is provided for illustrative purposes only and actual benefits and/or premiums may change after printing. Eligibility, benefits, limitations, services, premiums, claims processes and all other features & plan designs are offered and governed exclusively by the insurance provider or vendor contract and associated Summary Plan Description (SPD). All employees should review carrier documents posted on your employer’s benefits website or request documents before electing coverage.

When can I change my benefits?

Employee benefit elections are allowed as a new hire and during the annual open enrollment period The selected benefits will remain in effect throughout the plan year Plan year is from June 1st to December 31st. (Starting in 2027, plan year will be January 1 to December 31st.) st

Each year, during Open Enrollment, you will have the opportunity to make changes to your benefit elections for yourself and your covered dependents. Outside of Open Enrollment, you must experience a qualifying event that satisfies federal regulations outlined below:

Marriage, legal separation or divorce

Birth or adoption of a child

Death of a covered dependent

Loss or gain of other coverage (e.g. spouse loses job-based coverage)

Change in employment status (e.g. full-time to part-time or vice versa)

Change in dependent eligibility (e.g. child turns 26 and ages out of coverage)

Relocation that affects coverage options (e.g. moving out of a plan’s service area)

Court order requiring coverage for a dependent (e.g. through legal guardianship or custody)

Entitlement to Medicare

IMPORTANT NOTE: You will need to submit supporting documentation to process your life event. Please keep any records of the above occurrences.

Wellness and Health Management: Preventive Care

Understanding the full value of covered benefits allows you to maintain good health and build healthy habits.

With Cigna Healthcare, getting and staying healthy is important. That’s why most health plans include coverage for eligible preventive care services at no additional cost to you, when you receive them from a provider who participates in your plan’s network. This means no out-of-pocket costs to you. Covered preventive care services can include, but are not limited to:

Health Insurance 101

In-Network vs. Out-of-Network

In-Network providers have contracts with health plans to offer services at discounted rates. Out-of-Network providers are not contracted and rates are higher.

Explanation of Benefits (EOB)

A statement from the insurance provider showing what was billed, what the plan paid, and what you may still owe. An EOB is not a bill.

Summary of Benefits and Coverage (SBC)

A standardized overview of what the plan covers, costs, and examples of how the plan would pay for common medical situations.

Qualifying Life Event (QLE)

Qualified life change that allows midyear benefit changes.

Reasonable & Customary

Typical cost for services in your area.

Before enrolling, take a moment to review these key terms to better understand and navigate the benefits options with confidence. See your specific plan summary for additional details.

Premium

Amount you pay for coverage, which is separate from the deductible and out-of-pocket maximum.

Copayment

A fixed amount you pay for services that counts towards your out-ofpocket maximum, not the deductible.

Deductible

Amount paid for covered services before your insurance plan starts to pay on your behalf.

Coinsurance

The percentage paid after meeting the deductible.

Out-of-Pocket Maximum (OOPM)

The highest amount paid annually for covered services. Afterwards, the plan pays 100% (with minimal exceptions).

Preventive Care

Routine services like check-ups, immunizations, and screenings for adults and children.

Service Hub/Support Center

Campus Benefits is your dedicated advocate for all your voluntary benefits.

What We Can Help You With:

Evidence of Insurability

Qualified Life Event Changes

Requests

Benefit Questions

COBRA Information

How to File a Claim:

Typically medical, dental, and vision claims will be submitted by your providers. The instructions below are for filing other benefit claims.

Contact Campus Benefits via phone or email

Work with Campus Benefits’ claims specialist to complete the necessary paperwork

Submit the necessary paperwork to Campus Benefits via the secure upload

Secure upload located at: www.cityofcorneliabenefits.com

Enrollment in Benefits - Take Action

It is important to review your benefit elections every single year, even if not making changes to ensure your benefits meet your needs.

All benefits can be enrolled in one system.

Campus Benefits

Enrollment

New User Registration

Step 1: Visit www.cityofcorneliabenefits.com

Need help? Click Campus Connect tab to send in questions OR call 1.866.433.7661, opt. 5

1. Register as a new user and enter: First Name

Last Name

Company Identifier: COC26 PIN: Last 4 Digits of SSN

Birthdate

2.Click Next

3. Create login credentials (see FAQ)

4 Click Register then Login

5. Enter Username and Password

Step 2: Click Enroll/Login tab and complete your enrollment Still Need Help?

6. Click Start Benefits to begin enrollment

Frequently Asked Questions

What is my username?

Important Notes:

Plan Year is 6/1 - 12/31

Annual open enrollment occurs in the spring (May)

After the 2026 enrollment, annual enrollment will occur each fall and the Plan Year will be 1/1 - 12/31

Contact Campus Benefits

Email: mybenefits@campusbenefits.com

Call: 1.866.433.7661, opt. 5

The default username is your work email or the email on file with HR, unless you have changed it.

What is my password?

Create or reset your password on the login page. It must be at least 6 characters and include a number and symbol. Disclaimer: The

MyCigna Benefits

OR: Download the myCigna app

Need help? Refer to the Cigna section of the guide for additional details OR call Cigna at 888.806.5094. About the Cigna One Guide team:

During the enrollment period, you can call the Cigna One Guide team at 888.806.5094 Your personal guide will help you:

• Understand the basics of health coverage

• Explain the health plan available to you

• Check if your doctors are in-network

• Get answers to plan or network questions

Scan QR code with your phone camera and click the link on your screen to access the myCigna app.

After enrollment, One Guide offers ongoing support.

Cigna’s personal guides can help you: Get care

Know your coverage and how it works

Find an in-network provider, lab or urgent care center

Connect with health coaches and more Stay on track with appointments and preventive care Get support for complex health situations

Save and earn

Maximize your benefits. Get cost estimates and avoid surprise expenses. Check account balances and claim activity.

Once your plan is active, you can click, call or chat. Log in to myCigna.com or the myCigna app. Connect with us by:

Click to chat. Live chat assistance is available from 9:00 a.m. to 8:00 p.m. (EST). Call us. We're here for you 24/7 using the number on your ID card.

Disclaimer: The

Medical Plan (Cigna)

The table below is a high level overview, for official details and plan information please review the Cigna Summary of Benefits & Coverage for details.

Physician Services - Office Visits Primary Care Physician (PCP) Office Visit and Virtual Physician Services

Care Office Visit, Preventive Services, and Immunizations

Care (see virtual care page for more information)

Emergency Room (Includes ER Physician Charges, Lab and Radiology including Advanced Radiological Imaging (ARI) (Per visit copay is waived if admitted)

Laboratory and Radiology Services

Facility (Lab and Radiology)

Speech Therapy, Hearing Therapy, Occupational Therapy (Limit 20 visits)

Care (Limit 20 visits)

This plan uses a provider network. You will pay less if you use a provider in the plan’s network. You will pay the most if you use an out-of-network provider, and you might receive a bill from a provider for the difference between the provider’s charge and what your plan pays (balance billing). Be aware your network provider might use an out-of-network provider for some services (such as lab work). Check with your provider before you get services. See www.cigna.com or call 1-866-494-2111 for a list of network providers.

Virtual Care Benefits (Cigna)

Virtual care is making access to high-quality healthcare more convenient and affordable for you and every covered member of your family. That’s why Cigna Healthcare has partnered with MDLIVE to offer a broad suite of convenient virtual care options available by phone or video, and in English or Spanish.

Virtual Care Benefits (please see Summary of Benefits and Coverage for full details)

Plan Highlights

Primary Care

Easy, fast appointments, referrals, prescriptions, lab work and diagnostic tests

Virtual primary care through MDLIVE is only available for Cigna Healthcare medical members aged 18 and older.

Covered at 100% on the City of Cornelia Plan.

Urgent Care

Available via E-Treatment, phone or video.

Covered at 100% on the City of Cornelia Plan.

Dermatology

Fast, customized care for skin, hair, and nail conditions – no appointment required

Virtual dermatological visits through MDLIVE are completed via asynchronous messaging. Diagnoses requiring testing cannot be confirmed. Customers will be referred to seek in-person care. Treatment plans will be completed within a maximum of 3 business days, but usually within 24 hours.

Behavioral Care

Talk therapy and psychiatry from the privacy of home, with no waiting rooms

It’s easy to connect to care.

Access MDLIVE by logging into myCigna.com or the myCigna App.

Find the Talk to a Doctor button on the homepage You may have to scroll down

Select the type of virtual care you needMedical or Counseling Estimated cost will be shown

Schedule your visit today OR call MDLIVE at 888.726.3171 when you need virtual care

Preventive care and wellness screenings available at no additional cost to identify conditions early (Appointments are required. For customers who have a non-zero preventive care benefit, MDLIVE virtual wellness screenings will not cost $0 and will follow their preventive benefit.)

Manage chronic conditions and establish a relationship with the same primary care provider (PCP) through routine care. Receive orders for imaging scans, biometrics, and blood work at local facilities

Convenient, affordable alternative to urgent care centers and the emergency room

Care for many minor illnesses and injuries, such as infections, cold & flu, and sinus problems

Includes pediatric care, allowing your child to be seen quickly and from the comfort of their home

Care for common skin, hair and nail conditions including acne, eczema, psoriasis, rosacea, suspicious spots and more Upload photos and describe symptoms for board-certified dermatologists to review

Diagnosis and customized treatment plan, usually within 24 hours

Access to licensed therapists and board-certified psychiatrists

Schedule an appointment that works for you and have recurring sessions with the same provider

Care for topics such as anxiety, stress, life changes, grief and depression

Medical Plan Per Pay Period Rates

City of Cornelia pays 100% of employee only rates and 50% of dependent coverage

Pharmacy Benefits (Cigna)

The table below is a high level overview, for official details and plan information please review the Cigna Summary of Benefits & Coverage for details.

Pharmacy Benefits (please see Summary of Benefits and Coverage for full details)

Generic Drugs (Tier 1)

Preferred Brand Drugs (Tier 2)

Non-Preferred Brand Drugs (Tier 3)

Specialty Drugs (Tier 4)

Prescription Drug List:

$15 copay/prescription (retail 30 days),

$15 copay/prescription (retail & home delivery 90 days)

Deductible does not apply

$35 copay/prescription (retail 30 days),

$70 copay/prescription (retail & home delivery 90 days)

Deductible does not apply

$60 copay/prescription (retail 30 days),

$180 copay/prescription (retail & home delivery 90 days)

Deductible does not apply

25% coinsurance but not more than $250/prescription (retail & home delivery 30 days)

Deductible does not apply

50% coinsurance/prescription (retail); Not covered (home delivery)

Deductible does not apply

50% coinsurance/prescription (retail); Not covered (home delivery)

Deductible does not apply

50% coinsurance/prescription (retail); Not covered (home delivery)

Deductible does not apply

50% coinsurance/prescription (retail); Not covered (home delivery)

Deductible does not apply

Your Cigna Advantage Prescription Drug List includes a full range of drugs including all those required under applicable health care laws Some of the more expensive drugs are excluded when there are less expensive alternatives. To check which drugs are included in your plan, please log on to myCigna.com. Some highlights:

Coverage includes a self administered injectable drug, but excludes infertility drugs.

Contraceptive devices and drugs are covered with federally required products covered at 100%.

Insulin, glucose test strips, lancets, insulin needles & syringes, insulin pens and cartridges are covered.

Lifestyle drugs are covered - limited to sexual dysfunction.

Generic non-sedating anti-histamines are covered.

Prescription smoking cessation drugs are covered.

Prescription vitamins are covered.

Generic ulcer drugs (Proton Pump Inhibitors/PPI) are covered.

View your drug list online

Before your plan starts:

1 Go to Cigna com/PDL

2 Click on the dropdown next to “Drug Lists for Employer Plans ” Scroll down until you see Cigna Advantage Prescription Drug List

3.Click on 4-Tier (all specialty medications covered on Tier 4)

Once your plan starts:

1.Log in to the myCigna App or myCigna.com

2.Use the Price a Medical tool to see how your medication is covered and how much it costs.

Cigna Healthcare Well-Being Services

As part of your employer’s health plan, you get access to a variety of programs and services to help make your life easier — and healthier.

24/7 Customer Service

Get answers to health, claims and benefit questions.

Translation available for more than 200 languages.

24/7/365 Virtual Care

In-Network care at no extra cost for primary, non-emergency urgent care and checkups

Broad range of services including specialty care, therapies, behavioral health, nutrition counseling and chronic pain management

Please see Virtual Care page for more details

Health Information Line

Call a nurse advocate at 866.494.2111 for health and treatment concerns.

Chat is available Monday–Friday, 9:00 a.m.–8:00 p.m. ET, excluding holidays.

Identity Force

Monitors, alerts and restores identity theft for bank, credit card, credit report, credit score and fraud.

Go online to: cigna.identityforce.com/starthere Call 833.580.2523

Wellness Experience

Complete health assessment and receive a health score

Track activity and healthy habits

Invite loved ones to join you and participate in fun challenges

Emotional well-being resources

3 face-to-face visits with licensed behavioral health provider. Other services include: legal, financial, identity theft support and mental health resources

See next page for continuation of Well-Being Services.

Please also see Well-Being Services tab at www cityofcorneliabenefits com for more information on these services

Cigna Healthcare Well-Being Services (continued)

As part of your employer’s health plan, you get access to a variety of programs and services to help make your life easier — and healthier.

Veteran Support Line

Free 24/7 hotline to veterans, their families and caregivers. Does not have to be a Cigna Healthcare customer.

Services include resources health, counseling, financial, food, housing, legal and family resources.

Cigna Health Matters

Care Management

Free nurse advocate to assist in understanding condition(s) and treatment.

Care coordination and resources, including benefits and cost guidance, provider coordination, referrals, financial, transportation help and emotional support.

Omada

Virtual coaching program to support weight loss and lower risk for type 2 diabetes and heart disease for eligible members and their families who are at risk.

Behavioral care

Access to mental health and substance use providers - either virtual or in person. Both types of services costs the same.

Pharmacy home delivery

Convenient home delivery for medications with online ordering, tracking, and 90-day supply options, plus free standard shipping.

Ongoing support and savings, including 24/7 pharmacist access, automatic refills/reminders and optional payment plans.

Specialty Medication Support

Access 24/7 to pharmacists or nurses to received personalized help managing treatment

Find ways to save money and work through side effects

Speak with a pharmacist

Pharmacist support to stay on track with taking and understanding medication.

Cigna Pathwell Bone & Joint Program designed to manage spine, knee, hip and shoulder pain with a Clinical Care Advocate. Advocate can help go over benefits, finding a treatment plan, access virtual and in-person physical therapy and surgery support.

Employee Assistance Program (EAP)

What is an EAP? This is a program offered to City of Cornelia employees to provide guidance with personal issues, planning for life events or simply managing daily life which can affect your work, health and family.

Coverage

through OneAmerica

Available for all City of Cornelia employees, their household members and unmarried children up to age 26

Provides support, resources, and information for personal and work-life challenges

Visit the Employee Assistance Program website to view timely articles and resources on a variety of financial, well-being, behavioral and mental health topics

CALL 1.855.387.9727 or visit GuidanceResources.com (Web ID: ONEAMERICA3)

Confidential Counseling

Helps employees address stress, relationship and other personal issues for you and your family

An in-house team of master’s level EAP professionals who are available 24/7/365 to provide individual assessments

Three sessions per year (per household) conducted by face-to-face* counseling or telehealth (text, chat, phone or video) via a secure, HIPAA compliant portal

Sessions with highly trained master’s and doctoral level clinicians about the following topics:

Stress anxiety and depression

Relationship/marital conflicts

Problems with children

Job pressures

Grief and loss

Substance abuse

Financial Information and Resources

Speak by phone with a Certified Public Accountant and Certified Financial Planner on a wide range of financial issues, including:

Getting out of debt

Credit card or loan problems

Tax questions

Retirement planning

Estate planning

Saving for college

Work-Life Solutions

Work-Life Specialists will do the research for you, providing qualified referrals and customized resources for:

Child and elder care

Moving and relocation

Making major purchases

College planning

Pet care

Home repair

GuidanceResources Online

One stop for expert information on relationships, work, school, children, wellness, financial, and more Timely articles, HelpSheets, tutorials, streaming videos and self-assessments

“Ask the Expert” personal responses to your questions

Child care, elder care, attorney and financial planner searches

Free Online Will Preparation

EstateGuidance lets you quickly and easily write a will on your computer

Go to www.GuidanceResources.com and click on EstateGuidance link

Follow the prompts to create and download your will at no COST

Name an executor to manage your estate

Choose a guardian for your children

Specify your wishes for your property

Provide funeral and burial instructions

EAP Plan Rates

Coverage paid for by City of Cornelia at no cost to you

Disability Plans

What is Disability Insurance? Disability insurance replaces a portion of your income if injury or illness prevents you from working, providing financial security for you and your dependents.

Coverage through OneAmerica (Employee must be actively at work on the effective date )

Short-Term Disability: Annual enrollment, no health questions every year Does not offset for salary continuation, but will offset for workers compensation, or any other outside income

Long-Term Disability: Annual enrollment, no health questions every year. Benefit is offset by any outside income (Social Security, sick leave, retirement, etc.)

The chart below is a sample of covered services. Please see the Plan Certificate on your Employee Benefits Website for a detailed listing of services in their entirety.

Pre-existing Condition Limitation

begin after you have been out of work due to an injury or illness for 7 days

3/6 - Any sickness or injury for which you received medical treatment, consultation, care, or services during the specified months (3 months) prior to your coverage effective date. A disability arising from any such sickness or injury will be covered only if it begins after you have performed your regular occupation on a full-time basis for the specified months (6 months) following the coverage effective date.

(Applies to new enrollees only)

Long-Term Disability Quick Summary

3/3/12 - Any sickness or injury for which you received medical treatment, consultation, care, or services during the specified months (3 months) prior to your coverage effective date. A disability arising from any such sickness or injury will be covered only if it begins after you have performed your regular occupation on a full-time basis for the specified months (12 months) following the coverage effective date, unless you go treatment free for 3 months. (Applies to new enrollees only)

Disability Plan Rates

Cost of coverage is based on your age and salary.

Please consult with a Campus Benefits Counselor or log into the enrollment system for rate details.

Basic and Voluntary Term Life and AD&D Plans

Coverage through OneAmerica

Voluntary Term Life only:

Only covered employees may elect dependent coverage; Dependent coverage may not exceed employee coverage amounts.

Evidence of Insurability (EOI) may be required if electing outside of initial enrollment or above guaranteed issue amounts.

The chart below is a sample of covered services. Please see the Plan Certificate on your Employee Benefits Website for a detailed listing of services in their entirety.

65% at age 65, 50% at age 70

What is Term Life Insurance? A life and AD&D insurance plan provides financial protection by paying a lump-sum benefit to your beneficiary in the event of your death or accidental dismemberment, helping replace lost income and support your family’s financial goals. Voluntary Term Life and Accidental Death & Dismemberment (AD&D)

Accelerated Life Benefit

Child(ren) Benefit

If diagnosed with a terminal illness with less than 12 months to live, you can request your benefit while still living.

Basic Life and AD&D Plan Rates

Coverage paid for by City of Cornelia at no cost to you.

Voluntary Life and AD&D Plan Rates

Cost of coverage is based on the level of benefit you choose and your age. Spouse rate based on employee’s age. Please consult with a Campus Benefits Counselor or log into the enrollment system for rate details.

Increments of $10,000 up to the lesser of $500,000 or 5 times annual salary

Issue: $100,000

Increments of $5,000 up to $500,000 (50% of Employee Election)

Guaranteed Issue: $50,000

$5,000 or $10,000 Benefit

$1,000 for children Live Birth to 6 months

Guaranteed Issue: $10,000

AD&D Amount Match Life Amount

Age Reduction

Benefit reduces to 50% at age 70 Reduction is based on employee’s age

Portability & Conversion Included

Accelerated Life Benefit

Additional Features

If diagnosed with a terminal illness with less than 12 months to live, you can request 75% of your benefit while still living.

Seat Belt, Airbag, Repatriation, Education Benefit (See certificate for details)

If employee and spouse are both employed by City of Cornelia, they cannot cover each other or double cover their dependents. Please contact Campus Benefits if you have questions regarding coverage.

Permanent Life

What is Permanent Life Insurance? Permanent life insurance provides a level premium that remains stable throughout the life of the policy and is designed to extend into retirement. It is an individual, issue-age policy based on your age at issuance and can be kept regardless of changes in employment.

Coverage through Colonial Life (Whole Life Plus)

Underwriting may be required Coverage is not guaranteed

Must be actively at work on the effective date

Permanent offers the flexibility to meet a variety of personal needs while allowing employees the choice of benefit and premium amounts which fit their paychecks and life styles

Keep your coverage at the same cost even if you retire or change employers

Permanent Life Quick Summary Plan Maximums

Employee (Ages 18 - 79) $5,000 - $500,000 Spouse (Ages 18 - 79) $5,000 - $500,000 Child (Ages 0 - 17)

Employee

$10,000 - $500,000

Guaranteed Issue (No health questions for First Time Enrollees)

Up to $75,000 (Up to age 49) Up to $50,000 (Up to age 79)

Spouse Simplified Issue (answer questions in system) Child

$10,000 to $25,000 (Age 0 - 17)

Additional Plan Options/Riders

Accelerated Death Benefit 12 months or less (75% w/max of $150,000)

Choose from Paid Up Options: age 70 or age 100, Accidental Death Rider, Waiver of Premium, Cash Value options

Permanent Life Plan Rates

Cost of coverage is based on the level of benefit you choose and your age. Please consult with a Campus Benefits Counselor or log into the enrollment system for rate details.

Dental Plan

Have major dental work coming up? Avoid a surprise bill by exploring costs of dental services in your Cigna dental account.

Dental Services Quick Summary (see certificate for full list of services and frequencies)

Oral Exams (2/calendar year)

Cleanings (2/calendar year)

Routine X-rays (2/calendar year)

Tip: Submit a pre-treatment estimate to stay ahead of your expenses.

Fluoride Application (1/calendar year for children under 19)

Sealants (1/3 years for children up to age 14)

Non-Routine X-rays

Space Maintainers (limited to non-orthodontic treatment for children under 19)

Emergency care to relieve pain (administrated at In Network coinsurance)

Fillings

Oral Surgery - Simple Extractions

Oral Surgery - All Except Simple Extraction

Surgical Extraction of Impacted Teeth

Anesthetics

Minor Periodontics

Major Periodontics

Root Canal Therapy/Endodontics

Brush Biopsy

Relines, Rebases, and Adjustments

Repairs - Bridges, Crowns, Inlays, Dentures

Crowns/Inlays/Onlays

Stainless Steel/Resin Crowns

Dentures

Bridges

Manage your Dental on myCigna

Access services on the myCigna app or myCigna.com:

Find in-network providers. View, print or send your ID card information. Review coverage, manage and track claims. Sign up for new plan document alerts. Track your account balances and deductibles.

Disclaimer:

Dental Providers

In-Network Dental Providers within a 20 mile radius

*Choosing in-network dental providers helps you get the most value and savings from your plan benefits * Current providers list as of 4 28 2026 Providers are subject to change Refer to the In-Network Provider Directory for a full list of providers. Provider Directory: www.hcpdirectory.cigna.com Network: Dental PPO - Total

<10 Mile radius

Elite Dentistry of Georgia 679 Baldwin Rd, Cornelia, GA 30531 (706) 778-7147

Aspen Dental

341 Furniture Drive, Cornelia, GA 30531 (706) 903-2335

Renew Dental

157 Hodges St, Cornelia, GA 30531 (706) 894-1919

Regina A. Boling, DDS 5332 Georgia 115 Ste A, Clarkesville, GA 30523 (706) 754-3215

Scott M. Thompson, DMD 225 Jefferson St Clarkesville, GA 30523 (706) 754-5855

Cleveland Family Dental 3777 Highway 129 S Cleveland, GA 30528 (706) 219-0033

<15 Mile radius

Amir Ghalehgol, DMD (Agdmd)

471 S Main St Ste 110, Cleveland, GA 30528 (706) 865-0353

Amir Ghalehgol, DMD (Yonah Mountain Dentistry) 645 Helen Highway, Cleveland, GA 30528 (706) 865-0353

John J. Crumpton, DMD 84 Helen Hwy, Cleveland, GA 30528 (706) 865-3174

Stalin H. De Souza Borges, DMD (Smile Doctors Braces)

42 North Ave Ste 200, Cleveland, GA 30528 (770) 536-0882

Samuel Castillo, DDS (Samuel L Castillo Family Dentistry)

3418 Highway 17 Alt, Toccoa, GA 30577 (706) 886-4256

Lora Savage, DMD (Wauka Mountain Famil Dentistry)

5300 Cleveland Hwy, Clermont, GA 30527 (770) 983-9496

<20 Mile radius

Stalin H. De Souza Borges, DMD (Smile Doctors Braces)

82 Bell Plaza Dr, Toccoa, GA 30577 (706) 886-1491

Elite Dentistry Of Georgia

592 Medical Park Dr Ste B, Gainesville, GA 30501 (770) 863-7324

Dentistry For Children Of Ga

2150 Limestone Ridge NE 101, Gainesville, GA 30501 (770) 692-1000

Neethu Sajeev, DDS (Tebo Dentistry For Kids Gaines)

3535 Thompson Bridge Rd, Gainesville, GA 30506 (770) 925-3300

Sage Dental Of Gainesville Ga

1979 Jesse Jewell Parkway Southeast 102, Gainesville, GA 30501 (770) 830-3288

Lisa C. Selem, DDS (Gainesville Endodontics) 1100 Northeast Sherwood Park Drive suite 310, Gainesville, GA 30501 (770) 406-2051

Georgia Smile Team

578 S Enota Dr NE Ste B, Gainesville, GA 30501 (770) 536-3254

Hanna You, DMD (Everysmile Family Dentistry) 120 Banks Crossing Drive Commerce, GA 30529 (706) 423-0092

Green Street Smiles

615 Green St NW Ste 101, Gainesville, GA 30501 (770) 532-2336

Dentistry For Children Of Ga

655 Jesse Jewell Pkwy SE Ste E, Gainesville, GA 30501 (770) 692-1000

Hospital Indemnity Plan

What is Hospital Indemnity Insurance? Supplemental coverage that helps offset costs associated with hospital stays, whether for planned or unplanned reasons. Payments are made directly to you and benefits do not offset with medical insurance.

Coverage through Allstate

Employee must be actively at work on the effective date Dependent children are covered up to age 26

Routine childbirth and complications from pregnancy are covered No Health Questions Every Year!

The chart below is a sample of covered services Please see the Plan Certificate on your Employee Benefits Website for a detailed listing of services in their entirety.

Hospital Indemnity Benefits Quick Summary

(see certificate for full list of services and frequencies)

Plan Details

Coverage Off the Job

Pre-existing condition limitation

Pregnancy Waiting Period

Reduction

First Day Hospital Confinement (No limit on number of occurrences)

Hospital Confinement (daily)

(If First Day Hospital Confinement Benefit is not payable: Days 1-10) Hospital Intensive Care (daily)

(Maximum 10 Days Payable)

Why

Hospital

Indemnity Insurance Matters?

If you’re admitted to the hospital for a planned or unexpected stay, Hospital Indemnity Insurance helps provide financial support by:

Paying a lump-sum benefit directly to you, not providers

Helping cover deductibles, copays, and other out-of-pocket medical costs

Giving you flexibility to use funds for everyday expenses like housing, childcare, and transportation

Claims must be filed with the carrier for reimbursement

Accident Plan

What is Accident Insurance? Accident insurance provides direct payments to help cover medical and out-ofpocket costs from unexpected accidents, without offsetting your medical insurance.

Coverage through Allstate

Employee must be actively at work on the effective date

No health questions - Every Year!

Payments made directly to you and benefits do not offset with medical coverage

The chart below is a sample of covered services. Please see the Plan Certificate on your Employee Benefits Website for a detailed listing of services in their entirety.

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Fractures, Dislocations, Burns, and Lacerations Up to $8,000 (Amounts vary according to type of injury and severity) Outpatient Physician's Benefit Rider Payable once per day, per covered person, not to exceed 2 days per covered person, per calendar year and a maximum of 4 days per calendar year if dependents are covered Covers sickness

Accidents can happen anytime, Accident Insurance helps provide financial protection by:

Paying benefits directly to you for covered accidents

Helping offset out-of-pocket costs like deductibles, co-pays, and out-of-network care

Giving you flexibility to use funds for everyday needs such as childcare, transportation, or other unexpected expenses

Disclaimer: The

Claims must be filed with the carrier for reimbursement

Cancer Plan

What is Cancer Insurance? Cancer insurance is a form of supplemental insurance meant to offset cancer related expenses so you can focus on recovery.

Coverage through Allstate

Payments made directly to you and do not offset with medical insurance If electing outside of initial enrollment period, health questions will be required for new participants Must be diagnosed after approved for plan. Does not cover cancer previously diagnosed. The chart below is a sample of covered services. Please see the Plan Certificate on your Employee Benefits Website for a detailed listing of services in their entirety.

Wellness Incentives

What are Wellness Incentives? An annual reimbursement for covered members who complete one of the eligible screening procedures on an elected cancer plan.

Available Wellness Incentives

Allstate - Cancer

Biopsy for skin cancer

Blood tests for triglycerides

CA15-3 (breast cancer)

CA125 (ovarian cancer)

CEA (colon cancer)

PSA (prostate cancer)

Bone Marrow Testing

Chest X-ray

Colonoscopy

Low plan: $75 / High plan: $100

What Qualifies as a Wellness Incentive?

Allstate - Cancer (once per year for one of 23 exams)

Hemoccult stool analysis

HPV (Human Papillomavirus) Vaccination

Lipid panel (total cholesterol count)

Mammography, including Breast Ultrasound

Cervical Cancer Screening

Pap Smear, including ThinPrep Pap Test

Serum Protein Electrophoresis (test for myeloma)

Stress test on bike or treadmill

Thermography

Doppler screening for carotids or peripheral vascular disease

Echocardiogram

EKG

Flexible sigmoidoscopy

Select how payment should be made to you: direct

Choose which coverage the claim is for

Ultrasound screening for abdominal aortic aneurysms

Take photos and upload supporting documents such as a hospital bill

Verify electronically with E-signature Visit www.cityofcorneliabenefits.com for

What is a Flexible Spending Account? A pre-tax benefit account used to pay for out-of-pocket healthcare costs such as deductibles, copays, prescribed medications, and doctor visits.

What are Dependent Care Accounts? A pre-tax account used to pay for dependent care services such as daycare, before or after school programs, and elder care

Coverage through Consolidated Admin Services

Plan year is from June 1 - December 31. There will be another enrollment in the fall for new plan year from January 1 - December 31. Employees must re-elect each year.

Only family status changes will allow you to change your annual election. The altered election must be consistent with the status change.

Transfer of funds between Dependent Care and Medical Care are prohibited

Married and not filing jointly participants limited to $3,750 deferral for Dependent Care

Full list of eligible FSA expenses is on the website: www cityofcorneliabenefits com

(Maximum participants can carry over if re-electing the

Total elected amount is available at the beginning of the plan year All receipts should be kept to submit if verification is requested *Carryover funds are only available if re-electing the plan for the next year

Important Note:

Dependent Care FSA is for eligible expenses related to the care of your child, disabled spouse, elderly parent, or other dependent who is physically or mentally unable of or disabled for self-care (i.e. day care, adult day care). Medical expenses for your dependent are not eligible for reimbursement under the Dependent Care.

Helpful FSA Resources

FSA Eligibility List: www.consolidatedadmin.com/fsa-hsa-eligible-expenses

FSA Calculator www.fsastore.com/fsa-calculator

Medical FSA Account Covers:

Medical coinsurance and deductible

Doctor’s office visit copays

Emergency Room costs

Dental copays and out-of-pocket costs

Vision copays and out-of-pocket costs

Contacts and glasses

Prescriptions

Please see the full eligibility list for other covered expenses

Dependent Care Account

Covers:

Children ages 12 and under (including stepchildren, grandchildren, adopted or foster children, and children related to you who are eligible for a tax exemption on your federal tax return)

Tax dependents residing with you and incapable of self-care (this could include your spouse, a child age 13 and over, and elderly parents)

Eligible items for purchase without a prescription now include, but are not limited to:

Pain relief medications, e.g., acetaminophen, ibuprofen, naproxen sodium

Cold & flu medications

Allergy medications

Acne treatments

Access CAS at your fingertips

Eye drops

Stomach & digestive aids

Pads, tampons and menstrual sponges

Sleep aids

Children’s pain relievers, allergy medicines, and digestive aids

Download the app: Consolidated Admin Services

Visit the website: www consolidatedadmin com

The CARES Act permanently reinstates over-the counter products, and adds menstrual care products for the first time, as eligible expenses for your FSA funds WITHOUT A PRESCRIPTION!

The 2026 Benefits Guide is provided for illustrative purposes only Actual benefits, services, premiums, claims processes and all other features and plan designs for coverage offered is governed exclusively by the insurance contract and associated Summary Plan Description (SPD). In case of discrepancies between this document and the insurance contract and SPD, the contract and SPD will prevail. We reserve the right to change, modify, revise, amend or terminate these plan offerings at any time. Updates, changes, and notices are available for review at www.cityofcorneliabenefits.com or by contacting HR or the email above. These should be reviewed fully prior to electing any benefits.

Disclosures: All required SPD, legal and plan Disclosures are posted on the Benefit Website For a written copy please contact Campus Benefits at 866-433-7661, opt. 5.