On the Job Injury Program
One of the most important areas of Risk Management is the safety and the well being of employees. When employees are injured in the course and scope of their job, they are provided for through the City's On-The-Job Injury benefit program. Our goal is to help employees work in a safe, productive, friendly environment.
EMPLOYEE INJURY REPORT(
EIR) FORMS & ACCIDENT/INCIDENT REPORT (
AIR) FORMS MUST BE REPORTED TO YOUR SUPERVISOR & COMPLETED ON EACH INJURY AND/OR ACCIDENT WITHIN YOUR SHIFT OR 24 HOURS OF THE INJURY.
Once you have completed the form; please use the upload link below to submit it and any requested documentation to Risk Management.
To view the OJI Policy in full, please click
here.
Section 125 Flexible Benefits Plan: Allows you to reduce taxable income by paying certain insurance premiums with pre-tax dollars. You are automatically enrolled unless specify otherwise.
-Eligible benefits: health, dental, vision, & cancer/accident premiums
-You cannot change your election without a qualifying event unless it is during the annual open enrollment period.
Qualifying event or “Change of Status” examples would be marriage, birth, adoption, court order, etc. You have 30 days to make those changes. The IRS issues the regulations.
Medical Insurance
Cigna Network: Local Plus (Members who reside outside of TN will be in the Open Access Plus Network)
Copay- The fee you pay for a service. Office visits cover the office visit charge, most labs and x-rays at the office visit. Some additional services may be subject to the deductible and coinsurance (20%), up to the out-of-pocket maximum. Current copays are noted below:
$35 for general physician
$50 for specialist
$ 0 for behavioral health
RX ($5, $35, & $50)
ER $125 + deductible/coinsurance
Hospital Admission $250 + deductible/coinsurance
Outpatient $250 + deductible/coinsurance
Deductible- The amount the patient is responsible for before the health plan pays anything.
$1,000 for an individual
$2,000 for employee + child & employee + spouse
$3,000 for family
Coinsurance- The percentage the patient is responsible for after deducible is met. Ours is 20%
Out of Pocket Max- The maximum amount the patient could be responsible for each plan year.
$4000 individual, $8000 Employee Child/Employee Spouse/Family
Medical Plan Employee cost per month:
Single: $139.00 Employee + Child(ren): $290
Employee + Spouse: $346 Family: $375
Dental Insurance
Cigna Total DPPO Network
Coverage A: Preventative-Cleanings, annual bitewing x-rays- 100%
Coverage B: Restorative- Filings, tooth pulled, root canal- 80% coverage
Coverage C: Major: Bridges, crowns, dentures- 50% coverage
There is NO orthodontic coverage.
$50 annual deductible per person for coverage B or C, with $150 max per family.
$1500 maximum benefit per person per year
Dental Plan Employee cost per month:
Single: $10.00 Employee + Child(ren): $17.00
Employee + Spouse: $16.00 Family: $20.00
Vision Insurance
Cigna Vision (EyeMed) Network
Eye Exam every 12 months- $10 co-pay
Standard plastic lenses every 12 months -$20 copay
Frames every 24 months, $0 copay ($140 allowance on frame, 20% off balance over allowance)
Contacts (in lieu of lenses & frames) every 12 months, $0 copay ($140 allowance, 20% off balance over allowance)
Vison Plan Employee cost per month:
Single: $2.38 Employee + Child(ren): $4.80
Employee + Spouse: $4.74 Family: $7.64
FSA (Flexible Spending Account): Another section of the Cafeteria Plan that allows you to set aside a certain amount of your income for medical expense or dependent care with pre-tax dollars, therefore you save tax money. This amount is put on a debit card for you to use for qualified out-of-pocket medical expenses such as your deductible, copays, vison expenses, dental, and orthodontic expenses. Maximum amount allowed is $3,200 per year. However, only $640 is able to rollover to the next fiscal year.
FME (Flex Made Easy) is the administrator of the FSA plan. They have a website and a mobile app that allows you to see the balance left on your FSA account, transaction history, and allows you to submit the receipts required to substantiate your claims or submit a request for reimbursement if you didn’t use your card, but your expense is eligible.
For more information, visit
www.FlexMadeEasy.com. Please click
here, for a flyer about FME.
The City of Jackson offers you the opportunity to reduce your health premium by getting an annual preventative exam. Criteria used to determine the discount amount are Blood Pressure, Cholesterol, HT/WT, and Non-Tobacco. The maximum discount amount for single plans is $25 and $50 per month for family plans. If the employee has the wellness visit but the employee and/or spouse (if applicable) does not qualify for two out of the four criteria, a $10 per month maximum discount will be given for participation.
-DISCOUNTS AVAILABLE-
$10 per mth for employee participation of wellness visit (single or family coverage) OR
$25 per mth for employee wellness visit & 2 other criteria met (individual or employee+ child(ren) coverage) OR
$50 per mth for employee wellness visit and employee & spouse meet 2 each of other criteria (employee+ spouse or family coverage)
Please click
here to access the discount form. If you have any questions, please contact Risk Mgt. office. Please click
here, for a discount reminder information
Hartford Basic Life Insurance: The City of Jackson provides you with a life insurance policy in the amount of one (1) times your annual salary. This amount doubles in the event of an accidental death. A benefit reduction occurs at age 65, again at age 70 & age 75. This beneficiary is separate from your TCRS beneficiary. It has to be updated with Risk Mgt. Dept.
Hartford Supplemental Life Ins.: This is term life insurance (5 year terms) on the employee only. You can purchase 1, 2, or 3 times your annual salary up to $150,000 max; your rate is based on age & salary. Life insurance levels/premiums are subject to adjustment on the first payroll of the new calendar year. A benefit reduction of 50% occurs at age 70. You have the option to convert or port this coverage if you leave employment or retire. This beneficiary is separate from your TCRS beneficiary. It has to be updated in the Risk Mgt. Dept.
Hartford Dependent Life Ins.: Available through The Hartford, this is life insurance on your spouse & eligible children; $25,000 on spouse, $10,000 on each eligible child (children aged 15 days to 6 months have a benefit amount of $100) for a total cost of $1.07 per pay period. Dependent children are eligible until age 19 unless specific circumstances apply, check with Risk Mgt. for specific criteria. If you no longer have any eligible dependents, please contact Risk Mgt. to cancel your dependent life insurance. Please do keep in mind that married children are not eligible for dependent life insurance.
Symetra Long Term Disability: Insurance to help replace lost income (60%), in a time of long term disability, on or off the job. City provides a 5-year benefit period policy to you for free. You have the option to “buy-up”, which extends your coverage period from only 5 years to your social security normal retirement age.
