2026_Open_Enrollment_Booklet.pdf

pg. 9

2026 Open Enrollment Open Enrollment is Monday, Oct. 13-Friday, Oct. 31, with benefits effective Thursday, Jan. 1, 2026

Retirement, pg. 24Vision, pg. 8

Health Plan

Medical, pg. 9 Health Savings, pg. 23

Open Enrollment, pg. 4 Dental, pg. 14

Table of Contents 3 Open Enrollment Reminders

4 Open Enrollment 101

5 Things To Do and Remember

5 Benefit Options

6 Who is a Legal Dependent?

6 Dependent Eligibility by Benefit

7 Dependent Eligibility Documentation Requirements

7 Ineligible Dependents

8 The City Invests in You!

8 Vision Plan Information

9 Health Plan 03359

9 Health Plan 05774

10 Blue Options Health Plan Comparison

12 Excluded Services

14 Dental Plan Information

20 LegalShield Information

21 Short-Term Disability Insurance

21 Supplemental Life

22 Family and Medical Leave Act

23 Flexible Spending Accounts

24 Retirement Planning

24 Supplemental Retirement Planning

26 What are my Options if I Leave the City?

27 Work & Life

28 Personal Leave and Accruals

29 Employee Assistance Program (EAP)

29 Employee Health Services

29 Contact Information

Workday Availability Open Enrollment is available online through your Workday account. The Workday platform will be unavailable for weekly service updates for a maximum of four hours from Fridays at 2 a.m. (EST) through Saturdays at 6 a.m.

BlueDental Choice PPO and BlueDental CoPayment Update As a reminder --- there is no longer a 12-month waiting period for coverage of any major or orthodontic services.

Open Enrollment for the 2026 Plan Year is available Oct. 13-31, 2025

Benefit elections, changes and any dependent documents must be submitted no later than Friday, Oct. 31, 2025

Workday Online Enrollment-Changes ONLY!

You only need to log into Workday and go through the Open Enrollment process if you need to make changes to your current benefits or want to enroll in a Flexible Spending Account (FSA). It is highly recommended that all employees check their current benefits prior to determining whether online enrollment is needed or not.

Should You Participate?

Do you need to take any action during Open Enrollment? Check all boxes that apply to you.

I want to add/terminate a coverage or dependent.

I elect to waive my health care coverage through the City of Gainesville.

I want to enroll or re-enroll in a Flexible Spending Account (FSA). You must re-enroll in an FSA every plan year.

I want to enroll in, change or cancel coverage for myself and/or my eligible dependent(s). (e.g., from CoPay Dental to Choice Dental)

I want to enroll or re-enroll in STD through AFLAC. You must re-enroll in STD every plan year. For NEW enrollment, you must contact the AFLAC rep for your rate,

I currently cover a spouse/other eligible individual under my health benefits, and I want to continue their coverage in 2026.

I do not want to make any changes and want to keep the exact same coverage in 2026.

I do not want to continue or enroll in a Flexible Spending Account (FSA) for 2026.

If you only selected the above option(s) and did not select any option in the “yes”

recommend you review your benefits options to ensure you’re getting the best coverage.

Yes!

No!

Important reminders!

• Review your current benefits and discuss them with your family.

• If you do not want to change your current benefits (minus Flexible Spending Accounts), you do not need to enroll online via Workday.

• If you want to make a change to your benefits (e.g., add/terminate a dependent, add/terminate a benefit, add/ keep a Flexible Spending Account), access Workday and positively elect each benefit you wish to enroll in for 2026.

Open Enrollment 101

What do I need to do?

You may make changes if you have a qualifying life event (within 30 days of the event) such as:

• A change in marital status (marriage, divorce)

• Adding/terminating a dependent due to birth, adoption, gaining/losing other health coverage

• Change in employment status (part-time/full-time to part-time or vice versa, as well as converting from a temporary to permanent employee)

When may I make changes outside of Open Enrollment?

• You, your spouse, children (biological, step, foster, adopted, legal guardian)

• Certified domestic partner (only able to enroll at new hire and during Open Enrollment. Must be done in person at Risk Management.)

Who is eligible to be covered under my benefits?

• Benefits for 2026 are effective Jan. 1, 2026.

• If you are still on probation, you are not eligible to enroll in a Flexible Spending Account.

• If you are a new hire, the earliest your benefits may take effect is the first day of the month following your 30th day of employment.

When are my Open Enrollment elections effective?

• If you were hired between Oct. 1-Dec. 31, 2025, please complete the New Hire event that will be in your Workday inbox before starting your Open Enrollment event. Please pay careful attention to this detail. Due to the structure of Workday’s system, your benefits may be automatically removed if the New Hire and Open Enrollment events are completed out of sequence.

• If you are hired after Oct. 14, 2025, your New Hire benefit event should become available first. Your Open Enrollment event should also be available; however, you will still need to complete your New Hire event before completing the Open Enrollment event. Your new hire benefits will terminate at the end of 2025 and your Open Enrollment benefits are effective as of Jan. 1, 2026.

• Please notify Risk Management if you start your Open Enrollment benefit prior to your New Hire event.

I’m a new employee. What do I need to do?

• Review your current elections to determine if changes are needed. If changes are needed, enroll via Workday. If no changes are needed, there is no need to enroll via Workday and your benefits will remain the same, minus the FSAs.

• Verify current dependents are eligible to enroll in respective benefits (benefits for dependents terminate at age 26). If dependents need to be added or deleted, you must enroll for your 2026 benefits via Workday and make the changes.

• Check your beneficiary information on all relevant benefits to make sure it is up-to-date

> Group Life (add or change beneficiary via Workday)

> Pension (add or change beneficiary via Workday)

> 457 and Roth IRA (add or change with MissionSquare and on Workday)

• Supplemental life (enroll online via Workday)

• 457 and IRA accounts: enroll online through Workday for 457 accounts; enroll online through Workday and MissionSquare for IRAs. Go to page 23 for more information.

• If you wish to start or keep a Flexible Spending Account (FSA), please enroll via Workday or you will not have one for 2026. Please remember that you must have completed probation by the end of Open Enrollment to enroll in an FSA.

• Ensure all personal information is up-to-date in Workday and if changes need to be made, please do so in Workday.

• If you are on leave, FMLA, vacation, absent and/or otherwise not at work, and wish to have benefits, please enroll in your benefits via Workday or you will not have benefits for 2026. Workday may be accessed from any computer, as well as the Workday mobile app. Please remember to submit all supporting documents by Oct. 31, 2025 to avoid invalid enrollments.

Things to Do and Remember During Open Enrollment

Benefit Options

Health Insurance Florida Blue

• Blue Options

Dental Insurance Florida Combined Life

• Choice

• CoPayment

• DHMO (Blue Dental Prepaid)

Vision Insurance Humana

• Insight Network

As an eligible city employee, you may enroll in benefits that support your health, help you grow and protect your finances, and promote a balance of work and life. Below is an overview of all your 2026 benefit options.

Supplemental Life Insurance Sun Life Financial

• Employee Life (up to 5x salary)

• Spousal Life (1/2 employee election)

• Child Life (up to age 19 for non-students, 19-25 for students; proof of school enrollment required)

• Accidental Death & Dismemberment (must match employee amount)

Short-Term Disability

AFLAC

• Basic Disability

Flexible Spending Accounts Benefit Strategies Voya

• Medical– Max is $3,300* (Must have passed probation)

• Dependent Care-Max is $7,500* (Must have passed probation)

* increased from 2025

Legal Plan & Identity Theft LegalShield

• Comprehensive Legal Plan

• Identity Theft

Who is a Legal Dependent?

Dependent Eligibility by Benefit

• A spouse (one who is joined in marriage to an employee by a ceremony recognized by the laws of the federal government)

• A certified domestic partner [GG Employees Only] (A certified domestic partnership affidavit must be completed and notarized at the Risk Management office no later than Oct. 31, 2025. Must show proof of 12-months continuous living together e.g. utility bill in both names, apartment/home lease, etc.)

• An employee’s natural, legally adopted or stepchild under age 26.

• A child under the age of 18, for whom you have legal guardianship (permanent or deemed permanent for insurance purposes)

• A child 26 years or older who is incapable of self-support due to mental or physical disability, and who has a permanent disability

• Legal dependents are eligible to enroll in these benefits until the age of 26 (whether married, a student or residing with the parent/legal guardian).

• Dependents who are over the age of 26, who are physically or mentally unable to work and are supported by the employee (medical documentation required).

• Grandchildren: Newborns up to 18 months (as long as the parent of the child is also covered by the plan).

Health, Dental and Vision

• Never-married, dependent children of the employee or employee’s spouse who are under 21 and living at home

• Children under age 18 for whom the employee or employee’s spouse is the legal guardian

• Full-time, never-married students under 23 years old, if the student is a dependent of the employee or employee’s spouse

• Any dependent child, regardless of age, who is incapable of sustaining employment because of mental or physical disability and who is chiefly dependent on the employee or employee’s spouse for support

LegalShield

• Dependents under the age of 18

• Dependents between the ages of 18-26 (living at home or a full-time student or have never been married are still able to receive credit restoration services)

IDShield

• Legal dependents are eligible to enroll in this benefit under the age of 19. If a full-time student, they may be covered until age 25.

Supplemental Child Life

All children up to age 26, married or single, are eligible for coverage on their parents’ health plan.

Ineligible Dependents

You must drop coverage for your enrolled dependent within 30 days of the date they lose eligibility. For example, if you divorce your spouse or end your domestic partnership relationship, you must contact Risk Management to remove your dependent spouse or domestic partner within 30 days of the divorce or end of domestic partnership.

If you fail to remove ineligible dependents, you will be required to pay all costs for any benefits that were paid on their behalf and may be subject to disciplinary action.

The following are examples of individuals who are not considered eligible dependents:

• Your spouse following a divorce

• Someone else’s child (such as your nieces or nephews), unless you have been awarded legal custody or guardianship

• Parents, parents-in-law, or grandparents, regardless of their IRS dependent status

Dependent Eligibility Documentation Requirements

Dependents Documentation Required

For Spouse Copy of marriage certificate and copy of Social Security card. If previously married, copy of death certificate or divorce decree.

For Removal of Spouse/Child None at Open Enrollment. Court decree within 30 days of decree during the contract year.

For Natural Child(ren) Child’s birth certificate (showing the parent-child relationship to employee/retiree and/or spouse) and copy of Social Security card.

For Adopted Child(ren) Placement papers signed by the courts, child’s birth certificate and copy of Social Security card.

For Disabled Child (26 years and older)

Physician verification of permanent disability, child’s birth certificate and copy of Social Security card.

Foreign Adoptions Adoption papers signed by the courts; visa showing date of entry to USA, child’s birth certificate and copy of Social Security card.

For Stepchild(ren) Child’s birth certificate (showing parent-child relationship with employee/ retiree’s spouse); copy of marriage certificate and copy of Social Security card.

For Court-Ordered Support State affidavit; copy of signed court order requiring employee/retiree to provide support for health coverage, children’s birth certificate and copy of Social Security card.

For Guardianship Court ordered guardianship, birth certificate and copy of Social Security card.

For Domestic Partner

City of Gainesville Domestic Partner Affidavit (completed in-person by both parties at Risk Management and notarized within 30 days of application), as well as proof of 12 months of cohabitation. You may only enroll during Open Enrollment or at new hire.

The City Invests in You!

The city will reimburse employees 100% of the cost of tuition and lab fees for 18 credit hours per fiscal year.

Reimbursement will be equal to the actual cost, not to exceed the State of Florida University System credit-hour rate for undergraduate or graduate courses as applicable.

Eligible employees are those appointed to regular positions who have completed their probationary period and are taking courses for college credit at an accredited institution per the U.S. Department of Education database of accredited postsecondary institutions and programs. Interested employees can refer to the Community Builder Hub (https://gruadmin.sharepoint.com/sites/GGCommunityHub) or Workday for more details. Applicable contracts may be viewed at www.GainesvilleFL.gov.

The city purchases and pays the premiums for a life insurance policy for each regular employee that is equal to 200% of the annual base salary up to the maximum of $50,000. Term Insurance provides a death benefit only in the face amount stated and will be in force only while you are employed by the city. Each employee must update their beneficiaries in Workday. These cards will be kept on permanent record at the city. If the employee wishes to change the beneficiary, the employee must follow the same process. If additional insurance beyond the group life insurance coverage provided by the city is desired, a supplemental term life option is available.

You have a maximum of 60 days from your first day of employment to make elections for your voluntary benefits.

If you do not meet this deadline, you will have to wait until the next Open Enrollment period. The only other way to make a change to your coverage is through a qualifying event or during the next Open Enrollment. Any changes must be requested within 30 days of the qualifying event and proof of the qualifying event must be provided.

If hired prior to Oct. 1 and your benefits have taken effect: Log into Workday only if you want to make changes for 2026.

If hired between Oct. 1 and Nov. 1, 2025, you will need to make your elections via Workday for benefits to take effect Nov. 1, 2025 or Dec. 1, 2025. If you do not enroll in 2026 benefits, you will not have coverage for 2026. If you do not want coverage for 2025, but want benefits during 2026, please complete the Open Enrollment process.

Tuition Reimbursement

New Hires

Group Term Life Insurance

Vision Humana is the administrator for the City of Gainesville’s vision plan.

Bi-Weekly Premiums and Summary of Services

Biweekly premium $3.00 for the employee only $8.13 for the employee+1 or more

Eye Exam $10 - once every 12 months

Lenses $15 - once every 12 months

Frames $140 allowance (20% off balance over $140) - once every 24 months

Contact Lenses $130 allowance - once every 12 months $55 fitting fee https://gruadmin.sharepoint.com/sites/GGCommunityHub http://www.GainesvilleFL.gov

The City of Gainesville offers its employees a comprehensive health plan. Presently, the third-party administrator is Florida Blue. BlueOptions offers members the ability to choose any medical provider they wish. However, participants can maximize their benefits by choosing Network Blue “in-network” medical providers who participate in the Florida Blue PPO provider network.

2026 Bi-Weekly Premiums - Employee Pays Bi-Weekly Premiums - City Pays

Employee Employee + Spouse

Employee + 1 Child

Employee + 2 more (Family)

Full-time (40 hours)

$313.10 $430.90 $326.65 $562.05

Half-time (20 hours)

$164.01 $225.73 $170.58 $294.41

3/4 time (30 hours)

$238.55 $328.34 $248.11 $428.23

Employee Employee +Spouse

Employee +1 Child

Employee + 2 more (Family)

Full-time (40 hours)

$69.22 $317.43 $214.77 $400.29

Half-time (20 hours)

$218.31 $522.65 $369.84 $667.93

3/4 time (30 hours)

$143.77 $420.04 $292.31 $534.11

Health Plan 03359

A lower premium option is available to our selection of health plan benefits. The lower premium can save you money, so be sure to compare to see what is best for you and your family.

2026 Bi-Weekly Premiums - Employee Pays Bi-Weekly Premiums - City Pays

Employee Employee + Spouse

Employee + 1 Child

Employee + 2 more (Family)

Full-time (40 hours)

$312.14 $430.95 $322.15 $562.05

Half-time (20 hours)

$163.52 $225.22 $167.83 $294.41

3/4 time (30 hours)

$237.83 $328.34 $245.49 $428.23

Employee Employee +Spouse

Employee +1 Child

Employee + 2 more (Family)

Full-time (40 hours)

$35.64 $249.01 $166.92 $312.34

Half-time (20 hours)

$184.26 $454.23 $321.24 $579.98

3/4 time (30 hours)

$109.95 $351.62 $243.58 $446.16

Health Plan 05774

Blue Options Health Plan Comparison

Deductibles Option 03359 Family is 3 or more members

Option 05774 Per person, per calendar year

Plan Feature In-Network Out-of-Network In-Network Out-of-Network

Calendar Year Deductible (CYD) - Individual

$600 $600 $3,000 $6,000

Calendar Year Deductible (CYD) - Family

$1,800 $1,800 $9,000 $18,000

Out-of-Pocket Max - Individual $4,500 $5,000 $6,350 $15,000

Out-of-Pocket Max - Family $7,500 $10,000 $12,700 $30,000

Office Visits Option 03359 Option 05774

Service In-Network Out-of-Network In-Network Out-of-Network

Primary Care $15 copay deductible + 40%

$40 copay deductible + 50%

Medical Specialist deductible + 20% deductible + 40%

$100 copay deductible + 50%

Virtual Visits

Primary care provider: $15 Specialist:

deductible + 20% not covered Primary care provider: $0 Specialist: $100 not covered

Therapy Services Option 03359 Option 05774

Service In-Network Out-of-Network In-Network Out-of-Network

Spinal Manipulation and Therapy

Hospital-based Therapy* Option 1: $45 Option 2: $60 deductible + 40%

Option 1: $100 Option 2: $100 deductible + 50%

Laboratory Services Option 03359 Option 05774

Quest Diagnostics no charge no charge

All other labs deductible + 40% deductible + 50%

*Option 1 is community hospitals. Option 2 is research/teaching hospitals.

Option 1: $45 Option 2: $60 deductible + 40% Option 1: 100

Option 2: 100 deductible + 50%

Hospital Services Option 03359 Option 05774

Service In-Network Out-of-Network In-Network Out-of-Network

Inpatient Facility*

Copay per admission Option 1: $750 Option 2: $1,000 deductible + 40% Option 1 and 2:

deductible + 20% per admission deductible + 20% per admission

Inpatient Physician deductible + 20% in-network deductible + 20% deductible + 20% in-network deductible + 20%

Mental Health (inpatient) $150/day copay deductible + 40% no charge 50% co-insurance

Preventive and Diagnostic Services

Option 03359 Option 05774

Service In-Network Out-of-Network In-Network Out-of-Network

Well Care Visits no charge no charge no charge deductible + 40%

Mammogram no charge no charge no charge no charge

Colonoscopy* (routine) no charge no charge no charge no charge

*Note: For diagnostic colonoscopies, the deductible is waived, but the appropriate coinsurance or copayment will apply based on the location of service.

Blue Options Health Plan Comparison (cont’d.)

Outpatient and Emergency Services

Option 03359 Option 05774

Plan Feature In-Network Out-of-Network In-Network Out-of-Network

Outpatient Facility (hospital)* Opt. 1: $150 copay Opt. 2: $250 copay deductible + 40% co-insurance deductible + 20% co-insurance

50% co-insurance

Urgent Care $30 copay deductible + $30 $100 per visit deductible + $100

Emergency Room (facility) $250 copay $250 copay $400 copay $400 copay

Emergency Room (physician) deductible + 20% in-network deductible + 20% deductible + 20% deductible + 20%

*Option 1 is community hospitals. Option 2 is research/teaching hospitals.

*Option 1 is community hospitals. Option 2 is research/teaching hospitals.

Blue Options Health Plan Comparison (cont’d.)

Surgical and Imaging Services

Option 03359 Option 05774

Service In-Network Out-of-Network In-Network Out-of-Network

Imaging (x-ray) $50 copay deductible + 40%

$50 copay deductible + 50%

Advanced Imaging (AIS, MRI, CT, PET, etc.)

$125 copay deductible + 40%

$400 copay deductible + 50%

Pharmacy Benefits Option 03359 Option 05774

Pharmacy Deductible $300 (preferred and non-preferred) $300 (preferred and non-preferred)

Generic $10 copay or actual cost (whichever is the least)

$10 copay or actual cost (whichever is the least)

Preferred Brand $50 copay or actual cost $50 copay or actual cost

Non-preferred Brand $80 copay or actual cost $80 copay or actual cost

Specialty Drugs $160 copay $80 copay or actual cost

Mail Order (90-day supply) Generic: $20 copay Preferred: deductible + $100 Non-preferred: deductible + $160

Generic: $25 copay Preferred: deductible + $125 Non-preferred: deductible + $200

Excluded Services

Option 03359 Option 05774 The following services are not available under Option 03359 (neither in-network nor out-of-network):

• Cosmetic surgery

• Bariatric surgery

• Dental care (adult)

• Habilitation services

• Hearing aids

• Infertility treatment

• Long-term care

• Pediatric dental check-up

• Pediatric eye exam

• Pediatric glasses

• Private-duty nursing

• Routine eye care (adult)

• Routine foot care unless for treatment of diabetes

• Weight-loss programs

The following services are not available under Option 05774 (neither in-network nor out-of-network):

• Acupuncture

• Bariatric surgery

• Children’s eye exams, glasses and dental check- ups

• Cosmetic surgery

• Dental care (adult)

• Habilitation services

• Hearing aids

• Infertility treatment

• Long-term care

• Private-duty nursing

• Routine foot care (unless diabetic)

• Routine adult eye care

• Weight-loss programs

This page was intentionally left blank

Dental The City of Gainesville offers three dental plans through Florida Combined Life to its employees. You are encouraged to evaluate each of the three plans carefully in order to choose the plan that best suits your specific needs.

BlueDental Care Prepaid (DHMO)-F series The least expensive of the three plans is the BlueDental Care Prepaid (DHMO). This plan offers limited benefits and a limited provider network.

This plan requires the member to select a general dentist from the BlueDental Prepaid provider list and see that provider for all dental care. Once a dentist is chosen, employees must call DHMO customer service (877-325- 3979, opt. 1) to have them assign this dentist to you. If the enrollee uses a different provider than assigned, the plan provides no benefit. Members have the option of changing their primary dental provider once every 30 days, if desired.

The member is only responsible for the applicable copayment for covered services. The plan has no waiting periods for major services, and it does not cover orthodontics.

BlueDental Prepaid (DHMO) In-Network Out-of-Network

Calendar Year Deductible (CYD) $0 No coverage

Preventative services $0 No coverage

Basic services See the fee schedule on pgs. 16-17 No coverage

Major services See the fee schedule on pgs. 16-17 No coverage

Orthodontic services 25% discount for adults and children No coverage

Waiting period None No coverage

Annual maximum None No coverage

Biweekly rates Employee Employee +Spouse

Employee +1 Child

Employee +Children

Family

BlueDental DHMO $6.51 $11.20 $11.20 $17.24 $17.24

BlueDental CoPayment $8.49 $18.57 $22.77 $22.77 $33.79

BlueDental Choice PPO $12.42 $23.59 $29.67 $29.67 $40.85

BlueDental Choice PPO The BlueDental Choice PPO plan offers a wide variety of benefits and the largest provider networks. Enrollees have the freedom to use any dental provider they choose. The plan pays a higher percentage when services are rendered by a participating provider. The member may experience balance billing for all amounts not paid by the plan when using a non-participating provider.

Participating dental providers are responsible for submitting all claim forms for services provided. The member is responsible for filing all claims for services received from a non-participating provider. The plan has no waiting periods for major services, and it does not cover orthodontics.

BlueDental Choice PPO In-Network Out-of-Network

Calendar Year Deductible (CYD) $50 $50

Preventative services $0 20% of allowance, plus balance billing

Basic services 20% of allowance 50% of allowance, plus balance billing

Major services 50% of allowance 60% of allowance, plus balance billing

Orthodontic services for children age 19 years or younger only

50% of first allowable $1,000, then 100% of the balance

No coverage

Waiting period none none

Annual maximum $1,500 $1,500

BlueDental CoPayment The BlueDental Choice Copayment plan offers a wide variety of benefits and a moderate provider network.

Enrollees have the freedom to use any dental provider they choose. However, the plan rewards members for using a participating provider with a well-defined copayment fee schedule. Participating dental providers are responsible for submitting all claim forms for services provided.

Services received from a non-participating provider are paid at a percentage of allowed charges and the member is responsible for all amounts not paid by the plan. The member is responsible for filing all claims for services received at a non-participating provider.

The plan has no waiting periods for major services, and it does not cover orthodontics.

BlueDental CoPayment In-Network Out-of-Network

Calendar Year Deductible (CYD) $50 $50

Preventative services $10 30% of allowance, plus balance billing

Basic services See the fee schedule on pg. 18 50% of allowance, plus balance billing

Major services See the fee schedule on pg. 18 65% of allowance, plus balance billing

Orthodontic services for children age 19 years or younger only

Cost minus $1,000 No coverage

Waiting period none none

Annual maximum $1,500 $1,500

The information provided above is a summary of benefits. It is intended to highlight key points of the Dental Plan and is provided to the employee as an aid in deciding whether to enroll in the Plan. This summary should in no way be construed as part of the contract. Possession of this summary in no way implies coverage nor does it guarantee benefits under the plan. Some limitations may apply.

*Percentage of allowable charges. **Percentage of allowable charges plus balance charges, if any.

Note: Non-Participating Dentists may charge fees in excess of our Fee Schedule and may bill you for the difference.

Florida Combined Life Insurance Company, Inc. (FCL) is an affiliate of Blue Cross Blue Shield of Florida, Inc. (BCBSF). BCBSF and FCL are Independent licensees of the Blue Cross and Blue Shield Association.

22240-1218 BlueDental Choice LG

BlueDental Choice PPO Benefit Summary

Group Name: CITY OF GAINESVILLE Group Anniversary Date: 1/1

Deductible In-Network Out-of-Network No Deductible for Preventive Services (or ortho if selected)

Per Person Per Plan Year $ 50 $50 Per Family Per Plan Year $150 $150 Amounts used to satisfy the in-network deductible also satisfy the out-of-network deductible and amounts used to satisfy the out-of-network deductible also satisfy the in-network deductible.

We Pay* You Pay* We Pay* You Pay** Preventive Services 100% 0% 80% 20% Basic Services 80% 20% 50% 50% Major Services 50% 50% 40% 60%

Periodic Oral Evaluation (0120) Preventive

Comprehensive Oral Evaluation (0150) Preventive Bitewing X-rays, two films (0272) Preventive Cleanings – Adult/Child (1110, 1120) Preventive Fluoride Treatment – Child (1206, 1208) Preventive Office Visits (9430) Preventive X-rays - Intraoral/Complete Series (0210) Basic Sealant – per tooth (1351) Basic Amalgam Restorations (Silver Fillings) (2140) Basic Resin-Based Restorations – Anterior (2330) Basic Extractions – Routine and Surgical (7140) Basic Root Canal Molar (3330) Major Periodontal Scaling & Root Planing – per quad (4341) Major Crowns – Porcelain fused to noble metal (2752) Major Complete Dentures (5110, 5120) Major Pontic – Porcelain fused to noble metal (6242) Major Partial Dentures (5213, 5214) Major Surgical placement of implant body – endosteal implant (6010) Major Implant supported porcelain fused to metal crown (titanium, high noble metal) (6066)

Major

Orthodontia Services BlueDental Coverage

Child( ren) to age 19 50% 50%

Waiting Periods None NoneMajor Service Benefits

None Orthodontia Benefits Maximum Benefits

$1,500 $1,500Plan Year (per person) Lifetime Orthodontia (per person) $1,000 $1,000 Dental Rollover No

Deductible In-Network Out-of-Network No Deductible for Preventive Services (or ortho if selected)

Per Person Per Plan Year $ 50 $50 Per Family Per Plan Year $150 $150 Amounts used to satisfy the in-network deductible also satisfy the out-of-network deductible and amounts used to satisfy the out-of-network deductible also satisfy the in-network deductible.

We Pay* You Pay* We Pay* You Pay** Preventive Services 100% 0% 80% 20% Basic Services 80% 20% 50% 50% Major Services 50% 50% 40% 60%

Periodic Oral Evaluation (0120) Preventive

Comprehensive Oral Evaluation (0150) Preventive Bitewing X-rays, two films (0272) Preventive Cleanings – Adult/Child (1110, 1120) Preventive Fluoride Treatment – Child (1206, 1208) Preventive Office Visits (9430) Preventive X-rays - Intraoral/Complete Series (0210) Basic Sealant – per tooth (1351) Basic Amalgam Restorations (Silver Fillings) (2140) Basic Resin-Based Restorations – Anterior (2330) Basic Extractions – Routine and Surgical (7140) Basic Root Canal Molar (3330) Major Periodontal Scaling & Root Planing – per quad (4341) Major Crowns – Porcelain fused to noble metal (2752) Major Complete Dentures (5110, 5120) Major Pontic – Porcelain fused to noble metal (6242) Major Partial Dentures (5213, 5214) Major Surgical placement of implant body – endosteal implant (6010) Major Implant supported porcelain fused to metal crown (titanium, high noble metal) (6066)

Major

Orthodontia Services BlueDental Coverage

Child( ren) to age 19 50% 50%

Waiting Periods None NoneMajor Service Benefits

None Orthodontia Benefits Maximum Benefits

$1,500 $1,500Plan Year (per person) Lifetime Orthodontia (per person) $1,000 $1,000 Dental Rollover No

Copayment You Pay

Coinsurance We Pay* You Pay**

Periodic Oral Evaluation (0120) Preventive $0 70% 30% Comprehensive Oral Evaluation (0150) Preventive $0 70% 30% Bitewing X-rays, two films (0272) Preventive $0 70% 30% Cleanings -Adult/Child (1110, 1120) Preventive $10 70% 30% Fluoride Treatment -Child (1206, 1208) Preventive $0 70% 30% Office Visits (9430) Preventive $0 70% 30% Space Maintainers -fixed – unilateral (1510) Basic $47 50% 50% X-rays -Intraoral/Complete Series (0210) Basic $17 50% 50% Sealant – per tooth (1351) Basic $6 50% 50% Amalgam Restorations (Silver Fillings) (2140) Basic $15 50% 50% Resin-Based Restorations -Anterior (2330) Basic $20 50% 50% Extractions -Routine and Surgical (7140) Basic $17 50% 50% Root Canal Molar (3330) Major $305 35% 65% Periodontal Scaling & Root Planing-per quad (4341) Major $61 35% 65% Osseous Surgery – four or more contiguous teeth (4260) Major $322 35% 65% Crowns -Porcelain fused to noble metal (2752) Major $302 35% 65% Complete Dentures (5110, 5120) Major $382 35% 65% Pontic -Porcelain fused to noble metal (6242) Major $302 35% 65% Partial Dentures (5213, 5214) Major $420 35% 65% Surgical placement of implant body – endosteal implant (6010) Major $512 35% 65% Implant supported porcelain fused to metal crown (titanium, high noble metal) (6066)

Major $282 35% 65%

Orthodontia Services BlueDental Coverage

Child(ren) to age 19 50%

Waiting Periods Major Service Benefits None Orthodontia Benefits None

Maximum Benefits Plan Year (per person) $1,500 Lifetime Orthodontia (per person) $1,000 Dental Rollover No

BlueDental Choice Copayment Benefit Summary

Group Name: CITY OF GAINESVILLE Group Anniversary Date: 1/1

The information provided above is a summary of benefits. It is intended to highlight key points of the Dental Plan and is provided to the employee as an aid in deciding whether to enroll in the Plan. This summary should in no way be construed as part of the contract. Possession of this summary in no way implies coverage nor does it guarantee benefits under the plan. Some limitations may apply.

*Percentage of allowable charges. **Percentage of allowable charges plus balance charges, if any.

Note: Non-Participating Dentists may charge fees in excess of our Fee Schedule and may bill you for the difference.

Florida Combined Life Insurance Company, Inc. (FCL) is an affiliate of Blue Cross Blue Shield of Florida, Inc. (BCBSF). BCBSF and FCL are Independent licensees of the Blue Cross and Blue Shield Association.

22242-1218 BlueDental Choice Copayment

Deductible In-Network Out-of-Network No Deductible for Preventive Services (or ortho if selected)

Amounts used to satisfy the in-network deductible also satisfy the out-of-network deductible and amounts used to satisfy the out-of-network deductible also satisfy the in-network deductible.

HAVE YOU EVER?

Lost your wallet

Been pursued by a collection agency

Been concerned about your child’s identity Worried about being a victim of identity theft

Signed a contract Had trouble with a warranty or defective product Been overcharged for a repair or paid an unfair bill Needed your will prepared or updated

Worried about entering personal information online

Feared the security of your medical information

Had concerns regarding child support

WHAT IS LEGALSHIELD?

Received a moving traffic violation

LegalShield was founded in 1972, with the mission to make equal justice under law a reality for all North Americans. The 3.5 million individuals enrolled as LegalShield members throughout the United States and Canada can talk to a lawyer on any personal legal matter, no matter how trivial or traumatic, all without worrying about high hourly costs. LegalShield has provided identity theft protection since 2003 with Kroll Advisory Solutions, the world’s leading company in ID Theft consulting and restoration. We have safeguarded over 1 million members, provided more than 200,000 identity consultations, and helped restore nearly 10,000 individual identities.

LegalShield legal plans cover the member; member’s spouse/partner;

never married dependent children under 21 living at home; dependent children under age 18 for whom the member is the legal guardian; never married, dependent children up to age 23 if a full-time college student; and physically or mentally disabled dependent children.

Legal advice - personal and business legal issues*

Letters/ calls made on your behalf*

Contracts & documents reviewed (up to 10 pages)*

Lawyers prepare your Will, your Living Will and your Health Care Power of Attorney, Moving Traffic Violations (available 15 days after enrollment)

IRS Audit Assistance

Trial Defense (if names defendant/ respondent in a covered civil action suit)

25% Preferred Member Discount (Bankruptcy, Criminal Charges, DUI, Other Matters, etc.)

24/7 Emergency Access for covered situations

Residential Mortgage Document assistance

Assistance with Uncontested Separation, Divorce, Name Change, and Adoption

Privacy Monitoring Monitoring your name, SSN, date of birth, email address (up to 10), phone numbers (up to 10), driver license & passport numbers, and medical ID numbers (up to 10) provide you with comprehensive identity protection service that leaves nothing to chance.

Security Monitoring SSN, credit cards (up to 10), and bank account (up to 10) monitoring, sex offender search, financial activity alerts and quarterly credit score tracking keep you secure from every angle. With the family plan, Minor Identity Protection is included and provides monitoring for up to 8 children under the age of 18.

Consultation Your identity protection plan includes 24/7/365 live support for covered emergencies, unlimited counseling, identity alerts, data breach notifications and lost wallet protection.

Full Service Restoration Complete identity recovery services by Kroll Licensed Private Investigators and our $5 million service guarantee ensure that if your identity is stolen, it will be restored to its pre-theft status.

Family IDShield plan covers the member; member’s spouse/partner; never married, dependent children and full-time college students up to age 26.

Dependents will receive unlimited consultation and complete restoration benefit. Monitoring is not available for dependents between age 18-26.

This is a general overview and is for illustrative purposes only. Plans and services vary from state to state. See a plan consultant for your state of residence for complete terms, coverage, amounts, conditions and exclusions.

Payroll Deduction (Biweekly)

Individual Family

LegalShield $7.27 $7.27

IDShield $3.90 $7.36

Combined $11.17 $13.25

Additional Benefits Offered

Short-term disability insurance is designed to provide partial income replacement if you are out of work due to an illness or injury. Short-term disability coverage does not provide income replacement for a work-related injury. There are benefit limitations for disability due to pregnancy and childbirth. This coverage is only available to the employee, not dependents. The bi-weekly premium will vary based on level of benefit, age and length of elimination period.

Employees must contact the AFLAC representative, Soteria Mallard, at 352-317-3835 for their premium quote and to complete an application. The AFLAC representative will send your completed application to Risk Management.

**Employees need to contact the AFLAC representative whenever they have a pay change to ensure your short-term disability pays out based on the current salary and not the former one.

Supplemental term life insurance is offered to City of Gainesville employees through Sun Life Financial. The policy allows employees to purchase life insurance at group rates with the convenience of payroll deduction. Rates are age-banded. Therefore, premiums will vary from person-to-person based on an individual’s age and the amount of coverage requested. Premiums are based on the coverage amount and age as of Jan. 1 of the policy year.

If you and your spouse both work for the city, you cannot cover one another as dependents, and only one of you may insure any dependent children. There is an optional Accidental Death and Dismemberment (AD&D) rider equal to the amount of life insurance. This option is for the employee only.

This policy is portable and can be taken with you, when you leave employment with the City of Gainesville. Term insurance has no cash value accumulated. Rates are for a fixed term and increase as you get older.

As a new hire, spouses and certified/registered domestic partners are eligible for Guarantee Issue Amounts of half the coverage of the employee or $50,000, whichever is less. Coverage for children is available in amounts of $1,000, $5,000 or $10,000. Your unmarried children from live birth but less than age 19, or less than age 25 if a full-time student, may be covered. After 30 days of employment, any elections for the city’s supplemental life plans will require new hires to answer health questions for enrollment.

Q. When should I complete an Evidence of Insurability (EOI) application for my supplemental life insurance policy?

A. Please complete an EOI application for your policy by answering health questions, provided you are:

• Enrolling in an employee policy as a late entrant (anytime outside of days 1-30 of new hire) total of 60 days for election.

• Enrolling in an employee policy for the first time and the requested coverage amount is more than $150,000 (as a new hire)

Short-Term Disability Insurance

Supplemental Life

Please contact Employee Health Services if you qualify for FMLA. They will help you get started with this process.

Eligible employees may take a maximum of 12 weeks of family and medical leave each calendar year. Certification must be obtained from a health care provider and approved by Employee Health Services. This leave may be paid (if applicable leave is available) or unpaid. The FMLA Leave Year is defined as the 12-month period measured forward from Jan. 1 each year. FMLA will be granted for:

• The birth of a child and care for a child within 12 months following the birth.**

• The placement of a child with the employee. Leave must be taken within 12 months following placement.

• To care for the spouse, child, or parent of the employee who has a “serious health condition.”

• If the employee is unable to perform his or her own job because of the employee’s own serious health condition.

• An eligible employee who is the spouse, son, daughter, parent or next of kin of a covered service member, as defined by the FMLA, who is recovering from a serious illness of injury sustained in the line of duty on active duty is entitled to up to 26 weeks of leave in a single 12-month period to care for the service member.

This military caregiver leave is available during “a single 12-month period” during which an employee is entitled to a combined total of 26 weeks of all types of FMLA leave.

• An employee who exceeds the 12-week FMLA period and is placed in a “leave without pay” status will become ineligible for benefits. Subsequently, the employee’s benefits will be terminated. When the employee returns to work, the benefits will be reinstated, and the employee will be responsible for any missed deductions. Should the employee choose not to return to work, then the balance will be deducted from the last paycheck or the pension refund of a non-vested employee. If vested and the employee terminates employment, any outstanding premiums owed will be billed to the employee and will be assigned to an external collections agency, if not paid.

**To add a newborn to the benefits, copies of the birth certificate and Social Security card must be sent to Risk Management. Sending the birth certificate to Employee Health Services does not enroll newborns in insurance coverage.

Family and Medical Leave Act (FMLA)

Q. Where can I find the Evidence of Insurability application?

A. After you enroll in Workday, you will receive an email from Sun Life advising you to answer any health questions.

Please complete the questionnaire as soon as possible. If you do not receive an email from Sun Life within 24-4 hours, please contact Risk Management.

Q. What will happen if I do not complete an EOI as required?

A. Your supplement life plan will be removed from your benefit elections or reduced to a lower coverage amount.

Spouses will not be covered at all.

** Note: If you and your spouse are both city employees, you cannot elect Voluntary Life for spousal coverage; nor can both of you cover the same dependents. You may have separate policies and cover different dependents, and you may select your spouse as a beneficiary.

The City of Gainesville offers two flexible spending accounts (FSA) for its employees: a medical reimbursement account and a dependent care reimbursement account. These accounts allow employees to set money aside to pay for health care or dependent care expenses on a pre-tax basis. Any reimbursement from the account is also tax-free. Important note: These contributions are deducted from your earnings prior to calculation of federal taxes. The employee determines the annual amount they wish to contribute. The annual contribution amount is divided by 26, the number of paychecks per year, and deducted from the employees pre-tax earnings over the course of the year.

Flexible spending accounts are “use it or lose it” accounts. Any amounts not used by the end of the plan year are forfeited. A mandatory bi-weekly administration fee of $1.75 must be paid in addition to your bi-weekly medical and dependent care reimbursement account deduction.

A medical reimbursement account can be used to offset eligible medical, dental or vision expenses incurred by you, your spouse or eligible dependent children. Expense eligibility is determined by the Internal Revenue Service.

Examples of eligible expenses are deductibles, co-payments and co-insurance payments. The employee has access to 100% of the elected contribution amount Jan. 1, 2026. The annual maximum allowed for 2026 is $3,300.

In order to be eligible for reimbursement, services must be performed/received between Jan. 1, 2026 and March 15, 2027 and while you are an active participant in the account. All claims for reimbursement must be submitted to Voya no later than May 31, 2026. All participants will receive a debit card for health-related expenses. Should you want more than one card, please contact Voya (additional fees apply). New cards are issued once your current one expires; check the expiration date on the front of your card.

Some examples of common expenses you might have are:

Flexible Spending Accounts

Medical Reimbursement Account

FSA

Dependent Care Reimbursement Account The Dependent Care Reimbursement Account gives the employee an opportunity to set aside pre-tax dollars to pay for qualifying dependent daycare expenses. Presently, the maximum one can contribute to this account this year is $7,500 or $3,750 if married and filing separately. A Dependent Care Reimbursement Account may be right for you if:

• You incur daycare expenses so you can work or look for work.

• You are married and you incur daycare expenses so you can work full time and your spouse can work or go to school full time.

• You incur daycare expenses so you can work full time and your spouse, legal dependent or elderly parent is incapable of self-care.

Expenses eligible for reimbursement include the cost of care for dependents who meet the IRS definition of a dependent as follows:

• Charges for care of dependents under the age of 13, who reside in your household.

• Charges for the care of dependent adults or children, who are mentally or physically incapable of self-care, and spend at least eight hours a day in your household. You must provide proper documentation of such conditions.

• The cost of summer camp tuition if it is a day camp.

• The Dependent Care Reimbursement Account is a “dollar in, dollar out” type of account where an employee can only be reimbursed the amount currently contributed. All claims for reimbursement from a 2026 account must be received by Voya no later than May 31, 2027.

• Prescriptions

• Hearing aids

• Calendar year deductibles

• Copayments and co-insurance

• Dental fees and services and/or orthodontic fees

• Eye exams, glasses, contacts and/or Lasik

Retirement Planning

The City of Gainesville maintains two defined benefit pension plans for its employees. The Consolidated Police Officers’ and Firefighters’ Retirement Plan covers any full-time regular employee who is certified as a firefighter as a condition of employment or any full-time regular employee who is certified or required to be certified as a law enforcement officer for the City of Gainesville. All other regular employees of the City of Gainesville are covered under the Employees’ Pension Plan.

Participation in either pension plan requires a mandatory contribution from both the employee and the City of Gainesville. The city takes responsibility for producing the needed level of investment returns to meet the current and future pension benefit obligation of its retirees. Currently employees covered by the Consolidated Police Officers’ Plan contribute 7.5% and employees in the Consolidated Firefighters’ Retirement Plan contribute 9% of earnings during participation in the plan. Those covered by the Employees’ Pension Plan are required to contribute 5% of earnings during participation in the plan. Contributions cease when an employee enters the Deferred Retirement Option Program (DROP). Those hired after Oct. 1, 2012 are not eligible for DROP.

These plans are tax-qualified defined benefit plans. Because the plans are tax-qualified, you will not pay any income tax currently on the contributions you make to that plan. Instead, you will be taxed when you receive benefits under the plans, at which time you may be in a lower tax bracket than during your peak earning years. Because the plans are defined benefit plans, your ultimate benefit depends upon factors such as your compensation level, years of service, and the form in which your benefits are paid.

The plans are designed to provide a measure of economic security for retirement in addition to that provided by Social Security and your own personal savings. You are encouraged to establish and maintain your own retirement savings program and not to rely solely on Social Security and employer provided retirement benefits.

Although both plans are very similar in how they work, each plan has different criteria to define eligibility, plan multipliers for benefit calculation, COLA eligibility and DROP eligibility.

Summary Plan Descriptions for all plans are located on the City of Gainesville website, under the Financial Services Department, at www.GainesvilleFL.gov or on the Risk Management part of the Community Builder Hub. These Summary Plan Documents (SPD) are updated every two years.

City Defined Benefit Pension Plans

Supplemental Retirement Planning

The…