Medical, Dental and Vision
Enrollment Information
Health insurance becomes effective on the first day of the month following your effective hire date, provided the Employee Benefits Department has received your completed enrollment form within 60 calendar days of your hire date. If your paperwork is not received within this timeframe, you may enroll in any health coverages during the next open enrollment period.
You may waive medical insurance if you have medical coverage through another group health plan. To waive medical insurance, you must sign and submit a waiver form stating you have other group coverage elsewhere and provide proof of your other group health coverage.
You are responsible for any dependent coverage. Generally, "dependents" are the employee's spouse and unmarried children, who are covered from birth to age 25.
Employees may also enroll same-sex domestic partners in the health insurance program. Employees must provide a notarized Domestic Partnership Affidavit available at the Employee Benefits office. An employee must pay for his or her partner's health coverage on an after-tax basis.
You may change coverage during the Open Enrollment period, which normally occurs in the month of May. At this time, you may change plans, add or drop coverage, or add or drop dependents.
If you have a job status change (i.e. increase of work hours resulting in Benefit eligibility) or family status change occurs (i.e. marriage, divorce, birth of child, adoption of child, loss of employment), you have 31 days to make changes in your coverage. Legal, written proof of the family status may be required. In the event of a family status change, you are only allowed to add or drop coverage or dependents.
Medical Insurance
Kaiser Permanente. If you choose to enroll in one of the Kaiser Permanente plans, your health coverage is administered by Kaiser physicians, who coordinate your care in Kaiser facilities throughout the metro area. There are no deductibles or claim forms associated with either the high or low option Kaiser plans. For more information and to find a provider, go to www.kaiserpermanente.org.
PacifiCare. You can choose one of two available plans: PacifiCare HMO and PacifiCare Plus. PacifiCare HMO is a Health Maintenance Organization which requires that you select a primary care physician (PCP). PacifiCare Plus is a point-of-service plan. With PacifiCare Plus, you can go in or out-of-network as you choose each time you need health care. However you generally pay more for out-of-network care. For in-network services, have your PCP coordinate your health care treatment. For out-of-network services, you coordinate your own care and file your own claims. For more information and to find a provider, go to www.pacificare.com.
For Kaiser and PacifiCare rate information, go to Comparison of Rates.
For Kaiser and PacifiCare plan information, go to Comparison of Plans.
Health Insurance Benefit Update: $42 Monthly Benefit Savings!
Dental Insurance
Delta Dental Premier. With Delta Dental Premier, you may use any dentist you wish. If you use a dentist other than a Delta Dental Premier dentist, you pay the difference between the actual cost of the service and the cost approved by Delta Dental for a covered benefit. Delta provides two free cleanings per year, restorative care (basic fillings) covered at 80%, and major care covered at 50%. There is a $1,500 calendar year maximum benefit person. A $50 calendar year deductible (per person) is required for basic and major services.
Delta Dental EPO. The Delta Dental EPO provides coverage for services performed only by network care providers. Preventive and basic care expenses are covered at 100% for most services. All other services are paid based on a fee schedule. There are no deductibles or maximum benefit allowances.
For rate information, go to Comparison of Rates.
For plan information, go to Comparison of Plans.
For more information and to find a provider, go to www.deltadentalco.com.
Vision Insurance
Vision Service Plan (VSP). You will receive a higher level of reimbursement if you select a VSP provider. If you receive services form an out-of-network, licensed provider, VSP will reimburse you up to the amount allowed under your plan's out-of-network provider reimbursement rate.
If you use a VSP provider, you may receive one eye exam at no cost every 12 months ($10 per dependent per visit). Also, once each year, the plan covers 100% of the cost of basic lenses and provides an allowance for frames. If you choose contact lenses instead of glasses, the plan pays a $120 allowance for an exam and materials. Employees pay the cost of dependent coverage.
For rate information, go to Comparison of Rates.
For plan information, go to Comparison of Plans.
For more information and to find a provider, go to www.vsp.com.