The last several years have been financially challenging for individuals, families and employers. Washington County has not been immune to these challenges and has responded by selectively reducing the size of our workforce, implementing expenditure limits and actively managing the County’s overall finances with an eye towards long term stability – all while providing high quality services to the community.
While we have made reductions across the organization and expenditure categories, it is clear that managing the growth of employee benefit expenses has now become necessary for our long-term financial health.
Depending on elections, all regular, benefit eligible employees and elected officials will begin to share in the cost of medical premiums.
Please take this opportunity to review the materials and determine what health coverage is right for you and your family. Please see the table on page 2 for your opportunities to attend an informational session and have your questions answered.
You must return your Benefit Election Form to Human Resources before 5pm on
June 8, 2012
Premium Contributions
The County is rolling out premium contributions County-wide. (P. 3)
Vision Coverage We are proud to offer employees the option to purchase vision coverage for eligible dependents, through our current vision provider, ODS. In addition, we will be increasing the frequency for eyewear allowances. (P. 6)
Unum Individual Short Term Disability Plan (ISTD)
ISTD can replace some of your income if you experience a qualifying short term disability. Enrollment is only offered annually; take this opportunity to consider if it is right for you. (P. 8-9)
NEW Employee Benefits Handbook The County has formalized eligibility and benefit processes. This document is available on the Benefits webpage and exists as a reference guide during Open Enrollment and throughout the plan year. Visit www.co.washington.or.us/benefits.
What’s New & Different
Open Enrollment May 14-June 8, 2012
Employee Benefits
Plan Year Change The County will be transitioning all health plans to a calendar year plan, effective January 1, 2013. Coverage elected during this Open Enrollment will be for July 1-December 31, 2012.
Providence Health Plan Providence will continue as the County’s PPO plan offering, with minor plan benefit changes. (P.6)
Enhancements include:
• Deductible waived for removable custom shoe orthotics.
• Elimination of 60-day limit for residential mental health/chemical dependency.
Kaiser Health Plan Alternative care will now be offered as a part of the Kaiser plan. Grandchildren are only eligible for Kaiser coverage if County employee is the legal guardian. (P. 6)
ODS Dental & Willamette Dental Group There will be no benefit plan design changes. (P. 7)
The information in this publication is only a brief description of some Washington County benefits. The controlling provisions of these plans are outlined in the group policies or plan documents, which can be requested by contacting the Benefits Team at 503-846-8686. This is not a guarantee of benefits.
Urgent Action Required You must complete an election form during this enrollment period to confirm desired
coverage & provide dependent information.
P A G E 2
Make sure
you get all
of your
questions
answered
and your
Election
Form
submitted
to the HR
office by
5 PM on
Friday,
June 8th.
Calendar of Significant Dates
You will be re-enrolled in your current
coverage if no form is received.
Open Enrollment Begins Mon., May 14
Information Sessions Presentation of plan changes and new benefit options, followed by an opportunity for questions and answers
Mon., May 14 1-3pm PSB Auditorium
Tues., May 15 2-4pm Sheriff’s Office, Tr. Rm. C
Wed., May 16 9-11am PSB Auditorium
Wed., May 16 2-4pm Walnut Street Center
Thur., May 17 9-11am Service Center East, Rm. 195
Thur., May 17 2-4pm Sheriff’s Office, Tr. Rm. A
Thur., May 17 5:30-7pm PSB Auditorium
Mon., May 21 1-3pm PSB Auditorium
Tues., May 22 9-11am Sheriff’s Office, Tr. Rm. A
Tues., May 22 2-4pm Walnut Street Center
Wed., May 23 10am-noon PSB Auditorium
Thur., May 24 8-10am Service Center East, Rm. 195
Tues., May 29 2-4pm Sheriff’s Office, Tr. Rm. B
Thur., May 31 10am-noon PSB Auditorium
Mon., Jun. 4 10am-noon PSB Auditorium
Thur., Jun. 7 2-4pm PSB Auditorium
Benefit Fairs Opportunity to stop by and visit with benefit plan providers
Mon., May 21 10am-3pm PSB Cafeteria
Wed., May 23 2-4pm Walnut Street Center
Individual Appointments Opportunity to discuss questions one on one
Fri., May 18 11am-4pm By appointment only, x8686
Fri., May 25 11am-4pm By appointment only, x8686
Q&A Sessions Drop-in session for questions and answers
Jun. 4 10am-4pm PSB 270, Sequoia Rm.
Jun. 5 9am-1pm PSB 270, Sequioa Rm.
Fri., Jun 8 8am-5pm PSB 270, Sequoia Rm.
Unum Enrollment meetings
Short-term Disability Benefit
Wed., May 23 & Tues., May 29
By appointment only, call x8686
Open Enrollment Ends June 8, 2012 FINAL DAY TO SUBMIT ENROLLMENTS
Effective Date of Health and Dental Coverage
July 1, 2012
Effective Date of Premium Deductions
July 13, 2012 1st deduction July 13 paycheck
Effective Date of new ISTD Coverage
August 1, 2012
Effective Date of new ISTD Premiums
Aug. 10, 2012 1st deduction Aug. 10 paycheck
Jun. 6 & 7 8am-3pm PSB 270, Sequoia Rm.
E M P L O Y E E B E N E F I T S
P A G E 3
Premium Contribution Rates Rates outlined below are effective July 1-December 31, 2012. Premiums will be deducted on a semi- (2x) monthly basis, on the first and second checks of a month for coverage during that month. Employees will have the opportunity to change coverage during the Fall Open Enrollment 2012, (effective January 1, 2013).
Insurance Plan Coverage Level
Semi-Monthly Employee Contribution (Per Pay Period)
Kaiser Permanente Plan (HMO)
Employee No employee cost
Employee + Spouse No employee cost
Employee + Child(ren) No employee cost
Employee + Family No employee cost
Providence Open Option Plan (PPO)
Employee $12.03
Employee + Spouse $24.06
Employee + Child(ren) $21.66
Employee + Family $36.09
ODS Vision Plan
Employee No employee cost
Employee + Spouse $4.38
Employee + Child(ren) $4.38
Employee + Family $8.76
ODS Dental & Willamette Dental
Dental coverage continues to be 100% County-paid for employees and their eligible family members
More detailed information regarding this coverage is available in Human Resources or by selecting the Open Enrollment link at www.co.washington.or.us/benefits. You can also contact the Benefits Information Line at 503-846-8686 (x8686) with questions.
P A G E 4
E M P L O Y E E B E N E F I T S
Premium Deduction Plan
The County has adopted a Premium Deduction Plan that meets IRS code Section 125. This plan allows the County to offer employees the option to pay for their portion of monthly premiums on a pre-tax basis. This option is especially attractive as it results in greater take-home pay than after-tax premiums. A pre-tax arrangement means that the part of your salary that goes for health insurance premiums will become non-taxable and not subject to Federal income tax, FICA taxes (Social Security and Medicare taxes), or Oregon State and local income tax. Section 125 IRS regulations require that we formalize and uphold the following rules: Eligibility
Employees All regular full-time and part-time (20+ hrs/wk) employees are able to elect to pay for benefits on a pre-tax basis. Dependents Coverage for the following individuals can be offered on a pre-tax basis: • Legal spouse • Biological children, step-children, and legally adopted children, up to
age 26 • Children over age 26 incapable of self-sustaining employment by
reason of mental or physical disability • Children for whom you are the legal guardian • Children you support as the result of a valid court order
Enrollment and Qualifying Life Events Your elections made during the enrollment period are fixed for the remainder of the plan year, unless you have a qualifying life event. The following are considered “qualifying life events:” • A legal marital status change (marriage, death of spouse, divorce, or
annulment) • Commencement/Termination of registered same-sex domestic partnership • A change in the number of your dependents (birth, death, or adoption) • A change in employment status for you, your spouse, your registered
same-sex domestic partner or your dependent which results in a change of eligibility for benefits
• Your dependent ceases to satisfy eligibility requirements due to age • You or your dependent becomes entitled to or loses eligibility for Medicare
or Medicaid • Commencement of or return from an unpaid leave of absence which
results in a change of eligibility for benefits • Judgment, decree or order resulting from a divorce, annulment or change
in legal custody
Any changes during the plan year must be made within 30 days of the qualifying life event.
P A G E 5 M A Y 2 0 1 2
To qualify for pre-tax deductions, each employee must complete and submit an enrollment form. All forms are due by 5pm on Friday, June 8.
1. Decide which medical, dental, and vision plans best meet the needs of you and your family.
2. Confirm eligibility.
3. Complete Benefits Election Form, (included with this Open Enrollment mailing) to confirm desired coverage and provide dependent information.
4. Return completed forms to Human Resources by 5pm on June 8th.
5. If not already enrolled, decide if you want to elect Individual Short Term Disability. Contact UNUM (888-329-9384) for details and to apply.
6. Additional questions? Call the Benefits Information Line, 503-846-8686 (x8686).
Steps to Elect:
Paying for Benefits: the tax implications Dependents must qualify according to the IRS guidelines listed under Dependent Eligibility in order for premiums to be paid on a pre-tax basis. While some dependents are eligible for coverage under the County plans, their coverage may not be eligible for the pre-tax benefit. For example, the employer cost of providing benefits for registered same-sex domestic partners and any other non-tax dependents is considered ordinary income or “imputed income” and is, therefore, subject to taxes, including Federal, FICA (Social Security & Medicare), state and city taxes, where applicable. Imputed income will be calculated and entered upon enrollment. Effective Date of Coverage Enrollment will be effective July 1, 2012. After Open Enrollment, if you experience a qualifying life event, you have 30 days to submit paperwork to add/remove coverage for any newly eligible/ineligible dependents. For coverage to be effective the 1st of the month following the event, you must submit your form by the 15th of that month. Coverage will be delayed by an additional month for forms received on the 16th or after, but still within the 30 day window. Some life events require documentation in addition to completing a request for enrollment. Details can be found in the Employee Benefits Handbook.
Medical , Dental and Vision coverage elected during this Open Enrollment period will be effective for July 1-December 31, 2012 coverage. There will be an additional Open Enrollment in the Fall, with an opportunity to change coverage effective January 2013.
P A G E 6
E M P L O Y E E B E N E F I T S
Health Plans: Medical More complete benefits information is available on the Benefits web page at: www.co.washington.or.us/benefits under the Open Enrollment link.
Deductible None
Office Visit (primary) $15 co-pay
X-rays, Lab, Imaging No Charge
Rx (Outpatient) up to 30-day supply
$15/Rx Generic $30/Rx Brand-name 2 co-pays for 90 day supply
Hospital Inpatient No Charge
Emergency Visit $75 (waived if admitted)
Alternative Care Coverage effective 7/1/12
$15 co-pay: Acupuncture, chiropractic, naturopathic $25 co-pay: Massage Therapy (max: 12 visits per yr.) Annual max: $1,500
Medical
Kaiser members must utilize a Kaiser facility/provider for the benefit levels below to apply. A list of current providers is available at www.khpgroup.com.
Remember to consider premium deductions as you decide which plan is right for you and your family.
Grandchildren are only eligible for Kaiser coverage if the employee is the legal guardian.
Providence members have the option to utilize out-of-plan providers, or seek care from in-plan participating providers for lower out-of-pocket costs.
Plan enhancements:
• Deductible no longer applies for removable custom shoe orthotics
• Elimination of 60-day limit for residential mental health/chemical dependency (medical necessity applies)
In-plan Out-of-plan
Deductible
Office Visit $15 co-pay 40%, after deductible
X-rays, Lab, Imaging 20% 40%, after deductible
Rx (Outpatient) up to 30-day supply
$15/Rx Generic $30/Rx Brand-name 2 co-pays for 90 day supply
Emergency Only
Hospital Inpatient 20%, after deductible 40%, after deductible
Emergency Visit $250 co-pay $250 co-pay
Alternative Care
$15/visit: Acupuncture, chi-ropractic, naturopathy Annual max.: $1,500
Not covered
$250/person $750/family
New!
New!
P A G E 7
Health Plans: Vision & Dental
Service Max. amount covered
Eye Exam (every calendar year) 100% after $5 co-pay
Single Vision Lenses $40/pair*
Bifocal Lenses $60/pair*
Trifocal Lenses $80/pair*
Contacts Lenses $150/pair*
Frames (every calendar year) $110
Both dental plans are renewing this year with the same plan design and 100% County-paid premiums.
M A Y 2 0 1 2
Washington County will continue to provide vision benefits through ODS Vision (ODS Plus Provider network) with employee-only coverage offered at no cost-share.
The County is proud to be able to offer an option to buy-up additional
levels of dependent coverage on a voluntary pre-tax basis. Rates for dependent coverage are outlined on page 3.
Effective July 1, plan benefits will renew each calendar year according to the schedule below.
*This coverage does not provide for lenses and contacts in the same calendar year. Note: There is typically no additional benefit to electing “double coverage” for a dependent when this plan is the secondary insurance. Please see the Employee Benefits Handbook for additional Coordination of Benefits (COB) information.
Employee
surveys and
comments
have
consistently
indicated a
need to offer
the option
for
dependent
vision
coverage.
ODS Vision
Annual Maximum Benefit $1,500
Preventative & Basic Care (exams/x-rays, cleaning, fillings, endodontics & periodontics)
1st year– 30% co-insurance 2nd year– 20% co-insurance 3rd year– 10% co-insurance 4th year– 0%
Major Services (crowns, bridge work, dentures)
50%
Orthodontia No Coverage
Dental Providers Provider of choice
Dental
Annual Maximum
Benefit
None
Office Visit charge $4 co-pay
Exam/Cleaning/ X-rays
No Charge
Fillings No Charge for certain material
Crown/Inlay $40 co-pay
Root Canal Work $30 co-pay
Orthodontia $2,500 co-pay + office charge
Dental Providers Willamette Dental
Network
Willamette Dental Group
ODS Dental
New!
New!
Dental Both dental plans are renewing this year with the same plan design and 100% County-paid premiums.
Message from the County
How to Apply for Short Term Disability: Please, take time to discuss this benefit with a Unum Benefit Counselor; either in person or via Unum’s Call Center. Counselors are available at any of the benefit fair locations. They will have sign-up sheets available for individual meetings with the counselor to discuss your Short Term disability needs. You may also call 503-846-8686 (x8686) to schedule a time to meet with the benefit counselor. Individual meetings will be held Wed., 5/23 and Tues., 5/29. The Unum Call Center is available throughout Open Enrollment, 888-329-9384, Monday-Friday, 8am-5pm EST. Additional information is available on the Benefits webpage: www.co.washington.or.us/benefits. Follow the Open Enrollment link.
P A G E 8
Monthly expenses you should consider: Mortgage/rent · Transportation · Utilities · Insurance · Food & Clothing · Education ·
Loans/credit card debit · Child care/elder care · Savings contributions/retirement · · Medical costs ·
Individual Short Term Disability Annual Enrollment Opportunity
P A G E 9 M A Y 2 0 1 2
Maximum Monthly Benefit
7 Days Accident / 7 Days Sickness Elimination period / 3 Months Benefit
14 Days Accident / 14 Days Sickness Elimination period / 3 Months Benefit
Issue ages 17-49 Sickness & Off Job
Accident
Issue Ages 50-69 Sickness & Off Job
Accident
Issue Ages 17-49 Sickness & Off Job
Accident
Issue Ages 50-69 Sickness & Off Job
Accident
$ 800.00 $ 13.50 $ 16.34 $ 10.01 $ 12.05
$ 1,200.00 $ 20.24 $ 24.49 $ 15.02 $ 18.07
$ 1,600.00 $ 26.98 $ 32.66 $ 20.00 $ 24.10
Sample rates indicated above are Semi-monthly. Premiums will be after-tax deductions from the first two checks of the month.
P A G E 1 0 M A Y 2 0 1 2
Frequently Asked Questions (FAQs)
Q: Do I have to complete a form? A: Yes. You must complete and submit a form THIS Open Enrollment (May 14-June 8). A personalized Benefit Election Form is included with this mailing. Please review, complete and return this form to Human Resources no later than 5 PM on Friday, June 8th.
Q: What happens if I do not turn in a form? A: If you do not turn in a form, your current level of coverage will automatically rollover with any required premium payments beginning with your July 13th paycheck. Additionally, if you are covering dependents on your insurance, you must still provide the requested dependent information. You will not be permitted to change your benefits for the remainder of the plan year unless you have a qualifying life event (e.g. marriage, birth, adoption). Q: Why are you asking for my dependents’ social security number (SSN)? A: To comply with Center for Medicare & Medicaid Services regulations, the County is requesting Social Security numbers (SSN) for all dependents, regardless of age, for whom you are electing to cover on your medical plan. Q: What if I would like to cover dependents that eligible for coverage under the County plans, but do not qualify for pre-tax premiums? A: If the dependents are eligible, you can pay for that portion of your premium with after-tax dollars. Examples of dependents ineligible for pre-tax premiums include registered same-sex domestic partners and children of a registered same-sex domestic partner. For full details regarding pre-tax eligible coverage please reference the Employee Benefits Handbook at www.co.washington.or.us/benefits. Q: Do I have to cover the same dependents on all health plans? A: No. You can specify which dependents you would like to cover on the medical, dental and vision plans that you select as the employee.
Several Washington County employees may have double or dual coverage here at the County.
Q: What if my spouse and I are both employed by and covered by Washington County? A: You have some decisions to make for the new plan year, and your decision depends on your individual situation. Here are some options:
1. You can continue to have primary and secondary coverage through Washington County (dual or double insured). This could mean that you and your spouse would each be paying premium deductions on his or her pay check. This can be beneficial if you generally have high out-of-pocket costs (meet your deductible etc.).
2. You can decide to each carry your own coverage and each pay any applicable individual premiums. This will require that each employee complete a form electing the change in benefits.
3. You can cover both you and your spouse on your coverage; and your spouse can waive benefits. This allows any applicable premiums to be deducted from one paycheck. It also requires an election form from you, as well as a completed waiver form from your spouse.
P A G E 1 1
Q: Can I pay for my medical premiums using my Flexible Spending Account? A: No. Your medical premiums will already be paid on a pre-tax basis. Q: Can I change my Flexible Spending Account election now? A: Our FSA plan will not be open for changes in elections until the Fall Open Enrollment for the January 1, 2013 plan year. Q: When are forms due? A: The final deadline for forms is June 8, 2012 at 5pm. There are incentives for completing and submitting your form early; there will be weekly drawings during the Open Enrollment period. Brief details are included with the Open Enrollment mailing, with additional information on Horizons. Q: How do I apply for Individual Short Term Disability (ISTD) with Unum? A: There are two ways you can apply for Individual Short Term Disability coverage. Unum will have representatives on site for two separate days during Open Enrollment where you can apply in-person with a counselor. You can also contact the Unum Call Center and apply via phone.
Q: When is the next opportunity to change my benefit elections? A: This Open Enrollment affects the plan year July 1-December 31, 2012. There will be another Open Enrollment in the fall of 2012, for coverage in the following plan year, January 1-December 31, 2013. This will include all health benefits and flexible spending account enrollments. Q: Where can I find more Open Enrollment information? A: Additional information can be found in several ways: • Electronic versions of most materials can be found on the
Employee Benefits website, www.co.washington.or.us/benefits under the Open Enrollment link.
• All Open Enrollment materials, forms, policies, and complete plan summaries are available in Human Resources.
• Attend one of the informational sessions or benefits fairs.
• You can call the Benefits Information Line at (503) 846-8686.
Our mission is to provide excellent and cost effective services that support healthy, peaceful, safe and sustainable communities; and encourage meaningful participation in
community activities and County governance. Mission Driven We commit ourselves to relevant and quality services. The County will not be the government of last resort that attempts to provide all the services that no one else can or will provide. The County will, however, actively engage others to address a wide range of community concerns fulfilling the varied roles of direct service provider, partner or supporter.
Citizens We will be citizen-driven, both internally and externally. We will treat others with courtesy, respect and provide quality service.
Accountability We will ensure public funds provide priority service. We will strive to get the most benefit from available resources through sound business practices. We will act in accordance with the law, with integrity and in the public interest; ensuring quality supervision and accountability throughout the organization.
Pursuit of Excellence We commit ourselves to quality and excellence. Innovation and calculated risk taking are essential. We commit ourselves to best practices and professional standards and to continuous improvement and creativity. We will look ahead and not default to the status quo.
Integrity, Loyalty and Trust We believe ethical conduct is paramount and it will be a trademark of our organization. We will strive to create and maintain an environment of trust, loyalty, and civility which comes from open, honest, and direct interactions with each other and our residents.
Stewardship We commit ourselves to the efficient use of public resources. We will invest in our people, systems and facilities.
Valued Employees We will hire and develop capable and professional employees and provide them with the tools to perform their duties. We will enable employees and teams to manage their work and expect them to be accountable for their decisions and actions. We commit ourselves to employee development and active performance management.
Diversity We will treat all people with dignity, honesty and respect. We will demonstrate through our actions an understanding and appreciation for cultural diversity and individual differences. We will not tolerate harassment or discrimination.
Accessibility Citizens and employees, regardless of abilities, will have ready access to our services and facilities. Our processes will be open and fair to all.
Prevention We believe in prevention and early intervention and will promote healthy lifestyles and choices to prevent problems and reduce risks.
Teamwork We will enhance and support teamwork and team building in our diverse organization. We will strive for a professional and cooperative working relationship with residents, organizations and other public agencies.
Our Washington County
Mission & Guiding Principles