Health
Medical - Dental - Vision
The County pays all or a portion of the premium cost for employee coverage based on employee contract agreements. For employees who wish to cover their dependents, premiums are deducted each pay period on a pre-tax basis*. Employees pay 50% of dependent premiums. The table below outlines the cost, per pay period, to the employee based upon plan selection and number of family members covered:
| For Fiscal Year 14-15 | PPO | HDHP | HMO |
| Spouse or Domestic Partners* | $154.58 | $107.96 | $136.01 |
| Child or Children |
$127.58 |
$90.29 | $110.52 |
| Family (spouse plus child/ren) | $265.60 |
$181.68 |
$295.61 |
| * Domestic Partner premium is a post-tax deduction | |||
Self-funded Group Health Plan (SFGHP)
The PPO Plan for the Self-funded Group Health Plan is administered by CDS Group Health and the Preferred Provider Network is maintained by Universal Health Network.
Prescription benefits under this plan are managed by CVS Caremark.
Self-funded PPO Provider Network
Self-funded Plan Summary of Benefits and Coverage (SBC)
High Deductible Health Plan (HDHP) with a Health Savings Account (HSA)
The High Deductible Health Plan (HDHP) is administered by CDS Group Health and is paired with a Health Savings Account (HSA) which is administered by American Fidelity Assurance Company.
Self-funded High Deductible Plan Summary
HDHP Plan Summary of Benefits and Coverage (SBC)
Health Maintenance Organization (HMO) Plan
This plan is administered by Hometown Health, with prescription benefits managed by MedImpact.
Hometown Health HMO Provider Network
HMO Summary of Benefits and Coverage (SBC)
This GAP Plan is administered by American Fidelity Assurance Company, and is designed to help cover some of your out of pocket expenses with the HMO group health plan.
Dental and Vision Benefits
The Dental and Vision benefits are the same for all employees, regardless of which medical coverage is elected. Coverage under the dental and vision benefit plans is bundled with the medical plans, so employees are not able to opt out of any coverage offered.
The self-funded dental plan is administered by CDS Group Health and the list of PPO dental providers is managed by Guardian:
Self-funded vision benefits are with Vision Service Plan (VSP):
Vision Service Plan (VSP) Provider Network
Life Insurance
Cobra
The Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985 mandates that employers offering health insurance with 20 or more employees must continue to offer employee benefits when they quit, are laid off or fired, or have their work hours reduced. Additionally, benefits must be offered to the employee’s spouse and dependents. COBRA benefits apply to health care plans, dental plans, vision plans, prescription drug plans, etc. Benefits may continue for up to 18, 24, 29 or 36 months, depending on the cause for the loss of benefits.
Monthly Cobra Premium Rates FY 2014-2015
|
PPO - Option A Medical/Vision/Dental |
PPO - Option B Medical Only |
HMO - Option A Medical/Vision/Dental |
HMO - Option B Medical Only |
|
| Employee (coverage for one) | $685.73 | $626.03 | $641.20 | $$581.50 |
| Employee plus Spouse | $1,368.48 | $1,256.48 | $1,241.87 | $1,129.86 |
| Employee plus Child/ren | $1,249.15 | $1,145.65 | $1,129.18 | $1,025.68 |
| Employees plus Family | $1,859.18 | $1,699.77 | $1,947.31 | $1,787.90 |
|
Rates for Dependents Only |
||||
| Spouse | $685.73 | $626.03 | $641.20 | $581.50 |
| One Child Only | $685.73 | $626.03 | $641.20 | $581.50 |
| Two + Children | $1,249.15 | $1,145.65 | $1,129.18 | $1,025.68 |
| Spouse and Child/ren | $1,249.15 | $1,145.65 | $1,129.18 | $1,025.68 |
NOTE: The medical, dental, vision, prescription and life benefit plans are administered by the Human Resources department at Washoe County. The benefit information provided is subject to change. If there are conflicts of benefit descriptions at any time, the plan document for that benefit will prevail.
Flexible Spending Account (FSA)
Plan Section 125 Flexible Benefit Plans allow employees to direct a part of their pay, on a pre-tax basis, into a special account that can be used to reimburse them for Dependent Day Care and/or Unreimbursed Medical expenses. Because the money goes into the accounts before federal income taxes or FICA contributions are withheld, the employee pays less in taxes, and ultimately has more disposable income. As qualified Dependent Day Care and/or Unreimbursed Medical expenses are incurred, the employee submits appropriate claim paperwork to the plan administer for reimbursement.
A limited-purpose Flexible Spending Account (FSA) is also available to participants in the Health Savings Account/High Deductible Health Plan. This plan limits your FSA reimbursements to dental and vision expenses only.
Washoe County's Flexible Spending Benefit Plan is administered by American Fidelity Assurance Company.
Dependent Day Care Reimbursement
A Dependent Day Care Reimbursement account is used to reimburse eligible dependent care expenses incurred to allow the employee (and spouse if married) to work or look for work. Employees at Washoe County may allocate up to $5, 000 pre-tax per calendar year for reimbursement of dependent care services ($2,500 if you are married and file a separate tax return).
Dependent Day Care Reimbursement Claim Form
Unreimbursed Medical Expense Account
An Unreimbursed Medical Expense Account may be used to reimburse eligible medical expenses incurred for the employee, spouse and eligible dependents. Example of eligible medical expenses may be found on American Fidelity's website. Employees at Washoe County may allocate between $300 and $2,500 pre-tax dollars per calendar year for reimbursement of eligible medical expenses.
Unreimbursed Medical Claim Form
Reimbursement Process
Upon incurring an eligible expense, participants should complete the claim form appropriate for the expense (Dependent Day Care or Unreimbursed Medical) and submit the completed form along with supporting receipts to American Fidelity. Instructions are provided on the claim forms.
To expedite the reimbursement process, employees may wish to have reimbursements directly deposited into a checking or saving account. To enroll in that option, complete the direct deposit form and return it to American Fidelity.
The benefit information provided is subject to change. If there are any conflicts of benefit descriptions at any time, the plan document for that benefit will prevail.