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ADA COUNTY EMPLOYEE BENEFITS
SUMMARY
October 2006
- MEDICAL INSURANCE (administered by Blue Cross of Idaho)
Preferred Blue PPO – In Network
* No deductible
* $1,000 out-of-pocket maximum (includes deductible and coinsurance, as applicable)
* $20 co-pay per office visit (does not include diagnostic services)
* $10 co-pay plus 20% of balance for generic prescription drugs
* $20 co-pay plus 20% of balance for brand name prescription drugs
* Plan pays 90% of Maximum Allowance for Hospital Services
* Plan pays 90% of Maximum Allowance for Emergency Services
HMOBlue Point of Service – In Network
* No deductible
* No out-of-pocket maximum
* $20 co-pay per office visit (includes diagnostic services)
* $10 co-pay plus 20% of balance for generic prescription drugs
* $20 co-pay plus 20% of balance for brand name prescription drugs
* $200 co-pay for inpatient Hospital Services; $100 co-pay for outpatient Hospital Services
* $75 co-pay for Emergency Services
Blue Cross of Idaho County-paid coverage for employees:
* Examinations, x-rays and cleanings (1 per 6 months) - 100%
* Fillings, root canals, extractions & minor oral surgeries - 80%, after $25 deductible
* Crowns, bridges & dentures - 50%, after $25 deductible
* Maximum, total benefit per year, per member - $1,000
* Orthodontia for dependent children up to the age of 19 - pays 50% up to $1,000.
If services are provided by a non-participating dentist, coverage is limited to the lesser of actual charges or the Idaho customary (UCR) charges.
Willamette Dental of Idaho, Inc. County-paid coverage for employees:
* No deductible
* $10 co-pay for office visits
* Exams, X-Rays, Preventive, Restorative, Periodontics – plan pays 100%
* Endondontics, Oral Surgery, Crowns, Bridgework, Dentures – varied co-pays after $10.00 office visit charge
* Maximum Benefits - unlimited
* Orthodontia for dependent children and adult services available – $1,800.00 co-pay
* Frames (1 every 24 months) - up to $47
* Contact Lenses (1 pair per 12 months) – elective: up to $105; medically necessary: up to $210
** Insured may receive 1 pair of spectacle lenses or contact lenses every 12 months.
Approximately 60% of frames on the market will be paid at 100%. Employees must pay the difference for more expensive frames and for special features on lenses.
- LIFE, DISABILITY & DISMEMBERMENT INSURANCE (United Heritage Mutual Life Insurance Company)
County-paid coverage for employees:
* Employee Basic Life Insurance - 1x annual salary, up to maximum of $50,000
* Accidental Death Insurance - 2x annual salary, up to maximum of $100,000
* Accidental Death Insurance, while performing regular, county-related job duties - 3x annual salary, up to maximum of $150,000
* Dismemberment Insurance - 1/2 to 1x annual salary, depending upon loss
· Short-term Disability Insurance - 60% of gross, weekly salary - up to 26 weeks maximum
- OPTIONAL LIFE AND ACCIDENT INSURANCES (United Heritage Mutual Life Insurance Company & Public Employees Retirement System of Idaho) Employee-paid supplemental coverage for employees and dependents:
* Supplemental Employee Life Insurance (34¢ per $1,000 coverage, per month) - 1x or 2x annual salary
* Supplemental Dependent Life Insurance (45¢ per month, per family)
Spouse - $1,000
Children over 6 months age - $1,000
Children 14 days to 6 months age - $100
* NCPERS Supplemental Group Term Life Insurance ($16 per month, per family)
Employee - $7,500 to $225,000, depending upon age
Dependents - $4,000 to $20,0000, depending upon age
- VOLUNTARY LONG TERM DISABILITY INSURANCE (Standard Insurance) Employee-paid supplemental benefit plan if unable to work for a long period of time due to a sickness or injury.
- SICK LEAVE 3.7 hours of county-paid sick leave are accrued per bi-weekly period.
- VACATION LEAVE 3.7 hours of county-paid vacation leave are accrued per bi-weekly period for the first five years of service, 4.62 hours per bi-weekly period for 5 to 10 years of service, 5.54 hours per bi-weekly period for 10 to 15 years of service, 6.47 hours per bi-weekly period for 15 to 20 years of service, 7.39 hours per bi-weekly period for more than 20 years of service. (Entry probationary and interdepartmental promotional-probationary employees accrue vacation leave upon successful completion of probationary service, retroactive to date of commencement of probation.)
- EMPLOYEE ASSISTANCE PROGRAM (EAP) (Business Psychology Associates) County-paid program designed to give eligible employees and family members easy, free, and confidential access to professional counseling for up to five (5) sessions or visits per occurrence or incident.
- UNEMPLOYMENT INSURANCE County-paid Unemployment Insurance benefits to employees whose employment with the County is terminated in accordance with Idaho Department of Employment regulations.
- WORKERS COMPENSATION INSURANCE County-paid Workers Compensation benefits for work-related disabilities, which prevent employees from working.
- HOLIDAYS Ten county-paid holidays per calendar year.
- RETIREMENT PROGRAM (Public Employees Retirement System of Idaho Defined Benefit Retirement Plan). County contributes 10.39% of salary and employees contribute 6.23% of salary (General Members) or the county contributes 10.73% of salary and employee contributes 7.65% of salary (Public Safety Members) toward service retirement, early retirement, vested retirement, disability retirement, death benefits, and/or separation benefits. Employees' retirement accounts draw interest as prescribed by PERSI.
- CAFETERIA (Section 125) PROGRAM Premiums Plan excludes county group health insurance premiums from federal and state income tax and from social security/FICA tax.
- FLEXIBLE SPENDING ACCOUNTS: Allows employees to contribute pre-tax dollars to reimbursement accounts for qualifying health care expenses or qualifying dependent care expenses.
- POST EMPLOYMENT HEALTH PLAN (PEHP) (Nationwide) Eligible employees receive post employment medical/health benefits from funds contributed to a Universal Reimbursement Account and/or an Insurance Premium Reimbursement Account (funded by converted unused sick leave).
- DEFERRED COMPENSATION PROGRAM (Merrill-Lynch & Nationwide) (Optional). A voluntary, long term supplemental retirement savings program using pre-tax payroll deductions. **Matching Contributions: The County will match employee contributions, up to 2 percent (2%) of an employee’s gross pay.
***PLEASE NOTE…The benefits listed herein have been summarized and therefore do not list the applicable exclusions, limitations, and conditions. Please refer to the appropriate pamphlet, booklet, plan document or Personnel Ordinance provision for a complete description of that benefit.
Revised: 09/06
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Employee Benefits Summary
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