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Douglas County Personnel Rules

Douglas County Personnel Rule #19

GROUP INSURANCE

19.1       Insurance

19.1.1       Employees hired on or after January 1, 2014 who are budgeted to work at least 30 hours per week or as otherwise defined in any federal or state mandatory regulation, shall be eligible for the County Group Health and Dental Insurance plan(s). The County will contribute a monthly amount determined by the Board of Commissioners. Benefits become effective on the first day of the month following or coincident with, 60 days of continuous employment. For purposes of calculation of the 60-day waiting period, employees hired during the first seven calendar days of the month will be credited with being hired on the first day of that month. Once eligibility is established, coverage will remain continuous through the last day of the month in which an employee works, receives compensation, or is approved and qualified under a federal or state regulatory provision mandating continuation of health care coverage. For any plan requiring a payroll deduction as a portion of the monthly premium, coverage may be terminated should timely supplemental contributions not be made by the employee. EXCEPT AS SET FORTH IN PARAGRAPH 19.1.2 BELOW, ALL NEW, TRANSFERRED, OR REHIRED, PART-TIME EMPLOYEES BUDGETED TO WORK LESS THAN 30 HOURS PER WEEK ARE NOT ELIGIBLE FOR GROUP HEALTH AND DENTAL INSURANCE PLAN(S).

 

19.1.2       Opt Out Provision.  All active, benefitted part-time and regular employees as of June 30, 2010, who become part-time budgeted to work 20 to 29.9 hours per week prior to January 1, 2014, will be allowed a one-time option to either continue with their current coverage (as outlined in 19.1.2.1 below) or exercise a one-time opt out provision. Any qualified employee as defined in the above sentence who chooses the opt out provision will not be allowed to re-enroll into the group insurance plan(s) once they opted out, unless they are restored to a budgeted position of 30 hours or more per week. Once an employee opts out of their current group health and dental insurance plan outlined in 19.1.2.1 below, they will not be allowed any subsequent coverage for group health and dental coverage if they are hired, rehired or transferred into a part-time position working less than 30 hours.  

 

 19.1.2.1  Until January 1, 2014, the eligibility for those employees who continue their current coverage (part time employees budgeted to work between 20 and 29.9 hours per week beginning June 30, 2010, or former full time employees who become part-time budgeted to work between 20 and 29.9 hours per week) shall be in effect as follows:

     

An eligible part-time employee budgeted 20 hours per week (.5 FTE) or more for 12 months of the year is eligible for County group insurance on a pro-rated basis. The County will contribute the appropriate percentage of the established insurance cap (as outlined in the chart below) toward employee health and dental insurance coverage. Coverage will be continuous, once eligible, through the end of the month during which employment terminates, or unpaid leave is taken. In the case where an employee contributes through a payroll deduction to coverage, coverage may be terminated should the employee not make payment on the portion the employee is responsible for.

Employees active as of July 1, 2010, and budgeted between 20 hours per week and 29.9 hours per week for 12 months of the year will be eligible for the above County-paid benefits on a pro-rated basis. The specific formula for coverage is as follows:

Hrs Budgeted

FTE

% of Health Allowance[1]

20 - 23.9

.50 - .59

50%

24 - 27.9

.60 - .69

60%

28 – 29.9

.70 - .75

70%

This formula will be applied based on budgeted FTE's and will not vary with actual hours worked unless specific budget action is taken. Employees who are budgeted at or above .50 FTE, but frequently work less than their budgeted FTE, may have the County's contribution decrease to the appropriate level based on actual hours worked during a continuous period of 90 days, or they may lose coverage if actual hours worked frequently falls below .50 FTE.


 

[1] County contribution to insurance may vary – See Rule 19.4 for explanation.

19.2       Continuation of Medical and Dental Insurance.

19.2.1    When an employee has terminated employment, or is on unpaid leave status for the period approved by their Department Head, the employee may be eligible for continuation of group medical and dental insurance coverage up to but not exceeding the maximum period required by law.  To qualify, a continuation form, available in the Human Resources Department, must be completed and submitted within 60 days of the event causing loss of coverage or notification of loss of coverage, whichever is later.  An additional 45 days are allowed to make payment after notifying the County of your decision to elect continuation; however, at that time, payment must include premiums for the period beginning with the date of becoming eligible for continuation, plus the current month.   The employee is responsible for paying the premium by the first day of each month, for that month's coverage, to the Human Resources Department. 

Employees who have been covered by the group policy for a period of at least 180 continuous days may also elect, upon termination of the group coverage, a Portability plan issued by the County’s insurance carrier. Information on Portability may be obtained from the insurance carrier directly.

19.3       Insurance and Unpaid Leave.

19.3.1    Any employee who is on an unpaid leave of absence on the first workday of any month will be eligible for medical insurance coverage while on leave provided they pay the required premium by the first day of the month in which they become ineligible for County-paid insurance. Payments should be made to Management and Finance. Eligibility for coverage will continue as long as the employee makes the premium payments and, as required, remains on approved leave by the County, but limited to the time allowed by the County’s insurer.

19.3.2   Employees who return from an approved leave, whether or not they have chosen to maintain coverage during the leave, will have their coverage reinstated and paid for at the appropriate level by the County on the first of the month following their return to work.  If they return on the first workday of the month, their County paid coverage will start on that day.

19.3.3   Employees on an unpaid leave are not eligible for life insurance continuation.  This benefit will be reinstated under the same conditions as medical and dental insurance.

19.4       Changes.

19.4.1   The County contributes an amount toward the purchase of health benefits (Health Allowance).  The County, at its discretion, reserves the right to adjust this allowance based on industry practice and local market conditions.

To assure that employees receive the best benefits for the money, the Commissioners established an Employee Benefit Committee.  The Benefit Committee is comprised of employees representing each department, and they meet periodically to review plan design and make recommended changes to the Board.  The Benefit Committee also makes recommendations for bidding insurance, interviews prospective carriers, and make recommendations to the Board.