2014

Employee

Benefits Guide

medical | dental | vision | life | disability & more

Eagle County’s 2014

Employee Benefit Guide

important information enclosed

Purpose

To enhance the quality of people’s lives

Mission

To be the model of excellence for mountain communities

Values Passion



The commitment to never be satisfied and go beyond the best

Respect

The willingness to accept diversity and differences

Integrity

The responsibility to be honest and fair

Courage

The ability to do what’s right, even when it is unpopular

Engagement

01

Involving staff and the community

INTRODUCTION

ogram. mprehensive benefits pr co a ng idi ov pr of e nc s the importa ek, are benefit Eagle County recognize hours or more each we 30 ing rk wo es ye plo e em ily members That is why all our full-tim employees and their fam ide ov pr lp he s fit ne be e eligible employees. Thes all wellness. in their health and over ta ain m to ies nit rtu po op w: yees will be able to revie plo em ” ide Gu t efi en “B In this fit Program ensive Employee Bene eh pr m co s ty’ un Co employees gle ovide all benefit eligible • A description of Ea pr t us m ty un Co gle Ea tices that e their benefits • Important annual no help employees manag to s ite bs we d an rs be m • Important phone nu ial Summary Plan the full text of the offic to r fe re an pl fit ne be each Department. For complete details of unty Human Resources Co gle Ea e th h ug ro th Descriptions available , and nefit enrollment options be ur yo d an rst de un er fits Guide to furth ar. Please review this Bene rence throughout the ye fe re r fo ide Gu s fit ne please retain this Be ent: man Resources Departm Hu ty un Co gle Ea e th t tance, contac If you need further assis Phone: 970.328.8790

eagleCounty.us / berniece.gutierrez@

Email: Resources Eagle County Human P.O. Box 850 500 Broadway 50 Eagle, CO 81631-08 s .u www.eagleCounty

ounty.us

lisa.ponder@eagleC

re es to read this enti ye lo p em ll a ge ra u Lastly, we enco before you enroll! Benefits Summary

TABLE OF CONTENTS Health & Wellness 03 Dental and Vision Plan 04 Contribution Rates 05 Life Insurance/FSA 06 Disability/EAP 07 Care Advocacy 08

Retirement and more 09 Other Benefits 10 Holidays/Personal Leave 11 Important Notices 12-13 Medical Providers 14-15 FSA Worksheet 16 Notes 17 Important Contacts 18

02

HEALTH & WELLNESS

Medical and dental insurance are combined in the cost of your benefits. Wellness exams are not subject to the deductible. Prescription coverage includes a mail-order prescription benefit.

MEDICAL PLAN HIGHLIGHTS Health & Wellness Calendar Year Deductible

Individual/Family Maximum

Out-of-Pocket Maximum Individual /Family

Coinsurance Physician Office Visit Preventive Care In-Patient Hospital Out-Patient Hospital Lab / X-ray Diagnostic Procedures

(MRI/CT/PET/High Tech Imagery)

Emergency Room Urgent Care Prescription Drugs (30 day supply)

Generic Copay Preferred Brand Copay Non-Preferred Brand

Mail-Order Drugs (90 day supply)

Generic Copay Preferred Brand Copay Non-Preferred Brand

03

Health & Wellness PPO In-Network

Out-of-Network

$600/$1,200

$600/$1,200

$2,000/$3,500

$3,000/$6,000

80%

70%

$15 copay ($35 after 8 visits yr)

70% after deductible

100%

No coverage

80% after deductible

70% after deductible

80% after deductible

70% after deductible

80%, deductible waived

70% after deductible

80% after deductible

70% after deductible

80% after deductible

70% after deductible

$35 copay

70% after deductible

$0 $30 $60

No coverage No coverage

$0 $60

No coverage

$120

No coverage

YOUR DENTAL PLAN

This is a brief overview only and is not a complete list of your covered services. Please refer to your Summary Plan Description (SPD) for a detailed list.

GENERAL PROVISIONS Calendar Year Deductible Individual Family

Calendar Year Maximum Benefit Preventive Services (deductible waived) Basic Services Major Services Orthodontic Services Plan covers orthodontic services for eligible children and adults. Lifetime maximum is $1,000 per person

DENTAL PLAN $50 $150 $1,500 per person Plan pays 100% 80% after deductible 80% after deductible 50% after deductible

YOUR VISION PLAN

This is a brief overview only and is not a complete list of your covered services. Please refer to your Summary Plan Description (SPD) for a detailed list.

GENERAL PROVISIONS Benefit Amount

VISION PLAN The plan will pay up to $400 per calendar year per “Covered Person” for the following services and supplies, combined Eye Exams - Limited to one (1) exam per calendar year Prescription Lenses, Frames and Contact Lenses

Benefits

Corrective eye surgery, such as LASIK and PRK Work-related, non-prescription sunglasses or safety goggles are covered up to $100 of the plan’s $400 per Calendar Year maximum benefit

04

CONTRIBUTION RATES FOR 2014 Your monthly employee contribution rates are listed below:

Medical Contributions

PPO w/Wellness

Health & Wellness PPO

(rebate score 85+)

Employee Contribution Rates Employee Only $65 Employee + Spouse $220 Employee + Child(ren) $200 Family $350 EE +EE $130 EE+EE+Child(ren) $265 Note: Dental contributions are included in medical contributions.

Vision Contributions Employee Contribution Rates Employee Only Employee + Spouse Employee + Child(ren) Family EE+EE EE+EE+Child(ren)

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$45 $180 $180 $310 $90 $225

CNIC Vision Plan $0 $7.00 $7.00 $23.00 $0 $7.00

BASIC LIFE & ACCIDENTAL INSURANCE

As a full-time employee of Eagle County, you are eligible for a variety of company- sponsored benefit plans. Eagle County offers Basic Life and Accident Insurance (also referred to as AD&D). The Basic Life benefits are listed below based on your annual gross pay. The AD&D insurance is equal to the amount of life insurance coverage you have in the event of death due to an accident. The dismemberment coverage varies and is determined according to the extent of loss.

BASIC LIFE COVERAGE Annual gross pay between $50,000 & $200,000

COMPANY PAID BENEFITS $50,000 benefit minimum $200,000 benefit maximum

Additional Life Insurance is available on a Voluntary Basis (Employee Paid). Please contact HR for additional information.

FLEXIBLE SPENDING ACCOUNTS

Eagle County offers Health and Dependent Care Flexible Spending Accounts (FSAs) which allows you to use tax-free dollars to reimburse yourself for a wide variety of health and/or dependent care expenses not covered through your other benefit plans. Eagle County is partnering with Wage Works to administer the health and dependent care spending accounts. Remember, carefully estimate expenses using the information provided on the enrollment form. The maximum annual contribution for the Health Care FSA is $2,500. The maximum annual contribution for the Dependent Care FSA is $5,000 ($2,500 if you are married and filing a separate income tax return). Use the worksheet on page 16 to calculate your specific healthcare expenses. Additional benefits included in your FSA through Wage Works are listed below: • Mobile application available (includes claims submission) • Direct Deposit is available at no cost • Account Summary Statements are available online Automated Customer Service is available 24 hours a day, 7 days a week every day of the year. Agents are available 8:00 am - 8:00 pm EST. (877) - WAGEWORKS (924-3967) Comprehensive Web Tools available www.wageworks.com

06

EMPLOYEE ASSISTANCE PROGRAM

For the many personal issues and concerns that arise in life, your Employee Assistance Program is available any time, 24 hours a day, seven days a week, including holidays. It is a free and confidential service that will provide counseling, telephonic consultation, and support services for you and your family members. In addition to counseling services for issues like stress, relationships, depression, grief and loss, substance abuse, etc., they also provide legal services, financial services and child care and elder care services. The County provides four free visits for each employee and their family members.

Hearing Aid Benefit

There is a $1,000 lifetime maximum benefit and it is covered under the Medical Benefit Plan.

SHORT-TERM DISABILITY

Eagle County provides short-term disability coverage at 60% of the employee’s regular rate of pay for up to 26 weeks, after a 30 day waiting period.

COVERAGE TO AGE 65

ELIMINATION PERIOD

MAX WEEKLY BENEFIT

7 days

Replaces 60% of base weekly earnings up to $2,000 per week

Short Term Disability

LONG-TERM DISABILITY

Eagle County provides long-term disability coverage at 60% of the employee’s regular rate of pay after a six-month waiting period.

COVERAGE TO AGE 65 Long Term Disability

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ELIMINATION PERIOD 180 days

MAX MONTHLY BENEFIT 60% of monthly salary to a maximum benefit of $5,000

Directors, Full-Time Managers & Elected Officials receive a maximum benefit of $8,000

CARE ADVOCACY COMPREHENSIVE SERVICE PACKAGE (Employer Paid) Benefit Basics

Assists members with understanding benefits and what they cover. It is designed to broadly answer benefit questions.

Claims Assist

Provides expert assistance on issues such as claims, claim denials, out-of-pocket responsibilities, pre-authorizations, and questions on Explanation of Benefits.

Care Choice

Offers assistance with coordination of care. Our healthcare professionals counsel member on medical needs and guide them when seeking help from a physician-or after initial care.

Parent Care

Assists with care coordination of care. Select services include making arrangements for visiting nurses or personal care provider, hospice, home health, or equipment.

Want to learn more?

Call 1-866-891-3306 or visit www.careadvocates.com

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FMLA-Family Medical Leave

Under FMLA, eligible employee’s jobs and benefits are protected for up to 12 weeks for the birth and care of a newborn, serious health conditions of the employee, their spouse, child, parent or an adoption. Employees must use all available medical and personal leave time. As part of the 12 weeks once medical and personal leave has been exhausted, the remaining time of leave is unpaid.

Medical Leave

Medical leave is available for regular employees working 20 hours or more per week for use when an employee is unable to perform his/her job duties for medical reasons, scheduled examinations, or to care for an injured or ill member of the family. Medical leave will be pro-rated according to FTE (fulltime equivalency) for part-time employees. Full-time employees accrue medical leave at 2.46 hours per pay period, up to a maximum of 320 hours.

Family Heritage

Family Heritage is an industry-leading provider of life and supplemental health insurance products to families and businesses throughout America. Family Heritage offers products that are in greater need now than ever, paying cash directly to families dealing with illness and accidents. They specialize in catastrophic coverage, so regardless of whether it is a policy for cancer; heart disease, heart attack or stroke; or accidental injury, Family Heritage is here to serve your needs. They also offer unique life insurance and additional coverage for intensive care unit confinements. Many of the Family Heritage supplemental insurance policies include their flagship Return of Premium Benefit. If you keep your policy in force for a number of years as specified in your policy, and if you pay all your premiums, you will receive all your money back, minus the total amount of claims that have been paid to you. Contact Human Resources for further details.

Wellness

A $300 wellness benefit is available to employees for the purchase of wellness related expenses. This is a taxable benefit. An additional $150 benefit can be earned if a spouse also participates. Contact Human Resources for further details.

Discounted Recreation Center Passes

Eagle County has special discounted programs with the Gypsum Recreation Center and the Eagle Ranch Fitness Center.

RETIREMENT 401A

Eagle County is a member of Colorado County Officials & Employee Retirement Association (CCOERA). All full-time employees are required to participate as a condition of employment. Employees may choose to contribute 3%, 4%, 5% or 6%. The County will match the percentage you choose. Employees may self-direct their contributions into certain investments as allowed by CCOERA. Vesting occurs at 25% per year starting with your first year of contributing (i.e 00/25/50/75/100%). Employees are totally vested after participating in the retirement plan for five years. Employees 55 years of age and older, as well as elected officials are always 100% vested in the County’s retirement plans.

09

Deferred Compensation 457b

Employees may participate in the 457b plan immediately upon hire. Employees may self-direct their contributions. Anyone under the age of 50 may contribute up to a total of $17,500 (2013). Employees 50 years of age and older may contribute up to $35,000 (2013). These amounts may be adjusted for 2014.

Direct Deposit

Employees may have their bi-weekly pay checks directly deposited into a maximum of three each checking and/or savings accounts at any bank of their choice.

EDUCATION

Eagle County University (ECU)

In conjunction with Colorado Mountain College and other professionals, we offer leadership, computer, business-related and other important courses to all employees to build their skills. We believe in learning and growing in your job and want to contribute to that growth. These courses are offered at the County campuses during work hours.

Tuition Reimbursement

Regular employees working at least 30 hours per week who are enrolled in a degree program, related to their employment, are eligible for tuition reimbursement up to $2,500 annually (books and additional fees must be covered by the employee).

Free Colorado Mountain College classes

Credit classes in the 100 and 200 levels offered at the Edwards campus are free to Eagle County employees (books and fees must be covered by the employee).

Employee Volunteer Program

Eagle County Government wants to encourage and support our employees in their efforts to give back to the community. Full-time employees working 30 hours or more hours per week who have been employed for at least six months are eligible to receive up to eight hours per calendar year of paid leave for the purpose of volunteering. Part-time employees are eligible for up to four hours.

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HOLIDAYS

The Board of County Commissioners approves 11-12 holidays each year. Holiday pay for regular, part-time employees is pro-rated.

Personal Leave

Personal leave is provided for vacation or personal matters for regular employees working 20 or more hours per week. Full-time employees earn personal leave in accordance with the following schedule: 0 years through the completion of year 2 12 days/3.70 hours per pay period 3 years through the completion of year 4 14 days/4.31 hours per pay period 5 years through the completion of year 9 17 days/5.23 hours per pay period 10+ years 22 days/6.77 hours per pay period Part-time employees accrue on a pro-rated basis. Leave accrual is capped at 176 hours. Accrued personal leave is paid out to employees who leave the County if they have been employed for at least three months.

Funeral Leave

The County offers Funeral Leave of 40 hours for immediate family. We also offer Funeral Leave of 8 hours for extended family or a personal friend.

ECO Free Bus Passes Employees ride free of charge.

Service Recognition Program

Eagle County offers a service recognition program for 5, 10, 15, 20, 25 and 30 years of service.

11

IMPORTANT LEGAL NOTICES

Federal regulations require Eagle County to provide benefits-eligible employees with the following notices:

Private Health Information

A portion of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) addresses the protection of confidential health information. It applies to all health benefit plans. In short, the idea is to make sure that confidential health information that identifies (or could be used to identify) you is kept completely confidential. This individually identifiable health information is known as “protected health information” (PHI), and it will not be used or disclosed without your written authorization, except as described in the Plans HIPAA Privacy Notice or as otherwise permitted by federal and state health information privacy laws, A copy of the Plan’s Notice of Privacy Practices that describes the Plan’s policies, practices and your rights with respect to your PHI under HIPPM is available from your medical plan provider. For more information regarding this Notice, please contact Human Resources or the medical plan directly.

Women’s Health and Cancer Rights Act

On October 21, 1998, Congress passes a bill called the Women’s Health and Cancer Rights Act. This new law requires group health plans that provide coverage for mastectomy to provide coverage for certain reconstructive services. These services include: • All stages of reconstruction of the breast on which the mastectomy was performed • Surgery and reconstruction of the other breast to produce a symmetrical appearance • Prostheses and treatment of physical complications resulting from mastectomy (including lymphedema)

In addition, the plan may not:

• Interfere with a woman’s rights under the plan to avoid these requirements • Offer inducements to the health provider, or assess penalties against the health provider, in an attempt to interfere with the requirements of the law.

This coverage will be provided in consultation with the attending physician and the patient, and will be subject to the same annual deductibles and coinsurance provisions that apply to the mastectomy. For more information, contact your medical plan provider.

Special Enrollment Rights

If you are declining enrollment for yourself or your dependents (including your spouse) because of other health insurance coverage, you may be able to enroll yourself and your dependents in the Eagle County health plan if you or your dependents lose eligibility for that other coverage (or if the employer stops contributing towards you or your dependents’ other coverage). However, you must request enrollment in writing within 30 days after you or your dependents’ other coverage ends (or after the employer stops contributing toward the other coverage). In addition, if you have a new dependent as a result of marriage, birth, adoption, or placement for adoption, you may be able to enroll yourself and your dependents, provided that you request enrollment in writing within 30 days after the marriage, birth, adoptions, or placement for adoption. For more information, contact Human Resources.

Notice of Prescription Drug Creditable Coverage

Eagle County provides a “Notice of Prescription Drug Creditable Coverage” to all Medicare-eligible participants on an annual basis. This notice states that under the Eagle County medical plan, you have prescription drug coverage that is, on average, as generous as the standard Medicare prescription Drug Coverage. A copy of this notice is also available upon request from Human Resources.

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Individual Coverage Mandate

Effective January 1, 2014, Federal law requires that you have Health Care coverage or you may be subject to an income tax penalty. You can enroll in Eagle County’s health plan, or you may want to consider visiting www.healthcare.gov for information on health plans available through the Healthcare Marketplace in your area.

Premium Assistance Under Medicaid and the Children’s Health Insurance Program (CHIP)

If you or your children are eligible for Medicaid or CHIP and you are eligible for health coverage from your employer, your State may have a premium assistance program that can help pay for coverage. These States use funds from their Medicaid or CHIP programs to help people who are eligible for these programs, but also have access to health insurance through their employer. If you or your children are not eligible for Medicaid or CHIP, you will not be eligible for these premium assistance programs. If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, you can contact your State Medicaid or CHIP office to find out if premium assistance is available. If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, you can contact your State Medicaid or CHIP office or dial 1-877-KIDS NOW or www.insurekidsnow.gov to find out how to apply. If you qualify, you can ask the State if it has a program that might help you pay the premiums for an employer-sponsored plan. Once it is determined that you or your dependents are eligible for premium assistance under Medicaid or CHIP, as well as eligible under your employer plan, your employer must permit you to enroll in your employer plan if you are not already enrolled. This is called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance. If you have questions about enrolling in your employer plan, you can contact the Department of Labor electronically at www.askebsa.dol.gov or by calling toll-free 1-866-444-EBSA (3272).

COLORADO-Medicaid

Medicaid Website: http://www.colorado.gov/ | Medicaid Phone (In state): 1-800-866-3513 | Medicaid Phone (Out of state): 1-800-221-3943

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Workers Compensation

The County is committed to a safe work environment for employees. Employees should report any unsafe practices or conditions to their supervisor. If medical treatment for an on-the-job injury is needed, it must be obtained from one of the County’s designated physicians. If not, the employee may be responsible for the cost of medical treatment. If the injury requires immediate emergency treatment, employees and supervisors should utilize the nearest emergency facility or notify “911” for assistance.

Designated Medical Service Providers

Eagle Eagle Valley Medical Center

0377 Sylvan Lake Rd., Suite 220 Eagle, CO 81631 970-328-1650 Colorado Mountain Medical, P.C. 320 Beard Creek Road Edwards, CO 81632 970-328-1650

Edwards

Colorado Mountain Medical, P.C. 320 Beard Creek Road Edwards, CO 81632 970-926-6340 Continued on the next page....

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Additional Designated Medical Service Providers

Vail

Colorado Mountain Medical, P.C. 181 West Meadow Drive, #200 Vail, CO 81658 970-476-5695

Basalt/El Jebel

Glenwood Medical Associates 1905 Blake Glenwood Springs, CO 81601 970-945-8503

*Benefits are subject to eligibility requirements and are subject to change. Contact Human Resources for details.

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FLEXIBLE SPENDING ACCOUNT WORKSHEET BENEFIT

YOUR EXPENSES

EXPENSES FOR YOU & DEPENDENTS

Deductibles and Coinsurance

$

$

Office Visit Co-Pays

$

$

Prescription Drug Co-Pays

$

$

Chiropractic Treatment/Acupuncture

$

$

Infertility Treatments

$

$

Birth Control Pills, Devices, and Surgical Procedures

$

$

Medical Equipment and Supplies (Wheelchairs, Braces, Crutches, Oxygen, Etc.)

$

$

Transportation (mileage, lodging and meals if necessary to obtain health care)

$

$

Christian Science Practitioner

$

$

Over the Counter Medication with physician’s prescription Other (See IRS Publication 502 for Listing of Deductible Medical Expenses)

$

$

Eye Exams

$

$

Frames and Lenses

$

$

Contact Lenses, Cleaning Solutions and Supplies

$

$

Hearing Aids and Batteries

$

$

Radial Keratotomy Surgery to Correct Vision

$

$

Deductibles and Coinsurance

$

$

Exams, Cleanings and X-rays

$

$

Fillings

$

$

Fluoride Treatments

$

$

Crowns, Bridges and Dentures

$

$

Orthodontia (Please see “Orthodontic Treatment” Worksheet

$

$

Other Eligible Dental Expenses (See IRS Publication 502)

$

$

TOTAL ESTIMATED UNINSURED MEDICAL EXPENSES (Sum of Your Expenses and Expenses for Your Spouse and Dependents):

$

$

VISION AND HEARING CARE (not covered by insurance)

DENTAL EXPENSES (not covered by insurance)

16

Notes

17

CONTACT INFORMATION

If you have questions that are not answered in this booklet, please contact the appropriate carrier below.

BENEFIT

CONTACT

Medical

CNIC Health Plans www.cnichs.com (Account # 22204026)

(888) 426-7453

RX

RX-Total Script / Catamaran www.catamaranrx.com

(800) 752-2211

Dental

Dental Health Plan www.cnichs.com (Account # 22204026)

(888) 426-7453

Vision

Vision Health Plan www.cnichs.com (Account # 22204026)

(888) 426-7453

Short Term Disability

CNIC Plans www.cnichs.com (Account # 22204026)

(888) 426-7453

Flexible Spending Accounts

Wage Works www.wageworks.com

(877) WAGEWORKS (924-3967)

Basic Life / AD&D

Lincoln Financial Group www.lfg.com (Account # 000010149432)

(800) 423-2765

Patient Advocacy

Care Advocates (Account # CA1003)

(866) 891-3306

EAP

Colorado West Regional Health Samaritan Counseling Center

Family Heritage Insurance

Jeff Cerovich

Eagle (970) 328-6969 Vail (970) 476-0930 Edwards (970) 926-8558

(970) 306-7050

www.familyheritagelife.com Human Resources Department

Eagle County [email protected] [email protected]

(970) 328-8790

18

Choose your Benefits Wisely This booklet and the materials that accompany it are intended to provide only a general overview of the benefit programs for eligible Eagle County employees. This booklet is not a summary plan description and does not provide, nor is it intended to provide, complete details of any of the benefit plans. The plans are governed by legal plan documents and insurance contracts. If this booklet (and/or the materials that accompany it) and the plan documents or insurance contracts do not agree, the plan documents or the insurance contracts will rule. This brochure is not intended as a promise of continued benefits or employment. Eagle County reserves the right to change or end the plans at any time and for any reason.

P.O. Box 850 500 Broadway Eagle, Colorado 81631-0850

medical | dental | vision | life | disability & more

970-328-8600 [email protected]

Apply yourself... and we all benefit