All full time employees are eligible to enroll in the following benefits on the first of the month following 3 months of service. The eligibility letter and enrollment forms are sent approximately 1 month prior to eligibility date. If you fail to enroll within 31 days of eligibility you will not be eligible to enroll until an Open Enrollment period held in June for a July 1 effective date and December for a January 1 effective date.
Group Medical Insurance
The county provides a comprehensive medical plan based on medical necessity through AmeriHealth Administrators. The program provides a network of providers that provide services for a minimal co-pay. For non-participating providers eligible expenses are applied to a calendar year deductible, all eligible expenses after that are reimbursed at 80% of usual and customary charges.
The prescription plan through Express Scripts provides generic drugs and brand drugs for co-pays as designated in union agreements. There is also a mail order program that allows the purchase of a 3 month supply.
The dental carrier is Aetna Healthcare, which offers 2 plans. The dental option plan offers benefits through participating and non-participating providers. Participating provides will bill Aetna directly and charge the subscriber the applicable coinsurance. Non-participating providers may charge the subscriber the full amount, which the subscriber will be able to submit a claim for reimbursement. Most services under this plan are covered at 80% with some major services covered at 50% with a calendar year deductible. There is also an orthodontic provision available to children.
The dental choice program (DPO and DMO plans) is a dental HMO that provides most services at 100% there are some specific services that are covered at 50%. There are no deductibles, no annual maximums and no claim forms. All dental care must be coordinated through a participating dentist.