BENEFITS PROGRAM YOUR 2021 - Important Benefit Information Enclosed - Routt County
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YOUR 2021
BENEFITS PROGRAM
Important Benefit Information Enclosed
TABLE OF CONTENTS Introduction 1 Medical 2 Teladoc / DirectPath 3 Dental / Vision 4 Life / Disability / Retirement 5 Additional Benefits 6 Contacts 7 Important Notices 8-9 This booklet and the materials that accompany it are intended to provide only a general overview of the benefit programs for eligible Routt 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. Routt County reserves the right to change or end the plans at any time and for any reason. Routt County’s benefits are deducted on a pre-tax basis. Employee’s benefit elections will be in place for the duration of the plan year and cannot be changed unless they experience a qualifying life event.
INTRODUCTION
2021 Benefits Program
Open Enrollment occurs annually in November. There are certain qualifying events which may make
you eligible to apply for benefits outside of this time frame. Please contact Human Resources for more
details. The benefits that you choose at this time will remain in effect for the next full calendar year. It
is important that you understand your benefit options in order to make informed decisions. This guide
contains a brief description of the plans available to you and your family members.
FULL-TIME EMPLOYEES PART-TIME EMPLOYEES
(30+ Hours per week) (20-29 Hours per week)
• Comprehensive Medical Plan • Life/Long Term Disability Benefits
• Life/Long Term Disability Benefits • 457 and ROTH IRA Retirement Savings
• 401(a), 457 and ROTH IRA Retirement Plan
Savings Plan • Pre-Tax Medical Spending Account
• Pre-Tax Medical Spending Account • Pre-Tax Dependent Care Spending
• Pre-Tax Dependent Care Spending Account
Account • Voluntary Comprehensive Dental Plan
• Voluntary Comprehensive Dental Plan • Routt Federal Credit Union
• Voluntary Vision Program • Supplemental Insurance
• Routt Federal Credit Union • Generous Paid Holidays, Sick and Personal
• Supplemental Insurance Leave/Vacation
• Old Town Hot Springs Discount
• Merchant Ski Pass Program
• Generous Paid Holidays, Sick and
Personal Leave/Vacation
1
MEDICAL / HSA
Medical Plan Highlights
Routt County’s medical insurance plan is administered by UMR. UMR uses the United Healthcare Choice Plus network. The employee
may choose between the two plans described below. The benefits listed illustrate what you pay.
UMR MEDICAL OPTIONS
PPO PLAN HDHP WITH HSA PLAN*
BENEFIT IN-NETWORK OUT-OF-NETWORK IN-NETWORK OUT-OF-NETWORK
Deductible
Individual $1,250 $2,500 $1,500 $3,250
Family $2,500 $5,000 $3,000 $6,500
Individual “Embedded” Deductible $1,250 $2,500 N/A N/A
Out-of-Pocket Maximum
(Included deductible and copays)
Individual $5,000 $10,000 $5,000 $10,000
Family $10,000 $20,000 $10,000 $20,000
Individual “Embedded” Out-of-Pocket $5,000 $10,000 $6,550 N/A
Coinsurance 20% 40% After deductible, 20% After deductible, 40%
Office Visits - Primary Care $25 copay After deductible, 40% After deductible, 20% After deductible, 40%
Office Visits - Specialists $25 copay After deductible, 40% After deductible, 20% After deductible, 40%
Preventive Care 0% In-network only 0% In-network only
Telemedicine $25 copay N/A $40 N/A
Inpatient Hospital After deductible, 20% After deductible, 40% After deductible, 20% After deductible, 40%
Outpatient Surgery After deductible, 20% After deductible, 40% After deductible, 20% After deductible, 40%
Emergency Room Care
$100 copay $100 copay After deductible, 20% After deductible, 20%
Facility Only
Mental Health & Substance Abuse
Inpatient After deductible, 20% 40% after deductible After deductible, 20% After deductible, 40%
Outpatient $25 copay, 0% After deductible, 20% After deductible, 40%
Lifetime Maximum Unlimited Unlimited Unlimited Unlimited
Prescription Drug After deductible until
(tier-1/tier-2/tier-3) Copay of: out of pocket max
Not covered Not covered
Retail (30 day supply) $10/$30/$50 $10/$30/$50
Mail Order (90 day supply) $25/$75/$125 $25/$75/$125
Premiums Per Payroll
Employee Only $29.43 $14.71
Family $147.04 $73.52
*Employees that are enrolled in the HDHP medical plan are eligible to open a Health Savings Account (HSA) to pay for qualified
medical expenses. Qualified medical expenses are a defined term created by the IRS and include: medical care, prescription drugs,
and payment for long term care.
HSA Limits for Calendar Year 2021
Annual contribution limitation:
• For an individual with self-only coverage under a high deductible health plan is $3,600.
• For an individual with family coverage under a high deductible health plan is $7,200.
• Catch up contributions (age 55 and older) is $1,000.
2
Teladoc
Teladoc gives you 24/7/365 access to a doctor through the convenience of
phone or video consults. Teladoc allows you to see a doctor anytime, anywhere
and can be useful if your doctor is unavailable or if you’re considering the ER for
a non-emergency issue. Teladoc doctors can treat a variety of common medical
conditions including cold and flu symptoms, allergies, bronchitis, and more.
You can access Teladoc over the phone or on the web at www.teladoc.com or
1.800.TELADOC. The program does require you to register and complete a
medical questionnaire for each of your family members so that Teladoc doctors
can treat you properly from afar. Teladoc doctors can even prescribe certain
medications for you to pick up at your local pharmacy.
DirectPath
You Have a Health Care Advocate
• Get PAID to SAVE money on procedures and tests Call DirectPath in advance of scheduling
• Answers questions about your benefits any health care procedure or test.
• Helps you choose a health plan
• Resolves claims and billing issues
• Helps find a doctor or hospital Your Advocate will contact 2-3 network
• Assists with referrals and prior authorization providers to compare cost and quality
• Clarifies the total and out-of-pocket costs for services information.
• Assists with Flexible Spending Accounts, Health
Savings Accounts, and Health Reimbursement Arrangements Get rewarded with 50% of the plan
savings for choosing a lower cost option
of a qualifying test or procedure.*
*One reward per test or procedure per year.
SAMPLE COST COMPARISON (MRI):
$2,400
You would save $625 for
$2,000
choosing the lowest cost
$1,600 option!
$737
$1,200 $205
$2,400
$800 $1,225
$1,092
$0
$400
$600
$0
Employer estimated Your estimated
responsibility responsibility
Contact DirectPath at 866.253.2273 Monday-Friday from 7 a.m. - 8 p.m. CT or Saturday from 8 a.m. - 1 p.m.,
Or connect at directpathhealth.com to learn more.
3
DENTAL / VISION
Dental Plan Highlights
Routt County offers employees access to affordable dental care. All employees working 20 hours or more per week are eligible for
dental benefits. Voluntary Dental Coverage is available for eligible employees and their dependents through Delta Dental Insurance
Company. The program offers different levels of coverage for various services. Benefits range from 100% to 50% coverage. Visit
www.deltadentalco.com/dental or call 1.800.610.0201 for more information.
DELTA DENTAL PLAN
BENEFIT
Annual Individual Deductible $50
Annual Maximum (per individual) $1,000
SERVICES DELTA DENTAL PROVIDER
Preventive/Diagnostic Services
• Oral Examinations - twice in a calendar year
• Teeth Cleaning - twice in a calendar year 100%
• Fluoride Treatments for children (under age 14)
• X-rays
Basic Services
• Silver Fillings 80%
• Simple Extractions
Major Services
• Bridges/Dentures
10% in first year/25% second year/50% thereafter
• Endodontic Services (Root Canal)
• Crowns
Premiums Per Payroll
Employee Only $16.54
Employee + Spouse $33.06
Employee + Child(ren) $36.86
Family $53.39
Vision Plan Highlights
Routt County provides Voluntary Vision Coverage through Vision Service Plan (VSP). The plan provides coverage for network providers
and non-network providers. By using a participating VSP provider you will receive the highest level of benefits. To locate network
providers you can call VSP Member Services toll-free at 800.877.7195, or online at www.vsp.com.
VSP
BENEFIT In-Network Out-of-Network
Eye Exam (every 12 months) $10 copay Up to $35 reimbursement
Lenses; Up to $25/$40/$55
Single/Bifocal/Trifocal (every 12 months)
$30 copay
reimbursement
Frames (every 24 months) Up to $130 allowance Up to $45 reimbursement
Contact Lenses (every 12 months) No copay/$130 allowance Up to $105 reimbursement
Laser Correction 15% discount Not Covered
Premiums Per Payroll
Employee Only $5.65
Family $12.16
4
LIFE / DISABILITY / RETIREMENT
Life and Long Term Disability
Routt County’s life and disability will be provided by One America.
Employees working 20 hours or more per week are eligible for life,
AD&D and LTD benefits. The County carries $25,000 of Term Life
Insurance for each eligible employee along with a $25,000 Accidental
Death and Dismemberment (AD&D) Policy. The AD&D policy is payable
when certain circumstances are met upon a death or dismemberment.
Life insurance coverage will reduce upon reaching age 65, 70, and 75.
The Long Term Disability Benefit is available 90 days following the date
of disability. Benefits are paid at 66 and 2/3 of the employee’s pre-
disability wage.
Supplemental Insurance
Various insurance companies offer County Employees additional
insurance coverage for cancer policies, disability insurance and other
services. Currently, Aflac and Colonial Life Insurance offers these
benefits to County Employees. Supplemental Insurance may help
employees meet changing needs in medical coverage. You may set up
a payroll deduction to pay for the premiums.
ICMA Retirement Corporation The vesting schedule for the 401 plan is:
Employees may elect to participate in the 401 Money Purchase Plan after 0% upon completion of 1st year of employment
one year of employment. Employees are required to contribute 6% of their
compensation, and the County will match the employee’s contribution. 25% upon completion of 2nd year of employment
Contributions to the Plan are pre-tax contributions. The employee has 50% upon completion of 3rd year of employment
the ability to direct how all funds are invested. You cannot stop your 6% 75% upon completion of 4th year of employment
contribution to the 401 Plan once you enroll in the plan. The 401 Plan has
100% upon completion of 5th year of employment
a loan provision.
Employees may elect to participate in the 401 Money Purchase Plan with a voluntary after-tax contribution. Employees have the
ability to direct how the funds are invested.
Employees may elect to participate in the 457 Deferred Compensation Plan. This Plan is voluntary. The County makes no
contributions to this Plan. Contributions to the 457 Plan are pre-tax. Employees have the ability to direct how funds are invested.
This plan is more flexible than the 401 Plan in many ways, including the percentage or dollar amount you can contribute.
The County also allows you to enroll in a ROTH IRA. Several Advantages to a ROTH IRA are:
• There are no minimum distribution requirements.
• You may potentially reduce or eliminate the taxes your beneficiaries will have to pay after inheriting.
• You may realize tax savings if you think your tax bracket in retirement will be higher than your current rate.
• Up to $10,000 in earnings may be withdrawn tax-free if used for a qualified first-time home purchase.
• Earnings may be withdrawn free from federal taxes under certain circumstances.
• With a ROTH IRA, unlike Traditional IRAs and employer retirement plans, there is no requirement to begin taking taxable
required minimum distributions (RMD) at age 70½.
5
ADDITIONAL BENEFITS
Holidays/Personal Leave
Employees working less than 40 hours, but at least 20 hours per week will receive holiday • New Year’s Day
leave at a percentage of their hours worked. Each full-time, year–round employee has 24 • Presidents’ Day
hours of personal leave (based on a 40 hour workweek) to use during the calendar year with • Memorial Day
supervisor approval.
• 4th of July
• Labor Day
Vacation/Sick Leave • Veterans’ Day
Employees working less than 40 hours, but at least 20 hours per week will receive vacation • Thanksgiving Day
and sick leave at a percentage of their hours worked. • Day after Thanksgiving
• Christmas Day
Employees accrue vacation leave on the following schedule based on a 40 hour workweek:
Years of County Service Hours Earned
Through first 5 years 3.34 hours per pay period
Over 5 years, but under 10 5.00 hours per pay period
Over 10 years 6.67 hours per pay period
Employees accrue 6.68 hours of sick leave per month based on a 40 hour workweek. There is no cap on the amount of sick leave
that may accrue. After five years of employment, employees will be paid for half of their accrued sick leave, not to exceed 360 hours
at termination. (If an employee has 500 hours on the books, they will be paid for 250 hours. If an employee has 1,000 hours on the
books, they will be paid for 360 hours.)
Section 125 - Cafeteria Plan
Routt County’s Section 125 will continue to be administered by Discovery Benefits. The County’s Cafeteria Plan allows employees
to deduct miscellaneous medical expenses, dependent care expenses, and payroll deducted insurance premiums on a pre-tax basis
to reduce their taxable income. Employees who choose the PPO Plan may choose to put money into a Discovery Benefits Flexible
Spending Account (FSA) for medical expenses. If you enroll in the HDHP with a Health Savings Account you are eligible to enroll in the
“Limited Purpose FSA,” for dental and vision expenses only. Dependent Care accounts are available for eligible employees.
Old Town Hot Springs
The Old Town Hot Springs offers Routt County employees reduced annual memberships. The facility is open seven days a week with
eight hot spring-fed pools, a fitness center, exercise classes, and massage.
Routt Federal Credit Union
Convenient payroll deduction to savings, competitive interest rates on savings, loans and Certificates of Deposit and several other
benefits are offered to County Employees by the Credit Union.
6
CONTACTS
If you still have questions regarding your benefits, please contact the corresponding carrier listed below, or the Human
Resources Department.
Benefit Carrier Phone Number Website / Email
Medical Plan / Pharmacy UMR 800.826.9781 www.umr.com
Telemedicine Teladoc 800.835.2362 www.teladoc.com
Cost Transparency, Advocacy,
DirectPath 866.253.2273 www.directpathhealth.com
and Rewards Program
Dental Plan Delta Dental 800.610.0201 www.deltadentalco.com/dental
Vision Plan VSP Vision 800.877.7195 www.vsp.com
Life & Disability One America 800.451.3399 www.oneamerica.com
www.guidanceresources.com
Employee Assistance Program ComPsych 855.387.9727
Web ID: ONEAMERICA3
Colonial:
Supplemental Insurance 408.712.2522 dan.cory@coloniallifesales.com
Dan Cory
Washington National:
Supplemental Insurance 970.879.4231
Becky Lamb
Aflac:
Supplemental Insurance 970.629.0505 sheila_davis@us.aflac.com
Sheila Davis
ICMA RC: www.icmarc.org
Retirement Savings Plan 800.825.0765
Cherie Mason cmason@icmarc.org
Routt Federal Credit Union Susan Garrity 970.879.2723 susan@routtcreditunion.com
Routt County Human Resources Phone Number Website / Email
Kathy Nelson - Human Resources Director 970.870.5314 knelson@co.routt.co.us
Stephanie Pearce - HR Generalist/Benefits
970.870.5361 spearce@co.routt.co.us
Administrator
Doris Mayhan - HR Generalist 970.870.5223 dmayhan@co.routt.co.us
Kelsey Monger - HR Coordinator 970.870.5321 kmonger@co.routt.co.us
7IMPORTANT NOTICES
Federal regulations require Routt County to provide benefit Women’s Health and Cancer Rights Act
eligible employees with the following important annual Routt County medical plans, as required by the Women’s
notices. For a complete copy of each notice you may go to Health and Cancer Rights Act of 1998, provides benefits for
http://citynet.fcgov.com/humanresources/benefithome.php. mastectomy-related services. These services include:
Private Health Information • All stages of reconstruction of the breast on which the
A portion of the Health Insurance Portability and mastectomy was performed
Accountability Act of 1996 (HIPAA) addresses the protection • Surgery and reconstruction of the other breast to produce a
of confidential health information. It applies to all health symmetrical appearance
benefit plans. In short, the idea is to make sure that • Prostheses and treatment of physical complications
confidential health information that identifies (or could be resulting from mastectomy (including lymphedema)
used to identify) you is kept completely confidential. This
individually identifiable health information is known as This coverage will be provided in consultation with the
“protected health information” (PHI), and it will not be used attending physician and the patient, and will be subject to
or disclosed without your written authorization, except as the same annual deductibles and coinsurance provisions
described in the Plans HIPAA Privacy Notice or as otherwise that apply to the mastectomy. For more information, contact
permitted by federal and state health information privacy your medical plan provider.
laws. A copy of the Plan’s Notice of Privacy Practices that
describes the Plan’s policies, practices and your rights with Individual Coverage Mandate
respect to your PHI under HIPAA is available from your Effective January 1, 2014, federal law requires that you have
medical plan provider. For more information regarding this Health Care coverage. You can enroll in Routt’s health plan,
Notice, please contact Human Resources or the medical plan or you may want to consider visiting www.healthcare.gov for
directly. information on health plans available through the Healthcare
Marketplace in your area. Please note that the plan provided
Summary of Benefits and Coverage (SBC) by Routt County meets the affordability and minimum value
Effective for plan renewals after January 1, 2012, the Patient requirements for employee only coverage, and therefore you
Protection and Affordable Care Act requires employers will not be eligible for a tax credit through the Marketplace
that offer health coverage to provide a uniform Summary for that tier of enrollment.
of Benefits and Coverage (SBC) to people who apply for
and enroll in the health plan. This document contains the Notice of Prescription Drug Creditable Coverage
following: Routt County provides a “Notice of Prescription Drug
Creditable Coverage” to all Medicare eligible participants on
• Four-page overview of plan benefits, cost sharing and an annual basis. This notice states that under Routt County
limitations medical plan, you have prescription drug coverage that is, on
• Required set of examples of how the plan works average, as generous as the standard Medicare Prescription
• Phone number and internet address for obtaining copies of Drug Coverage.
plan documents
• A Standard glossary of medical and insurance terms must
also be available
The SBC will be updated each plan renewal to reflect
applicable plan changes.
8Continuation Of Coverage (COBRA) dependents might be eligible for either of these programs,
If your coverage ends under the Plan, you may be entitled to you can contact your State Medicaid or CHIP office at
elect continuation coverage (coverage that continues on in www.insurekidsnow.gov to find out how to apply. If you
some form) in accordance with federal law. qualify, you can ask the State if it has a program that might
help you pay the premiums for an employer-sponsored
If you selected continuation coverage under a prior plan plan.
which was then replaced by coverage under this Plan,
continuation coverage will end as scheduled under the prior Once it is determined that you or your dependents
plan or in accordance with the terminating events listed are eligible for premium assistance under Medicaid or
below, whichever is earlier. CHIP, as well as eligible under your employer plan, your
employer must permit you to enroll in your employer
When Coverage Ends plan if you are not already enrolled. This is called a “special
We may discontinue these Benefit plans and/or all similar enrollment” opportunity, and you must request coverage
benefit plans at any time. Your entitlement to Benefits within 60 days of being determined eligible for premium
automatically ends on the date that coverage ends, even assistance. If you have questions about enrolling in your
if you are hospitalized or are otherwise receiving medical employer plan, you can contact the Department of Labor
treatment on that date. electronically at www.askebsa.dol.gov.
When your coverage ends, we will still pay claims for For All States:
Covered Health Services that you received before your (877) 267-2323, Ext. 61565
coverage ended. However, once your coverage ends, we
do not provide Benefits for health services that you receive U.S. Department of Labor
after coverage ends for medical conditions that occurred Employee Benefits Security Administration
before your coverage ended, even if the underlying medical www.dol.gov/ebsa or 1-866-444-EBSA (3272)
condition occurred before your coverage ended. An Enrolled
Dependent’s coverage ends on the date your coverage ends. U.S. Department of Health and Human Services
Centers for Medicare & Medicaid Services
Premium Assistance Under Medicaid and the www.cms.hhs.gov or 1-877-267-2323, Ext. 61565
Children’s Health Insurance Program (CHIP)
If you or your children are eligible for Medicaid or CHIP and Uniformed Services Employment And
you are eligible for health coverage from your employer, your Reemployment Rights Act (USERRA)
State may have a premium assistance program that can help If you are called to active duty in the uniformed services, you
pay for coverage. These States use funds from their Medicaid may elect to continue coverage for you and your eligible
or CHIP programs to help people who are eligible for these dependents under USERRA. This continuation right runs
programs, but also have access to health insurance through concurrently with your continuation right under COBRA,
their employer. explained below, and allows you to extend an 18-month
continuation period to 24 months. You and your eligible
If you or your children are not eligible for Medicaid or dependents qualify for this extension if you are called into
CHIP, you will not be eligible for these premium assistance active or reserve duty, whether voluntary or involuntary, in
programs. the Armed Forces, the Army National Guard, the Air National
Guard, full-time National Guard duty (under a federal, not a
If you or your dependents are already enrolled in Medicaid state, call-up), the commissioned corps of the Public Health
or CHIP and you live in an eligible state, you can contact Services and any other category of persons designated by
your State Medicaid or CHIP office to find out if premium the President of the United States.
assistance is available.
If you or your dependents are NOT currently enrolled
in Medicaid or CHIP, and you think you or any of your
9Important Benefit Information Enclosed
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