BENEFITS PROGRAM YOUR 2022 - Important Benefit Information Enclosed - Routt County
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Important Benefit Information Enclosed YOUR 2022 BENEFITS PROGRAM
TABLE OF CONTENTS Introduction 1 Medical 2 Teladoc 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
2022 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 Plan
• 401(a), 457 and ROTH IRA Retirement • Pre-Tax Medical Spending Account
Savings Plan • Pre-Tax Dependent Care Spending Account
• Pre-Tax Medical Spending Account • Voluntary Comprehensive Dental Plan
• Pre-Tax Dependent Care Spending • Routt Federal Credit Union
Account • Supplemental Insurance
• Voluntary Comprehensive Dental Plan • Generous Paid Holidays, Sick and Personal
• Voluntary Vision Program Leave/Vacation
• Routt Federal Credit Union • Old Town Hot Springs Discount
• Supplemental Insurance
• 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 for the HDHP
plan and the SelectCO network for the PPO plan. The benefits listed illustrate what you pay.
Employees enrolled in the PPO plan can use Tier 1 or Tier 2 providers but will see the most savings by utilizing Tier 1 providers and
facilities. Members must select a Colorado Select PCP for primary care. If a Tier 1 provider is available and not utilized, in most cases,
Tier 2 benefits apply. Find providers on UMR’s website at www.umr.com. Insurance coverage for The Steadman Clinic, Vail Health and
the Shaw Center is available ONLY if you select the HDHP.
UMR MEDICAL OPTIONS
PPO Plan Select Colorado HDHP WITH HSA PLAN*
BENEFIT In-Network Tier 1 In-Network Tier 2 Out-of-Network In-Network Out-of-Network
Deductible
Individual $500 $1,250 No Coverage $1,500 $3,250
Family $1,000 $2,500 $3,000 $6,500
Out-of-Pocket Maximum
(Included deductible and copays) No Coverage $5,000
Individual $4,000 $5,000 $6,550 $10,000
Family $8,000 $10,000 $10,000 $20,000
Coinsurance 80% No Coverage After deductible, 20% After deductible, 40%
Office Visits - Primary Care $0 copay $25 copay No Coverage After deductible, 20% After deductible, 40%
Office Visits - Specialists $10 copay $25 copay No Coverage After deductible, 20% After deductible, 40%
Preventive Care 0% No Coverage 0% In-network only
Teladoc $0 copay No Coverage $40 N/A
Urgent Care $0 copay $50 copay No Coverage After deductible, 20% After deductible, 40%
Inpatient Hospital After deductible, 20% No Coverage After deductible, 20% After deductible, 40%
Outpatient Surgery After deductible, 20% No Coverage After deductible, 20% After deductible, 40%
Emergency Room Care Deductible
Deductible and coinsurance After deductible, 20% After deductible, 20%
Facility Only and coinsurance
Imaging No Coverage
$0 copay $100 copay After deductible, 20% After deductible, 40%
(CT/PET Scans, MRI’s)
Mental Health &
Substance Abuse
Inpatient After deductible, 20% No Coverage After deductible, 20% After deductible, 40%
Outpatient After deductible, 20% After deductible, 20% After deductible, 40%
In office 0%
Lifetime Maximum Unlimited Unlimited No Coverage Unlimited Unlimited
Prescription Drug After deductible until
(tier-1/tier-2/tier-3) out-of-pocket max
No Coverage Not covered
Retail (30 day supply) $10/$30/$50/$125 $10/$30/$50
Mail Order (90 day supply) $25/$75/$125 $25/$75/$125
*In-network maximum amount that any one person will satisfy towards the annual family out of pocket.
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.
2
HSA Limits for Calendar Year 2022
Annual contribution limitation:
• For an individual with self-only coverage under a high deductible health plan is $3,650.
• For an individual with family coverage under a high deductible health plan is $7,300.
• Catch up contributions (age 55 and older) is $1,000.
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.
3
DENTAL / VISION
Dental Plan Highlights
Routt County offers employees access to affordable dental care. Regular and part-time employees working 20 hours or more per
week are eligible for dental benefits. Dental Coverage is available for eligible employees and their dependents through UMR. The
program offers different levels of coverage for various services. Benefits range from 100% to 50% coverage. Visit www.umr.com or
call 1.800.826.9781 for more information.
UMR DENTAL PLAN
BENEFIT
Annual Individual Deductible $50
Annual Maximum (per individual) $1,250
SERVICES UMR 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
50%
• Endodontic Services (Root Canal)
• Crowns
Orthodontia (19 years and under) 50%
Orthodontia Maximum (per individual) $1,500
Premiums Per Payroll
Employee Only $6.48
Employee + Spouse $12.37
Employee + Child(ren) $13.55
Family $19.18
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 Mutual of Omaha.
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 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.
Employees can supplement their Basic Life and AD&D coverage with
Voluntary Life and AD&D. Eligible employees can elect up to 5x their
annual salary, capped at $500,000, in increments of $10,000. You can
also elect coverage for your spouse and child(ren).
Supplemental Insurance
Various insurance companies offer County Employees additional
insurance coverage for cancer policies, disability insurance and other
services. Currently, Aflac, Colonial Life Insurance, and Washington
National 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.
MissionSquare Retirement The vesting schedule for the 401 plan is:
Employees may elect to participate in the 401 Money Purchase Plan. 0% upon completion of 1st year of employment
Employees are required to contribute 6% of their compensation, and the
County will match the employee’s contribution. Contributions to the Plan 25% upon completion of 2nd year of employment
are pre-tax contributions. The employee has the ability to direct how all 50% upon completion of 3rd year of employment
funds are invested. You cannot stop your 6% contribution to the 401 Plan 75% upon completion of 4th year of employment
once you enroll in the plan. The 401 Plan has a loan provision.
100% upon completion of 5th year of employment
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
Dental Plan UMR 800.826.9781 www.umr.com
Vision Plan VSP Vision 800.877.7195 www.vsp.com
Life & Disability Mutual of Omaha 800.775.6000 www.mutualofomaha.com
Employee Assistance Program Mutual of Omaha 855.316.2796 www.mutualofomaha.com/eap
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
MissionSquare: www.icmarc.org
Retirement Savings Plan 202.281.6967
Michael Knapp mknapp@missionsq.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 970.870.5361 spearce@co.routt.co.us
Stacey Schad - HR Benefits Administrator 970.870.5223 sschad@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 Notice of Prescription Drug Creditable Coverage
respect to your PHI under HIPAA is available from your Routt County provides a “Notice of Prescription Drug
medical plan provider. For more information regarding this Creditable Coverage” to all Medicare eligible participants on
Notice, please contact Human Resources or the medical plan an annual basis. This notice states that under Routt County
directly. medical plan, you have prescription drug coverage that is, on
average, as generous as the standard Medicare Prescription
Summary of Benefits and Coverage (SBC) Drug Coverage.
Effective for plan renewals after January 1, 2012, the Patient
Protection and Affordable Care Act requires employers Continuation Of Coverage (COBRA)
that offer health coverage to provide a uniform Summary If your coverage ends under the Plan, you may be entitled to
of Benefits and Coverage (SBC) to people who apply for elect continuation coverage (coverage that continues on in
and enroll in the health plan. This document contains the some form) in accordance with federal law.
following:
If you selected continuation coverage under a prior plan
• Four-page overview of plan benefits, cost sharing and which was then replaced by coverage under this Plan,
limitations continuation coverage will end as scheduled under the prior
• Required set of examples of how the plan works plan or in accordance with the terminating events listed
• Phone number and internet address for obtaining copies of below, whichever is earlier.
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.
8When Coverage Ends in your employer plan, contact the Department of Labor at
We may discontinue these Benefit plans and/or all similar www.askebsa.dol.gov or call 1-866-444-EBSA (3272).
benefit plans at any time. Your entitlement to Benefits
automatically ends on the date that coverage ends, even COLORADO – Health First Colorado (Colorado’s Medicaid
if you are hospitalized or are otherwise receiving medical Program) & Child Health Plan Plus (CHP+)
treatment on that date. Health First Colorado Website: https://www.
healthfirstcolorado.com/
When your coverage ends, we will still pay claims for Health First Colorado Member Contact Center: 1-800-221-
Covered Health Services that you received before your 3943/ State Relay 711
coverage ended. However, once your coverage ends, we CHP+: https://www.colorado.gov/pacific/hcpf/child-health-
do not provide Benefits for health services that you receive plan-plus
after coverage ends for medical conditions that occurred CHP+ Customer Service: 1-800-359-1991/ State Relay 711
before your coverage ended, even if the underlying medical Health Insurance Buy-In Program (HIBI): https://www.
condition occurred before your coverage ended. An Enrolled colorado.gov/pacific/hcpf/health-insurance-buy-program
Dependent’s coverage ends on the date your coverage ends. HIBI Customer Service: 1-855-692-6442
Premium Assistance Under Medicaid and the To see if any other states have added a premium assistance
Children’s Health Insurance Program (CHIP) program since July 31, 2021, or for more information on
If you or your children are eligible for Medicaid or CHIP and special enrollment rights, contact either:
you’re eligible for health coverage from your employer, your U.S. Department of Labor
state may have a premium assistance program that can help Employee Benefits Security Administration
pay for coverage, using funds from their Medicaid or CHIP www.dol.gov/ebsa or 1-866-444-EBSA (3272)
programs. If you or your children aren’t eligible for Medicaid
or CHIP, you won’t be eligible for these premium assistance U.S. Department of Health and Human Services
programs but you may be able to buy individual insurance Centers for Medicare & Medicaid Services
coverage through the Health Insurance Marketplace. For www.cms.hhs.gov or 1-877-267-2323, Ext. 61565
more information, visit www.healthcare.gov.
Uniformed Services Employment And
If you or your dependents are already enrolled in Medicaid or Reemployment Rights Act (USERRA)
CHIP and you live in a State listed below, contact your State If you are called to active duty in the uniformed services, you
Medicaid or CHIP office to find out if premium assistance is may elect to continue coverage for you and your eligible
available. dependents under USERRA. This continuation right runs
concurrently with your continuation right under COBRA,
If you or your dependents are NOT currently enrolled explained below, and allows you to extend an 18-month
in Medicaid or CHIP, and you think you or any of your continuation period to 24 months. You and your eligible
dependents might be eligible for either of these programs, dependents qualify for this extension if you are called into
contact your State Medicaid or CHIP office or dial 1-877-KIDS active or reserve duty, whether voluntary or involuntary, in
NOW or www.insurekidsnow.gov to find out how to apply. If the Armed Forces, the Army National Guard, the Air National
you qualify, ask your state if it has a program that might help Guard, full-time National Guard duty (under a federal, not a
you pay the premiums for an employer-sponsored plan. state, call-up), the commissioned corps of the Public Health
Services and any other category of persons designated by
If you or your dependents are eligible for premium assistance the President of the United States.
under Medicaid or CHIP, as well as eligible under your
employer plan, your employer must allow you to enroll in
your employer plan if you aren’t 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
9Important Benefit Information Enclosed
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