Eligibility

Mary Hao, Director, Human Resources

Benefits Eligibility

Regular-hire full-time and part-time employees working half time or more are provided with an allowance that can be used to purchase health benefits including medical, dental, vision as well as life and long term disability insurance. Some of the unused portion of the cash allowance may be taken as taxable cash back according to the IRS (IRC, Section 125). All employees that are contingent-hire status may be eligible only for the Kaiser high-deductible health plan (HDHP) medical plan. For more information about medical benefits for contingent-hires see the Employee Benefits Guide for Contingent-Hire Employees.

Dependent Eligibility

Spouse or Domestic Partner

All benefits-eligible employees may enroll a legal spouse or registered domestic partner in the County’s benefits plans, including medical, dental, vision, and dependent life insurance. Proof of legal marriage or domestic partnership is required. Enrollment in benefits must be completed within 30 days of the date of marriage or partnership or during the Open Enrollment period.

Natural Children, Stepchildren, Adopted Children

A member’s natural child, stepchild, adopted child (including a child placed for adoption) and the natural or adopted child of a legal spouse or domestic partner are eligible for coverage in health benefits up to 26 years of age. The employee will be responsible for all taxes incurred under rules set by the Internal Revenue Service (IRS) and the Franchise Tax Board regarding imputed income. Newly eligible dependents must be enrolled in the dental, vision, medical and/or life insurance plans within 30 days of their eligibility.  Some examples of ‘newly eligible’ include: when an employee first becomes eligible for benefits (i.e. commencement of employment, employee change from extra-hire to at least half-time regular-hire status); when an employee marries; or when an employee welcomes a new child.

 

Enrolling or Making Changes to Benefits

Eligible new and rehired employees must enroll in health benefits within 30 calendar days from date of hire or rehire. If you do not enroll within this 30-day period, you can only apply for benefits during the next Open Enrollment period or within 30-days of qualifying event as benefit elections are irrevocable for the plan year under IRS regulations and plan rules. Open enrollment is the only time you can make changes to your health benefit elections, unless you have a “qualifying event”. That means once you have made your elections during the Open Enrollment period, no changes can be made unless you have a “qualifying/life changing event” such as marriage, divorce, birth, etc.   Refer to the 2018 Employee Benefits Guide for more information on "Qualifying Events" and changing benefit elections outside of Open Enrollment.

Enrollment and change forms are available online or through Human Resources. To access forms online, go to the upper left navigation pane and click "Forms" in the "Featured Links" section. Forms are listed alphabetically. Complete your form(s), and submit along with any other required documentation so that they are received by the Human Resources Benefits Division by the Open Enrollment deadline. If you have any question concerning benefits and/or open enrollment, please contact your Human Resources Benefits representative.

Late enrollment and change forms, proof of comparable group medical coverage and completed group insurance waiver forms will not be processed. If you are concerned because you cannot obtain all of the needed documentation, please call your HR Benefit Division representative during Open Enrollment to discuss.

Waiver of Participation in Medical

Employees may waive County sponsored medical insurance if they provide a Waiver of Participation Form affirming that the employee (and all members of the employee's "tax family") has other group “minimum essential coverage”. The Waiver of Participation form must be submitted each calendar year during Open Enrollment or within 30 days of a qualifying event. Employees waiving coverage through the County’s medical insurance plans who fail to provide a signed Waiver of Participation Form during Open Enrollment or within 30 days of a qualifying event will be ineligible to receive cash back of unused fringe. Refer to the 2018 Employee Benefits Guide for more information.