The following list summarizes the various benefit programs in effect for employees as of April 1, 2011:
The County pays 85% of the total premium for Kaiser or Blue Shield HMO plans (employees pay 15% of the total premium) and the County pays 75% of the total premium for Blue Shield POS plan (employees pay 25% of the total premium).
See section 21.3.
All employees must participate in a plan.
County Plan: County pays 85% of premium
1st year: $100 cap on deductible
60% UCR paid to dentists
2nd year: No deductible
85% UCR paid to dentists
Annual maximum of $2500/person
If recommended by dentist and approved by plan, cleanings may be more frequent than every six (6) months; employees may appeal plan rejections – see Plan Description Booklet.
Effective January 1, 2007, Blue Shield will offer the following tooth replacement implant benefit:
Replacement of any missing single tooth in the esthetic region of the upper teeth
Annual maximum $1,000/person
Paid at 85% of the billed amount, subject to the $1,000.00 annual maximum benefit.
Delta Dental PMI: See brochure.
VSP – VISION:
San Mateo County Plan B with $10.00 co-pay each on examination and materials for employees and dependents. Premiums paid by County.
Domestic partners and young adult dependents are included in the above plans. Children and young adult dependents of domestic partners are included.
Age limit for Young Adult Dependents is 26 effective January 1, 2011.
Grandchildren of custodial grandparents will be considered eligible dependents on all health, dental and vision plans provided there is documentation of primary responsibility and approval by the affected benefit plan. This will occur with or without formal adoption.
County paid $12,000 for employee ($20,000 effective March 1, 2007) / $500.00 for spouse / up to $500/child.
LONG TERM DISABILITY
County paid premiums. Must be employed by County 3 or more years to be eligible.
Maximum benefit: $2400 monthly
MEDICAL SPENDING ACCOUNT
The County implemented an IRC Section 125 Medical Spending Account on January 1, 2004.
This is a summary of various benefit programs in effect for eligible employees as of April 1, 2011. The descriptions are very general and are not intended to provide complete details about any or all plans. Exact specification for all plans are provided in the official Plan Documents, copies of which are available from Payroll Specialists or the Human Resources Department, Benefits Division. Where there is a difference between the description on these pages and the Plan Documents, the Plan Documents prevail. Please note that benefits are subject to change by the Plans and there is no guarantee that these benefits will be continued indefinitely. However, the County agrees to continue negotiated coverage as it currently exists unless such coverage is no longer offered by the plans.