AFSCME & SEIU Extra Help MOU Section 17.2.1: Initial Enrollment

Extra-help employees in classifications designated as “relief” are not eligible for coverage. The County will review the eligibility of extra-help employees in other classifications within the following two categories:

Category A

Extra-help employees in the classifications of Election Technician, Library Aide, Park Aide and Pest Detection Specialist, who have worked seven hundred fifty 750 hours in the prior fiscal year.

Category B

Extra-help employees in the classifications not designated as “relief”, who have worked nine hundred 900 hours in the prior fiscal year.

The Benefits Division will require individual payments by extra-help employees in Categories A and B who do not work regularly or sufficiently to cover their premium expenses from their paychecks.

17.2.2 Ongoing Eligibility

The ongoing eligibility period is from September 1, through August 31, of each year.

 Category A

Extra Help employees in Category A are not required to work thirty 30 hours per pay period during the “off-season”. At the end of the working season, when Category A individuals drop off payroll they will be notified that they can elect to continue coverage or drop coverage. If they choose to continue coverage, they pay one hundred percent (100%) of the premium. If they fail to pay the premium during any pay period they will be terminated from coverage, offered COBRA, and they will not be eligible for coverage again until they are re-hired. Such coverage will begin the first of the month following their re-employment.

If Category A extra-help employees choose to drop coverage, they can re-enroll if they are re-hired for the next season and are once again in a paid status. Coverage will begin the first of the month following their re-enrollment.

At the beginning of each fiscal year, extra-help employees who have worked seven hundred fifty (750) hours in the prior fiscal year will be eligible for the following year’s coverage. Any individual who is not eligible (after having been eligible in the prior year) will be offered COBRA.

Health coverage will be terminated for covered extra-help employees who:

  1. Terminate employment during the season (benefits terminate at the end of the month of termination).
  2. Fail to work seven hundred fifty (750) hours, as determined the following July (benefits terminate effective August 31, and COBRA is offered).
  3. Fail to work 30 hours per pay period in two (2) consecutive pay periods during the season of employment (benefits terminate effective the end of the month of termination).
  4. Fail to pay within a single pay period their portion of cost (during the season or if they have elected coverage in the off-season, during the off-season).Mary is a Park Aide who normally works from April through October and has more than seven hundred fifty (750) hours in the prior fiscal year. She elects to enroll during the August open enrollment and receives health coverage effective September 1. Mary continues to work until the end of October and is terminated because the season is over. Mary is given the chance to continue coverage until next April, at her own cost.
  5. Example:
  • If she elects coverage, she will be covered during the off-season, provided that she pays one hundred percent (100%) of the premium on a timely (pay period) basis. If, during the off-season, she does not pay her premium in the pay period, she will be terminated at the end of the month and will be able to re-enroll when she is rehired. If she has insufficient hours when eligibility is re-determined in July, she will be offered COBRA.
  • If Mary elects to drop coverage in November (when her season is over), she will be offered coverage in April when she is re-hired. If she elects coverage at this time she will be covered through August 31. If she loses coverage for any of the reasons listed above, she will be ineligible for coverage until September 1, provided she has worked seven hundred fifty (750) hours in the prior fiscal year.Extra-help employees in Category B, not designated as “relief”, will be eligible for coverage from September 1 through August 31 of each year, as long as they continue to meet the eligibility requirements. Health care coverage will be terminated for covered individuals who:
  • Category B
  1. Terminate extra-help employment during the year (benefits terminate at the end of the month of termination).
  2. Fail to work nine hundred (900) hours, as determined the following July 1 (benefits terminate effective August 31).
  3. Fail to work thirty (30) hours per pay period in 2 consecutive pay periods (benefits terminate effective the end of the month of termination).
  4. Fail to pay within a single pay period for any remaining premium costs when the County paycheck is insufficient to cover the premium cost (benefits terminate effective the end of the month of termination).At the beginning of each fiscal year, extra-help employees who have worked nine hundred (900) hours in the prior fiscal year will be eligible for the following year’s coverage. Open enrollment will be offered each August and coverage will begin each September. Any individual who is not eligible (after having been eligible in the prior year) will be offered COBRA.Mark is an extra-help employee who worked more than nine hundred (900) hours in the prior fiscal year. He elects to enroll during the August open enrollment and receives health coverage effective September 1.17.2.3 Cost17.2.4 Healthworx Contract Expiration
  5. The Healthworx Contract expires on August 31, 2015. In the event that the contract is not renewed, an employee enrolled in the plan who is determined to be eligible for the Kaiser HDHP based on eligibility as outlined in section 17.3.1 below, may choose to enroll in the Kaiser HDHP at that time through a qualified mid-year life event. For non-eligible employees, they can find health insurance through California’s health insurance exchange.
  6. The County will contribute 50% toward the premium, and the enrollee will be responsible for paying 50% of the premium.
  7. If, at any point during the year, he loses coverage for any of the above reasons, he will be terminated at the end of the month and will be offered COBRA effective the beginning of the following month after termination of coverage. If he does not elect COBRA he will be ineligible for any coverage. If, at the end of the fiscal year he has nine hundred (900) hours he will be able to re-enroll during the subsequent August open enrollment (with September 1 coverage).
  8. Example:
  9. Category B extra-help employees who are terminated from coverage for any of the above reasons will be ineligible for coverage until the following September 1.