The following list summarizes the various benefit programs in effect for workers:
The County pays 85% of the total premium for HMO Plans – Kaiser or Blue Shield HMO (workers pay 15% of the total premium) and the County pays 75% of the total premium for Blue Shield POS (workers pay 25% of the total premium). For full time employees enrolled in the Kaiser or Blue Shield High Deductible Health Plan, the County will annually contribute fifty percent (50%) of the cost of the deductible amount for the plan to a Health Savings Account. For part time employees working half time or more, the County’s contribution to the Health Savings Account shall be prorated based on their part time status.
See section 22.3.
All workers must participate in a plan.
County pays 90% of premium
- $100 cap on deductible
- 60% UCR paid to dentists
- 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 6 months; workers may appeal plan rejections – see plan booklet.
Effective January 1, 2007, the County Plan will offer a tooth replacement implant benefit:
- Replacement of any missing single tooth in the esthetic region of the upper teeth.
- Annual maximum of $1,000.00/person
- Paid at 85% of the billed amount, subject to the $1,000.00 annual maximum benefit
Delta Dental PMI:
San Mateo County Plan B with $10.00 co-pay each on examination and materials for workers 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.
- 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 $20,000 for worker; $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