HomeMy WebLinkAboutORD-2012-028 Amendment to the Orange County Personnel Ordinance Article IV, Section 28-36, Health Insurance oleo - Zo Z
Sec. -36. - Health insurance. 17h
It is the policy of Orange County to provide permanent employees both full-time and part-time
(regularly scheduled at least 20 hours each workweek) with group health insurance. The cost to the
employee for group health insurance is determined each year. Employees also have the option, at
additional expense, to cover the employee's spouse, dependent child(ren), domestic partner as
defined in this Ordinance, and/or family.
(a) Effective Date. Coverage is effective on the first day of the month following the date of
employment.
(b) Retiree Health Insurance. The County provides retiree health insurance and
contributes toward the cost of this for eligible employees.
(1) Employees Eligible.
a. A Permanent employee employed on or before June 30, 2012 is eligible
for retiree health insurance if he or she retires from Orange County and
meets one of the following criteria:
1. Has at least ten years of total Orange County Service as a
permanent employee.
2. Is age 65 or older and has at least five years of total Orange
County Service as a permanent employee.
3. Is retiring on a Disability Retirement and has at least five years of
total Orange County Service as a permanent employee.
b. A Permanent Employee, employed on or after July 1, 2012 is eligible for
retiree health insurance if he or she retires from Orange County and
meets one of the following criteria:
1. Has at least twenty consecutive years of Orange County Service
as a permanent employee.
2. Is age 65 or older and has at least ten consecutive years of
Orange County Service as a permanent employee.
3. Is retiring on a Disability Retirement and has at least ten
consecutive years of Orange County Service as a permanent
employee.
(2) Eligibility Period to Elect Participation in Retiree Health Insurance. To
participate in retiree health insurance, the eligible retiree must be retiring
directly from Orange County and request such participation within 30 calendar
days of the last date of employment.
(3) Retiree Health Insurance Plans Available
a. For an eligible retiree under age 65. The retiree is covered under one of
the County's group health insurance plans. The retiree remains on the
County group health insurance plan in which enrolled at retirement.
During any subsequent annual enrollment period, the retiree may change
to another County health insurance plan as well as add or drop
dependents.
b. For any retiree eligible for Medicare due to age or disability. Medicare
becomes the primary insurer and the County becomes the secondary
insurer. County group health insurance ends. The retiree enrolls in
Medicare Part A and Part B and pays the cost. The County provides
Medicare supplement hospitalization and provider insurance and
prescription coverage, as specified in this Ordinance.
(4) County Contribution for Retiree Health Insurance
a. Effective July 1, 2008, Orange County will not subsidize the cost of retiree
dependent health care for employees hired after July 1, 2008.
b. For an eligible retiree under Section (b)(1)a.1., the County subsidizes the
cost of retiree health insurance as follows:
Retiree/Dependent Health Plan Type Retiree Dependent
Supplement* Supplement*
Retiree under 65 Group Health Plan 100%
• Dependent under 65 Group Health Plan 52%
• Dependent 65 or over Medicare Supplement None
Retiree 65 and over Medicare Supplement 100%
• Dependent under 65 Group Health Plan None
• Dependent 65 or over Medicare Supplement None
c. For an eligible retiree, under Sections (b)(1)a.2 and (b)(1)a.3, the County
subsidizes the cost of retiree health insurance as follows:
Retiree/Dependent Health Plan Type Retiree Dependent
Supplement* Supplement*
Retiree under age 65 Group Health Plan 50%
• Dependent under 65 Group Health Plan 26%
• Dependent 65 or over Medicare Supplement None
Retiree 65 or over Medicare Supplement 50%
• Dependent under 65 Group Health Plan None
• Dependent 65 or over Medicare Supplement None
d. For an eligible retiree under Section (b)(1)b, the County subsidizes the
cost of retiree health insurance as follows:
Retiree Health Plan Type Retiree Dependent
Supplement* Supplement*
Retiree under 65 Group Health Plan 100% None
Retiree 65 and over or Medicare 100% None
Medicare eligible Retiree Supplement
under 65 Prescription
Coverage
Disability Retirement Group Health Plan 50% None
underage 65 between 10-
20 years of total Orange
County service
Retiree 65 and over with IMedicare 50% None
between 10-20 years of ISupplement
[total Orange County Prescription
service Coverage
*The County pays the percentage shown of the cost not to exceed the
amount it contributes for individual/dependent coverage for current
employees. For employees hired on or after July 1, 2012, the County cost
may not exceed 50% of the amount it contributes for individual/dependent
coverage for current employees. The retiree pays the cost for any group
health insurance or Medicare supplement coverage for the retiree or the
dependent costing more than the County contribution. If the retiree waives
coverage,the County provides no cash payment in lieu of such coverage.
(5) Payment of Premiums for Which the Retiree Is Responsible. The retiree pays
Orange County any required premiums monthly. With appropriate notice, the
County terminates coverage when premiums are more than 30 days past due.
The health insurance provider bills the retiree directly for any Medicare
supplement coverage for a dependent.
(6) Dependent Under Age 65 at Death of Eligible Retiree. Upon the death of the
retiree enrolled in the County retiree health insurance, the County offers a
dependent on group health insurance continuation of coverage under the
Consolidated Omnibus Budget Reconciliation Act (COBRA). The dependent is
eligible for such coverage for up to 36 months (or until attaining age 65)
provided the dependent pays the full cost of this coverage.
(7) Eligible Retiree Returning to Work in NC Local Government. If the retiree
returns to work with another North Carolina Local Government employer in a
position which offers group health insurance coverage (whether the employee
elects it or not), Orange County cancels the retiree's health insurance
coverage through Orange County and such coverage may not be reinstated.
(c) COBRA Coverage. Under the Consolidated Omnibus Reconciliation Act (COBRA),
Orange County continues health care coverage to persons who would otherwise lose
coverage under a health care plan due to specific events provided the employee,
covered spouse, domestic partner, and/or dependent child agrees to pay, and pays,
the cost of this coverage.
(1) When coverage ceases due to termination or reduction in hours of
employment, the employee, covered spouse, domestic partner, and/or
dependent child is entitled to up to 18 months of coverage.
(2) If the employee, covered spouse, domestic partner, or dependent child is
determined disabled under Social Security at the time of termination or
reduction in hours, he or she is entitled to purchase coverage for up to 29
months.
(3) The spouse, domestic partner, or dependent child of an employee is entitled to
up to 36 months of coverage if any of the following occurs:
a. Death of the covered employee
b. Divorce or legal separation of the covered employee from the
.employee's spouse or termination of a domestic partner relationship
c. A covered employee becomes entitled to Medicare benefits
d. A covered dependent is no longer a dependent.
(turd. of 06-07-1976, eff, 08-01-1976;Amend, of 09-16-1997.Art. 1V§ TO, eff 09-01-1997;Amend, of 09-21-2004.
eff 01-01-2005:Amend, of 06-24-2008, riff 07-01-2008;Amend, of 06-19-2012. eff 07-01-2012.)
Sec. 28-36. - Health insurance.
It is the policy of Orange County to provide permanent employees both full-time and part-time
(regularly scheduled at least 20 hours each workweek) with group health insurance. The cost to the
employee for group health insurance is determined each year. Employees also have the option, at
additional expense, to cover the employee's spouse, dependent child(ren), domestic partner as
defined in this Ordinance, and/or family.
(d) Effective Date. Coverage is effective on the first day of the month following the date of
employment.
(e) Retiree Health Insurance. The County provides retiree health insurance and
contributes toward the cost of this for eligible employees.
(5) Employees Eligible.
a. A Permanent Employee employed on or before June 30, 2012 is eligible
for retiree health insurance if he or she retires from Orange County and
meets one of the following criteria:
1. Has at least ten years of total Orange County Service as a
permanent employee.
2. Is age 65 or older and has at least five years of total Orange
County Service as a permanent employee.
3'. Is retiring on a Disability Retirement and has at least five years of
total Orange County Service as a permanent employee.
b. A Permanent Employee, employed on or after July 1, 2012 is eligible for
retiree health insurance if he or she retires from Orange County and
meets one of the following criteria:
4. Has at least twenty consecutive years of Orange County
Service as a permanent employee.
5. Is age 65 or older and has at least ten consecutive years of
Orange County Service as a permanent employee.
6. Is retiring on a Disability Retirement and has at least ten
consecutive years of Orange County Service as a permanent
employee.
(6) Eligibility Period to Elect Participation in Retiree Health Insurance. To
participate in retiree health insurance, the eligible retiree must be retiring
directly from Orange County and request such participation within 30 calendar
days of the last date of employment.
(7) Retiree Health insurance Plans Available
a. For an eligible retiree under age 65. The retiree is covered under one of
the County's group health insurance plans. The retiree remains on the
County group health insurance plan in which enrolled at retirement.
During any subsequent annual enrollment period, the retiree may change
to another County health insurance plan as well as add or drop
dependents.
b. For any eligible retiree eligible for Medicare due to age or disability.
Medicare becomes the primary insurer and the County becomes the
secondary insurer. County group health insurance ends. The retiree
enrolls in Medicare Part A and Part B and pays the cost. The County
provides Medicare supplement hospitalization and provider insurance and
prescription coverage, as specified in this Ordinance.
(8) County Contribution for Retiree Health Insurance
a. Effective July 1, 2008, Orange County will not subsidize the cost of retiree
dependent health care for employees hired after July 1, 2008.
b. For an eligible retiree under Section (b)(1)a.1., the County subsidizes the
cost of retiree health insurance as follows:
Retiree/Dependent Health Plan Type Retiree Dependent
Supplement* Supplement*
Retiree under 65 Group Health Plan 100%
• Dependent under Group Health Plan 52%
65
• Dependent 65 or Medicare Supplement None
over
Retiree 65 and over Medicare Supplement 100%
• Qependent under Group Health Plan None
65
• Dependent 65 or Medicare Supplement None
over
c. For an eligible retiree, under Sections (b)(1)a.2 and (b)(1)a.3, the County
subsidizes the cost of retiree health insurance as follows:
Retiree/Dependent Health Plan Type Retiree Dependent
Supplement* Supplement*
Retiree under age 65 Group Health Plan 50%
• Dependent under Group Health Plan 26%
65
• Dependent 65 or Medicare Supplement None
over
Retiree 65 or over Medicare Supplement 50%
• Dependent under Group Health Plan None
65
• Dependent 65 or Medicare Supplement None
over
d. For an-eligible retiree under Section (b)(1)b, the County subsidizes the
cost of retiree health insurance as follows:
Retiree Health Plan Type Retiree Dependent
Supplement* Supplement*
Retiree under 65 Group Health Plan 100% None
Retiree 65 and over or Medicare Supplement 100% None
Medicare eligible Prescription Coverage
Retiree under 65
Disability Retirement Group Health Plan 50% None
under age 65 between
10-20 years of total
Orange County
service
Retiree 65 and over Medicare Supplement 50% None
with between 10-20 Prescription Coverage
years of total Orange
County service
The County pays the percentage shown of the cost not to exceed the amount it
contributes for individual/dependent coverage for current employees. For
employees hired on.or after July 1, 2012, the County cost may not exceed 50%
of the amount it contributes for individual/dependent coverage for current
employees. The retiree pays the cost for any group health insurance or
Medicare supplement coverage for the retiree or the dependent costing more
than the County contribution. If the retiree waives coverage, the County
provides no cash payment in lieu of such coverage.
(5) Payment of Premiums for Which the Retiree Is Responsible. The retiree pays
Orange County any required premiums monthly. With appropriate notice, the
County terminates coverage when premiums are more than 30 days past due.
The health insurance provider bills the retiree directly for any Medicare
supplement coverage for a dependent.
(6) Dependent Under Age 65 at Death of Eligible Retiree. Upon the death of the
retiree enrolled in the County retiree health insurance, the County offers a
dependent on group health insurance continuation of coverage under the
Consolidated Omnibus Budget Reconciliation Act (COBRA). The dependent is
eligible for such coverage for up to 36 months (or until attaining age 65)
provided the dependent pays the full cost of this coverage.
(7) Eligible Retiree Returning to Work in NC Local Government. If the retiree
returns to work with another North Carolina Local Government employer in a
position which offers group health insurance coverage (whether the employee
elects it or not), Orange County cancels the retiree's health insurance
coverage through Orange County and such coverage may not be reinstated.
(f) COBRA Coverage. Under the Consolidated Omnibus Reconciliation Act (COBRA),
Orange County continues health care coverage to persons who would otherwise lose
coverage under a health care plan due to specific events provided the employee,
covered spouse, domestic partner, and/or dependent child agrees to pay, and pays,
the cost of this coverage.
(4) When coverage ceases due to termination or reduction in hours of
employment, the employee, covered spouse, domestic partner, and/or
dependent child is entitled to up to 18 months of coverage.
(5) If the employee, covered spouse, domestic partner, or dependent child is
determined disabled under Social Security at the time of termination or
reduction in hours, he or she is entitled to purchase coverage for up to 29
months.
(6) The spouse, domestic partner, or dependent child of an employee is entitled to
up to 36 months of coverage if any of the following occurs:
a. Death of the covered employee
b. Divorce or legal separation of the covered employee from the
employee's spouse or termination of a domestic partner relationship
c. A covered employee becomes entitled to Medicare benefits
d. A covered dependent is no longer a dependent.
(Ord, of 06-07-1976, eff 08-61-1976:09-16-1997, Art. IV§ 70, eff, 09-01-19971 09-21-2004, eff. 01-01-2005 06-24-
26£18, eff 87-01-2008)
b. Amendment to the Orange County Personnel Ordinance Article IV, Section
28-36, Health Insurance
The Board considered approving an amendment to the Orange County Personnel
Ordinance Article IV, Section 28-36, Health Insurance regarding retiree health coverage for
employees hired on or after July 1, 2012.
Interim Human Services Director Sharon Laisure went through the changes that would
occur as a result of this amendment:
- Increase the eligibility requirement from a total of ten year Orange County service to
twenty continuous years of Orange County service for a retiree under age 65 retiring
with a service retirement;
- Increase the eligibility requirement from a total of five years Orange County service
to ten continuous years of Orange County service for a retiree age 65 or older OR
an employee retiring with a disability retirement;
- Reduce the cap on the amount the County will pay for post-65 benefits to 50% of the
amount paid for active employees' health insurance (compared to the current 100%);
and
- Require any retiree eligible for Medicare due to disability or age to enroll in Medicare
Parts A and B and end enrollment in the County's group health insurance.
This will affect all employees hired on or after July 1st, 2012.
Commissioner Yuhasz asked about the "continuous service" and Frank Clifton said that
they found under the older program that people would work then leave and then come back to
retire in order to get the retirement health benefits. He said that this is a retention benefit.
Commissioner Yuhasz said that the 20-year period is long enough that would warrant
this particular benefit. Commissioner Jacobs agreed.
Commissioner Foushee suggested seeing what happens in the market for other local
governments.
Frank Clifton said that Orange County has one of the best benefit packages. He will do
further research if the Board wants.
Commissioner Hernminger agreed with Commissioner Yuhasz and Commissioner
Jacobs, however, she is not comfortable with continuous at this point and she would like to see
more information.
Commissioner McKee said that he would like to see more information on what other
local governments are doing or have done.
Commissioner Gordon agreed with the continuous function and she said that staff could
review it if the Board wants.
A motion was made by Commissioner McKee seconded by Commissioner Foushee to
approve an amendment to the Orange County Personnel Ordinance Article IV, Section 28-36,
Health Insurance regarding retiree health coverage for employees hired on or after July 1, 2012
and ask for additional information on other counties'actions.
VOTE: UNANIMOUS
Commissioner Jacobs said that he would like to see the breakdown of pay grade in the
motion and Commissioner McKee agreed.
Commissioner Foushee said that the County Commissioners did talk in the work session
that employees are to be informed during the entire health insurance discussion process
whether the County renews or not with United Health Care (UHC) and she too has received
numerous complaints from employees about UHC. She said that employees did not feel that
they got what they thought they were going to get in healthcare. She hopes that whatever is