Health Care Reform or Patient Protection and Affordable Care Act (PPACA)
The Individual Mandate went into effect January 1, 2014, and requires you and your dependents to have health insurance or pay a penalty on your taxable income.¬† Douglas County‚Äôs plans meet all of the requirements to satisfy your ‚ÄúIndividual Mandate‚ÄĚ.¬†
Effective January 1, 2015, Douglas County is required to offer all employees averaging 30 hours or more per week coverage that meets the PPACA requirements of qualifying and affordable coverage.¬† This new requirement will not have any impact on our plans as they already meet the PPACA requirements.¬† Since Douglas County provides their employees with qualifying and affordable coverage as defined by the PPACA, County employees and their dependents will not qualify for subsidies through the public exchange.
Under the PPACA rules, Douglas County‚Äôs United Health Care PPO plan qualifies as a grandfathered plan.¬† The United Health Care CDHP/HSA plan qualifies as a non-grandfathered plan.
Medical Plan Summaries:
UHC Summary 2016 $300 Deductible Plan¬†¬†(Special Union Employees)
UHC Summary 2016 $600 Deductible Plan¬†(Active and Retired Employees)
Preventative Care Limits for PPO Plans
The $600 deductible plan has a preventative care limit of $750 per calendar year
The $300 deductible plan has a preventative care limit of $500 per calendar year
The county contributes $1,000/EE or $2,000 for EE+1/EE+2 or more annually toward an HSA.¬† The EE only plan has a deductible of $3,000 and the EE+1/EE+2 or more has a $6,000 deductible.¬† If you would like to set up an HSA (for first time enrollees), please contact Lisa at 444-6533.
Health Savings Account (HSA) Limits
The IRS is¬†allowing the following HSA Limits for 2016 (this amount includes the County‚Äôs contribution and the employee‚Äôs contribution to their HSA account)
¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬† Type of Coverage¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†2016 Limit
¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬† Family Coverage¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†$6,750.00
¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬† Individual Coverage¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬† $3,350.00
¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬† Catch-up for those 55+¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†$1,000.00
UHC Summary 2016 HSA Plan¬†(Active Employees Only)
The self-funded United HealthCare medical insurance plan will provide coverage for the screening, diagnosis, and treatment of autism spectrum disorder in an individual under twenty-one years of age.
Preventative Breast Cancer Drugs Tamoxifen and Raloxifene Covered
The self-funded United HealthCare medical insurance plan will cover tamoxifen and raloxifene when prescribed to reduce the risk of breast cancer as a preventative benefit.¬† The benefit is available for women:
¬∑¬†¬†¬†¬†¬†¬†¬†¬† 35 years and older
¬∑¬†¬†¬†¬†¬†¬†¬†¬† At increased risk for invasive breast cancer after risk assessment and counseling who meet clinical criteria; and
¬∑¬†¬†¬†¬†¬†¬†¬†¬† Who obtain prior authorization
The provisions of this information are not intended and do not create an express or implied contract of employment or an offer of employment between the County and its employees nor any guarantee or promise that¬†benefits referenced here are permanent or cannot be changed. While retirees and current employees are offered the opportunity to participate in a subsidized medical insurance program until age 65, the ability to participate as well as the premiums are not guaranteed in the future and are subject, at any time, to change by the County Board of Commissioners. If there is any conflict in the information state or otherwise communicated, the plan provisions prevail. Please contact Human Resources with any questions.