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Full-Time Medical and Dental Benefits Overview

HROG Section:
Work/Life Benefits
Document Title:
An Overview of Medical Benefits (Full-Time Employees and Faculty and Retirees)
Initial Date Posted:
Sept. 1, 2010
Board Approval:
Applies To:
Full-Time Employees and Retirees
Source:
Related TASB Policy:
Last Date Revised:
Sept. 1, 2012 (United Healthcare)

Purpose

Full-Time Employees

Health Select is currently the only available medical plan for DCCCD employees and there is a 90-day waiting period before new full-time employees are eligible for medical health benefits.

Full-time employees of DCCCD are eligible for a wide range of benefits through the Employees Retirement System of Texas (ERS).

Medical

The Employees Retirement System of Texas (ERS): www.ers.state.tx.us
United Healthcare: http://healthselectoftexas.welcometouhc.com/index.html
 
A comprehensive health insurance program (Health Select) is provided through ERS and administered by United Healthcare.  Full-time employees will receive this coverage free of charge. Those electing to enroll dependents will pay 50% of the premiums set by the State. There is a 90-day waiting period for this benefit.

Dental

HumanaDental Plan: www.humanadental.com/ers

Dental insurance is available for full-time employees and begins on the first day of employment. Eligible employees may select from two dental plans: the State of Texas Dental Choice Plan or the Dental HMO both of which are administered by Humana Dental. The employee is responsible for 100% of the premiums and may also cover eligible dependents.

Retirees:

When you stop working and turn 65

For retirees with ERS health coverage who are eligible for Medicare at age 65, or eligible at a younger age due to a qualifying disability.

  • If you are retired and turning 65, call the Social Security Administration to sign up for Medicare Parts A and B.
  • You don’t need to sign up for Medicare Prescription Drug Coverage (Part D) in 2010.
  • Your state health plan assumes you are enrolled in Medicare if you are eligible and pays benefits as if you are in Medicare, even if you didn’t enroll.

When you become eligible, Medicare is primary. Your state health insurance coverage is secondary. After you meet your annual deductibles (if applicable), Medicare generally pays 80 percent of eligible charges. Your state health plan coordinates to pay secondary to Medicare.

Background

Definitions

Dependent as Defined by ERS:

  1. The spouse of an Employee or Retiree, or
  2. Any unmarried child who is either under 25 years of age or disabled; provided that in the case of a disabled child 25 years of age or older, such child is dependent upon the Employee or Retiree for care or support.

Copayment means the amount that a participant is required to pay when utilizing certain benefits within the specific plan. Participant's copayment is required at the time of service. Once the copayment is made, further payment may not be required of the participant.

Premium is the amount paid on a monthly basis for the selected insurance coverage. Currently the State pays the entire premium for employee only coverage and a portion of the different dependent coverages.

Plan Year is the period beginning September 1, xxxx and extending through August 31, xxxx.

Eligibility

Procedures

Employee Responsibility

HR Responsibility

Exceptions To Policy

Other Notes

Related Links