Port of Stockton 2024 Open Enrollment &Benefits Guide OE3 Police Employee Group
Table of Contents Benefits Page Number About Your Benefits 1 Open Enrollment & Benefit Fair Info 2 CalPERS Coverage 3‐6 Medical Premium Rate Sheet 7‐8 Other Important Medical Plan Info 9 Dental Coverage 10 Vision Coverage 11 Life and AD&D Insurance 12 Disability Insurance and Voluntary AD&D 13 Supplemental Life and AD&D Insurance 14 Employee Assistance Program 15‐16 Will Preparation Services 17 Employee Travel Assistance 18 Business Travel Assistance 19 Flexible Spending Accounts 20 Aflac 21 LegalShield 22 New York Life 23 Retirement Plans 24 CAPTRUST 25‐26 In‐Shape 27 ASPCA Pet Insurance 28 PerkSpot Discount Program 29 2023‐ Medicare Notice of Creditable Coverage 30‐32 Dental & Vision Plan Privacy Notice 33‐37 Premium Assistance Under Medicaid and the Children’s Health Insurance Program (CHIP) 38‐41 Contact Information 42
At the Port of Stockton, we are committed to providing a comprehensive and affordable benefits package for you and your family. Review this guide to learn about your options so you can make the most of your Port of Stockton benefits. If you have any questions, feel free to reach out to the Human Resources Department at [email protected]. Eligibility and Enrollment You are eligible to participate in Port of Stockton’s benefits plansif you are a regular full‐time employee working at least 30 hours per week. If you enroll for benefits, you will have the opportunity to extend coverage to your qualified dependents. Please refer to the list below to identify who can be included: Legal Spouse Domestic Partner Children up to age 26 Unmarried children of any age who are declared mentally or physically disabled You have 60 days from your hire date to submit your enrollment to Human Resources. Your benefits begin on the 1st of the month following date of hire. Making Changes to Your Benefits Each year, you have the opportunity to make changes to your benefits during open enrollment. Please note that any changes made outside of the open enrollment period will only be permitted if you experience a qualifying life event. Examples of qualifying life events include: Marriage or divorce Birth or adoption of a child Change in a dependent’s eligibility status Change in employment status for you or your dependentsresulting in the loss/gain of coverage A significant change in the cost or coverage of your dependent’s benefits Change in the cost of dependent care (for dependent care flexible spending accounts only) Death of a dependent You have 30 days from the date of the qualifying event to notify your Human Resources department to make the change. Carriers will not accept changes that exceed 30 days of the qualifying life event. Keep in mind, the changes you make must be directly related to the event. Any changes made will be effective the 1st of the following month after the change forms and appropriate documentation are submitted. About Your Benefits 1
Open Enrollment - September 18 – October 13, 2023 2 Open enrollment is an opportunity to review and make changes to your current health care coverage without a qualifying event. The CalPERS, dental and vision & voluntary benefits open enrollment period will run from Monday, September 18, 2023 through Friday, October 13, 2023. This is your opportunity to enroll for new benefits, add or remove dependents from any benefit plan, change CalPERS plans, or drop benefit coverage entirely. Benefit elections will become effective January 1, 2024 and remain in effect for the entire plan year (January 1, 2024 - December 31, 2024). If you would like to keep your existing medical and/or dental and vision elections, there is no action required on your part, except for the completion of the HRA form for 2024. New FSA elections are required for the plan year January 1, 2024 – December 31, 2024 for anyone wishing to participate in a Healthcare Flexible Spending Account or Dependent Care Flexible Spending Account for the new year. Guardian Insurance is the new vision benefits provider using the VSP network. All existing employee enrollments will carry over to the new provider. Employees will only need to complete a new enrollment form if they are enrolling for the first time, adding or deleting dependents or dropping the coverage altogether. The only changes allowed to your coverage once the plan year begins are those due to a qualifying life event. Please see previous information regarding qualifying life events. To access your CalPERS information, log into your account at my.calpers.ca.gov to view, download, and print your Health Plan Statement. As a reminder, CalPERS has a Self Service tool allowing you to make health plan changes online by logging into your my.calpers.ca.gov account. For more information, please visit the CalPERS website. Benefits Fair- September 27, 2023 The Human Resources Department will host a FUN and INFORMATIVE Health Benefits Fair on Wednesday, September 27, 2023 from 12:00 pm to 2:00 pm at the Lindley House. Do not miss out! 1. Delta Dental 2. Guardian Insurance (New VSP Vision Provider) 3. MetLife 4. New York Life 5. Gallagher Insurance 6. Aflac 7. In-Shape 8. Valley Strong Credit Union 9. AT&T 10. Costco 11. The Edible Schoolyard Project 12. American Cancer Society 13. St. Joseph’s Heart Center 14. St. Joseph’s Behavioral Health Center 15. Kaiser 16. Hills Physician Medical Group Raffle and Scavenger Hunt – To be announced soon! Lunch will be provided by Peñas Taqueria Taco truck for employees attending the Health Fair. RSVP with HR for a free lunch no later than 09/22/2023- More information coming soon. The Port is currently hosting a clothing and supplies drive for Washington Elementary School. Any employee who brings a donation to the Health Fair will receive an additional raffle entry. The following vendors will attend:
1 3 CalPERS Changes For 2024 CalPERS has announced benefit plan changes that take effect January 1, 2024. In addition, most of the health plans offered by CalPERS will see premium increases for 2024. As a result, costs for the Port and the employee will slightly increase. You can find out more information on plan and premium changes by visiting the CalPERS website, as well as the premium rate sheets on page 7 and 8 of this benefits guide. Please review changes for the Basic Health Plans listed below and on the following page. Basic Plan Design Changes Health Maintenance Organization (HMO) and Exclusive Provider Organization (EPO) Health Plan Changes Anthem Blue Cross Select Pharmacy mail-order program with opt-out option guiding members to use home delivery for non-specialty maintenance medications Anthem Blue Cross Traditional Exits Glenn County* Pharmacy mail-order program with opt-out option guiding members to use home delivery for non-specialty maintenance medications Blue Shield Access+ EPO Expansion into Del Norte and San Benito counties UnitedHealthcare SignatureValue Alliance Expansion into 12 counties for public agencies and schools members: Alameda, Contra Costa, Marin, Merced, San Francisco, San Joaquin, San Mateo, Santa Clara, Santa Cruz, Solano, Sonoma, and Stanislaus Pharmacy mail-order program with opt-out option guiding members to use home delivery for non-specialty maintenance medications UnitedHealthcare SignatureValue Harmony Expansion into Santa Clara and Santa Cruz counties Pharmacy mail-order program with opt-out option guiding members to use home delivery for non-specialty maintenance medications Western Health Advantage Pharmacy mail-order program with opt-out option guiding members to use home delivery for non-specialty maintenance medications
CalPERS Changes For 2024 4 Preferred Provider Organization (PPO) Health Plan Changes PERS Gold Site of care lab services incentive waives coinsurance when members use preferred lab providers for routine lab tests Pharmacy mail-order program with opt-out option guiding members to use home delivery for non-specialty maintenance medications Basic PPO out-of-network deductible will increase from $1,000 to $2,500 PERS Platinum Site of care lab services incentive waives coinsurance when members use preferred lab providers for routine lab tests Pharmacy mail-order program with opt-out option guiding members to use home delivery for non-specialty maintenance medications Basic PPO out-of-network deductible will increase from $500 to $2,000
CalPERS Open Enrollment 5
Understanding How CalPERS Works 6
2024 Medical Premium Rate Sheet (Police staff hired before 07/01/2022) 7
2024 Medical Premium Rate Sheet (Police staff hired after 07/01/2022) 8
Health Deduction Your health deduction rates will increase per the OE3 MOU for 2024. Please see the new health deduction amounts below. 2024 Monthly Employee Health Deduction Single $60.00 2-Party $120.00 Family $180.00 Health Reimbursement Arrangement (HRA) Please check the health premium sheets to determine eligibility for HRA contributions. For the new plan year, you will need to complete a new 2024 HRA form. You can find the form here. Be sure to list all eligible dependents up to age 26 on the HRA form for claims reimbursement purposes. SharePoint Site Visit our Open Enrollment Page on PortNet for all your open enrollment needs. You can find the following information and more on the PortNet open enrollment page. For your information, this cannot be accessed via cell phone. You must log in from your work computer. CalPERS Open Enrollment Page Your Guide to Choosing a Health Plan 2024 Health Benefit Summary 2024 Summary of Coverage & Evidence of Coverage Documents CalPERS Enrollment/Change Form 2024 Port Health Premium Sheets Other Important Medical Plan Information 9
Dental benefits are provided through the Delta Dental network at no cost to eligible employees and their eligible dependents. Preventive care is covered at 100% in network and Basic and Major services are covered at 90% in network after the deductible has been met. See the plan description for limitations and exclusions. . Delta Dental PPO In Network [Delta Dental PPO] In Network [Delta Dental Premier] Out of Network Annual Deductible (Individual/Family) $25/$75 $25/$75 $50/$150 Annual Maximum (Per Person) $2,000 $2,000 $1,500 Preventive Care (Routine Cleaning and X‐rays) 100% 100% 100% Basic Services (Fillings, Basic Root Canals) 90% after deductible 90% after deductible 80% after deductible Major Services (Extractions, Crowns) 90% after deductible 90% after deductible 80% after deductible Orthodontia (Children up to age 19) 50% after deductible 50% after deductible 50% after deductible Orthodontia Lifetime Maximum (Per Person) $1,500 $1,500 $1,500 Finding In‐network Dentists You pay less for services when you use a dentist in the Delta Dental network. You can find an in‐network dentist by visiting www.deltadentalins.com or calling 1.888.335.8227. 10 Dental Coverage - Delta Dental
Effective January 1, 2024, vision benefits will be provided through Guardian Insurance and the VSP network, . Coverage is offered at no cost to eligible employees and dependents. With Guardian, you have the opportunity to utilize the wide VSP Choice Network or choose the out-of-network options. This plan covers routine eye exams and lenses at 100%. See the plan description for limitations and exclusions. Vision Coverage & Changes–Guardian Insurance/VSP 11 Finding In‐network Optometrists You pay less for services when you use an optometrist in the VSP network. You can find an in‐network dentist by visiting www.vsp.com/eye-doctor or calling 1.800.877.7195.
Basic Life and Accidental Death and Dismemberment (AD&D) Insurance is provided through MetLife at no cost to eligible employees. If you want additional coverage for yourself, your spouse, or your children, you can purchase voluntary supplemental life coverage at our group rates. How it Works Basic Life and AD&D (Company‐paid benefit) Voluntary Life and AD&D (Employee‐paid benefit) Life Your beneficiaries receive this benefitif you pass away An amount equal to 2 times Your Basic Annual Earnings, rounded to the next higher $1,000 plus $50,000 You: Increments of $10,000, lesser of 5 times your basic annual earnings or $500,000 (cannot exceed 50% of the employee’s Supplemental Life benefit ) Your spouse: Increments of $5,000 up to $100,000 Your child(ren): Increments of $10,000 Flat Amount: $1,000, $2,000, $4,000, $5,000, or $10,000 AD&D You (or your beneficiaries) receive this benefit if you pass away or are seriously injured in an accident An amount equal to 2 times Your Basic Annual Earnings, rounded to the next higher $1,000 plus $50,000 You: Increments of $10,000, lesser of 5 times your basic annual earnings or $500,000 (cannot exceed 50% of the employee’s Supplemental Life benefit) Your spouse: N/A Your child(ren): N/A Life and AD&D Insurance- MetLife 12 Keep Your Beneficiaries Up to Date You must log on to www.metlife.com to designate a beneficiary (the person who will receive the benefit) for your life and AD&D insurance. Make sure to keep this person’s information updated so your benefit is paid according to your wishes.
Short-term and Long-term Disability insurance is provided through MetLife at no cost to eligible employees. This benefit replaces a portion of your income if you become disabled and are unable to work. How it Works Who Pays for the Benefit Short‐term Disability You receive 66.67% of your income up to $2,500 per week. Benefits begin after 30 days of absence from work due to Injury or Illness(incudes pregnancy) and continues for up to 22 weeks. Port of Stockton Long‐term Disability You receive 66.67% of your income up to $10,000 per month. Benefits begin after 180 days of absence from work due to Injury or Illness and continues until your Injury or Illness ends, or you reach the Social Security Normal Retirement Age. Port of Stockton Voluntary Accidental Dismemberment & Death insurance (AD&D) is provided through The Hartford Insurance Co and is available for employees and their dependents at group rates. How it Works Who Pays for the Benefit Voluntary AD&D Eligible employees are able to elect coverage for themselves up to 10x annual salary to a maximum of $300,000. Coverage can be elected for eligible dependents up to plan maximum. See plan description for limitations. Employee Short and Long Disability- MetLife 13 Voluntary AD&D- The Hartford
Supplemental Life & AD&D- MetLife 14 Supplemental Life and Accidental Death and Dismemberment (AD&D) insurance is available through MetLife at an additional cost to eligible employees and dependents. You can purchase this additional coverage for yourself, your spouse, or your children at our group rates. Employee Spouse Child Life Coverage: Provides a benefit in the event of death Schedules: Increments of $10,000 Increments of $5,000 Flat Amount: $1,000, $2,000, $4,000, $5,000, or $10,000 Non-Medical Maximum $100,000 $25,000 $10,000 Overall Benefit Maximum The lesser of 5 times Your Basic Annual Earnings, or $500,000 $100,000 $10,000 AD&D Coverage: provides a benefit in the event of death or dismemberment resulting from a covered accident Schedules: Yes (benefit amount is same as Supplemental Term Life coverage) N/A N/A AD&D Maximum Maximum amount is same as Supplemental Term Life coverage N/A N/A Employee Contribution 100% 100% 100%
Professional support andguidance for everydaylife Help is always at your fingertips. Our mobile app makesit easy for you to access and personalize educational contentimportant to you. Search “LifeWorks” on iTunes App StoreorGoogle Play. You can also log on to metlifeeap.lifeworks.com. Log inwith the following: username:metlifeeap password:eap The program offers easy to use educational tools and resources, online and through a mobile app. Expert advice for work, life, and your well-being The program’s experienced counselors provided through LifeWorks — one of the nation’s premier providers of Employee Assistance Program services — can talk to you about anything going on in your life, including: • Family: Going through a divorce, caring for an elderly family member, returning to work after having a baby • Work: Job relocation, building relationships with co-workers and managers, navigating through reorganization • Money: Budgeting, financial guidance, retirement planning, buying orselling a home, tax issues • Legal Services: Issues relating to civil, personal and family law, financial matters, real estate and estate planning • Identity Theft Recovery: ID theft prevention tips and help from a financial counselor if you are victimized • Health: Coping with anxiety or depression, getting the proper amount of sleep, how to kick a bad habit like smoking • Everyday Life: Moving and adjusting to a new community, grieving over the loss of a loved one, military family matters, training a new pet Convenient andconfidential helpwhenyouwantit, howyouwantit Your program includes up to 5 in person, phone or video consultations with licensed counselors for you and your eligible household members, per issue, per calendar year. You can call 1-888-319-7819 to speak with a counselor or schedule an appointment, 24/7/365. If you’re simply looking for information, There is a chat feature so you can talk with a consultant to guide you to the information you are looking for or help you schedule an appointment with a counselor. and turns, you can get help tokeep moving forward. We can help you and your family, support and guidance to make life a Program(EAP)is availabletoyouin services to help with the everyday challenges of life—atnoadditional cost to you. Employee Assistance Program 15
Answersto important questions Are Employee Assistance Program services confidential? Yes. Any personal information provided to LifeWorks stays completely confidential.* How do I get help? Getting professional help is just a phone call away. Simply call 1-888-319-7819 to speak with a counselor or to schedule an in person, phone or video conference appointment. These services are available 24 hours a day, 7 days a week. When is the right time to call? That’s up to you. Counselors are here whenever you need them —whether you simply need to talk or want guidance on something you are going through. Is my Employee Assistance Program included with my MetLife coverage? Yes. There is no cost to you because your employer pays for the services provided within our program. While we offer a broad range of services, there may be some assistance that’s not included. You can still work with counselors for these services by arranging to pay for them directly. Doesthe program have any limitations? While we offer a broad range of services, we may not cover all services you may need. Your Employee Assistance Program does not provide: • Inpatient or outpatient treatment for any medically treated illness • Prescription drugs • Treatment or services for intellectual disability or autism • Counseling services beyond the number of sessions covered or requiring longer term intervention • Services by counselors who are not LifeWorks providers • Counseling required by law or a court, or paid for by Workers’ Compensation Does the program offer Cognitive Behavioral Therapy (CBT)? Many LifeWorks EAP providers are trained in this type of counseling and the foundation of LifeWorks' CareNow digital programs, available through the programs website and mobile app, are built upon Cognitive Behavioral Therapy (CBT) techniques. CareNow provides instant accessto a range ofself-service programs developed by world leading experts, focused on behavior change in the areas of anxiety, stress, depression, and more. When you need some support, we’re here to help. Phone Web metlifeeap.lifeworks.com user name: metlifeeap and password: eap Mobile App username: metlifeeap and password: eap Employee Assistance Program 16
Will Preparation- MetLife MetLife offers online will preparation services provided by SmartLegalForms to create a binding will, living will, or assign a power of attorney at no cost to eligible employees. Easily create a will, living will, or power of attorney Having a will is one of the most important things you can do for your family. Making sure your will is up-to-date can help ensure that your assets are distributed the way you want. You may not need to have access to an attorney to create a binding will. Convenience at your fingertips in a secure web environment Sign on to an easy–to-use and secure website, available to you and your family members 24 hours a day, 7 days a week to create binding documents. Resources are available online to address questions you may have about creating a will or general estate planning. Once you create your binding documents, you will be provided with simple to follow instructions for witnessing/signing them in front of a notary public. Get Started • Visit www.willscenter.com and register as a new user. Be sure to enter your Employer/Association name. • Follow the simple instructions to create your online document • Return at your convenience to complete or update stored documents Complimentary services included with your life coverage Funeral Discount & Planning Services are included. Pre-plan to help alleviate the burden of making funeral arrangements from loved ones. 17
Employee Travel Assistance (For Leisure or Business)- MetLife About Travel Assistance MetLife offers a Travel Assistance program through AXA Assistance USA, Inc. (AXA) at no cost to eligible employees. They are best known for intervening in medical emergencies in foreign countries. AXA administers emergency medical assistance services when you or a family member becomes ill or injured while traveling 100 miles or more away from home. How to access Travel Assistance Next time you’re traveling be sure to carry the Travel Assistance ID card with you so you can get in touch with AXA if needed. This can be found on our Benefits page on PortNet. Call Travel Assistance if you need: • Medical assistance while traveling • Medical evacuation • Evacuation due to natural disaster or political unrest • Assistance while traveling with your pet • Help with lost documents, credit cards or luggage while traveling • Replacement prescription medication while traveling • You are the victim of identity theft and need assistance Emergency benefits include: • Emergency medical evacuation and transportation services • Return of remains • Evacuation due to natural disaster or political unrest •Transportation to join a patient • Transportation for minor children • Dispatch of Physician • Pet Repatriation Medical assistance services include: • Medical referrals, appointments and hospital admissions • Replacement of prescription medication • Replacement of medical devices 18
Business Travel Assistance- Zurich 19
Healthcare FSAs Dependent Care FSAs What is covered? Qualified medical expenses not covered by insurance Certain over-the-counter medications Supplies for chronic conditions. Dependent care expenses that allow you to work Eligible Expenses Examples include but are not restricted to: Out-of-pocket costs Deductibles and copays Healthcare expenses approved by the IRS not covered by your plan Over-the-counter drugs prescribed by a physician Examples include but are not restricted to: For eligible childcare expenses for children under the age of 13. Preschool expenses Adult dependent daycare for: A spouse who is physically or mentally unable to care for him/herself Any adult you can claim as a dependent on your tax return that is physically or mentally unable to care for him/herself Access to Funds Immediate access to annual election Access to funds only as you contribute every payroll Flexible Spending Accounts- Health Equity 20 Employees have the option to enroll in Healthcare and Dependent Care Flexible Spending Accounts (FSAs) through Health Equity. FSAs are governed by IRS regulations and allow you to use pre-tax income to pay for qualified expenses. You decide how much you want to set aside to pay for eligible expenses incurred during the plan year and make separate elections for each account. For more information on eligible expenses or restrictions, make sure to visit the IRS website. The 2024 maximum contribution limits will be posted as soon as the IRS announces them.
Aflac Aflac provides individual insurance products such as, accident, hospital, specified health event, critical illness, and short-term disability policies for Port employees and their family members. Employee premiums are paid through payroll deductions. For more information about the different products offered, please visit our personalized open enrollment page here. Policies Accident Insurance Helps ease the financial stress of a covered injury. Cancer/Specified Disease Insurance Helps financially and emotionally after a cancer diagnosis. Critical Illness Insurance Helps with the cost of treating covered critical illnesses. Disability Insurance Helps relieve the financial stress of a covered disability. Hospital Indemnity Insurance Helps with expenses health insurance does not cover. Life Insurance Helps financially protect your loved ones if something happens to you. For more information, please contact our agent Donna Deviny at (916) 296-3240 or [email protected]. 21
For more information, please contact our independent associate, Mark McDonald at (310) 951-4624 or [email protected]. LegalShield 2122 LegalShield LegalShield offers two plans for Port employees at affordable pricing to assist with legal matters and credit monitoring and protection. You get access to a quality law firm 24/7, for covered personal situations. From real estate to speeding tickets to will preparation, and beyond, LegalShield is able to help you with any personal legal matter—no matter how traumatic or how trivial it may seem. The two membership plans below are available to employees.
New York Life 23 New York Life offers employees the ability to purchase a new Guaranteed Whole Life Insurance Policy. Employees are able to purchase coverage up to $100,000 without completing a health questionnaire or undergoing a physical examination. Premium payments are direct billed to the policyholder and no payroll deductions are allowed. For more information, please contact our agent Irene “Alexa” Bracamonte at (925) 718-4308 or [email protected].
The Port offers two types of retirement plans for employees to participate in. See the details below for information related to the plans. Recordkeeper – OneAmerica (Both plans) 401a Money Purchase Pension Plan Employees have the option of participating in the 401a Money Purchase Pension Plan. This is a governmental plan and employee contributions are made on an after-tax basis. Employees are eligible to participate in the plan after 6 months of regular full-time employment (credited service). To participate, employees are required to contribute 5% of their base monthly earnings to the plan. The port contributes matching contributions in the amount of 15% of the employee’s base monthly earnings. This is a 3:1 match. Vesting is immediate and participants can direct their own investments among selected accounts offered through OneAmerica. Please see the plan summary and rules located on PortNet on the Retirement Benefits tab located here. 457b Deferred Compensation Plan Employees also have the option of participating in the 457b Deferred Compensation Plan. This is a governmental plan and employee contributions are made on a pre-tax basis. Regular full-time employees are eligible to participate in the plan immediately upon hire. There are no matching employer contributions with this plan. Employee contributions are not subject to vesting and participants can direct their own investments among selected accounts offered through OneAmerica. Please see the plan summary and rules located on PortNet on the Retirement Benefits tab located here. Account Management You can access your online account information or receive assistance at the following: • Website: www.stocktonportretirement.com • Customer service: (844) 623-4243 Representatives are available Monday through Friday from 5 a.m. to 7 p.m. Pacific Standard Time (PST). 24 Retirement Plans- 401a Money Purchase Pension Plan and 457b Deferred Compensation Plan
CAPTRUST 25 CAPTRUST is a retirement investment advice team with expert counselors that are available to you at no additional cost. They will be onsite on Thursday, October 5th to provide employee education sessions on retirement and financial planning. Group sessions and individual meeting opportunities will be available for all staff. CAPTRUST is a retirement investment advice team with expert counselors that are available to you at no additional cost. They will be onsite on Thursday, October 5th to provide employee education sessions on retirement and financial planning. Group sessions and individual meeting opportunities will be available for all staff.
CAPTRUST – Retirement Blueprint 26
In-Shape 27 Employees can once again sign up for a discounted In-Shape membership. An In-Shape membership is a great way to start reaching your health and fitness goals. In-Shape offers Port of Stockton employees a 15% monthly discount off their regular rates through payroll deductions. Amenities vary per club and include extras such as on-site childcare, indoor and outdoor pool, saunas, steam room, etc. Click to review Club Levels and here to review additional amenities and to receive a 1-Day guest pass. To sign up, use the special enrollment link located here, or visit your local club for more details. Enrollment is not subject to the open enrollment period and is available throughout the year. Current In-Shape members are grandfathered at their current rate levels. Any change will result in members being charged the new rate tiers. Rates can be found here. These employee premiums are payroll deducted every payroll on a semi-monthly basis.
Pet Insurance- ASPCA 28 Have you been thinking about pet insurance for your cat or dog? The Port partners with ASPCA to offer pet insurance for your four legged family members! Employees receive a 10% premium discount when signing up at www.aspcapetinsurance.com. Watch this video to get the facts about pet insurance. Enrollment is not subject to the open enrollment period and is available throughout the year. Premium payments are direct billed to the policyholder and no payroll deductions are allowed.
PerkSpot Employee Discount Program 29
Important Notice from the Port of Stockton About Your Prescription Drug Coverage and Medicare Please read this notice carefully and keep it where you can find it. This notice has information about your current prescription drug coverage with the Port of Stockton through CalPERS and about your options under Medicare’s prescription drug coverage. This information can help you decide whether or not you want to join a Medicare drug plan. If you are considering joining, you should compare your current coverage, including which drugs are covered at what cost, with the coverage and costs of the plans offering Medicare prescription drug coverage in your area. Information about where you can get help to make decisions about your prescription drug coverage is at the end of this notice. There are two important things you need to know about your current coverage and Medicare’s prescription drug coverage: 1. Medicare prescription drug coverage became available in 2006 to everyone with Medicare. You can get this coverage if you join a Medicare Prescription Drug Plan or join a Medicare Advantage Plan (like an HMO or PPO) that offers prescription drug coverage. All Medicare drug plans provide at least a standard level of coverage set by Medicare. Some plans may also offer more coverage for a higher monthly premium. 2. The Port of Stockton has determined that the prescription drug coverage offered by the Port of Stockton through CalPERS is, on average for all plan participants, expected to pay out as much as standard Medicare prescription drug coverage pays and is therefore considered Creditable Coverage. Because your existing coverage is Creditable Coverage, you can keep this coverage and not pay a higher premium (a penalty) if you later decide to join a Medicare drug plan. ****************************************** When Can You Join A Medicare Drug Plan? You can join a Medicare drug plan when you first become eligible for Medicare and each year from October 15th to December 7th. 30
However, if you lose your current creditable prescription drug coverage, through no fault of your own, you will also be eligible for a two (2) month Special Enrollment Period (SEP) to join a Medicare drug plan. What Happens To Your Current Coverage If You Decide to Join A Medicare Drug Plan? You can retain your existing Creditable coverage and choose not to enroll in a Medicare prescription drug plan at this time. However, if you decide to join a Medicare drug plan, your current Port of Stockton coverage will be affected. According to CalPERS, you cannot have prescription drug coverage under both Medicare and CalPERS. To continue your CalPERS health coverage, do not enroll in a non-CalPERS Medicare Part D plan. If you or your dependents are covered by CalPERS and another health plan that includes Medicare Part D prescription drug benefits, you must cancel that Part D coverage in order to enroll in (or continue enrollment in) a CalPERS Medicare health plan. When Will You Pay a Higher Premium (Penalty) To Join A Medicare Drug Plan? You should also know that if you drop or lose your current coverage with the Port of Stockton and don’t join a Medicare drug plan within 63 continuous days after your current coverage ends, you may pay a higher premium (a penalty) to join a Medicare drug plan later. If you go 63 continuous days or longer without creditable prescription drug coverage, your monthly premium may go up by at least 1% of the Medicare base beneficiary premium per month for every month that you did not have that coverage. For example, if you go nineteen months without creditable coverage, your premium may consistently be at least 19% higher than the Medicare base beneficiary premium. You may have to pay this higher premium (a penalty) as long as you have Medicare prescription drug coverage. In addition, you may have to wait until the following October to join. For More Information About This Notice Or Your Current Prescription Drug Coverage… For more information, contact the Port of Stockton, Human Resources Department at (209) 946- 0246, or CalPERS Customer Contact Center at 1-888-CalPERS (1-888-225-7377). For further information regarding your current prescription drug coverage, please contact OptumRx at (855) 505-8110 (Active Employees) or (855) 505-8106 (Medicare Members). NOTE: You will receive this notice each year. You will also get it before the next period you can join a Medicare drug plan, and if this coverage through CalPERS changes. You also may request a copy of this notice at any time. 31
For More Information About Your Options Under Medicare Prescription Drug Coverage… More detailed information about Medicare plans that offer prescription drug coverage is in the “Medicare & You” handbook. You will get a copy of the handbook in the mail every year from Medicare. You may also be contacted directly by Medicare drug plans. For more information about Medicare prescription drug coverage: Visit www.medicare.gov Call your State Health Insurance Assistance Program (see the inside back cover of your copy of the “Medicare & You” handbook for their telephone number) for personalized help Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048. If you have limited income and resources, extra help paying for Medicare prescription drug coverage is available. For information about this extra help, visit Social Security on the web at www.socialsecurity.gov, or call them at 1-800-772-1213 (TTY 1-800-325-0778) Remember: Keep this Creditable Coverage notice. If you decide to join one of the Medicare drug plans, you may be required to provide a copy of this notice when you join to show whether or not you have maintained creditable coverage and, therefore, whether or not you are required to pay a higher premium (a penalty). September 7, 2023 Port of Stockton Cassondra Hollins Human Resources Manager P.O. Box 2089 Stockton, CA 95201 (209) 946-0246 32
PRIVACY NOTICE PORT OF STOCKTON DENTAL AND VISION PLAN Your Information. Your Rights. Our Responsibilities The Port of Stockton Dental and Vision Plan (“the Plan”) is required by law to maintain the privacy of your protected health information (PHI), which includes any identifiable information that is obtained from you or others that relates to your health, health care or payment for your health care. We must provide this notice that includes our legal duties and privacy practices related to your PHI. We must also inform you if there is a breach of your unsecured PHI. This notice describes how we may disclose your PHI, and how you can access, change and manage your PHI. Please review carefully as it contains information on how to use your rights. Your Rights You have the right to: • Get a copy of your health and claims records • Correct your health and claims records • Request confidential communication • Ask us to limit the information we share • Get a list of those with whom we’ve shared your information • Get a copy of this privacy notice • Choose someone to act for you • File a complaint if you believe your privacy rights have been violated Your Choices You have some choices in the way that we use and share information as we: • Answer coverage questions from your family and friends • Provide disaster relief • Market our services and sell your information Our Uses and Disclosures We may use and share your information as we: • Help manage the health care treatment you receive • Run our organization • Pay for your health services • Administer your health plan • Help with public health and safety issues • Do research • Comply with the law • Respond to organ and tissue donation requests and work with a medical examiner or funeral director • Address workers’ compensation, law enforcement, and other government requests • Respond to lawsuits and legal actions 33
Contact Person If you have any questions or would like further information about this Privacy Notice, please contact Cassondra Hollins, Human Resources Manager at (209) 946-0246, extension 8207. Filing a Complaint If you believe that your privacy rights have been violated, you should immediately contact the Human Resources Manager at (209) 946-0246, extension 8207 to file a complaint. Your Rights When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you. Get a copy of health and claims records • You can ask to see or get a copy of your health and claims records and other health information we have about you. Ask us how to do this. • We will provide a copy or a summary of your health and claims records, usually within 30 days of your request. We may charge a reasonable, cost-based fee. Ask us to correct health and claims records • You can ask us to correct your health and claims records if you think they are incorrect or incomplete. Ask us how to do this. • We may say “no” to your request, but we’ll tell you why in writing within 60 days. Request confidential communications • You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address. • We will consider all reasonable requests, and must say “yes” if you tell us you would be in danger if we do not. Ask us to limit what we use or share • You can ask us not to use or share certain health information for treatment, payment, or our operations. • We are not required to agree to your request, and we may say “no” if it would affect your care. Get a list of those with whom we’ve shared information • You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why. • We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months. Get a copy of this privacy notice You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly. Choose someone to act for you • If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. 34
Choose someone to act for you • If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. • We will make sure the person has this authority and can act for you before we take any action. File a complaint if you feel your rights are violated • You can complain if you feel we have violated your rights by contacting us using the information on page 2. • You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting Filing a HIPAA Complaint | HHS.gov. • We will not retaliate against you for filing a complaint. Your Choices For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions. In these cases, you have both the right and choice to tell us to: • Share information with your family, close friends, or others involved in payment for your care. • Share information in a disaster relief situation. If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety. In these cases we never share your information unless you give us written permission: • Marketing purposes • Sale of your information __________________________________________________________________________________________________________________ Our Uses and Disclosures How do we typically use or share your health information? We typically use or share your health information in the following ways: Help manage the health care treatment you receive We can use your health information and share it with professionals who are treating you. Example: A doctor sends us information about your diagnosis and treatment plan so we can arrange additional services. Run our organization • We can use and disclose your information to run our organization and contact you when necessary. 35
• We are not allowed to use genetic information to decide whether we will give you coverage and the price of that coverage. This does not apply to long term care plans. Example: We use health information about you to develop better services for you. Pay for your health services We can use and disclose your health information as we pay for your health services. Example: We share information about you with your dental plan to coordinate payment for your dental work. Administer your plan We may disclose your health information to your health plan sponsor for plan administration. Example: Your company contracts with us to provide a health plan, and we provide your company with certain statistics to explain the premiums we charge. How else can we use or share your health information? We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information see: Your Rights Under HIPAA | HHS.gov. Help with public health and safety issues We can share health information about you for certain situations such as: • Preventing disease • Helping with product recalls • Reporting adverse reactions to medications • Reporting suspected abuse, neglect, or domestic violence • Preventing or reducing a serious threat to anyone’s health or safety Do research We can use or share your information for health research. Comply with the law We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law. Respond to organ and tissue donation requests and work with a medical examiner or funeral director • We can share health information about you with organ procurement organizations. • We can share health information with a coroner, medical examiner, or funeral director when an individual dies. Address workers’ compensation, law enforcement, and other government requests We can use or share health information about you: • For workers’ compensation claims • For law enforcement purposes or with a law enforcement official • With health oversight agencies for activities authorized by law 36
• For special government functions such as military, national security, and presidential protective services Respond to lawsuits and legal actions We can share health information about you in response to a court or administrative order, or in response to a subpoena. Our Responsibilities • We are required by law to maintain the privacy and security of your protected health information. • We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information. • We must follow the duties and privacy practices described in this notice and give you a copy of it. • We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind. For more information see: Your Rights Under HIPAA | HHS.gov Changes to the Terms of this Notice We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, on our web site, and we will mail a copy to you. Notice Revision Date: September 7, 2023 If you have any questions or would like further information about this Privacy Notice, please contact: Cassondra Hollins – Human Resources Manager Port of Stockton PO Box 2089 Stockton, CA 95201 (209) 946-0246, Ext. 8207 [email protected] 37
Premium Assistance Under Medicaid and the Children’s Health Insurance Program (CHIP) If you or your children are eligible for Medicaid or CHIP and you’re eligible for health coverage from your employer, your state may have a premium assistance program that can help pay for coverage, using funds from their Medicaid or CHIP programs. If you or your children aren’t eligible for Medicaid or CHIP, you won’t be eligible for these premium assistance programs but you may be able to buy individual insurance coverage through the Health Insurance Marketplace. For more information, visit www.healthcare.gov. If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, contact your State Medicaid or CHIP office to find out if premium assistance is available. If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, contact your State Medicaid or CHIP office or dial 1-877-KIDS NOW or www.insurekidsnow.gov to find out how to apply. If you qualify, ask your state if it has a program that might help you pay the premiums for an employer-sponsored plan. If you or your dependents are eligible for premium assistance under Medicaid or CHIP, as well as eligible under your employer plan, your employer must allow you to enroll in your employer plan if you aren’t already enrolled. This is called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance. If you have questions about enrolling in your employer plan, contact the Department of Labor at www.askebsa.dol.gov or call 1-866-444-EBSA (3272). If you live in one of the following states, you may be eligible for assistance paying your employer health plan premiums. The following list of states is current as of July 31, 2023. Contact your State for more information on eligibility – ALABAMA – Medicaid ALASKA – Medicaid Website: http://myalhipp.com/ Phone: 1-855-692-5447 The AK Health Insurance Premium Payment Program Website: http://myakhipp.com/ Phone: 1-866-251-4861 Email: [email protected] Medicaid Eligibility: https://health.alaska.gov/dpa/Pages/default.aspx ARKANSAS – Medicaid CALIFORNIA – Medicaid Website: http://myarhipp.com/ Phone: 1-855-MyARHIPP (855-692-7447) Health Insurance Premium Payment (HIPP) Program Website: http://dhcs.ca.gov/hipp Phone: 916-445-8322 Fax: 916-440-5676 Email: [email protected] COLORADO – Health First Colorado (Colorado’s Medicaid Program) & Child Health Plan Plus (CHP+) FLORIDA – Medicaid Health First Colorado Website: https://www.healthfirstcolorado.com/ Health First Colorado Member Contact Center: 1-800-221-3943/State Relay 711 CHP+: https://hcpf.colorado.gov/child-health-plan-plus CHP+ Customer Service: 1-800-359-1991/State Relay 711 Health Insurance Buy-In Program (HIBI): https://www.mycohibi.com/ HIBI Customer Service: 1-855-692-6442 Website: https://www.flmedicaidtplrecovery.com/flmedicaidtplrecover y.com/hipp/index.html Phone: 1-877-357-3268 38
GEORGIA – Medicaid INDIANA – Medicaid GA HIPP Website: https://medicaid.georgia.gov/healthinsurance-premium-payment-program-hipp Phone: 678-564-1162, Press 1 GA CHIPRA Website: https://medicaid.georgia.gov/programs/third-partyliability/childrens-health-insurance-program-reauthorizationact-2009-chipra Phone: 678-564-1162, Press 2 Healthy Indiana Plan for low-income adults 19-64 Website: http://www.in.gov/fssa/hip/ Phone: 1-877-438-4479 All other Medicaid Website: https://www.in.gov/medicaid/ Phone: 1-800-457-4584 IOWA – Medicaid and CHIP (Hawki) KANSAS – Medicaid Medicaid Website: https://dhs.iowa.gov/ime/members Medicaid Phone: 1-800-338-8366 Hawki Website: http://dhs.iowa.gov/Hawki Hawki Phone: 1-800-257-8563 HIPP Website: https://dhs.iowa.gov/ime/members/medicaida-to-z/hipp HIPP Phone: 1-888-346-9562 Website: https://www.kancare.ks.gov/ Phone: 1-800-792-4884 HIPP Phone: 1-800-967-4660 KENTUCKY – Medicaid LOUISIANA – Medicaid Kentucky Integrated Health Insurance Premium Payment Program (KI-HIPP) Website: https://chfs.ky.gov/agencies/dms/member/Pages/kihipp.aspx Phone: 1-855-459-6328 Email: [email protected] KCHIP Website: https://kidshealth.ky.gov/Pages/index.aspx Phone: 1-877-524-4718 Kentucky Medicaid Website: https://chfs.ky.gov/agencies/dms Website: www.medicaid.la.gov or www.ldh.la.gov/lahipp Phone: 1-888-342-6207 (Medicaid hotline) or 1-855-618-5488 (LaHIPP) MAINE – Medicaid MASSACHUSETTS – Medicaid and CHIP Enrollment Website: https://www.mymaineconnection.gov/benefits/s/?language=en _US Phone: 1-800-442-6003 TTY: Maine relay 711 Private Health Insurance Premium Webpage: https://www.maine.gov/dhhs/ofi/applications-forms Phone: 1-800-977-6740 TTY: Maine relay 711 Website: https://www.mass.gov/masshealth/pa Phone: 1-800-862-4840 TTY: 711 Email: [email protected] MINNESOTA – Medicaid MISSOURI – Medicaid Website: https://mn.gov/dhs/people-we-serve/children-andfamilies/health-care/health-care-programs/programs-andservices/other-insurance.jsp Phone: 1-800-657-3739 Website: http://www.dss.mo.gov/mhd/participants/pages/hipp.htm Phone: 573-751-2005 MONTANA – Medicaid NEBRASKA – Medicaid Website: http://dphhs.mt.gov/MontanaHealthcarePrograms/HIPP Phone: 1-800-694-3084 Email: [email protected] Website: http://www.ACCESSNebraska.ne.gov Phone: 1-855-632-7633 Lincoln: 402-473-7000 Omaha: 402-595-1178 39
NEVADA – Medicaid NEW HAMPSHIRE – Medicaid Medicaid Website: http://dhcfp.nv.gov Medicaid Phone: 1-800-992-0900 Website: https://www.dhhs.nh.gov/programsservices/medicaid/health-insurance-premium-program Phone: 603-271-5218 Toll free number for the HIPP program: 1-800-852-3345, ext. 5218 NEW JERSEY – Medicaid and CHIP NEW YORK – Medicaid Medicaid Website: http://www.state.nj.us/humanservices/ dmahs/clients/medicaid/ Medicaid Phone: 609-631-2392 CHIP Website: http://www.njfamilycare.org/index.html CHIP Phone: 1-800-701-0710 Website: https://www.health.ny.gov/health_care/medicaid/ Phone: 1-800-541-2831 NORTH CAROLINA – Medicaid NORTH DAKOTA – Medicaid Website: https://medicaid.ncdhhs.gov/ Phone: 919-855-4100 Website: https://www.hhs.nd.gov/healthcare Phone: 1-844-854-4825 OKLAHOMA – Medicaid and CHIP OREGON – Medicaid Website: http://www.insureoklahoma.org Phone: 1-888-365-3742 Website: http://healthcare.oregon.gov/Pages/index.aspx Phone: 1-800-699-9075 PENNSYLVANIA – Medicaid and CHIP RHODE ISLAND – Medicaid and CHIP Website: https://www.dhs.pa.gov/Services/Assistance/Pages/HIPPProgram.aspx Phone: 1-800-692-7462 CHIP Website: Children's Health Insurance Program (CHIP) (pa.gov) CHIP Phone: 1-800-986-KIDS (5437) Website: http://www.eohhs.ri.gov/ Phone: 1-855-697-4347, or 401-462-0311 (Direct RIte Share Line) SOUTH CAROLINA – Medicaid SOUTH DAKOTA - Medicaid Website: https://www.scdhhs.gov Phone: 1-888-549-0820 Website: http://dss.sd.gov Phone: 1-888-828-0059 TEXAS – Medicaid UTAH – Medicaid and CHIP Website: Health Insurance Premium Payment (HIPP) Program | Texas Health and Human Services Phone: 1-800-440-0493 Medicaid Website: https://medicaid.utah.gov/ CHIP Website: http://health.utah.gov/chip Phone: 1-877-543-7669 VERMONT– Medicaid VIRGINIA – Medicaid and CHIP Website: Health Insurance Premium Payment (HIPP) Program | Department of Vermont Health Access Phone: 1-800-250-8427 Website: https://coverva.dmas.virginia.gov/learn/premiumassistance/famis-select https://coverva.dmas.virginia.gov/learn/premiumassistance/health-insurance-premium-payment-hipp-programs Medicaid/CHIP Phone: 1-800-432-5924 WASHINGTON – Medicaid WEST VIRGINIA – Medicaid and CHIP Website: https://www.hca.wa.gov/ Phone: 1-800-562-3022 Website: https://dhhr.wv.gov/bms/ http://mywvhipp.com/ Medicaid Phone: 304-558-1700 CHIP Toll-free phone: 1-855-MyWVHIPP (1-855-699-8447) 40
WISCONSIN – Medicaid and CHIP WYOMING – Medicaid Website: https://www.dhs.wisconsin.gov/badgercareplus/p-10095.htm Phone: 1-800-362-3002 Website: https://health.wyo.gov/healthcarefin/medicaid/programs-andeligibility/ Phone: 1-800-251-1269 To see if any other states have added a premium assistance program since July 31, 2023, or for more information on special enrollment rights, contact either: U.S. Department of Labor Employee Benefits Security Administration www.dol.gov/agencies/ebsa 1-866-444-EBSA (3272) U.S. Department of Health and Human Services Centers for Medicare & Medicaid Services www.cms.hhs.gov 1-877-267-2323, Menu Option 4, Ext. 61565 Paperwork Reduction Act Statement According to the Paperwork Reduction Act of 1995 (Pub. L. 104-13) (PRA), no persons are required to respond to a collection of information unless such collection displays a valid Office of Management and Budget (OMB) control number. The Department notes that a Federal agency cannot conduct or sponsor a collection of information unless it is approved by OMB under the PRA, and displays a currently valid OMB control number, and the public is not required to respond to a collection of information unless it displays a currently valid OMB control number. See 44 U.S.C. 3507. Also, notwithstanding any other provisions of law, no person shall be subject to penalty for failing to comply with a collection of information if the collection of information does not display a currently valid OMB control number. See 44 U.S.C. 3512. The public reporting burden for this collection of information is estimated to average approximately seven minutes per respondent. Interested parties are encouraged to send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the U.S. Department of Labor, Employee Benefits Security Administration, Office of Policy and Research, Attention: PRA Clearance Officer, 200 Constitution Avenue, N.W., Room N-5718, Washington, DC 20210 or email [email protected] and reference the OMB Control Number 1210-0137. OMB Control Number 1210-0137 (expires 1/31/2026) 41
Contact Information 42