| Item Title: | HR - County's Health and Dental Summary Plan Description for plan year 2019*** | | Submitted By: | Melissa M. Carrillo, PHR, Chief Human Resources Officer, Human Resources Department (915) 546-2218 | | Subject: | Approve the restatement of the County of El Paso’s Health and Dental Summary Plan Description for 2019. The County’s Health and Dental Summary Plan Description was approved by the Risk Pool Board during their meeting on July 17, 2019. Funding is available in IS-HEALTH-HEALTH/DENTAL CLAIMS. (Contract No. 2019-0410) | | Background: | The County of El Paso sponsors a health care plan that is administered by a Third Party Administrator (TPA). As part of the plan, the County develops and maintains a Summary Plan Description (SPD) which describes the Medical, Dental, and Prescription Drug (Pharmacy) Benefits, as well as employee rights and responsibilities. The SPD is a guide to the benefits, provisions, and programs offered by the health care plan.
Each year, the plan is reviewed by staff and the County’s Risk Pool Board and recommendations are made to the Commissioners Court during the end of the year budget sessions. After approval of the budget and with the assistance of the Human Resources Department, County Attorney’s Office, HUB Health Consultants, and Aetna Life Insurance, the changes are reviewed for compliance with the Affordable Care Act and inserted into an updated Health and Dental Summary Plan Description for the following year.
The 2019 Health and Dental Summary Plan Description includes the following changes:
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Revised and/or added language to ensure plan is in full compliance with the Health Care Reform.
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Revised and/or added language to clarify employee coverage and eligibility.
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Revised and/or added language to clarify retiree and/or their dependents coverage and eligibility.
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Revised and/or added language to clarify benefits for survivors of certain public servants.
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Revised and/or added language to several sections in the document to reflect the services that are currently being provided.
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Added language to clarify provisions on supporting documentation.
The County’s Health and Dental Summary Plan Description for 2019 were reviewed by the County Attorney’s Office (2019-0410) | | Fiscal Impact: | The County’s Medical Plan is funded through the Risk Pool Fund. Fiscal impact is determined by individual use of the medical benefits while on the health care plan.
IS-HEALTH-HEALTH/DENTAL CLAIMS
COIS-5001-0000000-431-10-10000-0001-00000-540007- | | Recommendation: | Approve the restatement of the County of El Paso’s Health and Dental Summary Plan Description for 2019. The County’s Health and Dental Summary Plan Description was approved by the Risk Pool Board during their meeting on July 17, 2019. Funding is available in IS-HEALTH-HEALTH/DENTAL CLAIMS. (Contract No. 2019-0410) | | Prior Action: | July 21, 2014, Item #8, Commissioners Court approved an Amendment to the Health and Dental Summary Plan Description OP-14-121
December 15, 2014, Item #8, Commissioners Court approved the Health and Dental Summary Plan Description OP-014-282-PR
September 14, 2015, Item #8, Commissioners Court approved the Health and Dental Summary Plan Description and Amendments OP-15-336
May 16, 2016, Item #7, Commissioners Court approved the Health and Dental Summary Plan Description and Amendments OP-16-025
April 3, 2017, Item #7, Commissioners Court approved the Health and Dental Summary Plan Description and Amendments OP-17-099
June 4, 2018, Item #17, Commissioners Court approved the restatement of the Health and Dental Summary Plan Description Contract No. 2018-0269 | | Strategic Plan: | .. | | Strategic Plan Information: | |
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