Department: Human Resources and Talent
Department Head/Elected Official: Sakita Douglas
Regular or Supplemental RCA: Regular RCA
Type of Request: Policy
Project ID (if applicable): N/A
Vendor/Entity Legal Name (if applicable): N/A
MWDBE Contracted Goal (if applicable): N/A
MWDBE Current Participation (if applicable): N/A
Justification for 0% MWDBE Participation Goal: N/A - Goal not applicable to request
Request Summary (Agenda Caption):
title
Request for approval of a revised policy on reinstatement of retiree and dependent health insurance.
end
Background and Discussion:
On September 19, 2024, Commissioners Court directed Human Resources to revisit the policy on reinstatement of retiree and dependent health insurance and present recommendations to Commissioners Court. The current policy allows retirees whose group health and related benefits are terminated because of failure to make premium payments, to have their coverage reinstated prospectively if payment of all past due premiums are made within 60 days of termination of coverage. If a retiree’s financial institution refuses two (2) direct debits within a calendar year, coverage is not reinstated unless the payment was refused because of a bank error or delay in an expected Social Security or retirement payment. If a retiree is receiving the County’s 100% contribution for retiree only coverage, the policy does allow the retiree a one-time option to re-enroll in the medical plan at open enrollment if they pay the outstanding premium balance.
The proposed policy attached allows a retiree whose group health and related benefits are terminated because of failure to make premium payments, to have their coverage reinstated without loss of coverage if payment of all past due premiums are made within 15 calendar days from the date the debit was refused by the retiree’s financial institution. If payment is not made within 15 calendar days, retirees can still reinstate their coverage if payment is made within 90 days of the termination of coverage, and they have the option to reinstate their coverage retroactively if all past due premiums are paid. In addition, if payment of premiums are not made within 90 days of termination of coverage, retirees and their dependents are allowed to re-enroll in group health and related benefits at the next open enrollment following termination under the policy.
Expected Impact:
The proposed policy provides more leniency to retirees who miss premium payments for their health coverage, which will assist those who may be on a fixed income or may be a victim to identity theft or other fraud on their bank account.
Alternative Options: N/A
Alignment with Goal(s):
_ Justice and Safety
_ Economic Opportunity
_ Housing
_ Public Health
_ Transportation
_ Flooding
_ Environment
X Governance and Customer Service
Prior Court Action (if any):
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Date |
Agenda Item # |
Action Taken |
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9/19/2024 |
459 |
Direct Human Resources and Risk Management to revisit the current policy on reinstatement of retiree or dependent health insurance and come back with recommendations on November 12, 2024 Commissioners Court. |
Location:
Address (if applicable): N/A
Precinct(s): Countywide
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Anticipated Court Date: November 12, 2024
Anticipated Implementation Date (if different from Court date): N/A
Emergency/Disaster Recovery Note: Not an emergency, disaster, or COVID-19 related item
Contact(s) name, title, department: Sarah Acosta, Director of Benefits & Wellness, Human Resources and Talent
Attachments (if applicable): 2024 Retiree Healthcare Reinstatement Policy