HomeMy WebLinkAboutGUIDE Town of Estes Park Benefits Document 20212021
Benefits Overview
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WHAT’S INSIDE?
PAGE
4 Medical/Rx
UMR
800.826.9781 / www.umr.com
Group # 76412721
OptumRx
877.559.2955 / www.optumrx.com
Group # 2267
4 Teladoc
800.teladoc / www.teladoc.com
Group # 136819
5 MASA Medical Transport Solutions
800.643.9023 / www.MASAmts.com
Group # 1160286
Dental
800.547.9515 / www.standard.com
Group # 646170
Vision
800.877.7195 / www.vsp.com
Group # 12135694
6 Flexible Spending Accounts (FSA)
800.795.7772 / www.regionalcare.com
Life and AD&D
800.423.2765
www.lfg.com / Group ID: ESTESPARK
Long-Term Disability
800.423.2765
www.lfg.com / Group ID: ESTESPARK
7 Voluntary Benefits
800.992.3522 / www.aflac.com
Group # 11403
Employee Assistance Program (EAP)
800.873.7138 / www.minesandassociates.com
Retirement
8 Employee Home Ownership Program
Childcare Assistance Program
9 Paid Time Off
Contributions
10 Important Notices
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WELCOME
The Town of Estes Park recognizes the importance of providing a comprehensive benefits program
to our regular full-time and part-time benefit eligible employees. Benefits are extended to the
employee, spouse1 and their dependents. These benefits help provide employees and their family
members opportunities to maintain their health and welfare. This “Enrollment Booklet” provides
employees with:
• A description of the benefit options
• Important phone numbers and websites to help employees manage their benefits
For complete details of each benefit plan and benefit related forms, refer to the full text of the
official Summary Plan Descriptions available on the Town’s Human Resources intranet page.
Please review this enrollment booklet to understand your Town of Estes Park benefit enrollment
options. The benefits that you choose at this time will remain in effect until the next open
enrollment, unless you have a qualified change of family status, including but not limited to:
• Marriage/Divorce
• Birth/Adoption of a Child
• Spouse’s loss of other coverage
1If your spouse is eligible for any other employer-sponsored group medical benefit plan, he/she will not be eligible to
participate in the Town’s medical plan.
Emily Lizotte
Human Resources Generalist
hr@estes.org
970.577.4775
Jackie Williamson
Human Resources
Director/Town Clerk
jwilliamson@estes.org
970.577.4771
Life and AD&D
800.423.2765
www.lfg.com / Group ID: ESTESPARK
Long-Term Disability
800.423.2765
www.lfg.com / Group ID: ESTESPARK
7Voluntary Benefits
800.992.3522 / www.aflac.com
Group # 11403
Employee Assistance Program (EAP)
800.873.7138 / www.minesandassociates.com
Retirement
8Employee Home Ownership Program
Childcare Assistance Program
9Paid Time Off
Contributions
10Important Notices
Questions?
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BENEFIT IN-NETWORK OUT-OF-NETWORK
Annual Deductible $500/$1,500 $1,000/$3,000
Out-of-Pocket Maximum $2,000/$5,000 $5,000/$15,000
Coinsurance 10%30%
Preventive Care 100%30% after deductible
Office Visit
PCP/Telemedicine/Specialist $25 copay/$25 copay/$25 copay 30% after deductible
Teladoc No copay N/A
Urgent Care $40 copay 30% after deductible
Emergency Room $150 copay
Inpatient Hospital Services 10% after deductible 30% after deductible
+$750/admission deductible
Outpatient Hospital Services 10% after deductible 30% after deductible +$500/
admission deductible
Outpatient Lab & X-ray 100%30% after deductible
Acupuncture/Chiropractic Services
(20 visits/year)$25 copay 30% after deductible
Physical/Occupational/Speech Therapy $25 copay 30% after deductible
PRESCRIPTION DRUGS
Generic Brand $5 copay
Member pays 100%,
then reimbursed 50% after
applicable copay
Preferred Brand $25 copay
Non-Preferred Brand $50 copay
Specialty 20% ($150 maximum)
MEDICAL
The Town offers a self-funded medical plan (PPO Choice Plus)
administered by UMR. Below are the medical plan highlights.
Please refer to your plan document for a full description.
TELADOC
Need a consultation?
You can talk with a Teladoc
doctor via phone consult,
video consult within the secure
member portal, or video consult
within the Teladoc mobile app.
• 1-800-Teladoc
• Teladoc.com
• Facebook.com/Teladoc
• Teladoc.com/mobile
What is Teladoc?
Teladoc is the first and largest provider of telehealth medical
consults in the United States, giving you 24/7/365 access to quality
medical care through phone and video consults.
Get the care you need
Teladoc doctors can treat many medical conditions, including:
• Cold & flu symptoms
• Allergies
• Bronchitis
• Skin problems
• Respiratory infection
• ...and more!
All benefit eligible employees can utilize Teladoc at no additional
cost.
Dont forget! Telemedicine allows you to reach
a medical provider by phone (1-800-826-9781)
when access to regular doctor is not available.
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BENEFIT PPO DENTAL NETWORK
Calendar Year Deductible
Individual/Family (Type 2 & 3)$25/$75
Calendar Year Maximum $1,500
Preventive Care 100%
Basic Services 80%
Major Services 50%
Orthodontia 50%
Orthodontia Lifetime Maximum $1,500
BENEFIT IN-NETWORK OUT-OF-NETWORK FREQUENCY
Exam $10 copay Up to $50 12 months
Material $25 copay Reimbursements vary 12 months
Frames $130 allowance Up to $70 24 months
Necessary Contact Lenses Covered in full, after copay Up to $210 12 months
Elective Contact Lenses $130 allowance Up to $105 12 months
VISION
VSP allows you to choose an ophthalmologist or optometrist from the VSP national network, or you may use
any licensed provider of your choice. VSP offers you one of the largest vision care networks in the industry, with
a wide selection of experienced ophthalmologists, optometrists, and opticians.
Regardless of who you choose, the vision plan will cover a portion of the benefits.
Staying healthy includes obtaining quality dental care for you and your family. The Town offers a Dental plan
through The Standard. The chart below provides an overview of the Dental plan:
DENTAL
MASA MEDICAL TRANSPORT SOLUTIONS
Emergencies can happen to anyone, anytime and anywhere. With MASA, employees will have zero out of pocket
expenses for any emergent air or ground transport from anywhere in the U.S., regardless who transports you.
MASA is provided at no cost to all benefit eligible Town of Estes Park employees and their household members.
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LIFE AND DISABILITY
LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT (AD&D)
Life insurance is an important part of your financial well-being, especially if others depend on you for support.
Town of Estes Park provides at no cost to you, Basic Life and AD&D coverage in the amount of 1 times your
annual salary, up to $50,000 for full-time employees working 24 hours per week through Lincoln Financial
Group.
VOLUNTARY LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT (AD&D)
In addition to the Town-paid life and AD&D insurance, employees may purchase Voluntary Life and AD&D
insurance for themselves, their spouse and/or their dependent children. Please see the table below.
The cost of Voluntary Life & AD&D insurance is based on your age (for both employee and spousal coverage)
and the amount of coverage chosen. For dependent coverage, only one premium is required regardless of the
number of dependent children.
Annually, during the month of November, employees and spouses may be able to increase their coverage amounts to
the next election amount without medical evaluation/evidence of insurability (EOI). If you wish to increase any cover-
age amounts, please contact Human resources.
If you do not elect any coverage upon initial employment for you and your dependents, you will be subject to EOI.
Please see Human Resources for the appropriate paperwork.
VOLUNTARY LONG TERM DISABILITY
You may purchase Long Term Disability (LTD) benefits offered through Lincoln Financial Group. LTD benefits
are designed to replace your income in the event that you suffer an illness or off-the-job injury and are unable
to work.
If disability continues for longer than 90 days, the LTD benefit will reimburse 60% of your monthly earnings up
to a monthly maximum of $5,000. The benefit duration will depend on your age at the time of disability.
The Town of Estes Park’s Flexible Spending Accounts are administered through Regional Care Flex. You
may participate in the Town’s Health and Dependent Care Flexible Spending Accounts (FSAs). These accounts
allow you to use pre-tax dollars to pay for a wide variety of health and/or dependent care expenses that aren’t
covered through your other benefit plans. The maximum annual amount you can elect is $2,7501 for Health
and $5,0001 for Dependent Care. Your contribution to each account will be divided into equal amounts and
deducted pre-tax from your paychecks. You can incur claims for 2021 expenses up to March 15, 2022. You will
then have until April 15, 2022 to turn in those claim expenses.
1This amount is subject to change as directed by the IRS.
FLEXIBLE SPENDING ACCOUNT
BENEFIT AMOUNTS GUARANTEE ISSUE MINIMUM MAXIMUM
Employee
$10,000/$20,000/
$30,000/$50,000/
$80,000/$100,000
$100,000 < age 65
$25,000 age 65-69
No Guarantee Issue age 70+
$10,000 $100,000
Spouse $10,000/$15,000/
$25,000/$30,000
$30,000, if employee is < age 65
No Guarantee Issue, if Employee
is age 65+
$10,000 $30,000
Dependent
$250 (14 days - 6 months)
$10,000 (6 months-age 19 or
age 25, if full-time student)
$10,000 $10,000 $10,000
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EMPLOYEE ASSISTANCE PROGRAM
The Mines and Associates Employee Assistance Program (EAP) may help give you a performance boost,
helping employees and their immediate family members identify challenges that can interfere with work
performance, health, and well-being. As a Town of Estes Park employee, you and your household members
are each entitled to 5 counseling sessions per issue, per year. The use of your Employee Assistance Program
is strictly confidential and available 24/7. Mines and Associates can help with everyday issues that come
up in your life, including:
• Stress
• Career
• Child and elder care
• Death and grief
• Anxiety
• Financial problems
• Drug/alcohol abuse
• Eating disorders
• Depression
• Legal referrals
• Relationships
• Work-related issues
The EAP is a free service, so simply call 800.873.7138 or you can also go to the website at www.
minesandassociates.com. Please log in with username: estespark and password: employee.
VOLUNTARY BENEFITS
As a Town of Estes Park employee you are also able to purchase additional Aflac Voluntary Benefits, such as:
• Group Accident
• Critical Illness
• Hospital Indemnity
• Disability Insurance
• Term Life Insurance
PERA/ICMA
Town of Estes Park offers PERA and ICMA retirement plans. Eligible PERA employees are full-time and part-time
employees and management (optional). Eligible ICMA employees are sworn Police Officers and management
(optional). Employee and Employer contributions are listed below:
VOLUNTARY 401(k)/457/ROTH IRA
The Town of Estes Park also offers Voluntary 401(k) and 457/Roth IRA. There are also Roth IRA options available
through PERA. Please see Human Resources for additional Information.
RETIREMENT
PERA/ICMA CONTRIBUTIONS
Employee Employer
Contribution 8.5%14.2%
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EMPLOYEE HOME OWNERSHIP PROGRAM
CHILDCARE ASSISTANCE PROGRAM
The Town of Estes Park provides all eligible full-time employees the opportunity to purchase or build
a home in the Park R-3 School District as their primary residence. The Employee Home Ownership
Program offers 3-year and 5-year programs, in which an internal account is funded by the Town’s
contributions (amounts shown below) and can be used as part of a down payment on the purchase
of a home. The employee must set-up a separate savings account and make per payroll contributions
(amounts shown below). Please see Human Resources for eligibility requirements and restrictions. Due
to financial impacts from the COVID pandemic, the town is not accepting new participants in
the home ownership program for 2021. If this situation changes, we are hoping to reinstate the
program as soon as possible.
HOME OWNERSHIP PROGRAM CONTRIBUTIONS
The Town (per participating employee)Employee
3-year program $555.55 per month $159.00 per payroll
5-year program $333.33 per month $95.00 per payroll
Please note, The Estes Park Housing Authority evaluates eligibility for all employees and the Town reserves the
right to alter this program at anytime.
The Town of Estes Park will match up to a 100%1 of an employee’s annual contribution (up to the annual
maximum) to a Dependent Care Flexible Spending Account (DCFSA) to assist with childcare expenses.
In order to participate in this program, employees must meet the following requirements:
• Seasonal, part-time and contract employees without benefits are not eligible for this program;
• Have one or more dependent children aged birth through twelve (12) years;
• If there are two parents/guardians in the household, the second parent/guardian must work a
minimum of 20 hours per week or attend school with 6 credit hours or equivalent per term; and
• One (1) Childcare Assistance per household as allowed by IRS standards.
• Sign up for Dependent Care Flexible Spending Account through the Town.
1The amount of this contribution will vary by year depending on the Town’s budget.
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DENTAL CONTRIBUTIONS (BI-WEEKLY)
Employee Employer
Employee Only $2.23 $20.10
Employee + Family $6.60 $59.41
VISION CONTRIBUTIONS (BI-WEEKLY)
Employee Employer
Employee Only $0.53 $4.76
Employee + Family $1.14 $10.24
CONTRIBUTIONS
PAID TIME OFF
HOLIDAYS
The Town of Estes Park
observes eight holidays
and accrues thirty-two
floating holiday hours
each year for full-time
employees (new hires
are pro-rated based on
start date).
SICK LEAVE
As a Town of Estes Park
employee you accrue at
the rate of four hours
for the first two bi-
weekly pay periods of
each month (pro-rated
for eligible part-time
employees).
VACATION LEAVE
Vacation leave hours are
accrued based on years
of service.
For the first three years
of employment you
accrue at the rate of four
hours for the first two
bi-weekly pay periods of
each month (pro-rated
for eligible part-time
employees).
VOLUNTEER TIME
All full-time employees
are eligible for 8 hours of
Volunteer time per year
(pro-rated for eligible
part-time employees).
For more paid time off leave information, refer to Policy 306: Leave.
MEDICAL CONTRIBUTIONS (BI-WEEKLY)
Employee Employer
Employee Only $44.73 $350.00
Employee + Spouse $150.57 $678.34
Employee + Child(ren)$84.87 $664.09
Family $222.28 $961.88
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Private Health Information
A portion of the Health Insurance Portability and Accountability
Act of 1996 (HIPAA) addresses the protection of confidential
health information. It applies to all health benefit plans. In short,
the idea is to make sure that confidential health information that
identifies (or could be used to identify) you is kept completely
confidential. This individually identifiable health information is
known as “protected health information” (PHI), and it will not be
used or disclosed without your written authorization, except
as described in the Plan’s HIPAA Privacy Notice or as otherwise
permitted by federal and state health information privacy laws.
A copy of the Plan’s Notice of Privacy Practices that describes
the Plan’s policies, practices and your rights with respect to your
PHI under HIPAA is available from your medical plan provider.
For more information regarding this Notice, please contact the
Human Resources Department.
Summary of Benefits and Coverage (SBC)
Effective for plan renewals after January 1, 2012, the Patient
Protection and Affordable Care Act requires employers that
offer health coverage to provide a uniform Summary of Benefits
and Coverage (SBC) to people who apply for and enroll in the
health plan. This document contains the following:
• Four-page overview of plan benefits, cost sharing and
limitations
• Required set of examples of how the plan works
• Phone number and internet address for obtaining copies
of plan documents
• A Standard glossary of medical and insurance terms must
also be available
The SBC will be updated each plan renewal to reflect applicable
plan changes.
Women’s Health and Cancer Rights Act
The Town medical plans, as required by the Women’s Health and
Cancer Rights Act of 1998, provides benefits for mastectomy-
related services. These services include:
• All stages of reconstruction of the breast on which the
mastectomy was performed
• Surgery and reconstruction of the other breast to produce
a symmetrical appearance
• Prostheses and treatment of physical complications
resulting from mastectomy (including lymphedema)
This coverage will be provided in consultation with the attending
physician and the patient, and will be subject to the same
annual deductibles and coinsurance provisions that apply to
the mastectomy. For more information, contact your medical
plan provider.
Notice of Prescription Drug Creditable Coverage
The Town provides a “Notice of Prescription Drug Creditable
Coverage” to all Medicare eligible participants on an annual
basis. This notice states that under the Town’s medical plan,
you have prescription drug coverage that is, on average,
as generous as the standard Medicare Prescription Drug
Coverage.
Continuation Of Coverage
If your coverage ends under the Plan, you may be entitled to
elect continuation coverage (coverage that continues on in
some form) in accordance with federal law.
If you selected continuation coverage under a prior plan which
was then replaced by coverage under this Plan, continuation
coverage will end as scheduled under the prior plan or in
accordance with the terminating events listed below, whichever
is earlier.
When Coverage Ends
We may discontinue these benefit plans and/or all similar
benefit plans at any time. Your entitlement to benefits
automatically ends on the date that coverage ends, even if you
are hospitalized or are otherwise receiving medical treatment
on that date.
When your coverage ends, the Town will still pay claims
for Covered Health Services that you received before your
coverage ended. However, once your coverage ends, we do
not provide benefits for health services that you receive after
coverage ends for medical conditions that occurred before
your coverage ended, even if the underlying medical condition
occurred before your coverage ended. An enrolled dependent’s
coverage ends on the date your coverage ends.
Federal regulations require the Town to provide benefit eligible employees with the following notices listed below. If you
would like a complete copy of any of the following notices, please contact Human Resources.
IMPORTANT NOTICES
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This brochure provides only a highlight of the benefit plans offered to you by the Town of Estes Park and in no way serves as the actual
plan description or plan document for the plans. The plan documents will always govern the offered benefits that your employer provides
for you. We reserve the right to modify any or all of these plans at anytime.
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
are eligible for health coverage from your employer, your State
may have a premium assistance program that can help pay for
coverage. These States use funds from their Medicaid or CHIP
programs to help people who are eligible for these programs, but
also have access to health insurance through their employer.
If you or your children are not eligible for Medicaid or CHIP, you
will not be eligible for these premium assistance programs.
If you or your dependents are already enrolled in Medicaid or
CHIP, you can 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, you can contact your
State Medicaid or CHIP office at www.insurekidsnow.gov to find
out how to apply. If you qualify, you can ask the State if it has a
program that might help you pay the premiums for an employer-
sponsored plan.
Once it is determined that you or your dependents are eligible for
premium assistance under Medicaid or CHIP, as well as eligible
under your employer plan, your employer must permit you to
enroll in your employer plan if you are not 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, you can contact the Department of Labor electronically at
www.askebsa.dol.gov.
For All States:
(877) 267-2323, Ext. 61565
U.S. Department of Labor
Employee Benefits Security Administration
www.dol.gov/ebsa or 1-866-444-EBSA (3272)
U.S. Department of Health and Human Services
Centers for Medicare & Medicaid Services
www.cms.hhs.gov or 1-877-267-2323, Ext. 61565
Uniformed Services Employment And Reemployment Rights
Act (USERRA)
If you are called to active duty in the uniformed services, you may
elect to continue coverage for you and your eligible dependents
under USERRA. This continuation right runs concurrently with
your continuation right under COBRA and allows you to extend
an 18-month continuation period to 24 months. You and your
eligible dependents qualify for this extension if you are called into
active or reserve duty, whether voluntary or involuntary, in the
Armed Forces, the Army National Guard, the Air National Guard,
full-time National Guard duty (under a federal, not a state, call-
up), the commissioned corps of the Public Health Services and
any other category of persons designated by the President of the
United States.
Wellness Program
The Town’s wellness programs and activities are voluntary
programs. The programs are administered according to federal
rules permitting employer-sponsored wellness programs that
seek to improve employee health or prevent disease, including the
Americans with Disabilities Act of 1990, the Genetic Information
Nondiscrimination Act of 2008, and the Health Insurance
Portability and Accountability Act, as applicable, among others.
If you choose to participate in a program you may be asked to
answer voluntary questions about your health-related activities
and behaviors and whether you have or had certain medical
conditions (e.g., cancer, diabetes, or heart disease).
In some programs, employees who choose to participate can
earn a small incentive. If you are unable to participate in any
of the health-related activities to earn an incentive, you may
be entitled to a reasonable accommodation or an alternative
standard. You may request a reasonable accommodation or an
alternative standard by contacting the Human Resources/Benefit
Department.
Town of Estes Park Human Resources
970.577.4775 or 970.577.4771
170 MacGregor Avenue
Estes Park, CO 80517
Where benefits matter...