HomeMy WebLinkAboutGUIDE Town of Estes Park Benefits 2025Benefits Overview
2025
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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 ben-
efits that your employer provides for you. We reserve the right to modify any or all of these plans at anytime.
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Contents
PAGE
5 Welcome
6 Medical/Rx
UMR
800.826.9781 / www.umr.com
Group # 76412721
OptumRx
877.559.2955 / www.optumrx.com
Group # 2267
7 Teladoc
800.teladoc / www.teladoc.com
Group # 136819
MASA Medical Transport Solutions
800.643.9023 / www.MASAmts.com
Group # 1160286
8 Dental
800.942.0854 / www.metlife.com
Group # 5392144
9 Vision
800.877.7195 / www.vsp.com
Group # 12135694
10 Flexible Spending Accounts (FSA)
866.440.6556 / www.wexinc.com
12 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
13 Voluntary Benefits
800.662.1113 / www.americanfidelity.com
Employee Assistance Program (EAP)
800.873.7138 / www.minesandassociates.com
14 Retirement
15 Employee Home Ownership Program
Childcare Assistance Program
16 Paid Time Off
17 Contributions
18 Important Notices
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Emily Lizotte
Human Resources Manager
hr@estes.org
970.577.4778
Jackie Williamson
Human Resources Director/Town Clerk
jwilliamson@estes.org
970.577.4771
Questions?
Becky Weller
Human Resources Technician
hr@estes.org
970.577.4778
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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, eligible spouse1 and their dependents. These
benefits help provide employees and their family members opportunities to maintain
their health and welfare. This “Benefits Overview” 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.
Welcome
Click the icon through the benefits guide to download benefits summaries, voluntary coverage rate sheets, and other helpful communication.
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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.
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 30% after deductible
TELADOC No copay N/A
URGENT CARE $40 copay 30% after deductible
EMERGENCY ROOM $150 copay
INPATIENT HOSPITAL 10% after deductible 30% after deductible
+$750/admission deductible
OUTPATIENT HOSPITAL 10% after deductible 30% after deductible
+$500/admission deductible
OUTPATIENT LAB & X-RAY 100%30% after deductible
ACUPUNCTURE/CHIROPRACTIC
(20 visits/year)$25 copay 30% after deductible
PHYSICAL/OCCUPATIONAL/SPEECH THERAPY $25 copay 30% after deductible
OUTPATIENT MENTAL HEALTH $25 copay, deductible waived 30% coinsurance, deductible waived
PRESCRIPTION DRUGS
Generic - $5 copay
Preferred - $25 copay
Non-Preferred - $50 copay
Specialty - 20% ($150 maximum)
Member pays 100%,
then reimbursed 50% after applicable
copay
%
$
Click the icon
to learn more
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Masa Medical Transportation
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.
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
• Cold & flu symptoms
• Allergies
• Bronchitis
• Skin problems
• Respiratory infection
• ...and more!
All benefit eligible employees and immediate family members can utilize
Teladoc at no additional cost. Utilization of Teladoc is not dependent
upon enrollment in the Town’s medical plan.
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:
Click the icon
to learn more
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Staying healthy includes obtaining quality dental care for you and your family. The Town offers a Dental plan
through MetLife. The information below provides an overview of the Dental plan.
Dental
Search for a participating dentist online by using the PDP Plus Network at www.metlife.com/dental.
• Oral Examinations
• Flouride
• Bitewings X-rays
• Full Mouth X-rays
• Cleanings
• Periodontal
Maintenance
• Emergency Palliative
Treatment
• Periodontal Root
Planing & Scaling
• Periodontal Surgery
• Sealants
• Amalgam &
Composite Fillings
• Simple Extractions
• Root Canal
• Repair (Crown)
BASIC SERVICES MAJOR SERVICESPREVENTIVE CARE
100%80%50%
ORTHODONTIA SERVICES
$
50%
• Space Maintainers
• Crowns
• Dentures
• Bridges
• Surgical Extractions
• Implants
• Adults and
dependent children
up to age 26
$25
$2,500
Individual Family
$75Annual
Deductible
Maximums
Per Individual
(Dental)
$1,500
Per Individual
(Orthodontia)
Coinsurance Coinsurance CoinsuranceCoinsurance
Click the icon
to learn more
ANNUAL LIFETIME
Please note: If you choose a dentist who does not participate in the network, your out-of-pocket expenses may be
higher, since you will be responsible for paying any difference between the dentist’s fee and your plan’s payment for the
approved service.
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BENEFIT IN-NETWORK OUT-OF-NETWORK
EXAM $10 copay Up to $50
MATERIAL $25 copay Reimbursements vary
FRAMES $130 allowance Up to $70
NECESSARY CONTACT LENSES Covered in full, after copay Up to $210
ELECTIVE CONTACT LENSES $130 allowance Up to $105
Vision
VSP Vision Care 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.
CONTACTS
12 MONTHS
FRAMES
24 MONTHS
EXAM
12 MONTHS
Click the icon to
learn more
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The Town of Estes Park’s Flexible Spending Accounts are administered through Wex
Inc.. 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 $3,3001 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 2025
expenses up to March 15, 2026. You will then have until April 15, 2026 to turn in those
claim expenses.
Flexible Spending
Accounts
$3,300
$5,000
HEALTH CARE FSA
DEPENDENT CARE FSA
Annual Maximum
Annual Maximum
1This amount is subject to change as directed by the IRS.
1
1
Click on the icon
to learn more
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Child Care Assistance Program
The Town of Estes Park will match up to a 50%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 and part-time 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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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
coverage 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.
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
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.
Click the icon
to learn more
Click the icon to learn more
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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 American Fidelity Voluntary Benefits, such
as:
• Disability Insurance
• Life Insurance
• Accident Insurance
• Cancer Insurance
• Critical Illness Insurance
• Hospital Indemnity Insurance
Click the icon
to learn more
Click the icon
to learn more
American Fidelity also offers comprehensive benefits education. Please contact a representative to talk through all
your benefits options
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Retirement
PERA/MISSIONSQUARE (formerly ICMA)
Town of Estes Park offers PERA and MissionSquare
retirement plans. Eligible PERA employees are full-time
and part-time employees. Eligible MIssionSquare
employees are Sworn Patrol Officers. Management
(Director level or higher) have the option of selecting
either PERA or MissionSquare. Employee and
Employer contributions are shown on the left.
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.
Click on the icon
to learn more
14.78%14.78%
Employee
Contribution Rate
9%
Town of Estes Park’s
Contribution Rate
PERA*/MISSIONSQUARE
CONTRIBUTIONS
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*PERA may initiate automatic adjustments up to .5%
in June of each calendar year effective the following
calendar year. Mission Square contributions will be
the same as PERA contributions.
Please note: The Town pays into Social Security (both employee and
employer contributions) in addition to paying into PERA.
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Employee Home
Ownership 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.
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.
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Click on the icon
to learn more
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Paid Time Off
HOLIDAYS
The Town of Estes Park observes 10 holidays and accrues 32 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.
VACATION LEAVE
Vacation leave hours are accrued based on years of service.
For the first two years of employment you accrue at the rate of four
hours for the first two bi-weekly pay periods of each month
VOLUNTEER TIME
All full-time employees are eligible for 8 hours of Volunteer time per
year.
For more paid time off leave information, refer to Policy 306: Leave.
*Benefits accruals are pro-rated for eligible part-time employees.
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Contributions
(Bi-weekly)
Employee The Town
EMPLOYEE ONLY $53.82 $478.79
EMPLOYEE + SPOUSE $181.19 $937.26
EMPLOYEE + CHILD(REN)$102.12 $908.38
FAMILY $267.49 $1,330.29
ME
D
I
C
A
L
Employee The Town
EMPLOYEE ONLY $2.14 $19.26
FAMILY $6.32 $56.93DE
N
T
A
L
Employee The Town
EMPLOYEE ONLY $0.53 $4.76
FAMILY $1.14 $10.24VI
S
I
O
N
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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.
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.
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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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
970.577.4778
170 MacGregor Avenue
Estes Park, CO 80517