You are eligible to participate in the county group health, life and long term disability plans as well as the Flexible Benefits Program if you are an elected official, an appointed official or a regular employee who is employed by the county on a continuous basis for a regular work week of at least 32 hours.

 Dependents

Some of the options provide for participation of your eligible dependents. Eligible dependents are defined as follows:

Your legal spouse (Note: A common law spouse is considered a legal spouse. You are required to obtain a Certificate of Informal Marriage from the County Clerk.)

1.     Your unmarried child(ren) over eighteen (18) must be enrolled as

               a full-time student in an accredited college, university or trade

               school, or your natural child(ren), or

2.     your legally adopted child(ren) (including a child placed with

               adoptive parents pending finalization of adoption proceedings.

               Copies of adoptive papers must be provided upon finalization), or

3.     your stepchild(ren) who permanently reside in the employee’s

               home, or

4.     child(ren) permanently residing in your home for whom you have

               legal guardianship or legal custody (you must provide copies of

               the legal documents), or

5.     grandchildren (additional documentation required)

Your dependent’s eligibility for benefits ends on the last day of the month in which they have their 25^th birthday.

However, the age limits that apply to dependent children will not apply to any insured child who remains dependent on you for support and maintenance because he or she becomes incapable of working:

·         Due to physical handicap or mental retardation,

·         Before reaching the age of 25, and

·         While insured under this group policy or any prior plan provided such child was insured on the date of termination of the prior plan.

Written proof, satisfactory to the insurance company, of your dependent’s incapacity and dependency must be furnished to the insurance company at its home office at least 31 days prior to the dependent reaching the age of 25.  As a condition to the continued coverage of a dependent child who is totally disabled beyond the age of 24, certification of the dependent’s physical or total mental disability shall be provided by the employee once every two years.  Certification shall include current medical or mental condition and physician’s statement of prognosis.

Dependents not listed above (i.e.; in-laws, parents, grandparents, and non-qualifying relationships and other such non-qualifying dependents) are not eligible dependents under the Employee Benefits Program.

NOTE:  Any change of dependent status must be made within the same calendar year of qualifying change.

In 1967 the Texas Legislature created TCDRS to provide the state's county and
district employees with retirement, disability and death benefits.  Every time you
get a paycheck, 7% of your money goes into your TCDRS account.  Your money
currently earns interest at a rate of 7%.  The money you deposit into your
TCDRS account is not taxed until you withdraw it or choose a retirement benefit.

One of the great things about a defined-benefit plan like your TCDRS plan is that
the ups and downs of the investment market don't affect your account.  Whether
the market does well or does poorly, your account still gets the 7% interest
rate.  Harris County assumes the investment risk of providing your retirement
benefit.

You are considered "vested" when you have earned enough service time to be
eligible for retirement once you reach the age requirement.  To be vested, you
must have 8 years of service credit.  Once vested, you may stop working for
Harris County and still keep your right to a future retirement benefit.  Your
personal account will keep earning interest each year until your membership
ends.  Your membership ends when you withdraw your personal deposits or
choose a retirement benefit, or upon your death.

When you retire, you may choose to receive a monthly benefit payment.  All
payment options pay you for your lifetime.  Some of the payment options also
provide a monthly benefit for your beneficiary after your death.

Your monthly benefit is based on the amount of money in your account and the
matching credits your employer has agreed to provide.  Under your plan, you will
get a 2.25:1 ratio of matching credits when you retire.  This means that your
employer will provide $2.25 for every $1.00 in your account as part of your
monthly benefit.

Your participation in TCDRS is mandatory unless you are a temporary employee.

Questions or comments?   Send email to: Human Resources and Risk
Management 

Plan Year
The plan year begins March 1 and continues through the end of February of each year.

Current Employee
If you are eligible to participate in the Harris County Flex Plan, you may choose benefits during open enrollment which will be held each year during the month of January. The elections will become effective as of March 1 of that year.

New Employee
As a new employee, you will become eligible for benefits on the first day of the calendar month following three full months of continuous employment as a regular employee. You may then elect to participate in the group benefit plan as well as the HCFlex Plan.

Dependents
You may elect coverage for your dependents that will become effective on the same date as yours. However, if you or your dependent is confined in a hospital or other facility due to illness or injury on the day coverage is due to begin, coverage may be postponed until the confinement ends.

Newly Acquired Dependents
If you acquire eligible dependents during the year, you may enroll them any time during the calendar year of the acquisition. To do this, you must complete a Harris County Employee Benefits Change form which may be obtained from your Benefits Coordinator or from The Office of Human Resources & Risk Management.

Calendar Year Deductible: 
         In - Network:   
         Base Plan:   $250 per individual
                          $750 per family
         Plus Plan:     None
         Out - of - Network:
         Base Plan:  $600 per individual 
                         $1,800 per family 
         Plus Plan:   $600 per individual 
                         $1,800 per family

Calendar Year Out-of-Pocket Maximum:
         In - Network:
         Base Plan:  $1,750 per individual + deductible
                         $5,250 per family + deductible
         Plus Plan:    None
         Out - of - Network:
         Base Plan:   $6,000 per individual + deductible
                          $18,000 per family + deductible
         Plus Plan:    $6,000 per individual + deductible
                          $18,000 per individual + deductible

Physicians Services:
         In - Network:
         Base Plan:   Office Visit to PCP - $20
                           Office Visit to Aexcel Specialist - $30,
                           Office Visit to Non-Aexcel Specialist - $50
         Plus Plan:    Office Visit to PCP - $20
                           Office Visit to Aexcel Specialist - $20,
                           Office Visit to Non-Aexcel Specialist - $40
         Out - of - Network:
         Base Plan:  40% after deductible
         Plus Plan:    30% after deductible

Hospitalization:
         In - Network:
         Base Plan:  20% after deductible
         Plus Plan:   $400 per confinement copay
         Out - of - Network:
         Base Plan:  40% after deductible
         Plus Plan:   30% after deductible

Outpatient Surgery:
         In - Network:
         Base Plan:  20% after deductible
         Plus Plan:   $250 copay
         Out - of - Network:
         Base Plan:  40% after deductible
         Plus Plan:   30% after deductible

Mental Health Office Visit:
         In - Network:
         Base Plan:  $30 copay per visit
         Plus Plan:   $30 copay per visit
         Out - of - Network:
         Base Plan:  40% after deductible
         Plus Plan:   30% after deductible

Mental Health Inpatient Coverage:
         In - Network:
         Base Plan:  20% after deductible
         Plus Plan:   $400 per confinement copay
         Out - of - Network:
         Base Plan:  40% after deductible
         Plus Plan:   30% after deductible

Prescription Drug Plan Features
In – Network Prescription Drug Benefits
Harris County offers one Prescription Drug Benefit for both the Base and Plus Plans. This is a two-tiered, standard plan that consists of generic and brand name drugs. If the member or physician requests a brand name drug when a generic equivalent is available, the member will pay the brand name copay plus the difference between the generic price and the brand price. This is considered a mandatory generic prescription drug plan.

      25% Cost Share on all Prescription Drugs

Retail Pharmacy – 30 day supply
Generic Drug Copay:  $5 minimum / $15 maximum
Brand Name Copay:  $20 minimum / $60 maximum

Specialty Drugs/Self Injectables - thru Aetna Specialty Pharmacy (30 day supply)

Generic Drug Copay:  $25 minimum / $100 maximum
Brand Name Copay:  $25 minimum / $100 maximum

Mail Order (for 31 to 90-day supply)
Generic Drug Copay:  $10 minimum / $30 maximum
Brand Name Copay:  $40 minimum / $120 maximum

Self-injectable drugs are available only through the Aetna Specialty Pharmacy OR an Aetna designated and approved provider after the second refill at a retail pharmacy.

Please reference the Plan Document for a complete listing of covered services reimbursement amounts, limitations and exclusions.

Complete Visual Exam (one exam every 12 months from the date of last service) 
   PPO: 
      $10 copay
   Indemnity Reimbursement: 
      Up to $40
 
Standard Frames (PPO every 12 months, Indemnity every 24 months)
   PPO: 
      100% after $25 Materials Copay
   Indemnity Reimbursement: 
      Up tp $40
 
Single Vision Lenses
   PPO: 
      100% after $25 Materials Copay
   Indemnity Reimbursement: 
      Up to $40
 
Elective Contact Lenses
   PPO: 
      100% after $25 Materials Copay 
   Indemnity Reimbursement: 
      Up to $105
 
Necessary Contact Lenses
   PPO: 
      100% after $25 Materials Copay
   Indemnity Reimbursement: 
      Up to $210

Teeth Cleanings (limited to 2 cleanings per calendar year) 
   DHMO: 
      No Charge
   Indemnity Reimbursement: 
      See Schedule of Allowances

Basic Services 
   DHMO: 
      See Co-payment Schedule
   Indemnity Reimbursement: 
      See Schedule of Allowances
      Deductible is $50 per person up to $150 per family per calendar year
 
Major Services 
   DHMO: 
      See Co-payment Schedule
   Indemnity Reimbursement: 
      See Schedule of Allowances
      Deductible is $50 per person up to $150 per family per calendar year

Life insurance and accidental death and dismemberment (AD&D) insurance provides protection for your family in the event of your death or accidental injury. The county currently provides a basic level of insurance to eligible employees and your covered dependents at no cost as shown below.

   Life:       $25,000 
   AD&D:      $5,000

Dependent Life Insurance for:

   Spouse:       $5,000 
   Unmarried Child(ren):       $2,000

Monthly Benefits:
   Basic coverage: 
      50% of the first $10,000 of your pre-disabliity earnings, reduced by deductible income 
   Optional Coverage: 
      60% of the first $10,000 of your pre-disabliity earnings reduced by deductible income

Monthly Maximum: 
   Basic coverage: 
      $5,000 
   Optional Coverage: 
      $6,000

Monthly Minimum:
   Basic coverage: 
      $100 or 10% of your LTD benefit before reduction by deductible income, whichever is greater 
   Optional Coverage: 
      $200 or 10% of your LTD benefit before reduction by deductible income, whichever is greater

Benefit Waiting Period: 
   Basic coverage: 
      180 days 
   Optional Coverage: 
      90 days

Maximum Benefit Period:
   Basic coverage: 
      2 years
   Optional Coverage: 
      Determined by your age when disability begins.