| Eligible Employees | Top |
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, and
- Employed by the county as a regular full-time employee for a period of three months.
Dependents Some of the options provide for participation of your eligible dependents. Eligible dependents are defined as follows:
- Legal spouse;
- Unmarried children under age 25. Dependent children over eighteen* (18)
must be enrolled as a full-time student in an accredited college, university or trade school. For purposes of determining eligibility, an Employee's "children" includes:
1. natural children;
2. legally adopted children (including children placed with adoptive parents pending finalization of adoption proceedings);
3. stepchildren who permanently reside in the employee?s home;
4. children over age 24 who remain dependent on the Employee or retired employee for support and maintenance because the child becomes incapable of self support due to mental or physical incapacity. The incapacity must have commenced prior to reaching age 25 under the Plan or a prior health Plan of the Customer (if the child was insured on the date of termination of the prior health Plan);
5. unmarried grandchildren under age 25 for whom the Employee or retired employee furnishes (a) a certificate of financial dependency, (b) birth certificate on the grandchild, (c) birth certificate on the grandchild?s mother or father indicating that the Employee is the biological or adoptive parent and (d) the grandchild is claimed as a dependent on your Federal Income Tax Return;
- Children under age 19 permanently residing in the Employee's or retired
employee's home and for whom the Employee or retired employee is the appointed permanent legal guardian or permanent legal custodian; and
- Foster children under age 19 for whom the Employee or retired employee
furnishes documents from the State of Texas;
- All other individuals to whom the Customer is required by law to extend the
coverage provided in the Plan shall also be considered Dependents to the extent they do not also qualify for coverage as Employees; and
- All former Employees' Dependents to the extent that the Customer provides
for such coverage by Resolution of the Commissioners Court shall also be considered Dependents to the extent they do not also qualify for coverage as Employees.
No person may be covered both as an employee and dependent and no person may be covered as a dependent of more than one employee.
*For dependents reaching age 25, coverage continues until the end of the calendar month in which the dependent child turns age 25.
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.
Note: 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.
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| Texas County & District Retirement System (TCDRS) | Top |
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
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| Enrollment | Top |
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.
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| Medical Plan | Top |
Calendar Year Deductible: In - Network: Base Plan: $200 per individual $600 per family Plus Plan: None Out - of - Network: Base Plan: $500 per individual $1,500 per family Plus Plan: $500 per individual $1,500 per family
Calendar Year Out-of-Pocket Maximum: In - Network: Base Plan: $1,500 per individual + deductible $4,500 per family + deductible Plus Plan: None Out - of - Network: Base Plan: $3,000 per individual + deductible $9,000 per family + deductible Plus Plan: $2,000 per individual + deductible $6,000 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 - $45 Plus Plan: Office Visit to PCP - $20 Office Visit to Aexcel Specialist - $20, Office Visit to Non-Aexcel Specialist - $30 Out - of - Network: Base Plan: 40% after deductible Plus Plan: 30% after deductible
Hospitalization: In - Network: Base Plan: 10% after deductible Plus Plan: $300 per confinement copay Out - of - Network: Base Plan: 40% after deductible Plus Plan: 30% after deductible
Outpatient Surgery: In - Network: Base Plan: 10% after deductible Plus Plan: $200 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: 10% after deductible Plus Plan: $300 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
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.
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| Vision Plan | Top |
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
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| Dental Plan | Top |
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
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| Life Insurance and Accidental Death & Dismemberment Plan | Top |
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.
If your annual rate of basic earnings is $20,000 or more: Life: $25,000 AD&D: $5,000
If your annual rate of basic earnings is $15,000 but less than $20,000: Life: $20,000 AD&D: $5,000
If your annual rate of basic earnings is $10,000 but less than $15,000: Life: $15,000 AD&D: $5,000
If your annual rate of basic earnings is less than $10,000: Life: $10,000 AD&D: $5,000
Dependent Life Insurance for: Spouse: $5,000 Unmarried Child(ren): $2,000
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| Long Term Disability Plan | Top |
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. |