GOOD
SHEPHERD HEALTH CARE SYSTEM
SYSTEM-WIDE POLICIES AND PROCEDURES
Human Resources
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SUBJECT: Benefits,
Employee |
ADMINISTRATIVE APPROVAL:
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NO. 501 |
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SUPERSEDES: B-099 |
Page 1 of 6 |
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DEPARTMENT RESPONSIBLE FOR POLICY MAINTENANCE: HR |
REVISED DATE:
12/02, 11/03, 12/03, 12/04, 12/05, 9/06 FORMULATED: 01/93 |
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REVIEW DATE:
12/97 12/98 |
12/99 |
12/00 |
12/01 |
12/02 |
11/03 |
12/04 |
12/05 |
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A. HEALTH INSURANCE – REGENCE BLUE CROSS
BLUE SHIELD
Full premium rates effective
FULL RATE COBRA COST
Single 459.64 468.84
Employee
& Child(ren) 825.39 841.90
Employee
& Spouse 964.54 983.83
Family 1332.74 1359.39
Premium portions to be paid by covered
employees are:
1. Full-time employees & part-time employees working 90% or more of a full-time employee:
Single $ 45.96
Employee & Child(ren) $155.68
Employee & Spouse $197.42
Family $307.88
2. Part-time employees working 71% to 89% of full-time employee:
Single $108.02
Employee & Child(ren) $256.14
Employee & Spouse $312.50
Family $461.62
3. Part-time employees working 50% to 70% of full-time:
Single $149.38
Employee & Child(ren) $323.10
Employee & Spouse $389.20
Family $564.10
HEALTH INSURANCE – REGENCE BLUE
CROSS BLUE SHIELD
Health Savings Account – H.S.A. $1500 single deductible $3000
Family deductible. After meeting
deductible this plan pays 80% for prescriptions and medical expenses.
Full Premium Rates Effective NOV
1, 2006 TO
FULL RATE COBRA COST
Single 305.69 311.80
Employee
& Child(ren) 562.29 573.54
Employee
& Spouse 658.19 671.35
Family 910.69 928.90
Premium Portions to be Paid by Covered Employees are:
4. Full-time employees & part-time employees working 90% or more of a full-time employee:
GSHCS CONTRIBUTION
TO HSA
Single $ 15.28 $50.00/Month
Employee & Child(ren) $ 92.26 $100.00/Month
Employee & Spouse $121.04 $100.00/Month
Family $196.78 $100.00/Month
5. Part-time employees working 71% to 89% of full-time employee:
GSHCS CONTRIBUTION
TO HSA
Single $ 58.06 $42.50/Month
Employee & Child(ren) $162.78 $85.00/Month
Employee & Spouse $201.62 $85.00/Month
Family $303.88 $85.00/Month
6. Part-time employees working 50% to 70% of full-time:
GSHCS CONTRIBUTION
TO HSA
Single $ 87.90 $37.50/Month
Employee & Child(ren) $209.77 $75.00/Month
Employee & Spouse $255.32 $75.00/Month
Family $375.26 $75.00/Month
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B. DENTAL
INSURANCE - GOOD SHEPHERD EMPLOYEES’ GROUP DENTAL PLAN
(ADMINISTERED BY
Full Premium Rate Effective:
FULL RATE COBRA COST
Employee $22.41 $22.86
Dependents $35.77 $36.49
TOTAL $58.18 $59.35
Monthly premium portions to be paid by covered employees are:
Single $1.12
Employee + Dependents $19.00
Single $4.31
Employee + Dependents $24.88
Single $6.44
Employee + Dependents $28.80
C. OPTICAL INSURANCE - GOOD SHEPHERD
EMPLOYEES’ GROUP VISION PLAN
(ADMINISTERED THROUGH
Full premium rate effective:
FULL
RATE COBRA COST
Single 16.60 16.93
Two
Party 24.12 24.60
Family 39.08 39.86
1. Full-time employees & part-time employees working 20 or more hours per week:
Single $8.30
Two party $12.06
Family $19.54
D.
LIFE INSURANCE - (
1. Hospital
pays 100% of employee premium for employees who work 20 hours or more
per week. Coverage is equivalent to the
employee’s annual salary rounded up to the nearest $5,000 (Maximum $50,000).
2. Enrolled
Employees may elect to cover their dependents with life insurance, ($10,000 for
a spouse and $2,000 for each child over six months old). Cost for dependent coverage is $2.05
per month.
3. Covered
employees may purchase additional life insurance at low group rates in amounts
equivalent to one times or two times the base amount
that the hospital pays for.
SUPPLEMENTAL LIFE:
Monthly Premium cost per thousand
Age Rate Age Rate
29 & less .05
cents 50-54 .36 cents
30-34 .06
cents 55-59 .58 cents
35-39 .08
cents 60-64 .70 cents
40-44 .13
cents 65-69 $1.61
45-49 .22 cents 70-74 $2.00
PAGE 1 EMPLOYEE BENEFITS AT A GLANCE
BENEFIT
|
EFFECTIVE
DATE |
BENEFIT
AMOUNT |
EMPLOYEE
COST |
HOSPITAL
PAYS |
EMPLOYEES AFFECTED |
BENEFIT
PROVIDER |
REMARKS |
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HEALTH INSURANCE (PPO PLAN) |
1st of the month following 60 day
waiting period. |
PPO plan with a $20 Co-pay for most
services. Medical calendar year deductibles of $250 per member/$750 per
family. Plan includes a prescription
drug card benefit where patient pays a flat amount of the prescription cost.
Plan also includes complementary care and EAP benefits. Refer to Medical
Handbook. |
See attached schedule. |
GSHCS pays 90% of premium for
full-time employees & 70% for dependents, up to a cap. For part-time employees GSHCS pays
a percentage of the premium paid for full-time employees. |
Regular full-time employees and
regular part-time employees working at least 20 hours per week. |
Regence Blue Cross Blue Shield |
Enrollment optional. Open Enrollment period normally in September. |
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HEALTH INSURANCE (HSA PLAN) |
1st of the month following 60 day
waiting period. |
High deductible PPO plan where
patient pays all expenses until deductible of $1500 for single coverage or
$3000 for family coverage is met each calendar year. After deductible is met plan pays 80% when
using PPO. Refer to Medical Handbook. |
See attached schedule. Employee may contribute extra
pre-tax dollars to HSA account that if not spent for health reasons can be
used for retirement. |
GSHCS pays 95% of the premium for
full-time employees & 70% for dependents, and also contributes a set amount to your
Health Savings account from which deductibles and out of pocket expenses can
be paid. GSHCS contributes a pro-rated
percentage of premium and HSA contribution for part-time employees. |
Regular full-time employees and
regular part-time employees working at least 20 hours per week. |
Regence Blue Cross Blue Shield |
Enrollment optional. Open Enrollment period normally in
September. |
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DENTAL INSURANCE |
1st of the month following 60 day waiting
period. |
Plan pays preventative items,
(exam, x-rays, cleaning) at 100% with no deductible. Subject to$50 deductible per person
$150 deductible per family per year, Plan pays 80% for fillings, and
extractions. Pays 50% for bridges,
caps and crowns. 12 month exclusion
period for major dental services. Refer
to Dental Handbook. |
See attached schedule. |
GSHCS pays 95% of premium for full-time
employees and 50% for full-time employee dependents. GSHCS contributes a pro-rated
percentage of premium for part-time employees
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Regular full-time employees and
regular part-time employees working at least 20 hours per week. |
Good Shepherd Employees’ Group
Dental Plan ODS Administers Plan |
Enrollment optional. |
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VISION INSURANCE |
1st of the month following 60 day
waiting period. |
One vision exam every 24 months for
adults. (Every 12 months for
children). Lens and Frames every two years or
equivalent amount towards contact lens. |
See attached schedule. |
Cost is split equally between
employer and employee. |
Regular full-time employees and
regular part-time employees working at least 20 hours per week. |
Good Shepherd Employees’ Group Vision
Plan ODS Plan |
Enrollment optional. |
PAGE 2 EMPLOYEE BENEFITS AT A GLANCE
BENEFIT
|
EFFECTIVE DATE |
BENEFIT AMOUNT |
EMPLOYEE COST |
HOSPITAL PAYS |
EMPLOYEES AFFECTED |
BENEFIT PROVIDER |
REMARKS |
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LIFE INSURANCE |
1st of the
month following 60 day waiting period. |
Annual salary
rounded up to next $5,000 increment, maximum of $50,000. Double base amount if accidental
death. Dependent coverage
optional. Supplemental insurance
available at low group rates. |
-0- for employees
coverage. $2.05 a month for
benefits for dependents. *Supplemental
rates age based. |
100% |
Regular
full-time employees and regular part-time employees working at least 20 hours
per week. |
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Conversion option
available when leaving GSHCS. |
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AFLAC SUPPLEMENTAL INSURANCE |
1st of the
month following 60 day waiting period. |
Employee may choose
Personal Individual Insurance plans including: Cancer Protector,
Accident Expense, Voluntary Indemnity, Vision, & Short-Term Disability. |
Varies depending on
the plan. Some rates are age based. |
N/A |
Regular
full-time employees and regular part-time employees working at least 20 hours
per week. |
AFLAC |
Enrollment
optional. |
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SECTION 125 FLEXIBLE
SPENDING ACCOUNT |
1st of the
month following 60 day waiting period, or January 1 each year. |
Employees have
several options regarding participation and amounts they wish to set aside in
their Flexible Spending Account. |
No cost for paying
premium only. $5.25 per month to
participate in Flexible Spend-ing Account. $1.50 Per month for
Flex Card. |
Plan set-up and
administration fees. |
All regular
employees. Employees must
enroll each year in November for the ensuing year. |
BenefitHelp Solutions, an ODS company,
administers program |
This benefit
provides method for pre-tax payments of insurance premiums, dependant care,
and medical expenses. |
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RETIRE-MENT PROGRAM |
Eligible to
participate on January 1, April 1, July 1, or Oct 1, after completing 2 yrs
of continuous employment. |
Employer
contributions is based on
gross salary excluding overtime. Years of Service Contribution %2-5
4% 6-10
5% 11-20
6% 20+ 8% |
-0- |