2011 Health Information

This information applies to City of Modesto Employees and Retirees only.

2011 health information for City of Modesto employees and retirees is now available.

Important Dates

• The annual Open Enrollment period for City of Modesto is held in the month of October.
• If you wish to make an enrollment change outside of the annual open enrollment period, you are required to make the change within 30 days of the qualifying life event.
• On March 23, 2010, President Obama signed into law the healthcare reform bill, the Patient Protection and Affordable Care Act. Please click here to read some of the changes that affect health plans beginning January 1, 2011.

Health Insurance Rates and Health Plan Side-By-Side Comparisons

• Health Insurance Rates

  Please click on your bargaining group to view your health insurance rates for plan year January 1, 2011 – December 31, 2011.

  MCEA

  MCMA

  MPNSA

  UNREP

  MPOA

  MPMA

  RETIREES

• Health Plan Side-by-side Comparison

  • HMO Comparison
  • HDHP Comparison

• Cheat Sheet to your Health Insurance

  This document is a road map to your health insurance. Depending on what medical health insurance you are enrolled in, you may have different providers for different services. Click here to view your cheat sheet.

• Calculations Worksheets

  Following are calculations worksheets for you to use to evaluate your health plan options and make an educated decision on the plan best for you and your family. This worksheet will give you the opportunity to weigh plan benefits and estimate costs. This tool is for illustration purposes only.

  • Active Employee (All Except MPMA) – Single Coverage
  • Active Employee (All Except MPMA) – Family Coverage
  • MPMA – Single Coverage
  • MPMA – Family Coverage
  • Retiree – Single Coverage
  • Retiree – Family Coverage
  (Microsoft Excel or Excel Viewer is required.)

Health Insurance Information

• Anthem Blue Cross

  • Anthem Blue Cross Enrollment Kit
  • Anthem Blue Cross HMO Summary of Benefits
  • Anthem Blue Cross PPO Summary of Benefits
  • Anthem Blue Cross HDHP Summary of Benefits
  • Anthem Blue Cross Enrollment Form
  • Anthem Blue Cross Change Form
  • Find an Anthem Blue Cross Doctor

• Kaiser

  • Kaiser HMO Summary of Benefits
  • Kaiser HDHP Summary of Benefits
  • Kaiser Enrollment/Change Form
  • Find A Kaiser Doctor

Health Savings Account (HSA)

A Health Savings Account (HSA) is only available to employees enrolled in a HDHP medical plan (Anthem Blue Cross or Kaiser HDHP). A HSA is a tax-favored account that allows you to set aside funds to save and pay for qualified medical expenses incurred by you, your spouse, and any of your qualified dependents. The HSA is an individually-owned account that earns interest and the funds are carried over, without limit, from year to year. First Horizon Msaver will administer your HSA. First Horizon Msaver is a subsidiary of First Tennessee Bank National Association. There is a $2.50 per month administration fee.

• HSA Documents:
  • IMPORTANT - NEW 2011 HSA Rule Changes
  • The ABCs of HSAs
  • HSA Enrollment Form
  • HSA Change Form
  • First Horizon HSA Investment Options
  • HSA Contribution Limits
  • HSA Frequently Asked Questions
  • First Horizon Website
  • HSA Video Presentation - Learn about HSA

Flexible Spending Accounts

A Flexible Spending Account (FSA) is a tax-favored program offered by the City that allows employees to pay for eligible out-of-pocket health care and dependent care expenses with pre-tax dollars. The City offers three FSA accounts: Unreimbursed Medical (URM), Limited Expense Unreimbursed Medical (LEX URM), and Dependent Care Assistance Program (DCAP). ASI administers the FSA program. There is a $3.50 per month ($1.62 per pay period) administration fee.

• Unreimbursed Medical (URM)

  • URM Questions and Answers
  • URM Enrollment Form
  • URM Eligible Expenses
  • URM Ineligible Expenses
  • URM Reimbursement Request Form

• Limited Expense Unreimbursed Medical Program (LEX URM)

  • LEX URM Questions and Answers
  • LEX URM Enrollment Form
  • LEX URM Eligible & Ineligible Expense Examples
  • LEX URM Reimbursement Request Form

• Dependent Care Assistance Program (DCAP)

  • DCAP Reference List
  • DCAP Enrollment Form
  • DCAP Reimbursement Form
  • DCAP Highlights

Dental/Vision Plans

• Delta Dental

  • Delta Dental Benefit Highlights
  • Delta Dental Enrollment/Change Form
  • Delta Dental Link to Doctors

• VSP (Vision Plan)

  • VSP Benefit Highlights
  • VSP Link to Doctors

Chiropractic/Mental Health Plans

• Chiropractic Health Coverage

  The chiropractic coverage through American Specialty Health is for those employees/retirees who are enrolled in Anthem Blue Cross HMO, Anthem Blue Cross Traditional PPO, Kaiser HMO, or any of the Retiree Medicare Advantage plans. For those employees/retirees enrolled in any other medical plan, the chiropractic benefit would be through the medical plan. Employees who opt out of medical coverage do not have chiropractic coverage through City of Modesto.

  • American Specialty Health Benefit Highlights
  • American Specialty Health Website

• Mental Health Coverage

  The mental health coverage for employees/retirees is now integrated in your medical plan. For example, if you elect Anthem Blue Cross HMO plan, your mental health coverage is through Anthem Blue Cross HMO. For more details refer to the Benefit Plan Summaries of the medical coverage. Employees who opt out of medical coverage do not have mental health coverage through City of Modesto.

Health Care Reform

On March 23, 2010, President Obama signed into law the health care reform bill, the Patient Protection and Affordable Care Act. This legislation, along with the Health Care and Education Reconciliation Act of 2010, makes sweeping changes to the U.S. health care system. These changes will be implemented over the next several years. Below is an overview of the key reform provisions that affect the 2011 Plan year. If you would like more information on the Health Care Reform please visit their website at www.healthcare.gov.

• Extended Coverage for Young Adults

  Effective January 1, 2011, children are now eligible for coverage up to the age of 26 regardless of marriage status, financial dependency, or student status. If your child is now eligible due to the new law, you must re-enroll your child during the open enrollment period beginning October 1, 2010 ending November 5, 2010.

• Prohibition on Lifetime and Annual Limits

  The new health care reform law contains a provision stating that group health plans cannot establish a lifetime or annual limit on the dollar value of benefits. Plans are permitted to place lifetime and annual limits on specific covered benefits that are not considered essential benefits under the new health reform law.

• Coverage of Preventive Health Services

  Preventative services must be provided without member cost sharing requirements.

• Preexisting Condition Exclusions

  Effective January 1, 2011, a preexisting condition limitation cannot be applied to any enrollee who is under age 19. Starting plan year January 1, 2014, preexisting condition limitations will be prohibited for all plans and all covered individuals.

• Increase Tax on Withdrawal from HSAs

  The health care reform law will increase the additional tax on HSA withdrawals prior to age 65 that are not used for qualifed medical expenses from 10 to 20 percent.

• HSA Clarification for Overage Dependents

  The Health Savings Account has different guidelines as it relates to newly eligible over age dependents. These dependent children in question who are now eligible for coverage under the health plan may not be considered tax dependents for HSA distributions.

• Annual Notifications

  • SCHIP
  • Privacy Notice