2012 MCFFA Health Information

This information applies to City of Modesto Employees represented by MCFFA only.

Important Dates

• The open enrollment period will begin Monday, October 10, 2011 through Friday, November 4, 2011.
• All changes must be submitted to the Human Resources Department by 5:00pm on Friday, November 4, 2011.
• Elections made during open enrollment will become effective January 1, 2012.

Health Insurance Rates

CalPERS health rates are based on your home address zip code. Please click on your region for health insurance rates for plan year January 1, 2012 – December 31, 2012. If you are not sure on your region, please click below to find out which health plans are available in your area. It is important that you notify City of Modesto of any change of address within 30 days of move.

Click here to find which region you are in!

Health Insurance Information

During Open Enrollment you may enroll, change health plans, or add/delete eligible family members. Below please find information on the health plans available through CalPERS.

• Health Benefit Summary
• 2012 Evidence of Coverage Publications
• Health Plan Chooser
• PERS Health Insurance Enrollment/Change Form
• PERS Declaration of Health Coverage
• Instructions to complete your PERS Health Insurance Form
• Open Enrollment Center

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

• Stanislaus Foundation Dental

  The City of Modesto will be changing dental carriers from Delta Dental to Stanislaus Foundation effective January 1, 2012. This will be an automatic change and no enrollment form needs to be completed. You will receive your new dental insurance card on or after December 15, 2011. Below, please find a list of contracting dentists with Stanislaus Foundation. While you may utilize the services of any licensed Dentist, there are advantages to visiting a PPO network dentist instead of a Traditional or non-network dentist.

  • Stanislaus Foundation Dental Benefit Highlights
  • Stanislaus Foundation Dental Enrollment Form
  • Stanislaus Foundation Dental Change Form
  • PPO Network - Directory
  • Traditional Network - Directory
  • Procedures for out-of-network providers

• VSP (Vision Plan)

  • VSP Benefit Highlights
  • VSP Link to Doctors

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 have been implemented. 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.

• 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