City of Yorkton JURISDICTION. All City of Yorkton Employees

Transcription

1 City of Yorkton HEALTH CARE SPENDING ACCOUNTS ADOPTED BY City Manager ORIGIN/AUTHORITY JURISDICTION EFFECTIVE DATE Director of Human Resources All City of Yorkton Employees April 1, 1999 Amended March 1, 2013 Amended Jan. 1, of 5 COMPLETE DETAILS OF CITY OF YORKTON BENEFITS ARE AVAILABLE IN THE GREAT WEST LIFE GROUP BENEFIT PLAN BOOKLETS 1. Purpose: The purpose of this policy is to outline the City s Group Benefits Plan and to provide information regarding Health Care Spending Accounts (HCSA s) for all eligible employees. 2. Eligibility for Group Benefits: Full-Time Employees: To be eligible for group benefits, full-time employees must: work a minimum of 30 hours a week and be actively engaged in the performance of their duties and responsibilities 12 months a year. Participation in the plan begins on the first day of employment. Part-Time Employees: To be eligible for group benefits, part-time employees must: have worked 390 hours in 26 weeks; and work a minimum of 15 hours a week and be actively engaged in the performance of their duties and responsibilities 12 months a year. Seasonal Employees: Seasonal employees who do not work 12 months per year are not eligible for group benefits, but do qualify for a Health Care Spending Account. Students: Students are not eligible for group benefits or a Health Care Spending Account. Spouse: To be eligible for coverage: Spouse must be legally married to you or be living common-law with you. Children: Dependents eligible for coverage include: unmarried children under age 21, or under age 25 if they are full-time students. Note: Children under age 21 are not covered if they are working more than 30 hours a week, unless they are full-time students. unmarried children who are incapable of supporting themselves because of a physical or mental disorder are covered without age limit if the disorder begins before they turn 21, or while they are students under 25, and the disorder has been continuous since that time.

2 2 of 5 3. Benefits Overview: All eligible employees are automatically enrolled in the City s Group Benefits Plan which is administered by Great West Life (GWL). The Group Benefits package includes: Health & Dental Insurance Basic Life Insurance Dependent Life Insurance (spouse & dependent children) Accidental Death & Dismemberment Insurance (AD&D) Long-Term Disability Insurance Short-Term Disability Insurance (Full-Time CUPE employees only) **See Note below Employee and Family Assistance Program Note: Short-Term Disability coverage is also available to Out-of-Scope and IAFF employees but is fully funded and administered by the City of Yorkton. In addition, optional AD&D/Life Insurance benefits are available to employees. Information regarding these optional benefits can be obtained by contacting the Human Resources Department. Employees who have coverage through a spousal plan may opt out of the City s Health & Dental Group Benefits upon proof of coverage (eg. Spousal Card). For further details, contact Great West Life at Health Care Spending Accounts: A Health Care Spending Account (HCSA) is a non-taxable group benefit that provides reimbursement for a wide-range of health, dental and vision expenses not covered under a group benefits plan or other insurance plans. The City of Yorkton contributes a defined amount of money (City Allocation) into the account for each eligible member. Each eligible employee will receive a City Allocation which will first be used to cover the premiums for the group health & dental benefits. The balance of funds will then be placed in the HCSA and may be used: to cover the unpaid portion of expenses not covered by the GWL health and dental benefit plan such as deductibles, coinsurance amounts and amounts which exceed plan maximums. These expenses can be claimed for yourself, your spouse and any other eligible dependent. to cover expenses not covered by the GWL health and dental benefit plan. Further information regarding eligible expenses can be obtained from Great West Life at to contribute to an RRSP if your balance is $25.00 or more. Employees will have an opportunity to make changes to where their balance is applied once per year (December 1 st of each year). Example: Employees may switch from coverage of expenses to an RRSP, or the reverse.

3 3 of 5 Funds from the HCSA may not be used for Accidental Death & Dismemberment, Life Insurance, or Long-Term Disability premiums. Eligibility & Allocation of Funds: The City of Yorkton will allocate funds on a monthly basis as follows: Out-of-Scope Employees: $ per month for each full-time employee. Part-time employees will receive a percentage of the full-time rate based on hours worked. Example: An employee who worked 75% of full-time hours would receive a monthly allocation of $97.50 (75% of $130). Out-of-Scope Seasonal Employees: $ per month for each full-time employee for each month actively employed. Seasonal employees must utilize this allocation to purchase health and/or dental insurance from an underwriter of the employee s choice unless they provide proof of health and dental coverage through a spousal plan. The funds from the HCSA will be reimbursed to the employee upon proof of payment for premiums for health and dental benefits. CUPE Full-Time Employees: Health & Dental premiums are 100% paid for by the City of Yorkton. CUPE Seasonal Employees: $80.00 per month for each full-time employee for each month actively employed. Seasonal employees must utilize this allocation to purchase health and/or dental insurance from an underwriter of the employee s choice unless they provide proof of health and dental coverage through a spousal plan. The funds from the HCSA will be reimbursed to the employee upon proof of payment for premiums for health and dental benefits. IAFF Employees: Premiums for Group Benefits are cost shared between the City of Yorkton and the employee on a 50/50 basis, with the exception of the long-term disability premium with is 100% paid for by the employee. Submitting a HCSA Claim: Each eligible employee will receive a Health SolutionsPlus Card (HSP Card) which will be pre-loaded with their respective annual allotment of Health Care Spending dollars. For example, a full-time employee who receives the $130 monthly City Allocation will, after paying for Health & Dental Premiums, have the balance of funds for the full year loaded onto the HSP Card.

4 4 of 5 Employees will then use the HSP Card to pay instantly for various eligible healthcare expenses not covered by their Health & Dental Plan. Employees can check the balance remaining on their HSP Card at any time by accessing Great West Life s website at Employees will need to first register for online service by clicking GroupNet for Plan Members and then following the registration instructions. Paper claims can also be made using the Health SolutionsPlus claim form available on Great West Life s website at: Employees who have waived healthcare benefits (ie. employees on a spousal plan) will receive an HSP Card; however they will not be able to use the card at the pharmacy. The HSP card is designed to work in conjunction with the Pay Direct Drug Card (PDD). The employee is able to purchase prescription drugs at the pharmacy; however they will need to submit their claim online or submit a paper claim to Great-West Life. All other point of sale locations (such as physiotherapy clinics, dental offices, etc,) will accept the HSP Card. Employees must keep original receipts for purchases made using the HSP Card for 12 months from the date of purchase. Great West Life will perform random audits and may request paper copies of receipts for expenses. Balances on the HSP Card as of December 31st of each given year will be carried over to December 31 st of the following year. Any HSCA funds from the previous year not used by December 31 st of the current year will be reverted back to the City of Yorkton. Seasonal employees will not receive a HSP Card; they will continue to submit paper claims to the Payroll office (see attached Appendix A). When an employee is terminated, their Health Care Spending Account will become inactive on the date of termination. 5. Tax Implications: The advantage of participating in a Health Care Spending Account is that the balance and benefits are sheltered from tax. Before tax dollar contributions are used to pay for expenses that would otherwise have been paid on an after tax basis. The employee is responsible if a Revenue Canada audit determines that reimbursement for a claim results in a taxable benefit to the employee. 6. Responsibility: The Director of Human Resources is responsible for the ongoing review and update of this policy.

5 5 of 5 Appendix A