COBEN PROGRAM

1. COBEN PROGRAM Consolidated Benefits Becky Bayliss, Program Manager Department of Human Resources

2. Learning Objectives After this presentation, you will be able to: • Understand the two different types of CoBen benefits • Understand Dependent Vesting • Use the Benefits Calculator • Determine eligibility for CoBen • Discuss permitting events affecting enrollment

3. GENERAL INFORMATION Two types of benefits: • The Consolidated Benefits (CoBen) Program Benefit Allowance • The CoBen Cash Option

4. BENEFIT ALLOWANCE • The State will establish one “combined” employer contribution amount for an employee’s health, dental and vision benefits. • The employees’ benefit allowance is automatically established in the SCO payroll system, therefore, no enrollment form is required. • Eligible employees are automatically enrolled in the State’s vision plan, this benefit is mandatory under CoBen.

5. Amount of Benefit Allowance • The amount of employees’ benefit allowance will depend on the number of dependents that employees choose to cover (their party code). • If the total cost of the plans employees choose is less than their benefit allowance, they will receive the difference as taxable cash (excess cash) in their paycheck.

6. Benefit Allowance Slide 6 • If the total cost of the plan employees choose is more than their benefit allowance, they pay the difference (out-of-pocket) with pre-tax dollars automatically deducted from their paycheck. • If employees enroll in health and vision only, then the premium amount that would be deducted from your allowance for dental is applied to reduce your out of pocket premium cost.

7. Benefit Allowance, continued • If employees elect to receive cash in lieu of their health benefits but enroll in a dental plan, then the benefit allowance will be the amount of their dental and vision premium. • The CoBen allowance for represented employees is determined through collective bargaining.

8. Dependent Vesting New employees who have never had State health benefit eligibility may be subject to health dependent vesting. • 50% of the employer dependent contribution for the first 12 months • 75% of the employer dependent contribution for months 13 through 24 • 100% of the employer dependent contribution after 24 months

9. Dependent Vesting, continued • Beginning in September, 2013, some of the Unions have bargained a change in the dependent vesting to only one year at 75%. • The requirement of one year at 50% has been eliminated. Except for bargaining units 16.

10. BENEFITS CALCULATOR • The Benefits Calculator helps employees determine how much will be deducted from their paycheck, or added to it, based on which health and dental plans they choose. The State vision coverage is automatically added into the calculation. • The CoBen Handbook includes a worksheet that employees may fill out to help them calculate their benefit costs; however the Benefits Calculator is easier to use and allows employees to try different scenarios.

11. CoBen Cash • Employees may elect to receive cash in lieu of State-sponsored health and/or dental insurance coverage. • Employees are not eligible for cash in lieu of dental only. • Employees must certify that they have coverage through a spouse, domestic partner, or another source to be eligible for the cash.

12. Cash Option Cash Option payments are taxable and the amounts are listed below: • $155 per month in lieu of health and dental benefits • $130 per month in lieu of health benefits only • CoBen employees do not pay an administrative fee for the Cash Option.

13. Dental Plan Three-Year Commitment • When an employee enrolls into the Dental Cash, they have to stay in the dental cash for three plan years. • It is important to make that clear to employees who enroll. • The Personnel Office should take steps to check for compliance of this rule when employees try to cancel their dental cash.

14. Three-Year Commitment If employees enroll in the Cash Option for health and dental, they may not cancel their dental Cash Option for three plan years unless the following occurs: • Lose their other dental coverage • Cancel both their health and dental CoBen Cash during open enrollment • Have a valid permitting event

15. Delta Dental Plan 24-Month Restriction • Employees in CoBen do not serve the State Dental Program’s Delta Dental 24-month restriction period. • Newly hired employees and those who transfer from a Bargaining Unit that is not eligible for CoBen to one that is eligible, including those who are currently serving the 24-month restriction, will be allowed to enroll or change to a Delta Dental plan.

16. Eligibility • Employees in BU’s 2, 7, 8, 16, 17, 18 & 19, managerial, supervisory, exempt (except Judicial Council employees, Judges and Justices), confidential, and all other permanent employees excluded from collective bargaining. • LT or TAU employees appointed to six months or more – no mandatory right of return to a permanent position required.

17. Eligibility, continued • All eligible employees must work half-time or more. • Permanent-Intermittent (PI) employees may participate in the Cash Option but have limited eligibility. • Employees may have more than one appointment, as long as the combined time base is half-time or more.

18. Eligibility Restrictions • Not eligible for the FlexElect Cash Option. • Eligible to enroll in the Dependent Care Reimbursement Account (DCRA) and Medical Reimbursement Account (MRA).

19. Permitting Events • Typically, employees enroll into CoBen as newly eligible, during open enrollment or if they experience a change in status event (permitting event). • Allowable status changes are listed in Appendix A of the CoBen Section 1600 of the BAM.

20. Permitting events, continued • Initial appointment (includes reinstatement following a permanent break in service) • Change in time base/designation from one that was not eligible to one that is, or a PI who changes to a permanent position with a time base of half-time or more • Marriage, divorce, commencement or termination of domestic partnership, legal separation, or annulment

21. Permitting events, continued Slide 21 • Loss or commencement of health and/or dental coverage provided through spouse, domestic partner, or other source; • Move out of group practice plan service area • New health and/or dental plan(s) in area where none was previously available; • Change in bargaining unit or employee designation.

22. Enrollment Appeal Process Under the policies and procedures of the CoBenProgram there are established timeframes for the completion and processing of enrollment forms. In situations when there has been a discrepancy in form processing, and the employee is not at fault, CalHR will consider an enrollment/change appeal, upon request.

23. Appeals The appeal should be sent to CalHR at the following address: Department of Human Resources Benefits Division – FlexElect Program 1515 S Street, North Building, Suite 500 Sacramento, CA 95811-7258 Attention: Becky Bayliss

24. Contact Information Becky Bayliss becky.bayliss@calhr.ca.gov (916) 327-6429 (916) 322-3769 (fax) (855) 629-7814 (fax)