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Benefits at a Glance 2016-2017
The City of Leander offers a generous benefit package. Below is a glance at the benefit summaries and costs. All of our benefits are deducted 24 of the 26 pay periods.
Medical:United Health Care (UHC) is our carrier. Our network is called the “Choice” and only provides “IN-NETWORK” coverage. To find a doctor in the Choice network, go to .
Medical Plan Comparison Chart
Benefit / Low Plan (HDHP) / Mid PlanAnnual Deductible / $3000 individual /$6000 Family / $3000 individual /$6000 Family
Annual Out-of-Pocket Max / $6350 individual /$12,700 Family / $6000 individual /$12,000 Family
Co-insurance / 80% / 80%
Hospital Services- Inpatient / 80% after deductible / 80% after deductible
Emergency Room Treatment
Facility
Physician / 80% after deductible
80% after deductible / 80% after $250 copay
80% after deductible
Urgent Care-
Additional services may incur additional fees / 80% after deductible / $75 copay
Physician Visits
Primary Care Doctor
Primary Care Doctor- Under age 19
Specialist Tier 1 & Non-Tier 1
Virtual Visits / 80% after deductible
80% after deductible
80% after deductible
$40 copay / $30 copay
$0 copay
$30/ $60 copay
$25 copay
Preventative Care / 100% / 100%
Office & Outpatient Surgery / 80% after deductible / 80% after deductible
Diagnostic Lab & X-ray-Outpatient / 80% after deductible / 100%
Major Diagnostic
CT, PET, MRI, MRA & Nuclear Medicine / 80% after deductible / 80% after deductible
Prescription Program
Generic
Preferred Brand Name
Non-Preferred Brand Name
Mail Order – 90 day supply / $10 copay after deductible
$35 copay after deductible
$60 copay after deductible
2.5 x retail copay after deductible / $20 copay
$40 copay
$75 copay
2.5 x retail copay
The Low Plan (HDHP) is linked to the HSA. City of Leander contributes, at open enrollment, $750.00 to the current employee’s HSA Account. For individuals hired after October 1st, the $750.00 is prorated based upon the remaining months of the plan year. Participants can use the pre-tax dollars to pay for qualified medical expenses. Note: If your spouse is enrolled in a flexible spending account, you may not contribute to a Health Savings Account.
Medical Billing PremiumsTier / Mid Plan / City / EE / Biwkly / Tier / Low Plan (HDHP) / City / EE / Biwkly
EO / 517.04 / 517.04 / 0.00 / 0.00 / EO / 406.79 / 406.79 / 0.00 / 0.00
ES / 1230.58 / 802.46 / 428.12 / 214.06 / ES / 968.18 / 697.50 / 270.68 / 135.34
EC / 1023.78 / 719.74 / 304.04 / 152.02 / EC / 805.47 / 632.41 / 173.06 / 86.53
EF / 1561.50 / 934.82 / 626.68 / 313.34 / EF / 1228.53 / 801.64 / 426.89 / 213.45
What is an out of pocket max? It’s the most you pay during a policy year before your health plan begins to pay 100%. Once you reach the out-of-pocket limit, your health plan will pay for all covered services. This will not include any amounts for out-of-network providers, since our UHC plans do not cover out-of-network providers. All individual out of pocket limit amounts will count towards meeting the family out-of-pocket limit, but an individual will not have to pay more than the individual out-of-pocket limit amount. Your co-pays, co-insurance and deductibles include pharmacy and counts toward meeting the out-of-pocket max.
Dental:UHC is our carrier. To find a dentist, go to , select “find a dentist”.
For DHMO, select the TX DHMO network. This plan offers orthodontia
For the PP020 (In-network Dentists), select “National Options PPO20”.
For the PP030 (Out-of-network dentists), select “National Options PPO30”.
Dental Comparison Chart
Plan Types / DHMO / PP020 / PP030Type 1 Preventative
Oral exams, x-rays, cleanings / Copay; See Plan Details / 100% - no deductible / 100% - no deductible
Type II Basic
Fillings, extractions, root canal / Copay; See Plan Details / 100% - no deductible / 80% - no deductible
Type III Major
Crowns, bridges dentures, implants / Copay; See Plan Details / 60% - no deductible / 50% - no deductible
Annual Deduction (waived for Type I) / N/A
N/A / $50 Individual
$150 Family / $50 Individual
$150 Family
Annual Maximum / Unlimited / $1000 / $1000
Orthodontia / Copay; See Plan Details / Not Covered / Not Covered
Dental Billing Premiums
Tier / DHMO / City / EE / Biwkly / Tier / PPO20 & PPO30 / City / EE / Biwkly
EO / $9.45 / $9.45 / $0.00 / $0.00 / EO / $28.57 / $9.45 / $19.12 / $9.56
ES / $15.95 / $12.05 / $3.90 / $1.95 / ES / $57.28 / $28.58 / $28.70 / $14.35
EC / $24.18 / $15.34 / $8.84 / $4.42 / EC / $68.14 / $32.93 / $35.21 / $17.61
EF / $28.31 / $16.99 / $11.32 / $5.66 / EF / $96.86 / $44.41 / $52.45 / $26.23
Vision: UHC is our carrier. To find an eye doctor, go to select vision provider.
Benefits / In-NetworkExam copay / $10
Prescription Glasses copay / $25
Exam Frequency / 12 Months
Lenses Frequency / 12 Months
Frame Frequency / 24 Months
Frame Allowance / $150 allowance after $25 copay
Contact Allowance / $150 allowance for contacts & contact lens exam (fitting and evaluation)
Premiums Tiers / Employee Pays Per Month / Employee Pays Per Pay Period
Employee Only / $5.55 / $2.78
Employee + Spouse / $10.52 / $5.26
Employee + Child(ren) / $12.34 / $6.17
Employee + Family / $17.36 / $8.68
Life: Dearborn National is our carrier.
Basic Life:The city provides a $15,000 term life policy on each employee. If the person dies accidently, an additional $15,000 (AD&D) is awarded to the beneficiary. If you’re over the age of 65, that basic life policy will be subject to an age reduction schedule.
Voluntary Life: The employee may purchase additional voluntary term life for yourself and family members.
Employee / Increments of $10,000 up to $500,000Guaranteed Issue: $100,000
Spouse / Increments of $5,000 up to $$250,000
(Cannot exceed 50% of employee amount)
Guaranteed Issue: $25,000
Child(ren) / Birth – 14 days: No coverage
15 days – 6 months: $500
6 months – age 26: $5,000
Age Reduction Schedule / 35% at age 65, 55% at age 70, 70% at age 75, 80% at age 80, 85% at age 85+
All amounts exceeding the “Guaranteed Issue” will require an Eligibility of Insurance (ROI) and carrier approval is required.
If voluntary life has been elected and the member dies in an accident, the beneficiary will receive the elected voluntary life amount plus the AD&D life amount.When you’re calculating how much life insurance you may need, keep in mind your TMRS benefits include a supplemental death benefit approximately equal to your annual salary if you are an active employee at the city when you die.
Age Rated Premiums- per $1,000 (includes AD&D) / Employee or SpouseUp to 34 / $0.07
35-39 / $0.09
40-44 / $0.15
45-49 / $0.27
50-54 / $0.39
55-59 / $0.66
60-64 / $1.11
65-69 / $1.94
70-74 / $2.99
75-79 / $4.99
80-84 / $8.15
85-89 / $13.29
90-94 / $20.34
95+ / $59.03
Child Life Rate (per$5,000) / $0.95
Disability: Dearborn National is our carrier provider for short and long term disability. The employee may purchase one or bothof these coverages. When claims are approved, Short term benefits are paid out weekly.
Short Term DisabilityWeekly Benefit / 60% of basic weekly earnings
Maximum Weekly Benefit / $750
Elimination period (waiting period) / 14 days
Benefit duration / 11 weeks or until LTD begins
Short Term Rates Per $10 of Weekly Benefit
Age / Monthly Rate
Under 25 / $0.22
25-29 / $0.24
30-34 / $0.22
35-39 / $0.21
40-44 / $0.22
45-49 / $0.23
50-54 / $0.29
55-59 / $0.38
60-64 / $0.47
65-69 / $0.49
70+ / $0.55
When claims are approved, Long term disability benefits are paid out monthly.
Long Term DisabilityMonthly Benefit / 60% of monthly income
Maximum Monthly Benefit / $5,000
Elimination Period / 90 days
Maximum Benefit Duration / 5 years
Own Occupation Limitation / 24 months
Mental Health Limitation / 24 months
Substance Abuse Limitation / 24 months
Pre-existing Limitation / 12/24
Face-to-Face Counseling / Up to 3 sessions per year
Long Term Rates Per $100 of Basic Monthly Earnings
Age / Monthly Rate
Under 25 / $0.09
25-29 / $0.10
30-34 / $0.14
35-39 / $0.20
40-44 / $0.28
45-49 / $0.42
50-54 / $0.62
55-59 / $0.91
60+ / $1.52
Section 125: BMA is our carrier. An employee can set aside pre-tax dollars to pay for eligible medically related expenses. You can elect (Flex) medical and/or (DCA) child care. This is an excellent benefit, especially if you take certain medications every month or you pay for child care. Your Flex funds cannot be applied to your medical deductibles.
The 2016-17maximum contribution for FSA (Flexible) is $2550 and $5000 for child care. You may incur services during 10-01-16 to 12-15-17 (2 ½ month extension). All claims must be submitted by 12-31-2017 (if not using the debt card.)
Allstate Accident
Allstate Benefits group voluntary accident coverage pays cash benefits for expenses associated with an accidental injury and can help protect hard-earned savings should an off-the-job accidental injury occur. This plan has an outpatient physician’s benefit of $50 per visit, maximum 2 visits per year, or 4 visits per year if you carry dependents.
Bi-weekly (24) / $4.24 / $9.75 / $12.26 / $15.81
Allstate Cancer
Allstate Benefits group voluntary cancer coverage provides cash benefits for cancer and 29 specified diseases, and can help cover the costs of specific cancer and specified disease treatments and expenses as they occur. This plan has a cancer wellness benefit of $100 for covered annual checkups once per covered person per calendar year.
Mode / EE / EE + SP / EE +CH / FamilyBi-weekly (24) / $11.74 / $18.24 / $16.36 / $22.89
Employee Assistance Program: Alliance is our carrier and provides services that are confidential and free of charge for our employees and their qualified household members. Counseling, legal and financial assistance are available.
Retirement: TMRS: All regular full-time employees are required to become members of the Texas Municipal Retirement System (TMRS). Members deposit 7% of their salary each pay period. Once vested (5yrs), the City will contribute 2 to 1 match at retirement.
Death benefit: If an active employee dies, the beneficiary or estate will receive a death benefit approximately equal to your current annual salary, plus any retirement benefits due. If you retire with TMRS, a death benefit in the amount of $7500.00 will be paid.
457 Plan: Employees may also elect the 457 plan. As a public employee, you have the opportunity to build retirement investments and reduce taxes by enrolling in the deferred compensation plan.
Social Security: All employees of the City are covered under FICA regulations.
Holidays: The City will observe the following holiday schedule:
New Year’s DayLabor Day
Friday before EasterThanksgiving Day
Memorial DayFriday after Thanksgiving
4th of JulyChristmas Eve
MKL Day Christmas Day
Veteran’s Day
Sick:
All Employees Except 24 Hour ShiftPer Pay Period / 24 HR Shift Employees
Per Pay Period / Maximum Hours Capped
For All Employees
3.69 hours or (96 hours per year) / 5.54 hours or (144 hours per year) / 480
Sick Sell Back: A maximum of 24 hrs of sick time may be sold back after the 1st year of employment, provided no sick time has been taken during that calendar year. If sick time has been taken during that calendar year, the employee may sell back 24 hrs less the sick time taken.
Vacation: Vacation will be capped at two time (2x) the annual hours allowed by the individual as determined by the employee’s years of service regardless of when the cap is reached within the year. Accruals will resume once vacation time falls below the threshold.
All Employees Except Dept. Heads and 24 Shift Per Pay PeriodYears of Service
(Years) / Accrual Rate
(In Hours) / Accrual Rate Per Year
((Number of Days)
1-4 / 3.69 / 96
Beginning 5-9 / 4.62 / 120
Beginning 10-14 / 5.54 / 144
Beginning 15+ / 6.46 / 168
All 24 Shift Per Pay Period
Years of Service
(Years) / Accrual Rate
(In Hours) / Accrual Rate Per Year
(Number of Days)
1-4 / 5.54 / 144
Beginning 5-9 / 6.92 / 180
Beginning 10-14 / 8.31 / 216
Beginning 15+ / 9.69 / 252
Introductory period: The first 6 monthsof employment is the introductory period. Vacation is earned but may not be taken until the evaluationperiod is over, except with departmental head approval.
Longevity Pay: Regular full time employees employed for 1 year or more shall be eligible for additional compensation at a rate of $5.00 per month for each full year of continuous service with the City up to a maximum of 25 years. This pay will be awarded annually, as a lump sum and on a separate check, the pay period immediately prior to the Thanksgiving Holiday and only to regular full-time employees who are in an active status on November 1st.
Golf Course: All City employees may play at the Crystal Falls Golf Course for 50% off the regular rate. Driving Range, Food and Beverage are also 50% off the regular price. Merchandise is at the full rate.
HR forms/Benefits at a glance