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Sonoma County Association of Retired Employees (SCARE) vs. County of Sonoma

The County has reached a settlement of the above-entitled litigation involving SCARE. Details regarding the proposed settlement can be found on the SCARE website at:  http://www.sonomacountyretirees.com/legal.shtml

The proposed settlement covers current retirees who retired through June 30, 2016 and only impacts those retirees who were hired by the County before January 1, 2009.

Employees hired before January 1, 2009 and who are still actively employed, and recent retirees who retired on or after July 1, 2016 are not impacted by this proposed settlement.  Retiree medical benefits for these individuals continue to be subject to the applicable memoranda of understanding and/or the Salary Resolution.

SCARE - HRA

What is an HRA?

  • A Health Reimbursement Arrangement (HRA) is an employer-funded benefit in which your employer contributes money into an account that you can use to pay, or be reimbursed, for out-of-pocket medical, dental and vision expenses that you incur.  
  • HRAs are 100% employer-funded and not taxable to you the participant.
  • The Plan is established pursuant to the Settlement Agreement in the lawsuit entitled Sonoma County Association of Retirees, et. al. v. Sonoma County, CV 09-4432 CW.

When can I start getting reimbursements?

  • Effective June 30, 2017, the County of Sonoma will establish a Sonoma County Association of Retired Employees Health Reimbursement Arrangement (SCARE HRA) Plan for the purpose of providing benefits to Settling County Retirees.
  • The HRA contributions will be available to you and your eligible dependents effective July 1, 2017.  

How much will be deposited into the HRA account?

  • In accordance with the Settlement Agreement, the County shall contribute $12 million minus the cost of establishing the plan and an excise tax.
  • The County's contribution shall be allocated on a pro rata basis based on the number of surviving Settling County Retirees (determined as of the date of such contribution and including with respect to any Settling County Retiree who is deceased as of the date of such contribution, his or her Spouse).
  • The County's contribution will be paid in three (3) increments on or before the following dates: June 30, 2017, June 30, 2018, and June 30, 2019.

Is there an administrative fee?

Yes, a $2.30 administrative fee will be deducted each month from your HRA account as long as there are funds available.

Customer Service and HRA Plan Administrator

The P&A Group is the third party administrator for the Health Reimbursement Arrangement.

Contact P&A for questions regarding eligible expenses, claim submission, documentation requirements for expenses, or the status of claims & reimbursements.

  • Contact a Customer Service Representative or chat live online during P&A Group’s Customer Service hours: Monday through Friday: 5:30 a.m. to 7:00 p.m. (PST)
  • 24/7 online account access www.padmin.com
  • Automated account information available toll-free: (800) 688-2611
  • Toll-free Fax Number: (877) 855-7105

Eligible HRA Expenses

 

  • Acupuncture
  • Alcoholism treatment
  • Ambulance hire
  • Artificial teeth/dentures
  • Bandages
  • Blood pressure monitors
  • Braces
  • Braille-books and magazines
  • Breast pumps and lactation supplies
  • Cancer screening
  • Chiropractors
  • Co-insurance amount you pay
  • Co-pay amount you pay
  • Condoms
  • Contact lenses and eyeglasses
  • Contact lens solutions
  • Cold/Hot Packs
  • Cost of operations and related treatments
  • Crutches
  • Deductible medical coverage (amounts you pay)
  • Dental fees
  • Diabetic supplies
  • Drug addiction treatment
  • Eye exams, eye glasses, eye surgery
  • Fertility treatments (in vitro fertilization, surgery)
  • Guide dog/service animal (including purchase, maintenance)
  • Intellectually/developmentally disabled person’s school and education (i.e., payments made for a mentally impaired or physically disabled person to attend a special school including tuition, meals and lodging)
  • Hearing devices and batteries
  • Hospital services
  • Incontinence products
  • Insulin
  • Laboratory fees
  • Lead-base paint removal (for children with lead poisoning)
Yes

 

  • Medical alert bracelets
  • Medical information plan
  • Mentally handicapped persons cost of special home care
  • Nurses fees (including nurses’ board and social security tax paid by you)
  • Obstetrical expenses
  • Operations
  • Oxygen
  • Prosthesis
  • Pregnancy tests
  • Psychiatrists’ and psychologists’ fees
  • Radial keratotomy and Lasik eye surgery
  • Rolfing therapy
  • Routine physical & other non-diagnostic services or treatments
  • Smoking cessation programs
  • Speech Therapy
  • Special education for the blind
  • Special plumbing for handicapped
  • Sterilization (i.e., tubal ligation, vasectomy)
  • Surgical fees
  • Telephone, special for hearing impaired
  • Television audio display equipment for hearing impaired
  • Therapeutic care for drug and alcohol addiction received as medical treatment
  • Thermometers
  • Transportation expenses for person to receive medical care
  • Vaccines
  • Walkers
  • Wheelchair
  • X-rays

Maybe

  • Analgesics, fever reducers, pain reducers (aspirin, ibuprofen, acetaminophen)
  • Antacids and heartburn relief
  • Antibiotic ointments
  • Anti-itch creams and hydrocortisone creams
  • Allergy medication, nasal sprays
  • Arthritis pain relieving creams
  • Athlete’s foot treatment, anti-fungal creams
  • Birth control
  • Chondroitin
  • Cold medicines, tablets, syrups, cough drops & lozenges
  • Compression Hose
  • Diaper rash ointment
  • Dietary supplements
  • Doula
  • Ear wax removal kits
  • Eczema treatments
  • Exercise programs or equipment
  • Fiber supplements
  • First-aid cream
  • Glucosamine
  • Hemorrhoid treatments
  • Humidifier
  • Hypnosis
  • Infertility treatments

Eligible Expenses Only with a Prescription or Letter of Medical Necessity 

  • Lactose intolerance tablets
  • Lamaze classes
  • Latex gloves
  • Laxatives
  • Massage therapy
  • Menstrual pain relievers
  • Mineral supplements
  • Motion sickness pills
  • Nasal spray and strips
  • Nicotine gum, patches
  • Occupational therapy
  • Orthopedic shoe inserts
  • Over-the-counter medications
  • Petroleum jelly
  • Prenatal vitamins
  • Rogaine®
  • Scooter, electric
  • Sinus medication
  • Stomach & Digestive relief items
  • Sunburn cream (Solarcaine)
  • Toothache and teething pain relievers
  • Umbilical cord blood storage
  • Urinary pain relief medication
  • Varicose vein, treatment of
  • Vitamins
  • Wart removal medication
  • Yeast infection medication
Never Eligible

 

  • Cosmetic products
  • Disposable diapers
  • Diet program foods
  • Electrolysis
  • Feminine hygiene products
No

 

  • Hand sanitizer
  • Toothbrushes

Expense eligibility is subject to change. 

If you are unsure if an expense is eligible for reimbursement, please call the P&A Group at (800) 688-2611 or chat with a customer service representative through our online chat available at www.padmin.com

 Required Claim Documentation 

  • Insurance company statement or Explanation of Benefits (EOB)
  • Itemized bill from the provider showing date of service, services rendered, provider of service, amount aid and, if applicable, amount covered by insurance
  • Prescription claims MUST include the Rx pharmacy receipt with Rx number. Credit card receipts are not acceptable

Whose Expenses are Eligible for Reimbursement?

  • Expenses incurred by you or your dependents are eligible for reimbursement
  • IRC Section 152 Defines a Dependent:
    • Spouse – Under Federal tax law,  a couple will be treated as married if they are married in a state where their marriage is legal under law of that state.
    • Your own child, stepchild, adopted child, child lawfully placed for adoption, or eligible foster child, regardless of the child’s marital or student status or whether or not the child is claimed as a dependent on your taxes up to age 26.
    • An eligible dependent of a retiree who is the subject of a “qualified medical child support order,” even if the child does not otherwise qualify under Code Section 152.
    • Domestic partners’ expenses are NOT covered unless they also qualify as a dependent as defined by IRC Section 152.

SCARE - HRA Benefits Card

P & A Debit CardAccess your SCARE - HRA funds with your P&A debit card

  • Swipe your P&A HRA Benefits Card at the point-of-service
  • Funds are automatically deducted from your HRA account to pay merchant or service provider
  • Cards are good for three years from the date of issue
  • Card will be declined for ineligible expenses
  • Order additional or replacement cards at www.padmin.com

Online Resources

How to Access Your HRA Account

P & A Group Mobile Features and QuickClaim Process

Texting image 185TEXTING

Access your account information right from your mobile phone, anytime, anywhere! To setup this text messaging feature please log into your P&A online account. Under “Profile” enter your cell phone number and mobile carrier. You will then be setup to use the text messaging feature. Text the following codes to the number 70626 to receive updated, on-the-go account information. 

FeatureText CodeInstructions
Account BalanceBAL Text BAL to receive a text message with your account balance
 Claim StatusCLM Check the status of your most recent claim
 History of your Last Five ReimbursementsHIS Instantly get an update on your last five reimbursements
 Deposit UpdateDEP View your last five deposits into your account(s)

HOW TO USE QUIKCLAIM

Submit P&A claims and receipts directly from your smartphone - a totally paperless process!

  1. Go to www.padmin.com and log into My Benefits
  2. Select Upload
  3. Choose your account and enter claim amount
  4. Upload your receipt/documentation by selecting Add File, which will allow you to use your camera to take a picture of your receipt or select a picture from your gallery
  5. Select Continue
  6. Review the claim, agree to the authorization statement and click Submit
  7. You have successfully submitted a claim!

Questions and Answers

  1. I retired before or on June 30, 2016; how may this affect my continued retiree medical insurance County contributions?
    All current retirees who retired on or before June 30, 2016 are to visit SCARE’s website at www.sonomacountyretirees.com.
  2. I retired on or after July 1, 2016; how may this affect my continued retiree medical insurance County contributions?
    This proposed settlement does not affect current retirees who retired on or after July 1, 2016. Retirees who retired on or after July 1, 2016, receive retiree medical insurance subject to established eligibility criteria per their bargaining unit’s Memorandum of Understanding (MOU) or Salary Resolution in force on the date of their retirement, as amended from time to time through collective bargaining and/or Board of Supervisors approval.
  3. I am a current employee hired before January 1, 2009; how may this affect my retiree medical insurance
    If the proposed settlement is finalized as currently written, current employees hired before January 1, 2009, receive retiree medical insurance subject to established eligibility criteria per their bargaining unit’s Memorandum of Understanding (MOU) or Salary Resolution in force on the date of their retirement, as amended from time to time through collective bargaining and/or Board of Supervisors approval.
  4. I am a current employee hired after January 1, 2009; how may this affect my retiree medical insurance?
    This proposed settlement does not affect employees hired on or after January 1, 2009. Employees hired on or after January 1, 2009, receive County contributions into a retiree Health Reimbursement Account to use towards reimbursement of eligible medical expenses subject to established eligibility criteria per their bargaining unit’s Memorandum of Understanding (MOU) or Salary Resolution, as amended from time to time through collective bargaining and/or Board of Supervisors approval.