Salary Resolution No. 95-0926 Revised December 2018 Section 15: Medical Benefits for Retirees

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What’s on this Page

• 15.1 Retiree Medical Coverage
• 15.2 County Contribution toward Retiree Medical Plans - Employees Hired Before January 1, 2009 and Retired On or After July 1, 2016
• 15.3 Medicare Part B Reimbursement
• 15.4 County Contribution toward Retiree Medical Plans - Employees Hired On or After January 1, 2009 - Effective January 1, 2009
• 15.5 Surviving Dependent – County Contribution beginning June 1, 2009 for Employees Hired Before January 1, 2009
• 15.6 Surviving Dependent – County Contribution for Employees Hired On or After January 1, 2009
• 15.7 Dental and Vision Benefits for Elected Department Head Retirees

Read Next: Section 16: Meals and Lodging

15.1 Retiree Medical Coverage

(Amended 3/17/09, 12/11/18)

1. An eligible retiree and eligible dependent(s) (as defined below), may but are not required to enroll in a County offered medical plan. Retirees who elect to enroll in a County offered medical plan are allowed only to enroll either as a subscriber in a County offered medical plan or, as the dependent spouse / registered domestic partner of another eligible County employee / retiree, but not both. If an employee / retiree is also eligible to cover their dependent child / children, each child will be allowed to enroll as a dependent on only one employee or retirees’ plan (i.e., a retiree and his or her dependents cannot be covered by more than one County offered plan).
   
   An eligible dependent is¹:
   • Either the retiree’s spouse or registered domestic partner as documented by a Declaration of Domestic Partnership filed with the State of California, as defined in California Family Code Section 297, et. seq.; or 
   • An unmarried child up to age 26, or a disabled dependent child regardless of age. 
2. An eligible retiree must enroll in a County offered retiree medical plan at the time of retirement unless the retiree waives medical insurance coverage and/or the retiree’s eligible dependent(s) by completing a retiree waiver form. A retiree who waives medical coverage will be allowed to re-enroll themselves and any eligible dependent(s), upon the following conditions being met:
   1. The retiree must re-enroll within 30 days of losing other insurance coverage and provide the County with evidence of such loss of other coverage, or,
   2. At the latest, the retiree must re-enroll, or lose eligibility to receive a County contribution toward the retiree medical plan, no later than 60 days after the effective date of the retiree’s Medicare coverage. 
   3. The retiree’s re-enrollment is required in order for any eligible dependent(s) to be enrolled in a County offered medical plan, except as follows in #4 below.
   4. The retiree may add an eligible dependent spouse or registered domestic partner at a time later than the date the retiree enrolls as provided in Section 15.1 B above.
   5. Eligible dependent children must be enrolled at the time the retiree elects coverage.

¹As defined in each plan document / summary plan description.

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15.2 County Contribution toward Retiree Medical Plans - Employees Hired Before January 1, 2009 and Retired On or After July 1, 2016 

(Amended 7/12/11, 12/11/18) 

1. Eligibility. To be eligible for this benefit, the retiree must have:
   1. Completed at least 10 years of consecutive regular full-time paid County of Sonoma service employment. The equivalent worked or purchased regular part-time County service time can be counted toward the 10 years. However, any miscellaneous purchased service time such as extra help, contract, and leave of absence service time does not count toward this eligibility requirement, and
   2. Have been a contributing member of the Sonoma County Employees’ Retirement Association (SCERA) for the same time period, and
   3. Retire directly from County service
   4. Laid-Off & Restored Employees (Amended 7/12/11):  Employees who were employed by the County prior to January 1, 2009, but who were laid off thereafter shall be eligible for the benefits described in this Article 15.4 provided that they are subsequently restored to County employment, pursuant to Civil Service Rule 11.4, rejoin the County retirement system, and are otherwise eligible for retiree medical benefits under this section. The break in service caused by the layoff shall be bridged upon restoration such that, although no service time is earned during the break, consecutive service is restored for eligibility for this benefit.  To the extent allowed by law they shall not be eligible for the benefits described in Section 15.6 (County Contribution toward Retiree Medical Plans - Employees Hired On or After January 1, 2009 - Effective January 1, 2009).
2. County Contribution. The County shall contribute toward the cost of County offered medical plans for any eligible retiree whether or not the retiree covers eligible dependent(s), up to $500 a month. The County’s contribution amount is subject to change at any time by amendment to this resolution by the County Board of Supervisors.  
3. Additional Dependents.  Retirees eligible under this section may enroll eligible dependent(s) in the County offered medical plan elected by the retiree but the retiree is responsible for all premium costs in excess of the County’s contribution. 

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15.3 Medicare Part B Reimbursement

The County’s reimbursement of the retiree’s Medicare Part B premium will continue for those hired before January 1, 2009. Effective January 1, 2009, the amount will be frozen at the 2008 rate of $96.40. This reimbursement is in addition to the County’s contribution for the retiree’s medical plan premium as described above.

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15.4 County Contribution toward Retiree Medical Plans - Employees Hired On or After January 1, 2009 - Effective January 1, 2009

(Amended 7/12/11)

For employees hired on or after January 1, 2009, the County shall contribute to a Defined Contribution retiree medical benefit plan for each eligible employee in the form of a deposit into Health Reimbursement Arrangement (HRA) account, as described below. Any eligible retiree and eligible dependent(s), as defined below, may enroll in a County offered medical plan, but the retiree is responsible for all costs (including County offered retiree medical plan and Medicare Part B premiums).

1. Eligibility
   1. An employee must have been a contributing member (or a contribution was made on their behalf) of the Sonoma County Employees’ Retirement Association (SCERA) for the eligibility period described below.
   2. Regular full-time employees and part-time employees in an allocated position of .5 full-time equivalent or greater, hired on or after January 1, 2009 are eligible to receive a County HRA contribution, if they have completed two (2)  full years of consecutive Sonoma County regular service (excluding overtime) in pay status.
   3. If an employee separates employment before meeting the eligibility requirement, the employee shall receive no benefit.
   4. Laid-Off & Restored Employees. Employees who were employed by the County on or after January 1, 2009, but who were laid off thereafter shall be eligible for the benefits described in this Article 15.6 provided that they are subsequently restored to County employment, pursuant to Civil Service Rule 11.4, rejoin the County retirement system, and are otherwise eligible for retiree medical benefits under this section. The break in service caused by the layoff shall be bridged upon restoration such that, although no service time is earned during the break, consecutive service is restored for eligibility for this benefit.  
2. County Contribution.
   1. Initial County Contribution:
      1. On the first pay date following completion of the eligibility requirements, regular full-time employees shall receive a lump sum contribution of $2,400 deposited into an HRA account established in their name.
      2. The lump sum contribution amount for regular part-time employees shall be pro-rated based on their allocated position only (e.g., a regular employee in a 0.5 full-time equivalent allocated position will receive a lump sum contribution of $1,200 deposited into their HRA account).
   2. Regular County Contribution:
      After the initial contribution (defined above) is made, the County shall contribute $.58 per pay status hour, not including overtime, for each eligible employee. For a full time employee, this equates to approximately $100 per month or $1,200 per year, after the initial eligibility period is met.
   3. Access to Account Balance:
      1. Participants may access the balance in their HRA account at age 50 or upon retirement from the Sonoma County Retirement System, whichever is earlier.
      2. Participants may defer accessing the account balance to any time beyond the earliest date described in (a).
      3. Amounts that remain in the account balance are available to reimburse the participant for the same permitted medical expenses for the spouse and any other dependent covered under the retiree medical plan, however, federal regulations do not permit the inclusion of expenses for domestic partners.
   4. Survivors of eligible retirees with account balances:
      1. Spouses and eligible dependent children or dependent adults that are disabled may continue to access account balances after the death of the retiree.
      2. Domestic partners are not permitted access to the account balances of the participant by virtue of restriction in the federal regulations that govern these types of accounts
   5. Forfeiture of account balance:
      1. If an active employee dies prior to retirement, the amount of account balance is available to participating spouses and dependents to reimburse them for medical expenses permitted under the relevant section of the Internal Revenue code.
      2. Account balances in part or in total for active participants or retirees without any eligible spouse or dependent or unused account balances after the death of the last eligible spouse or dependent will be forfeited and returned to all other active and retired participants in the form of a dividend allocated in direct proportion to the amount to be distributed divided by the total account balance for all participants applied to each individual account balance. These distributions will occur within 120 days after the annual certified audit of the plan is submitted to the administrator and the County.

This benefit will be subject to regulation under section 105(b) of the Internal Revenue Code and subject to revenue rulings for these types of plans as promulgated.

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15.5 Surviving Dependent – County Contribution beginning June 1, 2009 for Employees Hired Before January 1, 2009

Upon the death of a retiree enrolled in a County offered retiree medical plan, the County will continue to pay the County’s contribution toward the medical plan premium costs in the same manner as if the retiree had survived.

An eligible surviving dependent will be allowed to continue their coverage under the same circumstances and with the same County contribution as if the retiree had survived. To be eligible, a surviving dependent must meet each of the following criteria:

1. Have been an eligible dependent of a retiree who was eligible to receive a contribution toward a County offered retiree medical plan under Sections 16.4. prior to the death of the retiree, and
2. Either be enrolled or have waived coverage at the time of the retiree's death.

Any additional surviving eligible dependent(s) enrolled under the retiree's medical plan at the time of the retiree's death, may continue participation in the County offered medical plan but remain responsible for all premium costs in excess of the County contribution.

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15.6 Health Reimbursement Account - Surviving Dependent – County Contribution for Employees Hired On or After January 1, 2009

Upon the death of a retiree enrolled in the Defined Contribution retiree medical benefit plan (as defined in Section 15.6), an eligible surviving dependent may continue participation in the County offered medical plan but remains responsible for all costs (including premiums).

To be eligible, a surviving dependent must either be enrolled or have a waiver on file with the County, at the time of the retiree's death.

This benefit will be subject to regulation under section 105(b) of the Internal Revenue Code and subject to revenue rulings for these types of plans as promulgated.

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15.7 Dental and Vision Benefits for Elected Department Head Retirees

Effective for those retiring on/after December 10, 2002, an elected Department Head who has served a minimum of (8) years of Sonoma County service shall be eligible for dental and vision benefits for the retiree and any eligible dependents under the same circumstances and upon the same conditions that apply to his/her eligibility to receive medical benefits in effect just prior to retirement, and after a service retirement from their respective office, except that having met the eligibility requirement as stated and if the member’s term of office involuntarily ceases prior to the earliest date of eligibility for retirement the elected department head may defer election to receive such benefits until the first day of eligibility to receive a benefit from the Sonoma County Retirement System.

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