2023 - 2026 SCPA Memorandum of Understanding: Article 11: Medical Benefits for Future Retirees

Return to 2023-2026 SCPA MOU Table of Contents

What’s on this Page

• 11.1 Retiree Medical Coverage
• 11.2 County Contribution Toward Retiree Medical Plans - Employees Hired Before January 1, 2009
• 11.3 County Contribution Toward Retiree Medical Plans – Employees Hired On or After January 1, 2009, Effective January 1, 2009
• 11.4 Surviving Dependents – County Contribution for Employees Hired Before January 1, 2009
• 11.5 Surviving Dependents – County Contribution for Employees Hired On or After January 1, 2009
• 11.6 County Contribution Toward Retiree Medical Plans – Employees Hired Before January 1, 2009 and retired on or After July 1, 2023

Read Next: Article 12: Holidays

11.1.1

An eligible retiree and eligible dependent(s) (as defined below) may be enrolled in a County offered medical plan as described in Section 11.2 but are allowed only to enroll either as a subscriber in a County offered medical plan or, as the dependent spouse/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 retiree’s plan (i.e. a retiree and their dependents cannot be covered by more than one County offered health plan).

An eligible dependent is (as defined in each plan document/summary plan description):

• Either the retiree’s spouse or domestic partner; or 
• An unmarried child based on your plan’s age limits or a disabled dependent child regardless of age.

11.1.2

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 the 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 domestic partner at a time later than the date the retiree enrolls as provided in Section 11.1.1 above.
5. Eligible dependent children must be enrolled at the time the retiree elects coverage.

Back to top

1. Eligibility
   In order to be eligible for this benefit, the retiree must have:
   1. Completed at least ten (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 ten (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 Sonoma County service.
   4. Current retirees receiving a County contribution for retiree medical based on eligibility at the time of their retirement who do not meet the ten (10) year requirement as listed above are grandfathered in at the eligibility at the time of their retirement.
   5. Laid-Off & Restored Employees: 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 11.2 provided that they are subsequently restored to County employment, pursuant to Civil Service Rule 11.4 or this MOU, 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 11.3 (County Contribution toward Retiree Medical Plans – Employees Hired on or After 1/1/2009, Effective 1/1/2009).
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), $500.00 per month. The retiree is responsible for all costs (including premiums) that exceed the total County contribution.
3. Additional Dependents
   Retirees eligible under this Section 11.2, 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.

Back to top

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 a 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 0.5 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 paid 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 Section 11.3 provided that they are subsequently restored to County employment, pursuant to Civil Service Rule 11.4 or this MOU, 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. Thereafter, contributions will be made each pay period based on the actual hours worked during that pay period.
      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 $0.58 per paid status hour (no more than eighty (80) hours biweekly), 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 upon termination of employment and attainment of 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 who are disabled may continue to access account balances after the death of the retiree, subject to any limitations and maximums established by law.
      2. Domestic partners are not permitted access to the account balances of the participant by virtue of restrictions 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 one hundred twenty (120) days after the annual certified audit of the plan is submitted to the administrator and the County.
      3. 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. 

Back to top

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 as follows:

One eligible surviving dependent will be allowed to continue their coverage under the same circumstances and with the same County contribution as if the retiree survived, if the surviving dependent meets each of the following criteria:

1. Has been an eligible dependent of a retiree who was eligible to receive a contribution toward a County offered retiree medical plan under Section 11.2 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.

Back to top

Upon the death of a retiree enrolled in the Defined Contribution retiree medical benefit plan as defined in Section 11.3, eligible surviving dependents may continue participation in the County offered medical plan but remain 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.

Back to top

A. Eligibility: In order 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)   Retired directly from Sonoma County service.  If retiree previously deferred membership in SCERA, the retiree forfeits eligibility to all benefits described in this section.

4)   Laid-Off and Restored Employees: 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 11.6 provided that they are subsequently restored to County employment, pursuant to Civil Service Rule 11.4 or this MOU, 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 Article 11.6 County Contribution toward Retiree Medical Plans – Employees Hired Before January 1, 2009 and Retired On or After July 1, 2023.

B. 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), an amount of five hundred dollars ($500) a month.

C. 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.

D. Retirees Who Reside Out of Managed Care Service Area

Retirees who meet eligibility requirements in Article 11.6 and who reside outside of any County-offered managed care medical plans’ service areas, are eligible to receive a contribution of $500 per month into the Retiree Health Reimbursement Account.  All retirees and eligible dependents who receive a County Contribution to a Retiree HRA are responsible for Medicare Part B premiums.  The benefits of this Article must be elected within the first 31-days of moving out of all Managed Care Service Areas.

Back to top