Benefit - Forms, Brochures, Guides, and Websites
Accidental Death & Dismemberment Insurance
Placer County PPEO represented employees receive the following for use in a cafeteria plan:
- CalPERS Miscellaneous Members
Bi-weekly contribution of 6% of the employee’s base salary plus any longevity
Bi-weekly contribution of 5% of the employee’s base salary plus any longevity
PPEO participants may elect to receive the cafeteria plan amount as cash, a 401(k) contribution, dependent care reimbursement, or any combination of the three options.
Placer County Management employees receive $2,100 per year for use in a cafeteria plan. Participants may elect to receive the cafeteria plan amount as cash, a 401(k) contribution, dependent care reimbursement, medical co-insurance, or any combination of the four options.
Placer County Confidential employees receive $2,798.12 per year for use in a cafeteria plan. Participants may elect to receive the cafeteria plan amount as cash, a 401(k) contribution, dependent care reimbursement, medical co-insurance, or any combination of the four options.
CalPERS Health Forms and Guides
CalPERS Long-Term Health Care
Long-term care coverage can be a valuable tool in your financial and retirement planning. Learn more about CalPERS Long-Term Care coverage, pricing and the application process
Frequently Asked Questions
CalPERS Service Credit
The CalPERS Service Credit booklet describes various types of CalPERS service credit you may be eligible to purchase, and helps you determine hether the increase in your future retirement benefits is worth the cost. After reading this publication, you will know whether you may be eligible for a particular service credit type and what process you need to follow to request cost information and elect the purchase.
CalPERS Service Credit Cost Calculator
Employee Assistance Program
Managed Health Network (MHN) is the administrator of the Placer County Employee Assistance Program. Offered to Placer County employees as well as their eligible dependents, MHN provides a variety of confidential services to navigate life’s more challenging moments. Help is available for relationship issues, workplace problems, stress, anxiety and sadness. Counseling services can be found for grief, loss, or responses to traumatic events, and concerns about use of alcohol or drugs. Financial and legal service providers can be located, as can referrals for childcare or eldercare assistance. Identity theft recovery services are available through consumer debt counselors and there are a number of health and wellness tools to help you take charge of your well-being.
Phone 24 hrs/7 days: 800-242-6220 or www.members.mhn.com Registration Code: placercounty
Your Employee Assistance Program
Employee Assistance Program - Benefit Summary
Members Website Information Sheet
FSA (Flex Spending Accounts) - WageWorks Dependent Care Forms Medical Reimbursement and Tahoe Rural Health Subsidy
The Dependent Care Flexible Spending Account is a plan to pay for eligible child or elder day care expenses. This plan does not cover any health-related expenses. As little as $5 a pay period may be set aside for use with this pre-tax fund and there is an annual $5000 maximum ($2,500 if married and filing separately). Employees are reimbursed for actual expenses only, and any unused funds are forfeit per IRS rules. The FSA is administered by WageWorks. For plan information visit www.wageworks.com.
Tahoe HRA Form
Placer County provides group health insurance through HMOs (Health Maintenance Organizations) and PPOs (Preferred Provider Organizations).
HMOs generally pay 100% of the cost of care after a co-payment, but require you to use in-network providers and have your care coordinated through a designated Primary Care Physician.
Anthem (Select & Traditional) (855) 839-4524 www.anthem.com/ca/calpers/HMO
Blue Shield (NetValue & Access+) (800) 334-5847 www.blueshieldca.com/calpers
Kaiser (800) 464-4000 www.kp.org/calpers
United Health Care (877) 359-3714 www.uhc.com/calpers
PPOs generally pay a percentage of the cost of care after co-pay and deductible requirements are met. The services of in-network providers are paid at a higher percentage than out-of-network providers.
PERS Choice (877) 737-7776 www.anthem.com/ca/calpers
PERS Select (877) 737-7776 www.anthem.com/ca/calpers
PERSCare & PERSCare DSA (877) 737-7776 www.anthem.com/ca/calpers
PORAC (DSA/Safety Mgmt Only) (800) 937-6722 www.porac.org
TruHearing® is making hearing aids affordable by providing exclusive savings to all VSP® Vision Care members. You can save up to $2,400 on a pair of hearing aids with TruHearing pricing. What’s more, your dependents and even extended family members are eligible, too. Learn more about this VSP exclusive member extra at https://vsp.truhearing.com or call (877) 396-7194.
In Lieu of Health(ILH Plan)
If you have other health insurance coverage, you may waive the Placer County health insurance and take advantage of an employer contribution to a 401(k) savings plan.
Long Term disability (LTD) Insurance
LTD insurance provides income of 60% of your monthly earnings, up to $6,500 per month, after you have been unable to work for one year due to illness or injury. The policy may continue to pay up to age 65 as long as you are disabled. Coverage begins automatically when employees working at least 20 hours per week reach 10,400 hours of active service (five years). Employees, at hire and working a minimum of 25 hours per week, may purchase LTD Insurance until they reach the required five years of service. Premiums are based upon earnings and age. Lincoln Financial Group is the plan provider www.lfg.com.
Supplemental Life Insurance
Placer County provides, at no cost, a life insurance policy in the amount of $10,000 for PPEO and DSA employees, and a policy in the amount of $50,000 to those employees who are Management and Confidential. Additional coverage in amounts up to $100,000 is available for purchase by employees. Coverage of up to $50,000 may be purchased for a spouse or registered domestic partner and in amounts up to $10,000 for unmarried dependent children less than 23 years.
ING ReliaStar Life Beneficiary Designation
ING ReliaStar Life Change Form
ING ReliaStar Life Insurance Application
Vision benefits are provided by Vision Service Plan (VSP). Coverage is provided to employees at no cost and dependents can be added at the employee’s expense. If requesting dependent coverage, all eligible dependents must be enrolled, and must remain on the plan for one year. Dropped dependents must remain off the plan for one year. Visit the VSP website at www.vsp.com and either login or if it is your first visit to the site, create an account, to view your benefits information.
If you need to file an Out of Network claim, you can file online at https://www.vsp.com/claims-reimbursement.html or you may also fill out this claim form VSP Out of Network Claim Form and mail it into VSP.
VSP Evidence of Coverage and Disclosure Form