Eligible City employees may enroll themselves and eligible dependents for coverage in one of the two offered medical plans.
- A Health Maintenance Organization (HMO) plan which provides a wide range of healthcare services on a pre-paid basis. Under this plan, medical services are received at no cost or for moderate co-payments.
- A Point of Service (POS) plan which allows you to receive services from an in-network or out-of-network provider of your choice. If you choose an out-of-network physician, healthcare services will be subject to plan deductible and co-insurance provisions.
- A High Deductible Health Plan (HDHP) a plan that has higher annual deductibles in exchange for lower premiums.
Eligible City employees may enroll themselves and eligible dependents for coverage in one of the two offered dental plans, even if medical coverage is declined.
A DHMO Plan is an “in-network” only plan that requires you to select and receive services from a Primary Dental Provider. In order to receive services, you can select any participating dentist in the network. The DHMO Plan does not cover any services rendered by out-of-network facilities or providers.
A Dental PPO Plan is “open access” and allows you to receive services from any dental provider without selecting a Primary Dental Provider (PDP) and does not require referrals to specialists. The PPO plan provides benefits for services received from in-network and out-of-network providers. You will save more by utilizing a dental provider in this network because fees have been contractually agreed upon. The PPO Dental Fee, or allowed amount, is the maximum amount a Dental PPO Provider can charge a member for a service. You are responsible for a Calendar Year Deductible (CYD) and then coinsurance, based on the plan’s Maximum Plan Allowance (MPA) charge limitations.
The City offers vision insurance to all benefit-eligible employees.
Receiving services from a provider that participates in the network offers you and your covered dependents with coverage for routine eye care, including eye exams, eyeglasses (lenses and frames) or contact lenses with the cost of a copay.
Out-of-Network Benefits Covered members may also choose to receive services from vision providers that do not participate in the vision network. If so, the cost of the services received would be paid to that provider at the time of the scheduled appointment, and the provider will then reimburse the covered members based on the plan’s out-of-network reimbursement schedule upon receipt of proof of services rendered.