2011 Benefits Guidebook Final to Post - Administration Home

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2011 Benefits Guidebook Final to Post - Administration Home

EL PASO COUNTY’SEMPLOYEE BENEFITS GUIDEBOOKPLAN YEAR 2011PREFACEYour Benefits Guidebook is intended to provide information you need to assist with youremployee benefit selections:• The types of questions you can ask yourself to help you decide which plan(s) are best foryou and your family;• What benefits are available for the 2011 plan year;• What administrative steps you must take to enroll;• How to access your benefits;• Where you can go to get more information or assistance regarding any of the plansoffered by El Paso County.To take full advantage of the benefits, please take the time to fully consider each of the availablebenefit plan options explained in the guidebook.We have included a benefits telephone directory on the following page for your conveniencewhen you have benefit questions. Please feel free to contact any of the vendors directly for anyplan-related questions you may have now and throughout the year.If you have a general question regarding any of the benefit plans, please do not hesitate to callthe EL Paso County EBMS Benefit Division at 719-520-7420, Monday-Thursday, 7:00 a.m. to5:00 p.m.OPEN ENROLLMENTPlease remember that open enrollment is the only time of the year that you may elect to makechanges to benefit plans without having a Qualifying Life Event.ABOUT THE BENEFITS GUIDEBOOKThis Guidebook is intended to provide a general overview of all the insurance benefit plans,including eligibility, cost, contact information and how to use your benefits. Should there be aninconsistency with any communications regarding these plans the actual Master Plan Documentswill govern. Any information contained herein may be subject to change.2011 Employee Benefit Guidebook Updated 11/08/10


PHONE DIRECTORYEmployment. Benefits and Medical Services DepartmentEmployee Benefits Division .......................................................................... 719 520-7420E-Mail ..................................................................................................ebms@elpasoco.comWorkers Compensation Division .................................................................... 719 520-7486HIPAA Compliance ........................................................................................ 719 520-7402Finance/Payroll OfficeKathy Jennison ................................................................................................ 719 520-6478Rhonda Wagoner ............................................................................................ 719 520-6427Debra Morrow ................................................................................................. 719 520-7404Payroll Fax ...................................................................................................... 719 520-6486Medical PlansUse the Member Service Number and Website below for Claims, ID Cards, and Pre-AuthorizationsEmployee Benefits Management Services (EBMS) Member Services .......1-866-887-4115EBMS miBenefits Web site Address ........................................................... www.ebms.comCare Link Pre-Notification and Priority Maternity Care .............................1-866-894-1505Use the Cofinity Customer Service Number and Website below for Provider Network questionsFind a Provider .................................... www.cofinity.net/EPCDirectory/Index.aspxCofinity Provider Network Customer Service .................................1-800-831-1166El Paso County Employee Health CentersRegional Development Center (RDC) Health Center ..................................... 719 520-7080East Health Center .......................................................................................... 719 520-7600Prescription BenefitsIn-House Walgreens Pharmacy (RDC)........................................................... 719 219-0670Walgreens Customer Care Center (WCCC) ...............................................1-800-207-2568Website ..................................................................................................... www.mywhi.comPrescription Refills .................................................. 1-800-RX-REFILL (1-800-797-3345)2011 Employee Benefit Guidebook Updated 11/08/10


Mail Service .................................................................................................1-888-265-1807Specialty Services and Home Care Services .................................................. 866-924-9377Vision PlanEyeMed Vision Care Customer Service ......................................................1-866-723-0596EyeMed Vision Care Website ................................................. www.eyemedvisioncare.comDental PlansGuardian Dental Member Services .............................................................1-800-541-7846Guardian Dental Web site ...................................................... www.GuardianAnytime.comGuardian Dental Pre-Enrollment Hotline……………………………...….1-888-600-1600Flexible Spending AccountsPayFlex Customer Service: .........................................................................1-800-284-4885PayFlex Claim Fax Number: ...................................................................... 1-800-450-0016PayFlex Website .................................................................................. www.healthhub.comReach Your Peak Wellness ProgramReach Your Peak Program Questions email: ..................... RYPsimplywell@elpasoco.comPhone: ................................................................................................. 719 520-6960Wellness Program Website ................................................................ www.simplywell.comWebsite Technical Questions .......................................................................1-877-991-9355Wellness Reimbursement Account (WRA) Website ........................... www.healthhub.comWellness Reimbursement Account (WRA) Customer Service…………...1-800-284-4885Employee Assistance Program (EAP)ComPsych ...................................................................................................1-800-272-7255Website ..................................................www.guidanceresources.com Web ID COM589Life and Disability InsuranceUNUM Life Insurance ……………………………………………………1-800-421-0344Plan Highlights & Forms ........ http://w3.unum.com/enroll/ElPasoCounty/enrollment.aspx2011 Employee Benefit Guidebook Updated 11/08/10


General Questions Contact the Employee Benefits Office ............................ 719 520-7420El Paso County Retirement PlanRetirement Benefit Information ...................................................................... 719 520-7490Internet Address ............................................................................... www.epcretirement.orgDeferred Compensation (457 Plan)Great West Retirement Services ..................................................................1-800-947-4409Key-Talk ......................................................................................................1-800-701-8255Web Site ....................................................................................................... www.gwrs.com2011 Employee Benefit Guidebook Updated 11/08/10


IMPORTANT INFORMATIONENROLLMENT AND EFFECTIVE DATE OF COVERAGE FOR MEDICAL, DENTAL ANDLIFE INSURANCE BENEFITS: Eligible employees may enroll themselves and theirdependents for coverage through Employee Self Service (ESS) and by agreeing to pay therequired contributions. Dependents of an eligible employee may not be enrolled in the Medicaland Dental plans unless the employee is also enrolled for coverage under the Plan.If both spouses are employees of El Paso County and both are eligible for benefits, you shouldcarefully review the contribution rates and select the option that provides the best coverage foryou and your family at the lowest total cost. If both parents of an eligible dependent child areenrolled as a subscriber, only one parent may enroll the child as a dependent.If a dependent child is also a full-time El Paso County employee, the dependent must enrolleither as a dependent or as an employee, but cannot be enrolled twice.ELIGIBLE DEPENDENTS: Eligible dependents include your lawful spouse and children whoare less than 26 years old. Dependent children are also covered if age 26 or more years old andprimarily supported by you and incapable of self-sustaining employment by reason of mental orphysical handicap. You may be required to provide proof of the child’s dependent status to thehealth care provider or to the EBMS Benefits Division.You must provide the social security number for dependents enrolled on our medical plan. Anew federal law requires group health plans and claim administrators to provide reports to theCenters for Medicare & Medicaid Services (CMS). We understand that you may have concernswith sharing your SSN. However, federal law requires that we collect this information so thataccurate reports can be provided to CMS. This information will be shared only for reportingdirectly to CMS. The medical administrator sends the reports to CMS using a secure datatransmission method to ensure the privacy and security of your information.Documentation for any covered dependents is also a requirement. If an employee enrolls aspouse, a copy of the marriage certificate must be provided. If enrolling children, copies of birthcertificates must also be provided.ENROLLMENT: Enrollment must be completed within 31 days of your full-time hire date. Ifyou do not enroll within this 31 day period, you will not be eligible to enroll until the next openenrollment period, unless you have a Qualifying Life Event.Full-time employees are required to have medical coverage. Therefore, if you waive medicalcoverage offered by El Paso County, you must provide proof of other medical coverage.If you do not submit your enrollment for medical coverage within the first 31 days, orwaive coverage and fail to provide proof of other medical insurance coverage, EBMS hasthe right to enroll you in the lowest medical plan option offered and you will be required topay past due premiums. If you do not submit your enrollment for dental coverage, you will notbe eligible for enrollment in a dental plan until the next dental plan Open Enrollment period.2011 Employee Benefit Guidebook Updated 11/08/10


WHEN COVERAGE IS EFFECTIVE: If you are hired full-time starting from the 1 st throughthe 15 th of the month, coverage for you and any of your enrolled dependents is effective on thefirst day of the next month. If you are hired full-time starting the 16 th through the last day of themonth, coverage for you and any of your enrolled dependents is effective on the first day of thesecond following month. (Example 1: First day of full-time employment is January 15 th ,coverage is effective February 1 st . Example 2: First day of full-time employment is January16 th , coverage is effective March 1 st .)In no event will health services be rendered or delivered before the effective date of coverage.WHEN COVERAGE ENDS: Coverage ends on the last day of the month that you separateemployment, are no longer a full-time employee, the last day premiums are paid through, orwhen you no longer meet the eligibility requirements.ANNUAL OPEN ENROLLMENT: Every year each eligible employee is given an opportunityto change his or her benefit elections for the upcoming benefit plan year*. Benefit elections madeduring the open enrollment period take effect January 1 st of the following calendar year. Changesto open enrollment elections will only be accepted if received by EBMS in writing by the lastbusiness day in December. After this date, changes can only be made during the plan year if youhave a Qualifying Life Event (please see the Making Changes on the following page).SPECIAL OPEN ENROLLMENT:Notice of Opportunity to Enroll in connection withExtension of Dependent Coverage to Age 26Individuals whose coverage ended, or who were denied coverage (or were not eligible forcoverage), because the availability of dependent coverage of children ended before attainment ofage 26 are eligible to enroll in El Paso County (EPC) Health and Benefit Plans. Individuals mayrequest enrollment for such children for 30 days (during the open enrollment period from October12 through November 10, 2010). Enrollment will be effective January 1, 2011. For moreinformation contact the El Paso County EBMS Benefits Department at (719) 520-7420.Notice Lifetime Limit No Longer Applies and Enrollment OpportunityThe lifetime limit on the dollar value of benefits under the El Paso County Medical Plan nolonger applies. Individuals whose coverage ended by reason of reaching a lifetime limit under theplan are eligible to enroll in the plan. Individuals have 30 days from the date of this notice torequest enrollment (during the Open Enrollment period from October 12 through November 10,2010). For more information contact the EPC EBMS Benefits Department at (719) 520-7420.BENEFIT PLAN YEAR: El Paso County’s “Plan Year” begins January 1 st and ends December31 st .2011 Employee Benefit Guidebook Updated 11/08/10


CALENDAR YEAR DEDUCTIBLE: El Paso County’s “Calendar Year Deductible” beginsJanuary 1 st and ends December 31 st .PROVIDER AND FACILITY CONTRACTS: Although most physicians or providers andfacilities that contract with our insurance plans remain with those network(s) year after year, youshould always contact the plan vendor to verify that they are still participating in the plannetwork(s) and to verify if they are accepting new patients to ensure coverage.EMPLOYEE CONTRIBUTIONS AND POP: The employee benefit contributions (seeschedule in this guidebook) are deducted each pay period through payroll deduction. El PasoCounty health plans are Premium Only Plans (POP) allowing deductions to be taken on a pre-taxbasis. With pre-tax deductions, you will not pay federal, state or social security taxes on thesemonies, but you may not claim your medical or dental premiums as a deduction on your FederalIncome Tax Return. Because your taxable income will be smaller under the pre-tax method,your tax withholding will be less and your take home pay may be higher. A lower social securityreportable income may lower your potential income from social security upon retirement.Unless you submit a written request for your contributions to be taken on after tax basis,contributions for health and/or dental premiums will automatically be deducted on a pre-taxbasis.BENEFITS MAY BE TERMINATED FOR NON-PAYMENT OF BENEFIT PREMIUMS.ARRANGEMENT MUST BE MADE IN ADVANCE WITH THE EBMS BENEFITSDIVISION IF BENEFIT CONTRIBUTIONS ARE NOT DEDUCTED THROUGHPAYROLL (SUCH AS WHEN AN EMPLOYEE IS OFF WORK DUE TO WORKERSCOMPENSATION, FMLA OR OTHER UNPAID LEAVE OF ABSENCE.) YOU WILLBE GIVEN 30 DAYS NOTICE EXCEPT IN CASES OF FRAUD OR INTENTIONALMISREPRESENTATION.MAKING CHANGES – QUALIFYING LIFE EVENTS: If you have a qualifying life event asdefined by the IRS you MUST submit a Benefit Change form directly to the EBMS BenefitsDivision within 31 days of the life event effective date.The following is a list of Qualifying Life Events and the required documentation:Qualifying Life Event Required Documentation:• Marriage: Marriage Certificate• Dissolution of Marriage/Common Law: Divorce Decree• Divorce: Divorce Decree• Legal Separation: Court Decree• Annulment: Court Decree• Birth/Adoption/Custody of Dependent: Birth Certificate/Final Court Decree• Death of a Dependent: Death Certificate2011 Employee Benefit Guidebook Updated 11/08/10


• Loss/Gain of Spousal Medical/Dental Coverage: Letter from Spouses Former Employeror Insurance Company• Ineligible Dependent: Proof of Age• Medicare Eligibility: Proof of Medicare Eligibility• Medicaid Eligibility for your Dependents: Proof of Medicaid EligibilityContact the EBMS Benefits Division with any questions regarding documentation.IF YOU DO NOT SUBMIT THE BENEFIT CHANGE FORM WITHIN THE 31-DAYPERIOD, YOU WILL NOT BE ALLOWED TO MAKE A CHANGE UNTIL THE NEXTOPEN ENROLLMENT PERIOD OR YOUR NEXT QUALIFYING LIFE EVENT. ElPaso County can require you to provide documentation of your qualifying life eventwhenever you make changes.Failure to remove a dependent within 31 days of when the dependent is no longer eligible(i.e. divorce) will result in additional premiums due based on the COBRA rates and may bededucted through payroll.QUALIFYING LIFE EVENT EFFECTIVE DATE: Your new benefit elections made as a resultof a Qualifying Life Event will take effect on the first day of the month coincident with orfollowing the effective date of the Qualifying Life Event. Any benefit election changes must beconsistent with the Qualifying Life Event.Any changes to coverage due to a Marriage or Birth/Adoption/Custody of Dependent will takeeffect on the day of the Qualifying Life Event.COBRA: In the event of a loss of coverage, you and/or your eligible dependents may be eligibleto continue medical/dental/vision insurance for a period of up to 18 months, or 29 months fordisabled individuals. Please contact the Employee Benefits Office for more information.SUMMARY PLAN DOCUMENTS: For a copy of the benefits Summary Plan Documents,contact the Employee, Benefits and Medical Services Department (EBMS) at 520-7402, or go towww.elpasoco.com under the EBMS Benefits & Compensation Division.REACH YOUR PEAK WELLNESS PROGRAM: Reach Your Peak (RYP) is a wellnessprogram designed to assist you by promoting and maintaining your good health. If you (andyour spouse, if applicable) are enrolled in any County medical plan, you can participate in thiswellness program. Please call 719 520-6960 with any questions and for information on theenrollment period.WORKERS COMPENSATION: For employees who are injured on the job or developoccupational illnesses, this insurance pays for all reasonable and necessary medical expensesand, if necessary, partial wage replacement during periods of temporary disability. It may alsoprovide permanent disability entitlements for those who qualify.2011 Employee Benefit Guidebook Updated 11/08/10


For any personal health (non-work related) problems, please seek the advise of your familyphysician. Worker’s Compensation does not cover expenses for non-work related accidents,injuries or illnesses (for example, a private automobile accident). Your health insurancecoverage would apply.IF INJURED ON THE JOB, WRITTEN NOTICE MUST BE GIVEN TO YOUR EMPLOYERWITHIN FOUR (4) WORKING DAYS OF THE ACCIDENT PURSUANT TO SECTION 8-43-102-1 C.R.S.For questions regarding workers compensation, call the EBMS Workers Compensation Divisionat 719 520-7488.2011 Employee Benefit Guidebook Updated 11/08/10


MEDICAL, VISION AND DENTAL PLAN PREMIUMSPER PAY PERIODJanuary 1, 20112011 Employee BenefitsSemi-Monthly Pay Period ContributionsEmployee Only Employee +SpouseEmployee +ChildrenEmployee +FamilyEl Paso CountyMedical/EBMSCofinity NetworkPlanEyeMed VisionPlanGuardian PPODental LowGuardian PPODental High$ 34.50 $124.00 $115.00 $153.50$ 2.86 $ 5.43 $ 5.72 $ 8.41$ 7.49 $12.58 $19.46 $28.45$19.45 $32.68 $50.57 $73.912011 Employee Benefit Guidebook Updated 11/08/10


MEDICAL PLANSEBMS MEDICAL BENEFITSEL PASO COUNTY MEDICAL EPO PLAN:In 2011 you will have one medical plan option – the El Paso County Medical EPO Planadministered by Employee Benefit Management Services.* With this plan you have access to theCounty Employee Health Centers and a customized Cofinity Network.The custom Cofinity Network uses only Penrose Hospital and Penrose affiliated providers andfacilities to serve the Colorado Springs service area. Any non-emergent, medical services mustbe provided through a contracted Cofinity provider or facility. If you have proceduresperformed at a Memorial Hospital or other non-contracted facilities (other than true emergenciesand/or certain medical procedures not available through Penrose that have been pre-approved bythe CareLink Care Management team), it will not be covered. If you are currently covered onthe medical plan you may find out if your provider is in the custom Cofinity Network by callingEBMS at 1-866-887-4115 or by logging on to your miBenefits website at www.ebms.com. Ifyou are not currently covered on the County medical plan, you may find out if your provider is inthe custom Cofinity Network by visiting the website atwww.cofinity.net/EPCDirectory/Index.aspx.This plan has a $2,000 individual deductible ($6,000 Family Maximum) that applies to someservices such as inpatient hospital services, surgery, and ambulance.See the EBMS Summary of Benefits on the following pages for additional information ondeductibles, co-pays and co-insurance.*(Please note that our new medical plan administrator has the same acronym but is NOT thesame as the El Paso County Employment, Benefits & Medical Services (EBMS) Department.)GENERAL INFORMATION: Once you make your elections you may not change or cancelyour benefits or change enrolled dependents until the next open enrollment period, unless youhave a Qualifying Life Event.GRANDFATHERED HEALTH PLAN:El Paso County believes this Medical Health Plan is a “grandfathered health plan” under thePatient Protection and Affordable Care Act (the Affordable Care Act). As permitted by theAffordable Care Act, a grandfathered health plan can preserve certain basic health coverage thatwas already in effect when that law was enacted. Being a grandfathered health plan means thatyour Plan may not include certain consumer protections of the Affordable Care Act that apply toother plans, for example, the requirement for the provision of preventive health services withoutany cost sharing. However, grandfathered health plans must comply with certain other consumerprotections in the Affordable Care Act, for example, the elimination of lifetime limits onbenefits.2011 Employee Benefit Guidebook Updated 11/08/10


Questions regarding which protections apply and which protections do not apply to agrandfathered health plan and what might cause a plan to change from grandfathered health planstatus can be directed to the plan administrator at EPC EBMS Benefits Department (719) 520-7420. You may also contact the U.S. Department of Health and Human Services atwww.healthreform.gov.Medical Plan Summaries:Two medical plan summaries are listed on the following pages. 1.) The Standard Medical EPOBenefits Schedule reflects benefits for employees who did not meet the Reach Your Peak (RYP)Wellness Plan requirements for Phase 1 by the established deadline. 2.) The Reach Your Peak(RYP) Medical EPO Benefits Schedule reflects benefits for employees who are consideredReach Your Peak Wellness Program Participants. Please refer to the appropriate schedule ofbenefits. Your medical ID card will reflect the plan in which you are enrolled.STANDARD MEDICAL EPO BENEFITS SUMMARYPARTICIPATINGPROVIDERSCALENDAR YEARANNUAL LIMIT $1,000,000NON-PARTICIPATINGPROVIDERSDEDUCTIBLE, PER CALENDAR YEARPer Covered Person $2,000 Not CoveredPer Family Unit $6,000 Not CoveredMAXIMUM OUT-OF-POCKET AMOUNT, PER CALENDAR YEARPer Covered Person $8,000 Not CoveredPer Family Unit $16,000 Not CoveredThe Plan will pay the designated percentage of Covered Charges until out-of-pocket amounts are reached, atwhich time the Plan will pay 100% of the remainder of Covered Charges for the rest of the Calendar Year unlessstated otherwise.The following charges do not apply toward the out-of-pocket maximum and are never paid at 100%.• CopaymentsCOVERED CHARGESHospital ServicesInpatient Room and Board 75% after deductible and $500Not Coveredcopayment per admissionsemiprivate room rateIntensive Care Unit 75% after deductible and $500 Not Covered2011 Employee Benefit Guidebook Updated 11/08/10


Outpatient Facility Servicescopayment per admissionHospital's ICU Charge75% after $250 copayment pervisitNo deductible appliesNot CoveredOutpatient Physician services75%, no deductible orcopayment appliesNote: The copayment will apply as long as services billed include one or more of the facility room charges:Operating room, recovery room, procedures room, treatment room, and observation room.Skilled Nursing Facility, RehabilitationHospital andSub-Acute Facilities75% after deductible thefacility's semiprivate room rateNot CoveredEmergency Room Services(including ER Physician services)100% after $200 copayment per visit;No deductible appliesMedical Non-Emergency CareNote: The ER copayment will be waivedif admitted to the Hospital directly fromthe ER.Urgent Care Services100% after $100 copayment pervisit;No deductible appliesNot CoveredNot CoveredNote: The Urgent Care copayment will be waived if admitted to the Hospital directly from Urgent Care.Physician ServicesInpatient Services 75% after deductible Not CoveredEl Paso County Employee Health Center(“Clinic”) Office VisitPrimary Care Physician (PCP)Office Visit100% after $10 copayment pervisitNo deductible applies100% after $50 copayment pervisitNot CoveredNot CoveredNo deductible appliesNote: A Primary Care Physician (PCP) is defined as a general practitioner, family practitioner, general internist(internist whose practice is 70% general medicine), Nurse Practitioner, Physician’s Assistant, or pediatrician.An OB/GYN will be considered a specialist.Specialist office visitsSurgery performed in the office (includingany medical supplies and injectionsrendered during the surgery)100% after $75 copayment pervisitNo deductible applies100% after $10 Clinic, $50 PCPor$75 Specialist copayment perNot CoveredNot Covered2011 Employee Benefit Guidebook Updated 11/08/10


visitNo deductible appliesInjections (other than allergy or100%chemotherapy)No deductible or copaymentwill applyAllergy serum and injections 100%No deductible or copaymentwill applyPreventive CareRoutine Well Care(ages birth through adult)100% after $10 Clinic copay or$40 copayment for all otherprovidersNo deductible appliesNot CoveredNot CoveredNot CoveredIncludes: Routine office visits, routine physical examination, mammogram, gynecological exam, Pap smear,PSA, routine lab and x-rays, routine colonoscopy, flexible sigmoidoscopy, and immunizations.Ambulance Service75% after deductibleNote: Pre-authorization with the Claims Administrator will be required for non-emergent transport.Advanced Radiological Imaging (i.e.,MRIs, MRAs, CAT Scans, PET Scans andNuclear Medicine)75%No deductible or copaymentwill applyNot CoveredDiagnostic X-ray & Lab Testing 100%No deductible appliesNot CoveredDurable Medical Equipment 100%Not CoveredNo deductible or copaymentwill applyHome Health Care 75% after deductible Not CoveredHome Infusion Therapy 75% after deductible Not CoveredHospice Care75% after deductibleNot CoveredBereavement Counseling75% after deductibleNot CoveredMental Disorders and Substance Abuse TreatmentInpatient Services Payable as any other Illness Not CoveredOutpatient Visits100% after $10 copaymentNot CoveredNo deductible appliesMorbid Obesity Benefit Payable as any other Illness Not CoveredNote: A pre-authorization is required prior to services being rendered. Please see the Covered Charges section formore information regarding this benefit.Nutritional EvaluationOutpatient Short-Term RehabilitationTherapy and Chiropractic ServicesPayable as any other Illness3 visits per Calendar Yearmaximum100% after $20 copay per visitNo deductible appliesNot CoveredNot Covered2011 Employee Benefit Guidebook Updated 11/08/10


Includes: Cardiac Rehab, Physical Therapy, Speech Therapy, Occupational Therapy, Pulmonary Rehab,Cognitive Therapy and Chiropractic services.Multiple services provided on the same day constitute one visit, but a separate copayment will apply to theservices provided by each Physician.Orthotics 75% after deductible Not CoveredNote: See Covered Charges section for details.Prosthetics 100%Not CoveredNo deductible or copaymentwill applyPregnancy *Initial visit(to confirm Pregnancy)All subsequent prenatal visits, postnatalvisits, and Physician’s delivery charges(i.e., global maternity fee)Physician’s office visits in addition to theglobal maternity fee (when performed byan OB/GYN or specialist)Delivery – Facility charges(Inpatient Hospital, Birthing Center)Organ TransplantsTransportation Benefit Maximum(Available only when using a COEfacility)100% after $75 Specialist officevisit copayment75% after deductible100% after $75 office visitcopaymentNo deductible appliesPayable per InpatientHospitalization benefitPayable as any other illness$10,000 Lifetime MaximumNot CoveredNot CoveredNot CoveredNot CoveredNot CoveredNote: See the Covered Charges section for more information regarding this benefit.Wigs75% after deductible$1,000 Lifetime MaximumNote: Limited to the initial purchase of a wig when deemed Medically Necesssary due to temporary or permanenthair loss. See the Covered Charges section for more information regarding this benefit.All Other Eligible Charges 75% after deductible Not Covered2011 Employee Benefit Guidebook Updated 11/08/10


REACH YOUR PEAK MEDICAL EPO BENEFITS SCHEDULEPARTICIPATINGPROVIDERSCALENDAR YEARANNUAL LIMIT $1,000,000NON-PARTICIPATINGPROVIDERSDEDUCTIBLE, PER CALENDAR YEARPer Covered Person $2,000 Not CoveredPer Family Unit $6,000 Not CoveredMAXIMUM OUT-OF-POCKET AMOUNT, PER CALENDAR YEARPer Covered Person $8,000 Not CoveredPer Family Unit $16,000 Not CoveredThe Plan will pay the designated percentage of Covered Charges until out-of-pocket amounts are reached, at whichtime the Plan will pay 100% of the remainder of Covered Charges for the rest of the Calendar Year unless statedotherwise.The following charges do not apply toward the out-of-pocket maximum and are never paid at 100%.• CopaymentsCOVERED CHARGESHospital ServicesInpatient Room and Board 75% after deductible and $500copayment per admissionthe semiprivate room rateIntensive Care Unit 75% after deductible and $500copayment per admissionNot CoveredNot CoveredOutpatient Facility ServicesOutpatient Physician servicesHospital's ICU Charge75% after $250 copayment pervisitNo deductible appliesNot Covered75%, no deductible or copaymentappliesNote: The copayment will apply as long as services billed include one or more of the facility room charges:Operating room, recovery room, procedures room, treatment room, and observation room.Skilled Nursing Facility, Rehabilitation 75% after deductible the facility'sNot CoveredHospital andsemiprivate room rateSub-Acute Facilities2011 Employee Benefit Guidebook Updated 11/08/10


Emergency Room Services(including ER Physician services)100% after $200 copayment per visit;No deductible appliesMedical Non-Emergency CareNot CoveredNote: The ER copayment will be waived if admitted to the Hospital directly from the ER.Urgent Care Services100% after $100 copayment perNot Coveredvisit;No deductible appliesNote: The Urgent Care copayment will be waived if admitted to the Hospital directly from Urgent Care.Physician ServicesInpatient Services 75% after deductible Not CoveredEl Paso County Employee Health Center 100% after $10 copayment perNot Covered(Clinic) Office VisitvisitPrimary Care Physician (PCP)Office VisitNo deductible applies100% after $50 copayment pervisitNo deductible appliesNot CoveredNote: A Primary Care Physician (PCP) is defined as a general practitioner, family practitioner, general internist(internist whose practice is 70% general medicine), Nurse Practitioner, Physician’s Assistant, or pediatrician.An OB/GYN will be considered a specialist.Specialist office visitsSurgery performed in the office (includingany medical supplies and injectionsrendered during the surgery)100% after $75 copayment pervisitNo deductible applies100% after $10 Clinic, $50 PCPor$75 Specialist copayment per visitNot CoveredNot CoveredNo deductible appliesInjections (other than allergy or100%chemotherapy)No deductible or copayment willapplyAllergy serum and injections 100%No deductible or copayment willapplyPreventive CareRoutine Well Care(ages birth through adult)100%No deductible or copaymentappliesNot CoveredNot CoveredNot CoveredIncludes: Routine office visits, routine physical examination, mammogram, gynecological exam, Pap smear, PSA,routine lab and x-rays, routine colonoscopy, flexible sigmoidoscopy, and immunizations.Ambulance Service75% after deductibleNote: Pre-authorization with the Claims Administrator will be required for non-emergent transport.2011 Employee Benefit Guidebook Updated 11/08/10


Advanced Radiological Imaging (i.e.,MRIs, MRAs, CAT Scans, PET Scans andNuclear Medicine)75%No deductible or copayment willapplyNot CoveredNote: If a Clinic referral is received and processed for tests to establish a diagnosis, Covered Charges will bepayable at 100%.Diagnostic X-ray & Lab Testing 100%Not CoveredNo deductible appliesDurable Medical Equipment 100%No deductible or copayment willapplyNot CoveredHome Health Care 75% after deductible Not CoveredHome Infusion Therapy 75% after deductible Not CoveredHospice Care 75% after deductible Not CoveredMental Disorders and Substance Abuse TreatmentInpatient Services Payable as any other Illness Not CoveredOutpatient Visits100% after $10 copaymentNot CoveredNo deductible appliesMorbid Obesity Benefit Payable as any other Illness Not CoveredNote: A pre-authorization is required prior to services being rendered. Please see the Covered Charges section formore information regarding this benefit.Nutritional EvaluationPayable as any other Illness3 visits per Calendar YearmaximumNot CoveredOutpatient Short-Term RehabilitationTherapy and Chiropractic Services100% after $20 copay per visitNo deductible appliesNot CoveredIncludes: Cardiac Rehab, Physical Therapy, Speech Therapy, Occupational Therapy, Pulmonary Rehab, CognitiveTherapy and Chiropractic services.Multiple services provided on the same day constitute one visit, but a separate copayment will apply to the servicesprovided by each Physician.Orthotics 75% after deductible Not CoveredNote: See Covered Charges section for details.Prosthetics 100%No deductible or copayment willapplyNot Covered2011 Employee Benefit Guidebook Updated 11/08/10


Pregnancy *Initial visit(to confirm Pregnancy)100% after $75 Specialist officevisit copaymentNot CoveredAll subsequent prenatal visits, postnatalvisits, and Physician’s delivery charges (i.e.,global maternity fee)Physician’s office visits in addition to theglobal maternity fee (when performed by anOB/GYN or specialist)75% after deductible100% after $75 office visitcopaymentNo deductible appliesNot CoveredNot CoveredDelivery – Facility charges(Inpatient Hospital, Birthing Center)Payable per InpatientHospitalization benefitNot Covered* Note: If a Clinic referral is received either to confirm a Pregnancy or after the initial diagnosis has beenmade and the Covered Person also enrolls in the CareLink Priority Maternity Care program during thefirst trimester of the Pregnancy, the Covered Person will not be subject to the inpatient hospital copay,inpatient hospital deductible or inpatient Physician deductible for the delivery charges or other pregnancyrelated treatment (billed with a primary diagnosis of “Pregnancy”). ER copay will also be waived if the visitis Pregnancy related (billed with a primary diagnosis of “Pregnancy”)Organ TransplantsPayable as any other IllnessNot CoveredTransportation Benefit Maximum(Available only when using a COE facility)$10,000 Lifetime MaximumNote: See the Covered Charges section for more information regarding this benefit.Wigs75% after deductible$1,000 Lifetime MaximumNote: Limited to the initial purchase of a wig when deemed Medically Necesssary due to temporary or permanenthair loss. See the Covered Charges section for more information regarding this benefit.All Other Eligible Charges 75% after deductible Not CoveredThis Guidebook is only a summary of benefits and is not a binding contract. Summary Plan Documents, Certificates ofCoverage, and the El Paso County Policies and Procedures Manual describes benefits in great detail and are availablethrough ESS or by contacting the Employee Benefits office. Should there be differences between this summary and the plandocuments, contracts or policies, the plan documents, contract, and/or policies will govern.2011 Employee Benefit Guidebook Updated 11/08/10


Employee/Retiree Health Centers &In-House PharmacyEmployees, retirees, spouses and children enrolled in the County’s medical plan can receive highquality health care services through the El Paso County Employee Health Centers.El Paso County Employee Health Centers and Pharmacy services compliment your medicalinsurance benefits, providing you with comprehensive, affordable, convenient and excellent healthcare. Two Board Certified Family Physicians and a Board Certified Nurse Practitioner provideservice at both El Paso County Employee Health Centers. This program works in collaboration withboth providers and your medical insurance benefits to ensure that you receive the very best in healthcare. The Health Centers offer acute care as well as a variety of preventive health and wellnesseducational services. When appropriate, the Health Centers can also make referrals to Specialists.The Health Center Physicians and Nurse Practitioners can also write prescriptions.Health Center copays are only $10.00 for both nurse practitioner and PCP visits! Other medicalservices, such as immunizations and vaccinations, may carry an additional cost.Ensuring your privacy and maintaining confidentiality is assured — strict adherence to HIPPAguidelines ensures all personal medical information obtained by the Health Centers and pharmaciesis protected and kept completely confidential.Following are just a few examples of the many services offered:Health Center Services include:Comprehensive Individual/Family Primary CareUrgent and Acute Care (flu, fever, viralinfections, nausea, cuts, sprains/strains)Prevent Health (annual adult and childrenphysicals)Disease ManagementAllergy ManagementStress management CounselingSmoking Cessation CounselingWellness Education / SupportReferrals to specialistsVaccinations, Injections & Laboratory ServicesPharmacy Services include:Prescriptions & RefillsCounseling & EducationGeneric Prescription OptionsFlavor Rx (for better-tasting liquids)Over the Counter Medications and SuppliesAccess to Walgreens Pharmacy NetworkPrescription Savings Club Membership OptionRewards Card (for over the counter purchases)Walgreens Mail Service Prescriptions24-Hour Call Center (866-924-9377)2011 Employee Benefit Guidebook Updated 11/08/10


Wellness ExamsThe County Health Centers offer physicals for employees, dependents and retirees and their enrolleddependents. The cost of a physical is $10.00.Adults – Well Woman Physicals: Well woman physicals are also offered in the Health Centers. Thephysical includes a Pap smear, breast exam and consultation on specific concerns or questions. Prenatalcare is not offered at the Health Centers.Adolescents – Physicals: School and sports physicals are offered. The physicals include acomprehensive examination, risk appraisal, vision screen and appropriate vaccinations. Health andwellness advice will also be provided. Please bring record of immunizations and required school forms.2011 RYP Program Participants who are enrolled on the County Medical Plan will receive 100%preventive coverage and will not be responsible for copayments.RDC Health Center2880 International Circle,Lower LevelColorado Springs, CO 80910(719) 520-7080Monday-Friday 8 am to 5 pmWalgreens In-House Pharmacy2880 International Circle, Lower LevelColorado Springs, CO 80910(719) 219-0670Monday-Friday 8:30 am to 5:30 pmEast Health Center5850 Championship View, Suite DColorado Springs, CO 80922(719) 520-7600Monday-Friday 8 am to 5 pm2011 Employee Benefit Guidebook Updated 11/08/10


Walgreens Health InitiativesWalgreens Health Initiatives (WHI) administers the Prescription Drug Program for El Paso County. In addition to filling your 90-day prescriptions at the El Paso County Employee pharmacy and Walgreens Mail Service (Tempe, AZ facility), you can alsoobtain a 90-day prescription through Walgreens Advantage90® program. This program allows you to obtain a 90-day supply ofmedication at over 6,500 retail Walgreens pharmacies nationwide.Filling Prescriptions at a Retail PharmacyThrough WHI you will have convenient access to a nationwide network of more than 6,500 retail Walgreens pharmacies inaddition to the El Paso County Employee pharmacy. You can obtain a complete listing of pharmacies in your network byaccessing the WHI website at www.mywhi.com. Go to the pharmacy locator link, enter your six-digit RxGrp number of 112359(found on your ID card), and enter your zip code or city and state.Walgreens In-House PharmacyThe Walgreens in-house pharmacy is located at 2880 International Circle, Lower Level, and is open Monday throughFriday, 8:30 to 5:30 pm (except holidays), phone 719 219-0670.Refill Prescriptions at the Walgreens In-House or Retail Pharmacy• If you have a current prescription at a retail pharmacy with valid refills, you will not need to obtain a new prescription(s)to continue to fill at that pharmacy.• Present your Walgreens prescription ID card to the pharmacist at the time the prescription(s) is filled to ensure thatyour prescription insurance information is updated to process through WHI.• The pharmacist will process and fill the prescription(s) through WHI, and collect the appropriate copayment.New Prescriptions at the Walgreens In-House or Retail Pharmacy• Present your new prescription ID card to the pharmacist. The pharmacist will process and fill the prescription(s)through WHI, and collect the appropriate copayment.• The Advantage90® program will require a new prescription for the 90-day quantity at the Walgreens retail pharmacies.Be sure to ask your doctor to write your prescription for a minimum of an 84-day supply up to a maximum of a 90-daysupply. Note: Some medications cannot be dispensed in 90-day quantities because of legal restrictions. Maintenancemedications are defined as medications that are used for chronic, long-term conditions such as high blood pressure,high cholesterol, etc. Specialty pharmacy medications are not considered to be maintenance medications.Filling Prescriptions at the Mail Service PharmacyThrough the Prescription Drug Program, you can take advantage of convenient delivery of your covered maintenancemedications to your home or other specified address. Maintenance medications are defined as medications that are used forchronic, long-term conditions such as high blood pressure, high cholesterol, etc. Specialty pharmacy medications are notconsidered to be maintenance medications.In order to use the Walgreens Mail Service pharmacy you will need to:• Fill out a new Walgreens mail registration form, which will be provided to you in your WHI Prescription packets. Youcan fill out one registration for your entire family even though you may not be filling a prescription for all members inyour family.• Obtain new prescription(s) from your doctor, and mail the originals along with your completed registration form, andcopayment. The address to mail your order is provided on the Walgreens mail registration form.©2008 Walgreens Health Initiatives, Inc., a wholly owned subsidiary of Walgreen Co. All rights reserved.


• Please allow 14 days to process and mail your prescription(s).WHI Clinical ProgramsSpecialty Pharmacy (injectable and oral medications)WHI Specialty Pharmacy provides convenient, dependable access to medications for people living with complex healthconditions. Our programs and services focus on injectables, oral medications, and medication therapies involving strictcompliance requirements; special storage, handling, and delivery; complex administration methods; andeducation/monitoring/ongoing support. Drugs that fall under this program can only be dispensed at the El Paso CountyEmployee Pharmacy, a Walgreens retail pharmacy or via a home delivery method through the Walgreens Mail Servicepharmacy. These drugs will be limited to a 30-day supply regardless if dispensed at a retail pharmacy or at a mail servicepharmacy. Specialty Pharmacy copayments will apply at retail/mail.Drugs include the following, but are not limited to: Cystic Fibrosis medications, Enzyme replacement medications, ViralHepatitis medications, Multiple Sclerosis medications, Growth Hormones, and all other biotech medications. Please call tollfree at 1-888-782-8443 to pre-enroll in the Specialty Pharmacy program.Clinical Prior Authorization (CPA)Certain prescriptions may require “clinical prior authorization” or approval from WHI before they will be covered by your plan.The categories/medications that require clinical prior authorization may include, but are not limited to:• Acne Topical (i.e. Retin-A, Avita, Differin) exceedingage 24• Actiq• ADHD/Narcolepsy (i.e. Dexedrine, Ritalin, Cylert)exceeding age 19• Anabolic Steroids (oral, topical, injectable)• Antiemetics (oral, i.e. Kytril, Zofran) are limited to a 7day supply per 25 days. CPA if quantity limit isexceeded.• Botulin Toxins (i.e. Botox, Myobloc)• Butorphanol exceeding 2 bottles(5 ml)/25 days• Byetta• Crinone 8%• Duragesic exceeding a quantity of 15/25 days• Fentora• Impotency (i.e. Viagra, Caverject, Levitra, Cyalis) CPAwith max quantity of 8, if approved.• Insomnia (i.e. Ambien, Restoril, Sonata) exceedingquantity of 90/144 days• Lamisil/Sporanox/Penlac• Oxycontin©2008 Walgreens Health Initiatives, Inc., a wholly owned subsidiary of Walgreen Co. All rights reserved.


To request prior authorization for your prescription, the pharmacy, the physician or you may call the Prior Authorization Departmenttoll free at 1-877-665-6609. Please have available the name of your medication, physician’s name, phone (and fax number, ifavailable), your ID number, and your Rx Group number of 112359.Your Cost: Retail, Mail-Order and Specialty PharmacyWhen covered prescriptions are filled under this program, you will share a portion of the cost; the plan pays for the rest. Yourprescription drug program provides you with three-tier options. These formulary medications have received FDA approval as safeand effective. The WHI Preferred Medication List (PML)/formulary is available on the WHI web site at www.mywhi.com. The on-lineguide is updated regularly every calendar quarter or more often if needed to reflect important changes. Please note that although adrug is on a formulary, it does not necessarily mean that it is a covered drug under your plan. Refer to your Summary PlanDescription for a list of coverages/exclusions.Your costs for the program are as follows:Pharmacy Drug Type/Copay Tier Member CopayUp to a 30 DaySupply84-90 Day Supply* Up to a 90Day SupplyIn-House Generic $6.00 $15.00Walgreens Preferred Brand $24.00 $60.00Pharmacy Non-Preferred Brand $42.00 $105.00Preferred Brand - Specialty$100.00Medication**Non-Preferred Brand - Specialty$200.00Walgreens RetailPharmacyWalgreens MailOrder PharmacyMedication**Generic $7.50 $16.50Preferred Brand $25.50 $61.50Non-Preferred Brand $43.50 $106.50Preferred Brand - Specialty Medication** $100.00Non-Preferred Brand - Specialty$200.00Medication**Generic $15.00Preferred Brand $60.00Non-Preferred Brand $105.00Preferred Brand - Specialty Medication** $100.00Non-Preferred Brand - Specialty$200.00Medication***Your prescription must be written for at least an 84-day supply in order to obtain at the retail pharmacy.**Covered Specialty Pharmacy medications are limited to a 30-day supply. For Specialty Pharmacy medications, a Patient Max-Out-of-Pocket (MOOP) of$2,500.00 applies per individual, per calendar year. Once the MOOP is met, the member's copayment is zero for the remainder of the calendar year.It is standard pharmacy practice (and in some states, it is even required by law) to substitute generic equivalents for brand-namedrugs whenever possible. When you use the mail service or a participating retail pharmacy, you may receive generic substituteswhenever available and allowable. If you select a brand name drug when a generic equivalent is available, you will be responsiblefor the difference in the cost of the brand and generic drug, plus your applicable copayment.2011 Employee Benefit Guidebook Updated 11//08/10


EYEMEDVISON PLANEyeMedBENEFIT FEATURES Current RenewalBasic Information Network Non-Network*Exams $10 copay $35Materials No copay N/AFrequency of ServicesExamsevery 12 monthsLensesevery 12 monthsFramesevery 24 monthsContact Lensesevery 12 monthsNetwork BenefitsStandard Lenses:Single Vision $25 copay $40Bifocals $25 copay $60Trifocals $25 copay $60Progressive $25 copay $80Contact Lenses (in lieu of lenses & frames)Medically NecessaryNo copay; Up to $130allowance$200Elective (Cosmetic) No copay; Up to $130allowance$105Standard Frames No copay $45Additional Purchases and Out-of-Pocket Discount Benefits are not provided for services or materials arisingfrom: Orthoptic or vision training, subnormal vision aids and any associated supplemental testing; Aniseikoniclenses; Medical and/or surgical treatment of the eye, eyes or supporting structures; Any eye or VisionExamination, or any corrective eyewear required by a Policyholder as a condition of employment; safetyeyewear; Services provided as a result of any Workers’ Compensation law, or similar legislation, or required byany governmental agency or program whether federal, state or subdivisions thereof; Plano (non-prescription)lenses and/or contact lenses; Non-prescription sunglasses; Two pair of glasses in lieu of bifocals; Services ormaterials provided by any other group benefit plan providing vision care; Certain brand name Vision Materials inwhich the manufacturer imposes a no-discount policy; or Services rendered after the date an Insured Personceases to be covered under the Policy, except when Vision Materials ordered before coverage ended aredelivered, and the services rendered to the Insured Person are within 31 days from the date of such order. Lost orbroken lenses, frames, glasses, or contact lenses will not be replaced except in the next Benefit Frequency whenVision Materials would next become available.Benefits may not be combined with any discount, promotional offering, or other group benefit plans.Standard/Premium Progressive Lens not covered - fund as a Bifocal Lens. Standard Progressive Lens covered -fund Premium Progressive as a Standard. Member will receive a 20% discount on remaining balance atParticipating Providers beyond plan coverage; the discount does not apply to EyeMed's Providers' professional2011 Employee Benefit Guidebook Updated 11//08/10


services or disposable contact lenses. Members also receive a 40% discount off complete pair eyeglass purchasesand a 15% discount off conventional contact lenses once the funded benefit has been used.Underwritten by Combined Insurance Company of America, 5050 Broadway, Chicago, IL 60640, except in NewYork. CICA Form # VN P63007 0801. This is a snapshot of your benefits. The Certificate of Insurance is on filewith your employer.2011 Employee Benefit Guidebook Updated 11//08/10


GuardianDENTAL PLANSEl Paso County offers two options with Guardian Dental: Low Option PPO and a High Option PPO. Acomparison of the two plans is shown on the following page.On the Low and High Guardian Dental options, dental procedures are covered either through a GuardianDental Guard Preferred Network PPO dental provider or through any licensed dentist. A listing of Networkproviders can be found through the Guardian website at www.GuardianAnytime.com, clock on the “Find aProvider” in the right hand corner of the page. Next click the box “Find a Dentist”. When prompted for theDental Plan, select “PPO”, and for the Dental Network choose ‘DentalGuard Preferred” Network.Guardian DentalComparison of 2011 PlansDENTAL SERVICES LOW OPTION HIGH OPTIONInNetworkOut ofNetworkInNetworkOut ofNetworkTeeth Cleaning – 2 per calendar year 100% 80% 100% 100%Oral Evaluations (Diagnostic) 100% 80% 100% 100%X Rays (Diagnostic) 100% 80% 100% 100%Lab and Other Diagnostic Tests 100% 80% 100% 100%Prophylaxis (Preventive) 100% 80% 100% 100%Fluoride Treatment (Preventive) for children100% 80% 100% 100%under age 19Fillings (Amalgam & Anterior Composites) 80% 60% 90% 70%Crowns: Stainless Steel 80% 60% 90% 70%Simple Extractions 80% 60% 90% 70%Oral Surgery (simple extractions) 80% 60% 90% 70%Endodontic Services – Root Canal Therapy 50% 30% 90% 70%Periodontal Services 50% 30% 90% 70%Inlays/Onlays/Bridges 50% 30% 60% 30%Dentures and other Removable Prosthetics 50% 30% 60% 30%Fixed Prosthetics 50% 30% 60% 30%Crowns: Resin, Metal 50% 30% 60% 30%Implants 50% 30% 60% 30%Orthodontia N/A N/A 50% 50%Orthodontia Eligibility N/A Child under age 19 OnlyDeductible Per Person $50/$150 $50/$150 $25/$75 $50/$150Deductible applies to Preventive & Diagnostic No No No NoOrtho Lifetime Maximum (children only) N/A N/A $1,500 $500Calendar Maximum includes In and Out of$1000 $1000 $1500 $1500NetworkWaiting Period applies No NoOut of Network Basis MAC UCR 90thThis Guidebook is only a summary of benefits and is not a binding contract. Summary Plan Documents, Certificates of Coverage, and the El Paso CountyPolicies and Procedures Manual describes benefits in great detail and are available through ESS or by contacting the Employee Benefits office. Shouldthere be differences between this summary and the plan documents, contracts or policies, the plan documents, contract, and/or policies will governDental Rate Proposal2011 Employee Benefit Guidebook Updated 11//08/10


Maximum Rollover Feature:• With Maximum Rollover, Guardian will roll over a portion of your unused annual maximum into yourpersonal Maximum Rollover Account (MRA). The MRA can be used in further years, if you reach theplan’s annual maximum.• Even better, if you use the services of Preferred Providers exclusively during the benefit year, Guardian willincrease the amount credited to your MRA.• To qualify, you must submit a claim for covered services for which a benefit payment is issued, in excess ofany deductible or co-pay, and you must not exceed the paid claims threshold during the benefit year.• You and your insured dependents maintain separate MRAs based on your own claim activity. Each MRAmay not exceed the MRA limit.• You will receive an annual MRA statement detailing your account and those of your dependents.High Plan:Low Plan:PLAN ANNUALMAXIMUM **THRESHOLDMAXIMUMROLLOVER AMOUNTIN-NETWORK ONLYMAXIMUMROLLOVER AMOUNTMAXIMUMROLLOVERACCOUNT LIMIT$1500 $700 $350 $500 $1250PLAN ANNUALMAXIMUM **THRESHOLDMAXIMUMROLLOVER AMOUNTIN-NETWORK ONLYMAXIMUMROLLOVER AMOUNTMAXIMUMROLLOVERACCOUNT LIMIT$1000 $500 $250 $350 $1000This Guidebook is only a summary of benefits and is not a binding contract. Summary Plan Documents, Certificates of Coverage, and the El Paso CountyPolicies and Procedures Manual describes benefits in great detail and are available through ESS or by contacting the Employee Benefits office. Shouldthere be differences between this summary and the plan documents, contracts or policies, the plan documents, contract, and/or policies will govern2011 Employee Benefit Guidebook Updated 11//08/10


What is an FSA?FLEXIBLE SPENDING ACCOUNTS (FSA)An FSA is a Flexible Spending Account that allows you to set aside money for eligible expenses on a pre-taxbasis. There are two types of Flexible Spending Accounts available - a healthcare account and a dependent daycare account.What you need to know about FSAs• You may only determine your contribution in an FSA during open enrollment or when you first becomeeligible.• You do not need to be covered by your employer’s health plan to participate in an FSA.• Expenses must be for services received, not for services to be provided in the future.• Once you establish your plan year contribution, you may only change it if you experience a Qualifying LifeEvent.• Any claims that were incurred during the plan year must be submitted for reimbursement by the end of yourrun out period (60 days). The run out date is 60 days after the end of your plan year or February 29, 2012.• Any amount left in your healthcare and/or dependent day care FSA at the end of the plan year will beforfeited.An FSA is a smart way to save!AnnualSalaryHealthcare contributionDependent daycare contributionSavings$20,000 $1,500 $0 $405$40,000 $1,750 $4,000 $1,553$60,000 $2,000 $4,500 $1,755Getting started is as easy as 1-2-3!1. Estimate the amount you will spend on out-of-pocket healthcare expenses and/or dependent day careexpenses during the plan year.• Review expenses from prior plan year.• Use our planning tools available at HealthHub.com2. Decide how much you wish to set aside in your healthcare FSA and/or dependent day care FSA.• Divide your annual contribution by 24 pay periods in your plan year to determine the amount thatwill be deducted from you paycheck each pay period.3. As you incur eligible healthcare and dependent day care expenses throughout the year, you canaccess your funds by:2011 Employee Benefit Guidebook Updated 11//08/10


• Using your PayFlex Card OR• Submitting a claim for reimbursementQuick Tip: View a listing of eligible expenses Login to HealthHub.com > My HealthHub Resources >Planning ToolsMy HealthHub Resources: Education & Planning Tools• Savings calculator to help you estimate your healthcare & dependent day care expenses• Digital library designed to help you understand FSAs• Educational materials & forms to better assist you with your spending account(s)Quick Tip: Find out how much you can save Login to HealthHub.com > My HealthHub Resources >Planning ToolsHealthcare Flexible Spending Account:What you should know:• Reimburses you for out-of-pocket medical, dental, prescription or vision services, such as deductibles, copays,and coinsurance.• Allows you to set aside money for eligible expenses on a pre-tax basis for you, your spouse and/ordependents.• You do not pay Federal income or Social Security taxes on this money.• Your entire contribution is available at the beginning of the plan year.• View a detailed listing of eligible expenses at HealthHub.comNew legislation impacts OTC itemsStarting January 1, 2011, certain OTC medicines and drugs will be considered ineligible unless you have awritten prescription from your doctor.How does this new legislation impact you?It impacts you two ways:1. Setting your contribution - since a prescription will be required starting 1/1/2011, you should keep this inmind when deciding your healthcare contribution.2. Using your FSA dollars – you cannot get reimbursed for OTC drugs or medicine unless you have aprescription. In addition, starting 1/1/2011, healthcare cards (e.g., PayFlex Card ) cannot be used to pay forOTC drugs and medicines.Dependent Day Care Flexible Spending Account:What you should know:• Reimburses you for expenses such as day care, before and after school programs, nursery school orpreschool, summer day camp and even adult day care.2011 Employee Benefit Guidebook Updated 11//08/10


• For day care expenses of a child under age 13 OR for the care of a dependent who is physically or mentallyincapable of taking care of themselves.• You and your spouse, if married must be actively working, seeking employment, or full-time student, inorder to get reimbursed.• You can only be reimbursed up to the amount that is available in your account.• View a detailed listing of eligible expenses at HealthHub.com• The annual expense reimbursement may not exceed:o the lesser of your earned income;o if married, your spouse’s earned income;o $5,000 ($2,500 if married, filing separate income tax returns)Eligible expenses:• Licensed day care provider• In-home provider as long as the care provider is not your child under age 19, or someone you claim as atax dependent• Summer camps (not overnight)• Tuition through preschool• Before and after school care (under age 13)Ineligible expenses:• Tuition expenses for kindergarten and beyond• Overnight camps• Child care expenses for a child 13 or older (unless disabled)• Child care expenses for night-time babysitting• Child care expenses while you are on an extended leave of absence• Care provided by an older dependent or siblingQuestions?Contact PayFlex Customer Service at 800.284.4885, 7am-7pm, Monday – Friday and Saturday 9am-2pm CT.Quick Tip: Enroll in direct deposit Login to HealthHub.com > Financial Center > Enroll in Direct DepositReimbursement MethodsOnline: www.HealthHub.comFax: 402.231.4310Mail: PayFlex Systems USA, Inc.PO Box 3039 Omaha, NE68103-30392011 Employee Benefit Guidebook Updated 11//08/10


LIFE INSURANCE PLANSBASIC LIFE/ACCIDENTAL DEATH AND DISMEMBERMENT PLAN BENEFITEMPLOYEE: LIFE BENEFIT: $40,000 AD&D BENEFIT: $40,000SPOUSE: LIFE BENEFIT: $2,000 AD&D BENEFIT: $0CHILD: LIFE BENEFIT: $1,000 first 6 months/$2,000 thereafter until age 26TERM LIFE: This coverage is Term Life Insurance. The Life Insurance benefit is payable tothe designated beneficiary upon the death of the insured. Coverage is provided for the timeperiod that you are eligible and premium is paid. There is no cash value associated with thisproduct.AD&D: Accidental Death and Dismemberment Insurance provides specified benefits for acovered accidental bodily injury that directly causes dismemberment (i.e. the loss of a hand, foot,or eye). In the event that death occurs to an employee from a covered accident, both the Life andthe AD&D benefit would be payable.ELIGIBILITY: All full-time active employees working 40 or more hours per week in an eligibleclass are eligible for coverage on the policy effective date. A delayed effective date will apply ifthe employee is not actively at work on the date the insurance would otherwise take effect.GUARANTEE ISSUE: For timely entrants enrolled within 31 days of becoming eligible, up to$40,000 in coverage is available without any evidence of insurability requirement.LIVING BENEFIT: A living benefit (also called an Accelerated Death Benefit) is available toemployees who have satisfied the Active Work Rule. When such employees are diagnosed asterminally ill (having 12 months or less to live), they may withdraw up to 75% of their lifeinsurance coverage to a maximum of $30,000. The death benefit will be reduced by the amounttaken as a Living Benefit, plus interest.PORTABILITY: If you terminate your employment or if you become ineligible for thiscoverage, you have the option to convert all or part of the amount of Life Insurance in force onthe date of termination at the group rates. Conversion election must be made within 31 days ofyour date of termination.BENEFIT REDUCTION: Life and AD&D benefits will terminate at retirement. Prior to this,reduce to: 65% at age 70 and at age 75 benefits reduce further to 50% of the original amount.This is only a summary of coverage and is not a binding contract. A certificate of coverage willbe made available to you that will describe the benefits in greater detail. Should there bedifferences between this summary and the contract, the contract will govern.2011 Employee Benefit Guidebook Updated 11//08/10


VOLUNTARY TERM LIFE INSURANCEVoluntary Term Life insurance is an optional benefit. Coverage is available in $10,000units starting at $10,000 up to the lesser of seven (7) times your salary rounded to the nexthighest $10,000 or $500,000 for employees and up to the lesser of 100% of the employee’selected amount or $250,000 for spouses. You may also elect a flat $10,000 of coverage fordependent child(ren).You must elect coverage in order to elect coverage for your spouse or dependent child(ren).If you choose to elect AD&D coverage, the amount of coverage will be the same as your lifeinsurance.Up to $200,000 of coverage is guaranteed for you the employee and up to $30,000 for yourspouse as long as you, your spouse or dependent children meet eligibility requirements andenroll within the first 31 days from your eligibility date. This means no medical questions areasked in order to sign up for coverage up to these limits.Any coverage applied for above the guaranteed coverage amounts requires an Evidence ofInsurability form to be completed along with the Enrollment Form. These forms can be found athttp://w3.unum.com/enroll/ElPasoCounty/enrollment.aspx.If you do not elect the minimum coverage when first eligible, you will only be eligible again atthe next Open Enrollment period and Evidence of Insurability will be required to obtain thiscoverage.Additional medical information may be required depending on the amount applied for, or inresponse to the information disclosed on the application.During the initial open enrollment period September 2010 through December 2010, if youpurchase the minimum amount of life insurance ($10,000) for yourself and your dependents, youcan purchase additional insurance up to the Guaranteed Issue (GI) amount during future annualenrollments, as long as you remain actively at work.Please see rates on the following page.2011 Employee Benefit Guidebook Updated 11//08/10


AD&D Coverage RatesEmployee, Spouse & ChildAD&DSemi-Monthly Rate$.100 per $10,000Term LifeCoverage RatesRates shown are your Per-Paycheck deduction:A tobacco user is defined as anyone who currently uses or has used atobacco product within the last 12 months.Employee and Spouse Life Per-PaycheckStep Rates per $10,000Child LifePer-Paycheck RateAge Non-Tobacco Tobacco15-24 0.220 0.310 $1.00 per $10,00025-29 0.220 0.31030-34 0.265 0.39535-39 0.310 0.53040-44 0.570 1.27545-49 0.925 2.15550-54 1.585 3.39055-59 2.465 5.70060-64 3.870 8.85065-69 6.700 15.9570-74 12.50 28.5075+ 12.50 28.50Insurance Age: Your rate is based on your insurance age. To calculate your insurance age,subtract your year of birth from the year your coverage becomes effective.2011 Employee Benefit Guidebook Updated 11//08/10


DISABILITY BENEFITSSHORT TERM DISABILITY (STD)WEEKLY BENEFIT: If you are Totally Disabled beyond the elimination period due to acovered injury or sickness, you may be eligible to receive a weekly benefit of 60% of your basicweekly income to a maximum benefit of $1,000. This benefit may be reduced by income orbenefits from certain other income sources listed in your plan document.DEFINITION OF TOTAL DISABILITY: Total Disability is defined as the inability to performthe material and substantial duties of the employees’ regular occupation due to injury or illnessas certified by a health care provider and approved by the Disability Management Company.ELIGIBILITY DATE: An employee becomes eligible for coverage provided by the Policy onthe later of the Policy’s effective date or the date the Insured Employee satisfies the WaitingPeriod specified in the Policy Effective Date.POLICY EFFECTIVE DATE: Employees are eligible for coverage on the first of the monthfollowing the first day of full-time employment or concurrent with their date of hire if hired onthe first day of the month. If you are hired full-time starting from the 1 st through the 15 th of themonth, coverage is effective the first day of the next month. If you are hired full-time startingthe 16 th through the last day of the month, coverage is effective on the first day of the secondfollowing month. (Example 1: First day of full-time employment is January 15 th , coverage iseffective February 1 st . Example 2: First day of full-time employment is January 16 th , coverageis effective March 1 st .)ELIMINATION PERIOD: Benefits begin following 14 continuous days of Disability orfollowing exhaustion of available sick and vacation benefits, whichever is later.HOW TO REPORT A DISABILITY CLAIM:1. Advise your supervisor or manager as soon as possible, preferably on or before your firstabsence.2. Call the UNUM hotline as soon as possible, or you can access the form on the followingwebsite: http://w3.unum.com/enroll/ElPasoCounty/enrollment.aspxNOTIFICATION OF CLAIM DECISION: The insurance company will notify both theemployee and the Benefits Administrator of their claim decision. Claims can take a few weeksor even longer to be processed so employees are encouraged to submit their paperwork as soonas possible. STD checks are available in the Employee Benefits and Medical Services officeafter 9:00 a.m. on paydays.SUMMARY PLAN DESCRIPTION (SPD): The SPD information may be obtained bycontacting the Employee Benefits Division at 719-520-7420.WHO PAYS FOR DISABILITY COVERAGE: Employees are required to contribute $5.00 perpay period for their Short Term Disability coverage.2011 Employee Benefit Guidebook Updated 11//08/10


LONG TERM DISABILITY (LTD)MONTHLY BENEFIT: If you are Totally Disabled beyond the elimination period due to acovered injury or sickness, you will be eligible to receive a weekly benefit of 60% of predisabilityearnings (when combined with other income sources) up to a maximum monthlybenefit of $6,500. This benefit may be reduced by income or benefits from certain other incomesources listed in your certificate.ELIMINATION PERIOD: You need to satisfy a 180-day elimination period before benefitswould begin. This elimination period can be satisfied with days of Partial Disability, TotalDisability or a combination of both. The elimination period may be met by days of disabilitybuilt up over an accumulation period of 360 days, so there is no penalty for briefly attempting toreturn to work during this elimination period.ELIGIBILITY: All full-time active employees working 40 or more hours per week are eligiblefor coverage on the policy effective date. A delayed effective date will apply if the employee isnot actively at work on the date the insurance would otherwise take effect.DEFINITION OF TOTAL DISABILITY: Total Disability is defined as the inability to performeach of the main duties of your own occupation, due to injury and illness. Your “own”occupation is covered for 24 months. Following this, the definition of disability becomes theinability to perform any occupation for which you are reasonably fitted, based on yourexperience, education or training.BENEFIT DURATION: Benefits may continue to be paid until you reach age 65/SSNRA, aslong as you meet the definition of disability. Please note that certain conditions may be limitedbenefit durations. Review your employee certificate of coverage for clarification.PRE-EXISTING CONDITION: Benefits will not be paid for any disability for which youreceived medical treatment, care or consultation, including diagnostic measures or tookprescribed drugs or medications during the three months preceding your effective date under thispolicy, until you are covered under this policy (or a prior policy) for 12 consecutive monthsbefore disability begins.SUMMARY PLAN DESCRIPTION (SPD): The Long Term Disability SPD information maybe obtained by contacting the Employee Benefits office at 719-520-7420.WHO PAYS FOR DISABILITY COVERAGE: El Paso County pays the full cost for Long TermDisability premium costs.For more information, please contact the Employment, Benefits andMedical Service Division.This is only a summary of coverage and is not a binding contract. Certificates of Coverage, which describesbenefits in great detail, are available through ESS or by contacting the EBMS Benefits Division. Should therebe differences between this summary and the plan contract, the contract will govern.2011 Employee Benefit Guidebook Updated 11//08/10


2011 Employee Benefit Guidebook Updated 11//08/10EL PASO COUNTY RETIREMENT PLANThe El Paso County Retirement Plan is a Defined Benefit Plan as stated under section 401(a) ofthe IRS Code. Participation is mandatory.CONTRIBUTION LEVEL: The contribution amount is 7% of your pre-tax salary. TheCounty also contributes 7% each pay period. By having the contributions withheld on a pre-taxbasis, the amount of your taxable income is lowered. No additional contributions can be madeto this Plan.VESTING: The vesting period under this Plan is 5 years. This means after you have beenemployed 5 years, once you reach the age requirements, you would be eligible for a lifetimeretirement benefit.RETIREMENT ELIGIBILITY: Normal retirement age is 62. You can retire under the Ruleof 75 with a full benefit. The Rule of 75 = your age and service total the number 75 (i.e. age 50with 25 years). No minimum age. Early retirement is age 55 at a reduced rate of 3% for eachyear you are under 62. All benefits are lifetime benefits.BENEFIT CALCULATION: The benefit is calculated using your FAMP Final AverageMonthly Salary (highest 36 months out of last 10 years) x Service x the benefit multiplier.Pre-2010 employment-The formula for calculating your monthly benefit is:FAMP x Service x 2.22%Post-2010 employment-The formula for calculating your monthly benefit is:FAMP x Service x 2.00% (1 st ten years)FAMP x Service x 2.11% (2 nd ten years)FAMP x Service x 2.22% (all years above 20)SEPARATION BENEFITS – NOT VESTED: If you leave employment with less than 5 yearsof service, you are required to remove your contributions from the Plan. You are paid yourcontributions plus interest. The County’s portion is forfeited.Since the money was withheld on a pre-tax basis, unless the money is rolled over into an IRA oranother retirement plan, 20% Federal Income Tax is withheld from the distribution. In addition,at the time you file your taxes for the year in which you received the distribution; there is a 10%early distribution penalty if you are under age 59 ½ . If you roll it over, taxes are deferred andthere is no tax penalty.


2011 Employee Benefit Guidebook Updated 11//08/10SEPARATION BENEFITS – VESTED: If you leave employment with 5 years or more ofservice, you have the option of taking the money out of the Plan with the same provisions statedabove.You may choose to leave your money in the Plan until you are eligible to begin a monthlybenefit anytime between age 55 and 61 at a reduced benefit (3% for each year under age 62), orat age 62 with no reduction. No further contributions can be made. Your contributionsaccumulate interest. The current interest rate is 3%.You may withdraw the money at anytime which then forfeits any future benefits and the taxesand penalties apply. Again, you only get back your contributions plus interest. The County’sportion is forfeited.DEATH BENEFITS: If you die while you are actively employed by the County and are notvested, your beneficiary will receive your contributions and interest.If you die, were vested and under age 55, your beneficiary could take the lump sum or they couldleave the money in the Plan until you would have been 55. They would then receive a lifetimebenefit equal to 60% of the benefit you had accrued. If you were already 55 and vested, theycould begin that 60% benefit immediately. If you were already 62, it would be treated as a 100%J & S benefit and benefits would begin immediately.IF YOU LEAVE AND RETURN: If you leave employment and return to work full-timewithin 48 months and had removed your contributions from the Plan, you have the option of repayingyour contributions, plus interest, for the period of time you were gone. You would getcredit for your prior service. You have one year from the date you are re-hired to re-pay thePlan. If you were vested and left your money in the Plan, you would pick up where you left offand would be credited with the prior service at retirement.PURCHASE OF SERVICE: After 5 years you can purchase service from a previous employer.The cost is based upon an actuarial equivalent of your final average salary at the time ofpurchase. You would be purchasing service from a previous employer you are not entitled to aretirement benefit from. It has to be full-time employment. Verification from your previousemployer is needed stating your dates of full-time employment and non-vested status.MEDICAL BENEFITS: To be eligible for continuation of medical coverage the employeemust be enrolled on a medical plan at the time of retirement. Retiree Eligibility Definitions:Normal Retirement – Age 62 Years and who have a minimum of five (5) years of creditableservice as an employee of El Paso County are eligible for continuation of health insurancemedical benefits, if enrolled at the time of retirement.Early Retirement – Retirees who were fifty-five (55) years of age or older when he/she left thecontinuous service of El Paso County and who have a minimum of five (5) years of creditableservice as an employee of El Paso County are eligible for continuation of health insurancemedical benefits, if enrolled at the time of retirement. Elected officials who were fifty-five (55)years of age or older when he/she left the service of El Paso County and who have a minimum offour (4) years of creditable service with El Paso County are eligible for continuation of the


2011 Employee Benefit Guidebook Updated 11//08/10County’s self-funded medical benefits, if enrolled at the time of retirement. This eligibilityclause is effective for all employees retiring after January 1, 2003.Special Early Retirement – Rule of 75 Years. Age + creditable (continuous) years of servicemust equal 75 years. (No minimum age requirement)Eligibility: Retirees and eligible dependents (spouses and/or children) of retirees may continuemedical coverage on the County’s self-funded medical plans if the retiree is currently enrolledand elects such coverage at the time of retirement. (Retirement is not a qualifying life event.)Spouses and dependent children can continue coverage under the medical plans if they meet theeligibility requirements outlined in Chapter IX of the El Paso County Employee Policies andProcedures manual.Spouses may continue to receive coverage under their own identity after the retiree has becomeentitled to Medicare, reached age sixty-five (65) or death. The spouse is eligible to remain onthe EPO medical plan until age sixty-five (65) or Medicare entitlement, whichever may occurfirst, at which time they may choose to enroll in the 65+ PPO Plan.Dependent children of a retiree that is no longer eligible for the medical plans will be allowed tocontinue coverage as a dependent on the EPO Medical Plan until the retiree’s spouse reaches theage of sixty-five (65) or Medicare entitlement, provided the dependent child meets the eligibilityrequirements. Once the retiree’s spouse reaches the age of sixty-five (65) or Medicareentitlement, the dependent child is no longer eligible for the EPO Medical Plan.If the retiree has coverage for eligible dependent children and no spouse coverage and the retireebecomes entitled to Medicare, reaches age sixty-five (65), or dies, the dependent child is eligibleto remain on the EPO Medical Plan until they no longer meet the definition of an EligibleDependent.Retirees and spouses of retirees who are enrolled on a County medical plan can enroll in the PPO65 + Plan when Medicare entitlement is attained. This plan will be the covered individual’ssecondary insurance and pay after Medicare pays in accordance with plan provisions. Pleasecontact the Employee Benefits office for more information at 719-520-7420. (The PPO 65+ Planwill only be offered if the County meets all eligibility requirements as defined by the PlanProvider. If the eligibility requirements are not met, the benefit will not be offered until sucheligibility is guaranteed and will begin on January 1st of the following year.)For the retiree and dependents of the retiree to be eligible for continuation of health benefits,the retiring employee and dependents must be currently enrolled and elect to continue thecoverage at the time of retirement. If the retiring employee does not elect continuation of thebenefit at the time of retirement, the benefit is forfeited for the retiree and dependents of theretiree.If the retiring employee is married to another El Paso County employee, the retiring employeemay elect to be covered under the active married employee.


2011 Employee Benefit Guidebook Updated 11//08/10Contribution Schedule: The cost for continuation of health benefits for retirees and dependentsof retirees will be subject to the premium rate for the benefit plan(s) elected; however, the countymay provide a medical plan retirement subsidy depending upon the number of years of creditableservice the retiree had at the time of retirement. If the premium rate of the medical plan selectedis less than the provided subsidy, no subsidy reimbursement to the retiree will occur. If thepremium rate of the medical plan selected is more than the provided subsidy, the balance duewill be deducted from the retiree’s benefit paymentIf the premium rate of the medical or dental plan exceeds the retiree benefit payment, the retireeis responsible to make payment for the health benefits directly to the Retirement Plan office bythe 1 st day of each month. Non-Payment of Health Premiums: In the event of late or nonpaymentof health premiums, coverage will be terminated retroactively to the last day coveragewas paid in full. You will be given 30 days notice except in cases of fraud or intentionalmisrepresentation. Health benefits will not be reinstated if payment has not been received infull by the end of the 30-day grace period.The Health Plan Trust Board will determine the subsidy amount. The retiree subsidy rate may bere-evaluated and may be adjusted each year with increases to the retiree subsidy, which will bebased on contributions for active employees.RETIREE DENTAL AND VISION PLANRetirees who meet the eligibility requirements of the medical plan are also eligible forcontinuation of dental and vision coverage if enrolled at the time of retirement. The rate fordental and vision coverage will be based on the actual cost of plans.Special Retiree Dental and Vision Open Enrollment – Retirees who are not enrolled on thedental and/or vision plan as of December 31, 2010, but who are enrolled in the Medical Plan ,have the option of electing the dental and/or vision plan during the 2011 Open Enrollment for aJanuary 1, 2011 effective date.BOARD OF RETIREMENT: The Board of Retirement consists of five members. Two areelected by the participants. Two are appointed by the BOCC. One is the County Treasurer who ismandated by State Statute to be on the Board.The Board makes all decisions pertaining to the Plan (COLAS, benefit factor, investmentmanagers, etc.)WEB SITE ADDRESS- www.epcretirement.org:A Web Site has been established to provide more current and detailed information. Informationprovided:Benefit Calculator (Calculate your own benefit)Investment PerformanceFinancial StatementsActuarial ReportOther Retirement Planning Tools


2011 Employee Benefit Guidebook Updated 11//08/10DISCLAIMEREl Paso County Retirement Plan DocumentMinutes of MeetingsThis summary information is intended to provide general information about the El PasoCounty Retirement Plan. The El Paso County Retirement Plan Document is the governingauthority.


2011 Employee Benefit Guidebook Updated 11//08/10NOTICE OF PRIVACY PRACTICESGROUP MEDICAL PLAN(El Paso County Medical Group Plan)GROUP DENTAL PLAN(Guardian Dental Group Plan)FLEXIBLE SPENDING ACCOUNT (FSA) (PayFlex)THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BEUSED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THISINFORMATION. PLEASE REVIEW IT CAREFULLY.El Paso County provides many types of services, such as employee benefits, various health, welfare, and wellnessactivities as well as an assortment of social services. We must collect information about you in order to providethese services.At El Paso County, we respect your privacy and will protect your health information responsibly and professionally.Both Federal and State law require that we maintain the privacy of your health information.This Notice of Privacy Practices is being provided to you as a requirement of the Health Insurance Portability andAccountability Act (HIPAA) and describes how we may collect, use, and disclose your health information. It alsodescribes your rights concerning your health information. El Paso County is required to abide by the terms of theNotice that’s currently in effect.As you read this Notice, you’ll see an important term: “Protected Health Information” or PHI. PHI isindividually identifiable health information, including health and demographic information created, transmittedand/or received by us that can reasonably be used to identify you regardless of form (oral, written, or electronic).Some examples of PHI might be age, gender, and address information. PHI also includes information relating toyour past, present, and future physical or mental health or condition, the provision of health care and/or health carerelated services, and payment for that care.To the extent practical or feasible, any PHI created, transmitted, received and/or otherwise used by us shall,regardless of form (oral, written, or electronic), be de-identified in order to protect individual privacy.


2011 Employee Benefit Guidebook Updated 11//08/10DESIGNATED PRIVACY OFFICERIn compliance with HIPAA regulatory requirements, El Paso County has designated a “Privacy Officer” who isresponsible for overseeing privacy


2011 Employee Benefit Guidebook Updated 11//08/10


2011 Employee Benefit Guidebook Updated 11//08/10


2011 Employee Benefit Guidebook Updated 11//08/10


2011 Employee Benefit Guidebook Updated 11//08/10


2011 Employee Benefit Guidebook Updated 11//08/10

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