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Health & Wellness

Health Insurance 2016 Plan Year

Healthcomp Enrollment Form, Declaration of Dependent Eligibility Form, Address – Emergency Contact Form.

City’s Medical Plan: “Plan A”

Because the City is self-insured, the City’s Medical Plan must meet the requirements of the federal health care reform law, the Patient Protection and Affordable Care Act (“ACA” or “Affordable Care Act”). Although the federal government adopted the ACA in 2010, the majority of reforms were implemented in 2014. Additional ACA health care reforms are expected to be implemented in 2017 and 2018. 

In accordance with the ACA and agreements reached with the City’s bargaining units and unrepresented employees, effective January 1, 2015, the City of South Lake Tahoe’s Medical Plan for all plan participants will be “Plan A," (see below for detailed description of Plan A). For more information on employer’s requirements under the health care reform act (aka Affordable Care Act), follow this link

All eligible plan participants receive the same Medical Plan, Plan A. Follow the link below to review the Summary of Benefits and Coverage document for Plan A. Additional summary information is available through Human Resources.

Plan A Summary Plan Document

Plan "A" Summary Plan Document

Optional Plan Upgrades Summary Plan Documents

The City's insurance brokerage and consulting firm Keenan and Associates designed four optional medical plans with lower deductibles, co-pays and out-of-pocket maximums than the City's Medical Plan ("Plan A"). Eligible plan participants may elect to upgrade to one of the four optional plans by paying the difference between the amount of premium covered by the City for Plan A and the monthly premium for any of the four optional upgrade plans. 

Optional Plan "B" Summary Plan Document  
Optional Plan "C" Summary Plan Document
Optional Plan "D" Summary Plan Document
Optional Plan "E" Summary Plan Document

Medical Plan Rates

The City’s Medical Plan (Plan A) and differential rates for optional plan upgrades are in the Open Enrollment packets or following the link for rates. For employees, the City covers the premium for Plan A for employee (single rate), employee plus one dependent (two-party rate) or employee plus more than one dependent (family rate).  

Health and Wellness Insurance Options 

The City provides access to an optional dental plan, as well as an optional vision insurance plan. In addition, the City has authorized America Fidelity Assurance Company to offer additional Health and Wellness insurance options described below:

  • Dental insurance
  • Vision insurance
  • Disability Income Insurance*
  • Accident Insurance *
  • Additional Life Insurance *
  • Cancer Insurance*
  • Critical Illness Insurance *
  • TexasLife Individual Life Insurance*
  • Hospital GAP Plan Choice*

* these are optional benefits provided through American Fidelity Assurance Company. For more information about American Fidelity Assurance Company, read the company profile.

Life and AD&D Insurance Benefits through Sun Life
The City provides a Group Term Life Insurance/AD&D policy equal to $50,000 for eligible employees at no cost through SunLife Insurance. This policy includes a "travel accident" benefit.  During the initial enrollment period upon hire, new hires can purchase additional life insurance through SunLife up to a guarantee issue amount.  To review a summary of the life insurance benefit, please use the link below.  Detailed plan document is available though Human Resources.  Group Life Insurance Benefit Summary

Optional Group Life and AD&D Insurance Benefits through Sun Life
Upon initial hire, all employees are eligible to enroll in additional life insurance for themselves, spouse, and child through Sun Life (up to $50,0000 guarantee issue for employee).  After initial hire, employees may be able to enroll upon approval by Sun Life.  For a "late enrollment"  please contact Human Resources for an Evidence of Insurability form.  To review a summary of the optional group life and accidental death and dismemberment insurance, please use the link below.
SunLife Optional Life Insurance Summary

Short Term and Long Term Disability Insurance Through Sun Life
Depending upon the bargaining unit agreement, some employees are also covered through SunLife for short term and long term disability.  Certain labor groups have elected as a group not to participate and provide access to coverage through their association.  A summary of the SunLife short term and long term disability benefit is available through the link below.  For additional information or information on filing a claim for benefits, please contact Human Resources.  The City does not participate in the State Disability Program.  Short Term and Long Term Disability Benefit Summary