§ 28-36. Health insurance.

It is the policy of Orange County to provide permanent employees both full-time and part-time (regularly scheduled at least 20 hours each workweek) with group health insurance. The cost to the employee for group health insurance is determined each year. Employees also have the option, at additional expense, to cover the employee's spouse, dependent child(ren), domestic partner as defined in this Ordinance, and/or family.

(a)

Effective Date. Coverage is effective on the first day of the month following the date of employment.

(b)

Retiree Health Insurance. The County provides retiree health insurance and contributes toward the cost of this for eligible employees.

(1)

Employees Eligible.

a.

A Permanent Employee employed on or before June 30, 2012 is eligible for retiree health insurance if he or she retires from Orange County and meets one of the following criteria:

1.

Has at least ten years of total Orange County Service as a permanent employee.

2.

Is age 65 or older and has at least five years of total Orange County Service as a permanent employee.

3.

Is retiring on a Disability Retirement and has at least five years of total Orange County Service as a permanent employee.

b.

A Permanent Employee, employed on or after July 1, 2012 is eligible for retiree health insurance if he or she retires from Orange County and meets one of the following criteria:

1.

Has at least 20 consecutive years of Orange County Service as a permanent employee.

2.

Is age 65 or older and has at least ten consecutive years of Orange County Service as a permanent employee.

3.

Is retiring on a Disability Retirement and has at least ten consecutive years of Orange County Service as a permanent employee.

(2)

Eligibility Period to Elect Participation in Retiree Health Insurance. To participate in retiree health insurance, the eligible retiree must be retiring directly from Orange County and request such participation within 30 calendar days of the last date of employment.

(3)

Retiree Health Insurance Plans Available.

a.

For an eligible retiree under age 65. The retiree is covered under one of the County's group health insurance plans. The retiree remains on the County group health insurance plan in which enrolled at retirement. During any subsequent annual enrollment period, the retiree may change to another County health insurance plan as well as add or drop dependents.

b.

For any retiree eligible for Medicare due to age or disability. Medicare becomes the primary insurer and the County becomes the secondary insurer. County group health insurance ends. The retiree enrolls in Medicare Part A and Part B and pays the cost. The County provides Medicare supplement hospitalization and provider insurance and prescription coverage, as specified in this Ordinance.

(4)

County Contribution for Retiree Health Insurance.

a.

Effective July 1, 2008, Orange County will not subsidize the cost of retiree dependent health care for employees hired after July 1, 2008.

b.

For an eligible retiree under Section (b)(1)a.1., the County subsidizes the cost of retiree health insurance as follows:

Retiree/Dependent		Health Plan Type	Retiree Supplement*	Dependent Supplement*
Retiree under 65		Group Health Plan	100%
	•Dependent under 65	Group Health Plan		52%
	•Dependent 65 or over	Medicare Supplement		None
Retiree 65 and over		Medicare Supplement	100%
	•Dependent under 65	Group Health Plan		None
	•Dependent 65 or over	Medicare Supplement		None

 

c.

For an eligible retiree, under Sections (b)(1)a.2 and (b)(1)a.3, the County subsidizes the cost of retiree health insurance as follows:

Retiree/Dependent		Health Plan Type	Retiree Supplement*	Dependent Supplement*
Retiree under 65		Group Health Plan	50%
	•Dependent under 65	Group Health Plan		26%
	•Dependent 65 or over	Medicare Supplement		None
Retiree 65 and over		Medicare Supplement	50%
	•Dependent under 65	Group Health Plan		None
	•Dependent 65 or over	Medicare Supplement		None

 

d.

For an eligible retiree under Section (b)(1)b, the County subsidizes the cost of retiree health insurance as follows:

Retiree	Health Plan Type	Retiree Supplement*	Dependent Supplement*
Retiree under 65	Group Health Plan	100%	None
Retiree 65 and over or Medicare eligible Retiree under 65	Medicare Supplement Prescription Coverage	100%	None
Disability Retirement under age 65 between 10—20 years of total Orange County service	Group Health Plan	50%	None
Retiree 65 and over with between 10—20 years of total Orange County service	Medicare Supplement Prescription Coverage	50%	None

 

*The County pays the percentage shown of the cost not to exceed the amount it contributes for individual/dependent coverage for current employees. For employees hired on or after July 1, 2012, the County cost may not exceed 50% of the amount it contributes for individual/dependent coverage for current employees. The retiree pays the cost for any group health insurance or Medicare supplement coverage for the retiree or the dependent costing more than the County contribution. If the retiree waives coverage, the County provides no cash payment in lieu of such coverage.

(5)

Payment of Premiums for Which the Retiree Is Responsible. The retiree pays Orange County any required premiums monthly. With appropriate notice, the County terminates coverage when premiums are more than 30 days past due. The health insurance provider bills the retiree directly for any Medicare supplement coverage for a dependent.

(6)

Dependent Under Age 65 at Death of Eligible Retiree. Upon the death of the retiree enrolled in the County retiree health insurance, the County offers a dependent on group health insurance continuation of coverage under the Consolidated Omnibus Budget Reconciliation Act (COBRA). The dependent is eligible for such coverage for up to 36 months (or until attaining age 65) provided the dependent pays the full cost of this coverage.

(7)

Eligible Retiree Returning to Work in NC Local Government. If the retiree returns to work with another North Carolina Local Government employer in a position which offers group health insurance coverage (whether the employee elects it or not), Orange County cancels the retiree's health insurance coverage through Orange County and such coverage may not be reinstated.

(c)

COBRA Coverage. Under the Consolidated Omnibus Reconciliation Act (COBRA), Orange County continues health care coverage to persons who would otherwise lose coverage under a health care plan due to specific events provided the employee, covered spouse, domestic partner, and/or dependent child agrees to pay, and pays, the cost of this coverage.

(1)

When coverage ceases due to termination or reduction in hours of employment, the employee, covered spouse, domestic partner, and/or dependent child is entitled to up to 18 months of coverage.

(2)

If the employee, covered spouse, domestic partner, or dependent child is determined disabled under Social Security at the time of termination or reduction in hours, he or she is entitled to purchase coverage for up to 29 months.

(3)

The spouse, domestic partner, or dependent child of an employee is entitled to up to 36 months of coverage if any of the following occurs:

a.

Death of the covered employee.

b.

Divorce or legal separation of the covered employee from the employee's spouse or termination of a domestic partner relationship.

c.

A covered employee becomes entitled to Medicare benefits.

d.

A covered dependent is no longer a dependent.

(Ord. of 06-07-1976, eff. 08-01-1976; Amend. of 09-16-1997, Art. IV § 7.0, eff. 09-01-1997; Amend. of 09-21-2004, eff. 01-01-2005; Amend. of 06-24-2008, eff. 07-01-2008; Amend. of 06-19-2012, eff. 07-01-2012)