Continuation of Coverage Notice – COBRA
The Federal Consolidated Omnibus Budget Reconciliation Act (COBRA) gives you the right to choose continuation of health care coverage if you and/or your eligible dependents lose County coverage. You may continue health care coverage for up to 18, 29 or 36 months, depending on the situation and who is being covered. Within a couple of weeks of the loss of coverage, you will receive a separate COBRA notification from WageWorks, our COBRA TPA, explaining these rights.
If you think you or your dependents’ health care coverage will end because an event is occurring causing ineligibility under the plan, there are certain things you must do to continue coverage under COBRA. In some cases, you must notify the County of the event. If COBRA is an option for you, you must make an election and pay for coverage within certain time periods.
If you retire, the County will notify you and your dependents of your right to continue health care coverage under COBRA. This notification will explain in detail how COBRA works. You may elect Retiree coverage or COBRA coverage.
If you die, the County will notify your dependents of their right to continue health care coverage under COBRA. This notification will explain in detail how COBRA works.
If you divorce or legally separate or your child loses dependent status under a group health plan, you or your covered dependents are responsible for notifying the County within 60 days from the date of these events. The County’s Third Party Administrator, WageWorks, will then notify your dependents of their right to continue health care coverage under COBRA. This notification will explain in detail how COBRA works. COBRA rights will be forfeited if WageWorks is not notified within 60 days of the qualifying event.
Continuation of Coverage Notice – Domestic Partner
A domestic partner and/or their dependents are not eligible under COBRA law; however, the Broward County Board of County Commissioners extends continuation of group health, dental and/or vision coverage to employee’s domestic partner and their dependents for up to a period of 18 months, if they experience one of the events listed below.
- employee’s termination or reduction of hours of employment
- death of the employee
- employee becomes entitled to Medicare
- dissolution of the domestic partnership registered with Broward County Records Division (Per County Ordinance, domestic partners remain on your coverage through the end of the month, 30 days after the dissolution date.)
- a dependent child will also have the opportunity to apply for continuation coverage for up to 18 months if the dependent ceases to qualify as a “dependent child” as defined by the insurance plan.
You will have the opportunity to continue the same coverage in which you were enrolled the day before you experienced one of the events described above. You do not have to show that you are insurable to choose continuation coverage. No additional time extensions past the 18 months are available under this continuation benefit.
Should the employee and the domestic partner or their dependents want continuation coverage because of the same event, the employee would apply separately for COBRA and the domestic partner and their dependents would apply for domestic partner continuation benefits.
If you have any further questions regarding COBRA or Domestic Partner Continuation of Coverage benefits, please contact Employee Benefit Services at 954-357-6700; for billing and payment questions, contact WageWorks at: 800-342-8017.
DOMESTIC PARTNER AND OVER AGE DEPENDENTS (AGE 26 - 30)
Premiums and County Subsidy
Federal Tax laws governing taxation of domestic partner and Over Age Dependents benefit plan enrollment are continually evolving. Because of these tax laws, the County must include the fair market value of benefits in employees’ income, referred to as “imputed income.” In this case, “imputed income” is defined by the IRS as monies that are taxable to the employee when received as a benefit in relation to covering a domestic partner, dependents of a domestic partner or over age dependents. The Internal Revenue Service allows the employee to receive “tax free” insurance subsidies for themselves and their eligible dependents as defined under IRS guidelines,
but excludes those amounts attributable to coverage of a domestic partner, dependents of domestic partner or over age dependents. The premium charts for health, dental and vision premiums illustrate the imputed income and aftertax amounts for which you would be responsible based on various scenarios.
- “Pre” and “After” Tax – The employee’s full deduction for health insurance is separated into two parts: When the “Pre” tax and “After” tax amounts are added together, that amount is the full employee deduction for health insurance.
- Imputed Income – As described above, the amounts shown in the column marked “Imputed Income” become additional income to the employee, per IRS rules, and are taxed accordingly. That is why we suggest you consult a tax adviser on how to best claim exemptions on your W2 and on your income tax.
Additionally, a domestic partner, dependents of a domestic partner or over age dependents are not eligible to receive reimbursement from a “Health Reimbursement Account (HRA)” under a Consumer Driven Health plan or “Health Savings Account” under a High Deductible Health Plan. These dependents can be insured and receive coverage as any other insured and be subject to the same copayments, coinsurance and deductible; however, the employee would not receive the portion of the HRA or HSA attributable to coverage for a domestic partner, their dependents or an over age dependent.
IMPORTANT DISCLAIMER NOTICE: Because there will be additional “out-of-pocket” costs associated with taxation of these related benefits, you should consult a tax adviser in order to determine your individual tax liability based on the exemptions you claim. The information shown on the Rate Sheet is the dollar amount that will be used in calculating your pre-and after-tax deduction as well as imputed income, where shown.
NEW HEALTH INSURANCE MARKETPLACE COVERAGE OPTIONS AND YOUR HEALTH COVERAGE
Part A: General Information (PDF)
Part B: Information About Health Coverage Offered by Your Employer: This section contains information about any health coverage offered by your employer. If you decide to complete an application for coverage in the Marketplace, you will be asked to provide this information. This information is numbered to correspond to the Marketplace application.
3. Employer Name: Broward County Board of County Commissioners
4. Employer Identification Number (EIN): 59-6000531
5. Employer Address: 115 S. Andrews Avenue, Room 514
6. Employer Phone Number: 954-357-6700
7. City: Fort Lauderdale
8. State: FL
9. ZIP Code: 33301
10. Who can we contact about employee health coverage at this job? Lisa Morrison
11. Phone number (if different from above) 954-357-6700
12. Email address: firstname.lastname@example.org
HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA)
Under HIPAA, enrollment in health, dental or vision insurance (outside of Open Enrollment) is allowed for employees and their dependents in certain circumstances. Special enrollment is allowed if the following criteria are met:
- The individual is benefit eligible but not enrolled, and
- When enrollment was previously offered and declined, the individual had other coverage, and
- When enrollment was declined, the individual stated in writing he/she was declining coverage because he/she had other coverage (this point only applies if the plan required such a statement at the time coverage was declined and the individual was notified of the requirement and consequences of not providing the statement), and
- Special enrollment is also allowable for employees and their dependents if they lose coverage due to a loss of coverage, which might include:
- a death
- decreased work hours (some restrictions may apply)
- loss of employment
The employee must notify Employee Benefit Services within 31 days of the qualifying event and the employee must take prompt action to complete enrollment. If notice is not timely, re-enrollment can be done only during an Open Enrollment or when a subsequent qualifying event occurs. Verification of the loss of coverage event will be required.
Contact Employee Benefit Services at 954-357-6700 or email email@example.com for more information about HIPAA. Employees may also call the Department of Labor at: 866-4-USADOL (866-487-2365) or visit their website, dol.gov, regarding rights under HIPAA.
MEDICAID AND THE CHILDREN’S HEALTH INSURANCE PROGRAM (CHIP) OFFER FREE OR
LOW-COST HEALTH COVERAGE TO CHILDREN AND FAMILIES
If you are eligible for health coverage from your employer, but are unable to afford the premiums, some states have premium assistance programs that can help pay for coverage. These states use funds from their Medicaid or CHIP programs to help people who are eligible for employer sponsored health coverage, but need assistance in paying their health premiums.
If you or your dependents are already enrolled in Medicaid or CHIP you can contact your State Medicaid or CHIP office or dial: 877-KIDSNOW (877-543-7669) or go to insurekidsnow.gov to find out if premium assistance is available.
If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, you can contact your State Medicaid or CHIP office or dial: 877-KIDSNOW (877-543-7669) or insurekidsnow.gov to find out how to apply. If you qualify, you can ask the State if it has a program that might help you pay the premiums for an employer sponsored plan.
Once it is determined that you or your dependents are eligible for premium assistance under Medicaid or CHIP, your employer’s health plan is required to permit you and your dependents to enroll in the plan – as long as you and your dependents are eligible, but not already enrolled in the employer’s plan. This is called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance.
MEDICARE D PRESCRIPTION COVERAGE NOTICE
The Medicare Prescription Drug, Improvement and Modernization Act of 2003 (MMA) added a new prescription drug program to Medicare effective January 1, 2006. (See Part D of Title XVIII of the Social Security Act (Act), referred to here as “Part D” of Medicare.)
Eligible members can join a Medicare Prescription Drug Plan or join a Medicare Advantage Plan (like an HMO or PPO) that offers prescription drug coverage. All Medicare drug plans provide at least a standard level of coverage set by Medicare. Some plans may also offer more coverage for a higher monthly premium.
Broward County has determined that the prescription drug coverage offered by Catamaran is, on average for all plan participants, expected to pay out as much as standard Medicare prescription drug coverage pays and is considered Creditable Coverage.
Because the County’s existing coverage is, on average, at least as good as standard Medicare prescription drug coverage, participants can keep this coverage as part of their group health plan and not pay a higher premium (a penalty) if they later decide to join a Medicare drug plan.
Eligible participants can join a Medicare drug plan when they first become eligible for Medicare and each year from October 15 through December 31. However, upon loss of coverage under Broward County’s plan due to termination or retirement, participants are eligible to join a Part D plan at that time using an Employer Group Special Enrollment Period.
Contact Employee Benefit Services at firstname.lastname@example.org or 954-357-6700 for further information. Eligible employees and dependents will receive a notice each year in November, or sooner, if this coverage through Broward County changes. For more information about Medicare prescription drug coverage, visit medicare.gov.
NOTICE OF PRIVACY PRACTICES
Human Resources Division – Employees Benefits Section (EBS)
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
If you have questions about this notice, please contact 954-357-6500. This notice went into effect on April 14, 2003, and was revised on September 4, 2013, and will continue until we replace it.
- EBS is required by federal and state law to maintain the privacy of your Protected Health Information.
- The law requires us to give you this notice telling you about the law, your rights, and our privacy practices.
- The law requires us to abide by the terms of our notice that is currently in effect.
HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION:
EBS has engaged a Third Party Administrator (TPA) to operate the Broward County Pharmacy Benefit Plan (the Plan) on behalf of our employees. In most cases, the use and disclosure of any Protected Health Information about you is handled by the TPA to make sure you get the benefits you qualify for, to administer the plan accurately and fairly, and as otherwise required by law. Your Protected Health Information may not be used or disclosed for employment-related purposes other than the administration of the Plan.
As a part of its day-to-day activities, EBS may receive, gather and maintain personal and health information needed to determine your eligibility and keep track of your enrollment in the Plan. The following describes the ways we may use and disclose Protected Health Information that identifies you (“Health Information”). Except for the purposes described below, we will use and disclose Health Information only with your written permission. You may revoke such permission at any time by writing to our Privacy Liaison.
For Treatment. The TPA may use and disclose Health Information for your treatment and to provide you with treatment-related health care services. For example, the TPA may discuss your medical condition with doctors, nurses, technicians or hospital staff to authorize or consider medications or services covered by the Pharmacy Benefit Plan.
For Payment. The TPA may use and disclose Health Information so that it may bill and receive payment from you, an insurance company, or a third party for the treatment and services you received. EBS may use your Health Information to pay for or account for services. For example, we may give your health plan information about you so that they will pay for your medication.
For Health Care Operations. EBS may use and disclose Health Information for health care operations purposes. These uses and disclosures are necessary to make sure that you receive quality care, to verify that you are actually receiving the services that are scheduled and to operate and manage our Division. For example, we may use your information to manage or purchase services. We may also use or disclose your information as necessary for legal,
auditing, and management purposes.
For Performing Underwriting Activities. EBS will not use or disclose any genetic information for underwriting purposes.Treatment Alternatives and Health Related Benefits and Services. We may use and disclose Health Information to contact you for the administration of the Plan. We also may use and disclose Health Information to tell you about treatment alternatives, medications, or health-related benefits and services that may be of interest to you.
Research. Under certain circumstances, we may use and disclose Health Information to licensed researchers or care groups, who are under strict rules regarding how they use and disclose Health Information. For example, researchers or medical review members may use the information about individuals with your condition for a study to improve ways to treat or manage diseases.
OTHER USES AND DISCLOSURES:
As Required by Law. We may disclose Health Information when required to do so by international, federal, state or local law.
To Avert a Serious Threat to Health or Safety. We may use and disclose Health Information when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person.
Business Associates. We may disclose Health Information to our business associates that perform functions on our behalf or provide us with services if the information is necessary for such functions or services. For example, we may use another company to perform billing services on our behalf. All of our business associates are obligated to protect the privacy of your information and are not allowed to use or disclose any information other than as permitted by the terms of an applicable Business Associate Agreement.
Health Oversight Activities. We may disclose Health Information to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections and licensure. These activities are necessary for the government to monitor the health care system, government programs and compliance with civil rights laws.
Data Breach Notification Purposes. We may use or disclose your Health Information to provide legally required notices of unauthorized access to or disclosure of your Health Information.
Lawsuits, Disputes and Judicial Requests. If you are involved in a lawsuit or a dispute, we may disclose Health Information in response to a court or administrative order, subpoena, discovery request or other lawful process.
Law Enforcement. We may release Health Information if asked by a law enforcement official if the information is in response to a court order, subpoena, warrant, or similar process.
Public Health Risks. We may disclose Health Information for public health activities. These activities generally include disclosures to prevent or control disease, injury or disability; report births and deaths; report child abuse or neglect; report reactions to medications or problems with products; notify people of recalls of products they may be using; notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition; and notify the appropriate government authority if we believe a patient has been the victim of abuse, neglect or domestic violence. We will only make this disclosure if you agree or when required or authorized by law.
Other Uses and Disclosures When Required or Authorized by Law. We may disclose Health Information to the following when required or authorized by law: Coroners, medical examiners and funeral directors; organ and tissue donation organizations; the military; national security and intelligence activities; protective services to the President; workers’ compensation issues; inmates or individuals in custody of a correctional institution or law enforcement official.
USES AND DISCLOSURES THAT REQUIRE US TO GIVE YOU AN OPPORTUNITY TO OBJECT
AND OPT OUT:
Individuals Involved in Your Care or Payment for Your Care. Unless you object, we may disclose to a member of your family, a relative, a close friend or any other person you identify, your Health Information that directly relates to that person’s involvement in your health care. For example, if a family member calls us with prior knowledge of a claim, we may confirm whether or not the claim has been received and paid. If you are unable to communicate, such as in an emergency, we may disclose such information as necessary if we determine that it is in your best interest based on our professional judgment.
Disaster Relief. We may disclose Health Information to disaster relief organizations that seek your Health Information to coordinate your care, or notify family and friends of your location or condition in a disaster. We will provide you with an opportunity to agree or object to such a disclosure whenever we practically can do so.
YOUR WRITTEN AUTHORIZATION IS REQUIRED FOR OTHER USES AND DISCLOSURES:
The following uses and disclosures of your Health Information will be made only with your written authorization:
- Uses and disclosures of Health Information for marketing purposes unless (1) the communication occurs face-to-face; (2) consists of marketing gifts of nominal value; (3) is regarding a prescription refill reminder that is for a prescription currently prescribed or a generic equivalent; (4) is for treatment pertaining to existing condition(s) and EBS does not receive any financial remuneration in either case or cash equivalent; or (5) communication from a healthcare provider to recommend or direct alternative treatments, therapies,
healthcare providers, or settings of care when EBS does not receive any financial remuneration for making the communication; and
- Disclosures that constitute a sale of your Health Information.
Other uses and disclosures of Health Information not covered by this notice or the laws that apply to us will be made only with your written authorization. If you do give us an authorization, you may revoke it at any time by submitting a written revocation to our Privacy Liaison and we will no longer disclose Health Information under the authorization. An authorization provided as a condition of obtaining insurance coverage, provides the insurer with the right to contest a claim under the policy of the policy itself. Any disclosure that we made in reliance on your authorization
before you revoked it will not be affected by the revocation.
You have the following rights regarding Health Information we have about you:
Right to Inspect and Copy. You have a right to inspect and copy Health Information that may be used to make decisions about your care or payment for your care. This includes medical and billing records about you, or enrollment, payment, claims adjudication, and case or medical management systems, as applicable. You have the right to access in order to inspect and obtain a copy of your Health Information contained in your designated record set, except for (1) psychotherapy notes; (2) information compiled in reasonable anticipation of, or for use in, a civil, criminal or administrative proceeding; and (3) Health Information maintained by us to the extent to which
the provision of access to you would be prohibited by law. To inspect and copy this Health Information, you must make your request, in writing, to the address listed at the end of this notice. We have up to 30 days to make your Health Information available to you and we may charge you a reasonable fee for the costs of copying, mailing or other supplies associated with your request. We may deny your request under certain limited circumstances. If we
do deny your request, you have the right to have the denial reviewed by a licensed healthcare professional who was not directly involved in the denial of your request, and we will comply with the outcome of the review.
Right to an Electronic Copy of Electronic Medical Records. If your Health Information is maintained in an electronic format (known as an electronic medical record or an electronic health record), you have the right to request that an electronic copy of your record be given to you or transmitted to another individual or entity. We will make every effort to provide access to your Health Information in the form or format you request, if it is readily producible in such form or format. If the Health Information is not readily producible in the form or format you request, your record will be provided in either our standard electronic format, or if you do not want this form or format, a readable hard copy form. We may charge you a reasonable, cost-based fee for the labor associated with transmitting the electronic medical record.
Right to Get Notice of a Breach. You have the right to be notified upon a breach of any of your unsecured Health Information.
Right to Amend. If you feel that the Health Information we have is incorrect or incomplete, you may ask us to amend the information. To request an amendment, you must make your request, in writing, with a description of the reason you want your record amended, to the address listed at the end of this notice. EBS may deny your request if: (1) the information was not created by EBS, unless you provide a reasonable basis that the person or entity that created the information is no longer available to make the amendment; (2) the information is not part of the Health Information
kept by EBS; (3) the information is not part of the Health Information which you would be permitted to inspect or copy; or (4) the information is accurate and complete. If we deny your request you have the right to file a statement of disagreement with us and we may prepare a rebuttal to your statement and will provide you with a copy.
Right to an Accounting of Disclosures. You have the right to request a list of certain disclosures we made of Health Information for purposes other than treatment, payment and health care operations or for which you did not provide a written authorization. The first accounting of disclosures in any 12-month period will be free. Any additional requests within that same time period may be charged a reasonable cost-based fee. To request an accounting of disclosures,
you must make your request, in writing, to the address listed at the end of this notice.
Right to Request Restrictions. You have the right to request a restriction or limitation on the Health Information we use or disclose for treatment, payment, or health care operations. You also have the right to request a limit on the Health Information we disclose to someone involved in your care or the payment for your care, like a family member or friend. For example, you could ask that we not share information about a particular medication with your spouse. To request a restriction, you must make your request in writing and describe the specific restriction, to the address listed at the end of this notice. We are not required to agree to your request unless you are asking us to restrict the use and disclosure of your Health Information to a health plan for payment or health care operation purposes and such information you wish to restrict pertains solely to a health care item or service for which you have paid us “outof-pocket” in full. If we agree, we will comply with your request unless the information is needed to provide you with
emergency treatment or otherwise required by law.
Out-of-Pocket-Payments. If you paid out-of-pocket (or in other words, you have requested that we not bill the Plan) in full for a specific item or service, you have the right to ask that your Health Information with respect to that item or service not be disclosed to the Plan for purposes of payment or health care operations, and we will honor that request.
Right to Request Confidential Communications. You have the right to request that we communicate with you about medical matters in a certain way or at a certain location if you state that the disclosure of information could endanger you. For example, you can ask that we only contact you by mail or at work. To request confidential communications, you must make your request, in writing, to the address listed at the end of this notice. Your request must specify how
or where you wish to be contacted. We will accommodate reasonable requests.
Right to a Paper Copy of This Notice. You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice. You may obtain a copy of this notice at our web site, www.broward.org.
CHANGES TO THIS NOTICE:
We reserve the right to change this notice and make the new notice apply to Health Information we already have as well as any information we receive in the future. We will post a copy of our current notice at our office and website.
If you believe your privacy rights have been violated, you may file a complaint with our office or with the Secretary of the Department of Health and Human Services. To file a complaint with our office, contact the Broward County Office of Intergovernmental Affairs and Professional Standards, 115 S. Andrews Ave., Suite 427, Fort Lauderdale, FL 33301, telephone 954-357-6500. All complaints must be made in writing. You will not be retaliated against for filing a complaint.
If you have any questions in reference to this notice please contact 954-357-6500.
All requests must be made in writing and mailed to the HIPAA Privacy Liaison, 115 S. Andrews Ave., Room 514, Fort Lauderdale, FL 33301.
NOTICE OF PRE-EXISTING EXCLUSION
The County’s health plans do not include a Pre-existing Exclusion.
HIPAA stands for the “Health Insurance Portability and Accountability Act of 1996.” The original purpose of HIPAA was to make health insurance more “portable” so that workers could take their health insurance with them when they moved from one job to another, without losing health coverage. The scope of HIPAA was broadened to require the health care industry to adhere to uniform codes and forms. This would help streamline the processing and use of health data and claims, and contribute to better, more accessible care. The scope of HIPAA also was broadened
to better protect the privacy of people’s health care information and give them greater access to that information. The HIPAA Privacy Rule was finalized on August 14, 2002, with a firm deadline for compliance of April 14, 2003.
Broward County’s Employee Benefit Services (EBS) respects the privacy of legally protected health information and understands the importance of keeping this information confidential and secure. Certain divisions or division sections within the County have access to what is called “Protected Health Information” or “PHI,” as it is defined by HIPAA. Not all health care information handled by Broward County is included in the definition of PHI. Only certain kinds of health care information are protected by the Privacy Rule. The following divisions or division sections are called “covered components” because they have access to the PHI covered by the HIPAA rules and regulations: the Elderly and Veterans Services Division, the Employee Benefits Section of the Human Resources Division and the Substance Abuse Section of the Broward Addiction Recovery Centers (BARC) Division.
EBS will use or transmit only the minimum amount of PHI needed to communicate enrollment, eligibility and termination data to Third Party Administrators or to any other entity to which we are required to respond. In addition, EBS will transmit only the minimum amount of PHI to appropriate entities for assistance with claims processing, claims reconsideration and review. EBS also ensures that the vendors, with whom we contract for benefit services, have been duly informed of their need to fully comply with all HIPAA Rules and Regulations.
All Broward County employees receive basic awareness training in HIPAA, which will be updated as required by law. Employees who work for the covered components and certain support agencies receive more extensive training to better enable them to comply with HIPAA.
For more information about rights under HIPAA, employees may contact Broward County’s Privacy Officer at: 954-357-6500. Employees may also contact the Employee Benefits Manager at 954-357-6700.
SOCIAL SECURITY NUMBER, COLLECTION OF
Broward County, Division of Human Resources, Employee Benefit Services, shall collect your Social Security number as allowed under section 119.071(5) (a) 2, Florida Statutes, for the following purpose: to match, verify and retrieve benefit plan information as well as for the purpose of payment and audit of premiums collected. You are being provided notice of this activity pursuant to section 119.071(5)3, Florida Statutes.
The County shall also collect the Social Security number of all enrolled dependents as required under the Mandatory Insurer Reporting Law (Section 111 of Public Law 110173) which requires group health plan insurers, third party administrators and plan administrators or fiduciaries of self-insured/self-administered group health plans to report, as directed by the secretary of the Department of Health and Human Services, information that the secretary requires for purposes of coordination of benefits. The law also imposes this same requirement on liability insurers
(including self-insurers), no-fault insurers and workers’ compensation laws or plans. Two key elements that will be required to be reported are SSNs (or HICNs) and EINs. In order for Medicare to properly coordinate Medicare payments with other insurance and/or workers’ compensation benefits, Medicare relies on the collection of both the SSN or HICN and the EIN, as applicable.
SPECIAL ENROLLMENT NOTICE
If you are declining enrollment for yourself or your dependents (including your spouse) because of other health insurance or group health plan coverage, you may be able to enroll yourself and your dependents in this plan if you or your dependents lose eligibility for that other coverage (or if the employer stops contributing toward your or your dependents’ other coverage). However, you must request enrollment within 31 days after your or your dependents’
other coverage ends (or after the employer stops contributing toward the other coverage).
In addition, if you have a new dependent as a result of marriage or Declaration of Domestic Partnership, you may be able to enroll yourself and your dependents. However, you must request enrollment within 30 days after the marriage or Declaration of Domestic Partnership.
If you have a new dependent as a result of birth, adoption, guardianship or placement for adoption or foster care, you may be able to enroll yourself and your dependents. However, you must request enrollment within 60 days after the event.
To request special enrollment or obtain more information, contact Employee Benefit Services at: email@example.com or 954-357-6700.
SUMMARY PLAN DESCRIPTION
The following is important information about your participation in the County’s Section 125 Benefit Plan and about certain benefits and benefit practices. Please take time to read this information carefully. Contact Employee Benefit Services at firstname.lastname@example.org or 954-357-6700 if you have questions.
Purpose: This document provides only a brief description of available benefits for easy reference. Official plan documents for the Broward County Section 125 Benefits Plan, and Flexible Spending Account (Medical Expense and Dependent Care) Plans are available for review at the office of Employee Benefit Services, 115 S. Andrews Ave.,Room 514, Fort Lauderdale, FL 33301. The purpose of this handbook is to set forth, or incorporate by reference, a description of the various benefits which benefit eligible employees are entitled to participate in by virtue of their
employment. The County intends that all such benefits be legally enforceable and are for the exclusive benefit of its employees. These benefits are intended to be eligible for exclusion from the employees’ gross income for Federal income tax, Social Security tax and state and local tax purposes, where applicable, except to the extent that the rules under the Internal Revenue Service Code may require taxation of any such benefits to those employees deemed to be “highly compensated.”
Plan Changes: The County reserves the right to amend, expand, reduce or terminate any of the benefits and the plan or its benefit policies and practices at any time. If any of the benefits are terminated and coverage is not replaced with comparable coverage, ample notice will be given. If benefits under a County health plan are materially reduced, you will be notified within 60 days of the effective date of such material reduction in benefits. Participation in this plan is not a guarantee or contract of employment between employees and Broward County.
Plan Summaries: Descriptions of the various benefit plans available to you under the County’s Section 125 Benefit Plan, Dependent Care Accounts and Medical Expense Accounts are explained in this book. Plan summaries for the Section 125 Benefit Plan are available for employee’s review in Employee Benefit Services; these documents explain the eligibility for, limitations on, funding of and duration of the various benefit plans.
Plan Documents: Copies of plan documents for Broward County’s Section 125 Benefit Plan, Dependent Care FSA and Medical Expense FSA are available upon written request submitted to Employee Benefit Services. A reasonable charge may be imposed for copies.
Termination of Benefits: Benefits under any of the plans may terminate, unless the plan specifically provides otherwise, if:
- your employment terminates or your employment status changes to one that is not eligible for benefits
- the group plan terminates
- premiums are not paid
- the County amends or terminates the plan
Plan Sponsor: The Broward Board of County Commissioners is the plan sponsor. All notices concerning benefits should be sent to:
Broward County Commission, Employee Benefit Services
Attn: Plan Administrator
115 S. Andrews Ave., Room 514
Fort Lauderdale, FL 33301
More Information: Contact Employee Benefit Services at 954-357-6700 or email@example.com if you have any questions about plans or your benefits.
USERRA (UNIFORMED SERVICES EMPLOYMENT AND RE-EMPLOYMENT RIGHTS ACT)
USERRA protects the job rights of individuals who voluntarily or involuntarily leave employment positions to undertake military service. For more information on USERRA, please consult the posters which have been displayed prominently in public areas.