Vote: adopted

Item Text

38. EMPLOYEE BENEFITS PLAN AND ADMINISTRATIVE CHANGES FOR FY 2016-17 Approve the Maricopa County Benefits Plan (Sixth Amendment and Restatement) document effective July 1, 2016, attached as Exhibit A, which governs how employee health and welfare benefits (such as medical, prescription, behavioral health, etc.) are administered. This document supersedes all previous plan documents. New or amended features are shown in the redline with tracked changes attached for convenience. The following is a summary of the substantive changes: • Change the Benefits Effective Date to the first day of the month following date of hire or date of benefits eligibility. See Exhibit A, Sections 2.3 and 4.2. • Add the definition of a “Qualified Health Plan.” See Exhibit A, Section 2.22. • Amend qualifying “Change in Status” events under the Plan to (i) clarify a qualifying change in the place of residence that affects eligibility for coverage; (ii) include as a qualifying change a change in employment status such that the Employee is no longer expected to average at least thirty (30) hours of service per week, yet does not lose eligibility under the Plan; and (iii) exclude as a qualifying change the loss of coverage under a Qualified Health Plan on account of cancelling the plan or failing to pay the premiums. See Exhibit A, Section 4.12(b). • Require submission of required documentation to satisfy a Dependent Audit within 60 calendar days of the Benefits Effective Date. If outside the 60 calendar days, employees must wait until the next Open Enrollment period (unless they experience a qualifying “Change in Status” event) to add dependents to coverage effective July 1, 2017. See Exhibit A, Section 4.12(c). • In the event of a Dependent ceasing to be a Dependent or otherwise not continuing to qualify for benefits under a Benefit Plan, allow the Plan Administrator to seek redress pursuant to any and all available remedies afforded under the Patient Protection and Affordable Care Act and other applicable state and federal law. See Exhibit A, Section 4.12(c). • Amend the provision governing amendments to the amount of Benefits Purchase Orders for the purpose of satisfying non-discrimination requirements or maintaining the non-taxable status or orderly and efficient operation of the Plan or Benefits Trust so that such amendments may only be adopted by the Board of Supervisors. See Exhibit A, Section 5.5. • Amend provision governing contributions by Participants electing to participate in a health savings account to clarify minimum and maximum contribution requirements. See Exhibit A, Section 5.10(a). • Provide that forfeited amounts of credit in Participants’ Benefits Funding Accounts may include unclaimed premium refunds. See Exhibit A, Section 6.4. • Authorize the Plan Administrator to pursue claims for reimbursement for charges incurred by the Plan as a result of error, mistake, overpayment, misrepresentation, or third-party liability (such as provided under A.R.S. § 12-962, which conveys certain subrogation rights to the State and its political subdivisions to recover the cost of medical care and treatment). See Exhibit A, Section 6.8. The Maricopa County Benefits Plan document (Exhibit A) governs basic issues of plan eligibility, participation (enrollment), coverage, payroll withholding, and funding accounts pursuant to the Internal Revenue Code. The document does not define specific benefit programs, which are adopted by the Board of Supervisors in separate actions. (C-39-16-015-2-00)

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