Health Benefit Plan Information
For customer service issues about your account, claims adjustment, or the network status, please contact our Health Benefit Provider:
Plan Administrator
Aetna
PPO: 1-888-398-4467
HEALTH BENEFIT COVERAGE
The City of Fort Worth offers an attractive package of insurance benefits for eligible employees. The Group Health and Life Benefits Program is administered by the Human Resources Department. Information packets with a full description of the program and enrollment forms are provided to new employees during orientation. The Human Resources Department provides updates periodically and assists employees with any changes on an ongoing basis. A monthly newsletter, Better Health for Life, advises employees of updated benefits. Open enrollment is held at least once annually.
Health Benefit Costs - Employee Contribution Rates
Currently, the City pays a portion of the coverage for the employee and his/her eligible dependants; the employee pays for the remainder of the cost. You are responsible for all payments in the event you are off without pay for any reason. Coverage is available for employees and eligible dependents (as defined in the City's Eligibility Rules) or spouse. Coverage begins the first of the month following thirty days of employment.
Health benefits for the City of Fort Worth includes three options Basic, Basic Plus and Select. Below are the different Health plans with the bi-weekly employee contribution based on employment status, in addition to the total monthly cost paid (employee plus City contributions) as of 01/01/05. These rates will continue to be in effect for the 2008 plan year
For retiree rates click here.
Active Employee Health Benefits Costs for 2005, 2006, 2007 & 2008:
Full-time Employee (40 or more hours per week) Bi-weekly Contribution
|
|
Basic
|
Basic Plus
|
Select
|
|
|
Bi-weekly Rates
|
Bi-weekly Rates
|
Bi-weekly Rates
|
Employee Only
|
$17.25
|
$43.12
|
$77.62
|
Employee & Child
|
$93.35
|
$141.73
|
$206.25
|
Employee & Spouse
|
$108.01
|
$160.80
|
$231.17
|
Employee & Family
|
$145.87
|
$225.24
|
$324.14
|
Part-time Employee (20 but less than 30 hours per week) Bi-weekly Contribution
|
|
Basic
|
Basic Plus
|
Select
|
|
|
Bi-weekly Rates
|
Bi-weekly Rates
|
Bi-weekly Rates
|
Employee Only
|
$94.87
|
$120.74
|
$155.24
|
Employee & Child
|
$207.95
|
$256.33
|
$320.85
|
Employee & Spouse
|
$229.95
|
$282.73
|
$353.10
|
Employee & Family
|
$314.42
|
$390.32
|
$488.07
|
Part-time Employee (30 but less than 40 hours per week) Bi-weekly Contribution
|
|
Basic
|
Basic Plus
|
Select
|
|
|
Bi-weekly Rates
|
Bi-weekly Rates
|
Bi-weekly Rates
|
Employee Only
|
$56.06
|
$81.93
|
$116.43
|
Employee & Child
|
$150.65
|
$199.03
|
$263.55
|
Employee & Spouse
|
$168.98
|
$221.76
|
$292.14
|
Employee & Family
|
$230.14
|
$307.78
|
$406.11
|
Monthly Total Cost (Employee plus City contributions)
|
|
Basic
|
Basic Plus
|
Select
|
Employee Only
|
$373.72
|
$429.78
|
$504.53
|
Employee & Child
|
$698.86
|
$803.69
|
$943.47
|
Employee & Spouse
|
$762.40
|
$876.76
|
$1,029.24
|
Employee & Family
|
$1,046.43
|
$1,203.39
|
$1,412.68
|
COBRA Monthly Premium
|
|
Basic
|
Basic Plus
|
Select
|
Employee Only
|
$381.19
|
$438.38
|
$514.62
|
Employee & Child
|
$712.84
|
$819.76
|
$926.34
|
Employee & Spouse
|
$777.65
|
$894.30
|
$1,049.82
|
Employee & Family
|
$1,067.36
|
$1,227.46
|
$1,440.93
|
Active Employee Health Benefits Costs for 2009:
Full-time Employee (40 or more hours per week) Bi-weekly Contribution:
|
|
Basic
|
Basic Plus
|
Select
|
|
|
Bi-weekly Rates
|
Bi-weekly Rates
|
Bi-weekly Rates
|
Employee Only
|
$19.84
|
$49.59
|
$89.26
|
Employee & Child
|
$107.35
|
$162.99
|
$237.19
|
Employee & Spouse
|
$124.21
|
$184.92
|
$265.85
|
Employee & Family
|
$167.75
|
$259.03
|
$372.76
|
Part-time Employee (20 but less than 30 hours per week) Bi-weekly Contribution
|
|
Basic
|
Basic Plus
|
Select
|
|
|
Bi-weekly Rates
|
Bi-weekly Rates
|
Bi-weekly Rates
|
Employee Only
|
$109.10
|
$138.85
|
$178.53
|
Employee & Child
|
$239.14
|
$294.78
|
$368.97
|
Employee & Spouse
|
$264.44
|
$325.14
|
$406.07
|
Employee & Family
|
$361.58
|
$448.87
|
$561.28
|
Part-time Employee (30 but less than 40 hours per week) Bi-weekly Contribution:
|
|
Basic
|
Basic Plus
|
Select
|
|
|
Bi-weekly Rates
|
Bi-weekly Rates
|
Bi-weekly Rates
|
Employee Only
|
$64.47
|
$94.22
|
$133.90
|
Employee & Child
|
$173.25
|
$228.89
|
$303.08
|
Employee & Spouse
|
$194.33
|
$255.03
|
$335.96
|
Employee & Family
|
$264.67
|
$353.95
|
$467.02
|
See the Retiree Rates
Health Card Info - Each family receives 1 card per family with the employee or retiree's name on the card.
If you change plans for 2008, you will receive new cards. Do NOT discard your current card until after January 1, 2008.
The Aetna System that the City uses is the Choice POS II. This means that the Providers you want to use are in the Choice POS II Network. NOTE: This network only applies to active employees and non-medicare retirees.
The new Cards do not use Social Security Number as the ID Number. See your new ID number and under the number is a list of all your dependents covered on that plan.
GRP: This prvides you with the Group Number, Suffix and Plan Information. Example: 889000 (group number) - 010 (suffix) - 00002 (plan enrolled)
Suffix
010 Active Employee
020 Retiree, Non-Medicare under 65
021 Retiree, Non-Medicare over 65
022 Retiree, Medicare
023 Retiree, Split Family, Dependents Non-Medicare
024 Retiree, Split Family, Retiree Non-Medicare
025 Retiree, Split Family, Retiree w/Medicare
023 Retiree, Split Family, Dependents Spouse w/Medicare
Plan
00001 Basic Plan
00002 Basic Plus Plan
00003 Select Plan
00010 Traditional, Medicare Retirees
If you have not received your ID card, need a replacement ID card or have experienced difficulties in accessing your benefits, please call Aetna Customer Service at 1-888-398-4467 or log on to the website www.aetna.com.
Online Services:
www.aetna.com
You can establish your own secured, personalized account to:
Pharmacy Services
Refill and new prescriptions.
Locate a participating in-network retail pharmacy.
Preferred Drug Lists
Co-Pays for Prescriptions
Benefits for Part-Time Employees
An eligible part-time employee may participate in the Group Health Plan and the Life Insurance Program at a cost specified by the City. See Employee Contribution Rates.
Family/Life Status Changes
When you have a change in your family status, remember that you have a 31-day period to make changes to your benefits, such as add or drop dependent coverage. If you do not make those changes within the 31-day period you must wait until the next OPEN ENROLLMENT period to make changes.
Employees may not change their election for group medical or dental benefits except at the annual Open Enrollment or if they experience a “qualifying event” as defined in the Health Insurance Portability and Accountability Act.”
Examples of events qualifying for outside-of-Open-Enrollment changes to benefits are marriage, divorce, birth or adoption of a child, loss of coverage or new coverage through a spouse's employment. These changes must be made within the 31-day period following the event. These changes require an effective date as of the date the event occurs. Adding dependent coverage MAY increase your contribution, thereby increasing the amount of your payroll deduction. YOU WILL BE REQUIRED TO MAKE ANY ADDITIONAL CONTRIBUTION TO COVER THE BENEFIT FROM THE EFFECTIVE DATE OF THE QUALIFYING EVENT.
COBRA - Option for Continuing Health Insurance Coverage after Employee Termination
The Consolidated Omnibus Budget Reconciliation Act (COBRA), Federal Law PL-99-272, became effective for the City March 1, 1987. This legislation allows an employee and enrolled spouse and/or dependents to continue health coverage beyond the 30-day period following termination of employment with the City in certain situations. The employee's coverage may be extended for 18 months; an extension of 29 months coverage is possible for the employee who is disabled at the time of termination or who becomes disabled within 60 days of such termination. Dependent coverage may generally be extended for 36 months when the qualifying event is the employee's death, divorce or legal separation, loss of dependency status or the employee's Medicare entitlement, or in the case of multiple qualifying events.
Continuation of the City's Group Health Plan - The monthly cost for the employee's 18-month and the dependent's 36-month coverage may be the City's cost plus a two percent (2%) administrative charge. If the employee is eligible for 29 months, the monthly cost for such coverage may be the City's cost plus two percent (2%) for the first 18 months and the City's cost plus fifty percent (50%) for the 19th month through the 29th month of coverage.
Contact the City's Health Benefit Office at 817-392-7743.
For customer service issues about your account, claims adjustment, or the network status, please contact our Health Benefit Provider:
Plan Administrator
Aetna
PPO: 1-888-398-4467