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Medical Insurance 

Douglas County offers medical insurance coverage to regular part and full time employees who work more than 20 hours per week and employees who meet the criteria under the Patient Protection and Affordable Care Act (PPACA)

Insurance coverage is effective on the 1st day of the month following 30 days of regular employment. Premiums are deducted, pretax, from each pay period beginning the month coverage is effective.

The County provides two types of medical plans:

1. Preferred Provider Organization (PPO)

2. High Deductible Health Plan with Health Savings Account (HDHP/HSA).

Both of the County's plans are administered by Blue Cross & Blue Shield of Nebraska.

All pretax benefit elections are effective for the calendar year in which they are chosen unless an employee experiences a qualifying event as defined by the IRS.

Some examples of a qualifying event are marriage, birth of child, adoption and gaining or losing other coverage. HR must be notified of the event and proper paperwork submitted within 31 days of the event. 

Douglas County has an open enrollment period annually, where changes can be made to pretax benefits with an effective date of January 1 of the following year.   

BCBS logo

Guide to Finding Providers - Use NetworkBlue       

 

Summary of Benefits and Summary of Benefit Coverage (SBC)

 

Medical and Pharmacy Forms

Retail Pharmacy Reimbursement Claim Form

Medical Claim Form-Non Participating BCBS Provider

 

Other Helpful Information

Preventive Care Guidelines

myblue Flyer

Blue Distinction Specialty Care

Telehealth

Guide to Your Explanation of Benefits

Maternity Management Program

 

BCBS HIPAA Documents

Important HIPAA Privacy Information

Notice of Privacy Practices

Authorization for Release of Protected Health Information

 

Patient Protection and Affordable Care Act (PPACA)

Individual Mandate

The individual Mandate went into effect January 1, 2014, and requires you and your dependents to have health insurance or pay a penalty on your taxable income. Douglas County's plans meet all of the requirements to satisfy your "Individual Mandate."

Employer Mandate

Douglas County is required to offer all non-temporary employees averaging 30 hours or more per week coverage that meets the PPACA requirements of minimum essential coverage and affordability. This requirement does not impact the County's medical plans as they meet PPACA requirements and employees will not qualify for subsidies through the healthcare exchange.

Grandfathered/Non-Grandfathered Plans

Under the PPACA rules, Douglas County's PPO plan qualifies as a grandfathered plan. The HDHP plan is a non-grandfathered plan.

IRS Reporting & 1095-C Form

The PPACA requires Douglas County to offer health insurance coverage to full-time employees (defined as those working 30 hours or more on average per week) and their eligible dependents. Further, the County must provide an annual 1095-C statement to all employees eligible for coverage, describing the insurance available to them. 

For more information regarding the Form 1095-C, refer to the Frequently Asked Questions (FAQ) document directly below or the link to the IRS website.

Frequently Asked Questions

Additional Information from the IRS


The provisions of this information are not intended and do not create an express or implied contract of employment or an offer of employment between the County and its employees nor any guarantee or promise that benefits referenced here are permanent or cannot be changed. While retirees and current employees are offered the opportunity to participate in a subsidized medical insurance program until age 65, the ability to participate as well as the premiums are not guaranteed in the future and are subject, at any time, to change by the County Board of Commissioners. If there is any conflict in the information stated or otherwise communicated, the plan provisions prevail. Please contact Human Resources with any questions.

 

 


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