About HMO plans
With an HMO plan, you choose a Primary Care Physician (PCP) from a network of local healthcare professionals who will refer you to in-network specialists or hospitals when necessary. All of your healthcare is coordinated through that PCP. HMO plans allow you to select one of 4 coverage levels:
- Employee only
- Employee and spouse
- Employee and children
- Employee and family
You may choose the Kaiser Permanente Health Plan or Valley Health Plan. With Kaiser, you must live or work within a 30-mile radius of a Kaiser hospital. With Valley Health Plan, you can access the provider network across Santa Clara, San Benito, and Monterey counties.
Most services are covered at 100% with minimal or no office visit copayments. Out-of-network services are not covered except under life threatening emergency conditions. See a Summary of Benefits for each HMO plan here:
Important note about Valley Health Plan HMO - No premium costs for most county employees
Valley Health Plan is owned and operated by the County of Santa Clara. It provides access to quality health care through the largest public hospital system in northern California. A system recognized repeatedly for high-quality outcomes and innovation. VHP is not "just the County hospital." It is a significant network of great providers throughout Santa Clara, San Benito, and Monterey counties. For most County employees* there is a zero premium cost paid by the employee regardless of coverage level. This is an employee benefit you will find nowhere else but the County of Santa Clara.
*VHP Premium information
For the 2023-2024 Plan Year, the only County of Santa Clara employees that share premium costs for the VHP medical plan are: Executive Management employees, Valley Physicians' Group-represented employees, and Committee of Interns and Residents-represented employees. All other employees pay zero insurance premiums for VHP membership.
About the Health Net POS plan
The Health Net Point-of-Service plan is a type of managed care health insurance plan that offers you a choice of different types of providers, separated into three “Tiers.” The benefits paid by the plan - and what you’ll pay out of your own pocket - will vary, based on your Tier choice when you receive your care. The Health Net HMO plan allows you to select one of two coverage levels:
- Employee only
- Employee and family
See a Summary of Benefits for the POS plan here:
What are County employees paying for their share of medical insurance premiums?
See exactly what premiums are for the 2023 - 2024 Plan Year here. Keep in mind how these low premiums contribute to keeping more earned income in your pocket.
Please note - this Plan Year reference shows:
- Medical Plan Name
- Coverage Level (self, self and spouse, self and children, family)
- Employee group/Bargaining unit
Premiums are negotiated with employee bargaining units, so this reference shows the premiums broken out by employee groups and bargaining units. Therefore, the same level of coverage (self, self+spouse, etc.) may have different premium amounts between different groups/bargaining units based on the negotiated rates. See the key of bargaining unit abbreviations at the bottom of the web page that are used in the chart column headings.
Dental Insurance plans
The County offers two dental plans to its employees, Delta Dental (PPO) and Liberty Dental (DHMO). The County of Santa Clara pays 100% of the insurance premium for both plans for our employees.
Delta Dental
With this plan you may choose a Delta Preferred Provider Organization (PPO) dentist, a Delta Premier dentist, or a non-network dentist that is a member of the California Dental Association. When you visit a Delta Dental dentist, you’ll pay a share of the contracted fee for most services. If you visit a non-network dentist, the plan pays its share of “allowable charges” for services provided and you are responsible for any balance.
Your costs are usually lower when you choose a Delta PPO dentist. Some providers may require you to complete a claim form, although most dentists will file the claim electronically for you.
Liberty Dental
Liberty Dental is a Dental Health Maintenance Organization (DHMO). Similar to a medical HMO plan, you must live in the plan’s service area and receive care from participating dental providers. Copayments apply for specific services; however, there are usually no annual limits and no claim forms.
Vision Insurance plans
The County offers vision benefits from Vision Service Plan (VSP). The County of Santa Clara pays 100% of the insurance premium for this plan for our employees.
You may select a provider from their list of optometrists or go out of network. When you make your appointment, mention to your selected provider’s office that you are a VSP member. The provider’s office will contact VSP for you and verify your eligibility.
Vision benefits cover an exam with a $20 copay and lenses every 12 months at no cost. The plan provides a $120 allowance for frames every 24 months. The plan does not cover scratch resistant coating, tinting, tinted contacts or designer frames. Some providers will offer you discounts on these items or discounts on a second pair glasses. The plan also covers contact lenses up to $120 every 12 months in lieu of glasses, including the exam.
Health Care Bonus Waiver program
The Health Care Bonus Waiver program gives you the option to receive a taxable increase in gross wages by waiving the County’s medical coverage. Full-time employees who elect to waive medical coverage currently receive $74 per pay period in taxable wages. Part-time employees who participate in this program receive a prorated amount for this benefit.
If you elect to participate in this program, you must complete the necessary paperwork and provide written documentation annually showing proof of medical coverage with an insurance program other than that provided by the County (e.g., your spouse’s employer’s plan).
Health Flexible Spending Account (HFSA)
This program allows you to set up a special account for paying out-of-pocket health expenses with tax-free dollars. You may contribute up to $3,200 per calendar year to this account.
How it works
- You may use your funds to pay eligible expenses for you, your spouse, and your qualified dependents, regardless of whether they are enrolled in the County’s medical, dental, and vision plans.
- The HFSA is a pre-funded benefit - this means you have access to your full annual election at any time during the year. You repay the pre-funded amount through regular payroll deductions each pay period.
- The HFSA plan year spans across a 12-month period (January – December) and offers an additional 2.5-month grace period following the end of the plan year. Therefore, you may use any funds leftover at the end of the plan year and reimburse yourself for expenses incurred through March 15 of the following plan year.
- The HFSA is administered by P&A Group, which charges a $.85 per pay period service fee for your account. (Note, you are not “double charged” this fee if you enroll in our Dependent Care Assistance Program, as well.) The HFSA comes with a debit card; you can use it to pay your providers directly for health care expenses. You can also set up an online account and submit claims online or through your mobile phone. Reimbursement payments are made via a check or direct deposit to your bank account.
- As a new hire, you may elect to participate in this program within 30 days of your date of hire.
COBRA
The County of Santa Clara works with P&A Group to provide COBRA benefits.
The Consolidated Omnibus Budget Reconciliation Act (COBRA) allows you and your covered dependents to continue terminated group insurance coverage by self-paying premiums. You can choose which benefits you would like to continue under COBRA and your coverage levels will remain the same as your prior group coverage. Employees, covered spouses, domestic partners, and covered children all have rights to continued coverage under COBRA.
You have 60 days to elect COBRA after experiencing a qualifying event, such as termination of employment, retirement or a child loses dependent status under your plan. You may elect COBRA continuation coverage for up to 36 months.
Ready to find your fit with the County of Santa Clara? View all current, open-competitive recruitments.
Abbreviations Key: Column Headings in the 2023-2024 Plan Year Insurance Premiums Chart
EXEC MGMT: Executive Management employees
CEMA & CONF ADMIN: County Employees Management Association and Confidential Administrative employees
SEIU & CONF CLERICAL: Service Employees International Union and Confidential Clerical employees
PROBATION PEACE OFFICERS: Probation Peace Officers' Union represented employees
E&A: Engineers & Architects Association represented employees
CORRECTIONAL PEACE OFFICERS: Correctional Peace Officers' Association represented employees
PARK RANGERS: Park Ranger Association represented employees
DSA: Deputy Sheriff's Association represented employees
GAA: Government Attorneys Association represented employees
CCAA: County Counsel Attorneys Association represented employees
ESC: Engineers & Scientists of California represented employees
BTC: Building Trades Council represented employees
DAIA: District Attorney's Investigators Association represented employees
UAPD: Union of American Physicians and Dentists represented employees
VPG: Valley Physicians' Group represented employees
CIR: Committee of Interns and Residents represented employees
RNPA: Registered Nurses Professional Association represented employees
*VHP Premium information: For the 2022-2023 Plan Year, the only County of Santa Clara employees that share premium costs for the VHP medical plan are: Executive Management employees, Valley Physicians' Group-represented employees, and Committee of Interns and Residents-represented employees. All other employees pay zero insurance premiums for VHP membership.