Important Details About Plan Years

• Effective Dates: Health plan effective dates follow payroll schedules, not the calendar year. This means plan start and end dates vary each year.

• Deductibles & Out-of-Pocket Maximums: Most health plans administer deductibles and out-of-pocket maximums on a calendar-year basis. Please refer to each plan’s Summary Plan Document and other official carrier materials for specific details. Because the County’s plan year and the calendar year do not align, your deductible and out-of-pocket maximum may reset at the beginning of a plan year. For example, the HDHP PPO deductible is administered on a calendar-year basis to comply with IRS requirements for Health Savings Account (HSA) eligibility.
• This means that even if the County’s new plan year begins sometime in December, the HDHP deductible will reset on January 1. As a result, covered services received in the prior calendar year will not apply toward the new calendar-year deductible.

• Plan-Specific Questions: The County Benefits Department facilitates employee and dependent health plan enrollment.  However, questions regarding plan-specific details—such as coverage, prescriptions, deductibles, and out-of-pocket maximums—should be directed to the plan provider. Always reference the official plan documents for accurate information.  In the event of any discrepancy between County materials (including websites and handbooks) and the official plan documents, the plan documents will take precedence.