Benefits Frequently Asked Questions

General Open Enrollment Information

Open Enrollment occurs once each year and provides employees the opportunity to make changes to their health plans without a qualifying life event.  Please keep the following in mind:

• Plan Options & Premiums: Health plan offerings and premium rates may change annually.  Review the bi-weekly premium rates for any plan you are currently enrolled in or considering.
• Flexible Credit Allowance: The County’s contribution (Flexible Credit Allowance) toward medical premiums can change each year.  Be sure to review this allowance along with your plan options before making enrollment decisions.
• Flexible Spending Accounts (FSA): Per IRS requirements, FSA elections must be made each year to maintain enrollment for the upcoming plan year—even if you are currently enrolled.  Employees must elect and properly submit an FSA enrollment during Open Enrollment to participate in the next plan year.  No exceptions.
• Enrollment Deadline: Open Enrollment is a defined period.  If changes are not submitted correctly during this time, no further changes can be made after the deadline.
• Employee Responsibility: Employees are responsible for ensuring all desired changes are submitted and confirmed during their Open Enrollment period.
• System & Submission Verification: Employees must verify their elections have been properly submitted.  We suggest you print or save your latest Submitted Enrollment Statement and keep a copy for your records.  To confirm your submission:
  • Log in to VCHRP → Employee Self-Service → Benefit Details → Benefit Statements.
  • Verify that your latest submission reflects the elections you intended.
  • Verify that the “Status” of your latest submission in the online event shows “Submitted,” along with the correct timestamp for your most recent submission (if you submitted more than once). The status field is located directly above the “Submit” button.
  • Review the Submitted Enrollment Statement for accuracy. (If it’s not there, our position is that it was not submitted.)

Issues such as system errors, payroll related shutdowns, remote login or password difficulties, or failure to confirm your elections will not permit changes after the deadline. To help avoid these situations, please complete your enrollment early and seek assistance right away if you experience any problems.

There is an annual Flexible Benefits Program Open Enrollment period, which generally takes place in November. New choices can be made at that time, including changes in plans, re-enrollment and enrollment in Flexible Spending Account(s), and the addition of dependents who are not eligible to be added as dependents mid-year.

Health plan coverage for the new Plan Year begins with the first day of the County’s biweekly payroll period that includes January 1, and ends with the last day of the payroll period that precedes January 1 of the following year. Flexible Spending Account Plan Years begin on January 1 and end on December 31.

If you are on an approved leave of absence, and you or your department has continued to pay your premiums while you are on leave, any plan changes will be effective at the beginning of the new Plan Year. If you are on an approved leave of absence and your coverage has lapsed, your coverage effective date will be delayed until the pay period following your first paycheck with premium deductions after you return to work.

Due to IRS restrictions on Flexible Benefits Programs, the choices you make generally cannot be changed until the next annual Open Enrollment period. However, the IRS does permit you to file revised elections, or adjust Flexible Spending Account contributions, within 60 days of certain qualified mid-year events, such as changes in your family/employment status. See below for more information and review the Mid-Year Change Spreadsheet found on the Benefits Page for more detailed information and what documentation is required to request a mid-year change.

The change in your plan selections must be because of, and consistent with, the reason for the change. Consistency is met if the election change affects eligibility for coverage under the plan. The election change has to be on account of and correspond with the event. In some cases, the IRS requires that the change be retroactive to the pay period in which you became eligible to make the change. Please see Chapter 1 of the Benefit Plans Handbook to see a complete list of qualified mid-year events that would allow you to make changes to your plan selections.

Revised forms must be received by CEO/Human Resources/Benefits within 60 days of the qualified change in status, or you may not be able to make the requested change until the next Open Enrollment period. Depending on the nature of the change, documentation may be required (such as a copy of a marriage or birth certificate, court documents, or a letter from a current or former employer). If there is a delay in obtaining the documentation, submit the form within 60 days and attach a note of explanation. Follow-up as soon as possible with the documentation.

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.

All plans accept these dependents for coverage under your medical, dental and vision plans:

o Your current legal spouse,

o Domestic partners officially registered with the appropriate entity, such as the State of California or any other California County or Municipality official domestic partner registry,

o Your children under the age of 26,

o Dependent children of an officially-registered domestic partner who meet the same eligibility requirements as other dependent children,

o Certain unmarried dependent children age 26 and over if handicapped, incapable of self-support, continuously covered by a County-sponsored plan since prior to age 26, and whose disability was certified by the health plan and began before age 26. Please contact the health plans directly no later than 60 days prior to your child turning 26 years of age to initiate certification of disability.

The basic definition of Child(ren) is the same for all plans: Any natural child, stepchild, child placed with you for permanent adoption, or child for whom permanent legal custody has been granted, of either you or your current spouse or registered domestic partner, or both. Some plans are more restrictive, and some recognize additional categories. The chapters that describe specific health plans list any variations in dependent eligibility requirements.

For most plans, ineligible dependents include your ex-spouse, parents, grandparents, grandchildren, brothers, sisters, nieces, nephews and non-relatives.

If you make changes to your plan selections during Open Enrollment, the health plan changes become effective at the beginning of the pay period that includes January 1st of the next year.

Dependent coverage ends when your coverage ends, or on the date the dependent becomes ineligible (divorce, loss of eligibility as a dependent child, etc.), whichever occurs first.

If your dependent becomes ineligible, you must complete a County of Ventura Enrollment & Change Form and cancel coverage for the dependent or submit a VCHRP Employee Self-Service Life Event within a maximum of 60 days of the date your dependent becomes ineligible. The dependent will be terminated from coverage as of their ineligibility date. The completed form/VCHRP Life Event must be submitted to CEO/Human Resources/Benefits within 60 days of the event. You do not need to cancel coverage for your overage dependent. They will be automatically dropped, and coverage will be terminated.

If you are terminating or retiring or if you lose coverage due to a reduction of standard hours, you and any enrolled dependents are covered for a full pay period after the end of the pay period in which your paycheck includes a premium deduction.

You are eligible to enroll in the Flexible Benefits Program if you are a regular County employee with a regular work schedule (standard hours) of at least 40 hours each biweekly pay period.

Once you have enrolled in the Program, you may continue to participate as long as you remain a regular employee and your regular work schedule (standard hours) does not fall below the minimum hours per pay period required to participate.

If your job classification is represented by a collective bargaining agreement, your Flexible Benefits Program eligibility and Flexible Credit Allowance are subject to periodic negotiations between the County and that union

You must enroll in a medical plan to participate in the Program or, if you already have employer group medical insurance or Medicare, you may opt-out of County medical coverage. You may choose other benefit plans (dental plan, vision plan and/or flexible spending accounts) with any remaining Flexible Credits. Any unspent Credits will be added to your biweekly paycheck as “Cash Back.” If you spend more than your Credits will cover, part of your salary will be taken on a pre-tax basis to cover the cost of the benefits you choose.

You can also choose to waive all coverage. This means forfeiting your participation in the Flexible Benefits Program and your Flexible Credit Allowance.

To enroll, complete the proper enrollment form(s) and return within the deadlines discussed in the Benefit Plans Handbook (link to handbook).

All plan documents and forms are available on our websites: http://myvcweb/index.php/benefits (intranet) and http://www.ventura.org/benefits (internet).

The Human Resources/Benefits Representative for your department can also provide you with the form(s) you need, and help you with the enrollment process.