The City of Kettering offers three medical insurance plans to eligible employees. These plans are administered by United Healthcare. Detailed information is provided during new employee orientation and annual enrollment. Please contact Human Resources if you have any questions or need additional information.
The Platinum Plan is a High Deductible Health Plan (HDHP) and is available to all full-time employees, organized and non-organized. This plan has an annual deductible of $2,000 for single coverage and $4,000 for family coverage. Participants pay the full cost of coverage for all services (except Preventive Services – those are covered at 100%) until the deductible is met. After the deductible is met, the plan will start paying and the participant’s responsibility is any applicable Point-Of-Service or Prescription Co-Pay. The maximum one will pay out of pocket for network benefits is $6,250 for single and $6,850 for family coverage.
Depending on eligibility, the Platinum Plan is paired with either a Health Savings Account (HSA) or Health Reimbursement Account (HRA) which can be used to pay for qualifying medical expenses. For Plan Year 2023, the City will make an annual contribution of $1,300 for a single plan or $2,600 for a family plan to the participant’s account.
2023 Pre-Tax Monthly Premiums for Platinum Coverage:
Employee (17%): $115.69 (Single); $298.48 (Family)
Employer (83%): $564.84 (Single); $1,457.29 (Family)
Total (100%): $680.53 (Single); $1,755.77 (Family)
Platinum Plan – Benefit Summary
Platinum Plan – Summary of Benefits and Coverage
The Silver Plan is available to all full-time employees, organized and non-organized. This plan offers “first dollar coverage”, meaning the plan begins paying right away. Participant responsibilities under this plan are Point-Of-Service and Prescription Co-Pays, and after the deductible ($2,000 Single; $4,000 Family) a 20% Coinsurance. Like the Platinum Plan, the Silver Plan offers 100% coverage on Preventive Services. The maximum one will pay out of pocket is $4,000 for single coverage and $8,000 for family coverage.
2023 Pre-Tax Monthly Premiums for Silver Coverage:
Employee (17%): $97.18 (Single); $250.73 (Family)
Employer (83%): $474.46 (Single); $1,224.13 (Family)
Total (100%): $571.64 (Single); $1,474.86 (Family)
Silver Plan – Benefits Summary
Silver Plan – Summary of Benefits and Coverage
The Bronze Plan is available to all full-time employees, organized and non-organized. This plan is a High Deductible Health Plan (HDHP) with an annual deductible of $4,000 for single coverage and $8,000 for family coverage. Participants pay the full cost of coverage for all services (except Preventive Services – those are covered at 100%) until the deductible is met. After the deductible is met, the plan will start paying and the participant’s responsibility is a 30% Coinsurance on all services (medical and prescription). The maximum one will pay out of pocket is $6,350 for single coverage and $12,700 for family coverage.
2023 Pre-Tax Monthly Premiums for Bronze Coverage:
Employee (17%): $79.83 (Single); $205.95 (Family)
Employer (83%): $389.77 (Single); $1,005.54 (Family)
Total (100%): $469.61 (Single); $1,211.50 (Family)
Bronze Plan – Benefits Summary
Bronze Plan – Summary of Benefits and Coverage
Waiving coverage is an option for eligible employees who have medical insurance coverage through another source and choose to decline coverage from the City of Kettering. An employee who waives coverage will receive $3,000 per year (prorated over each bi-weekly pay) in taxable income. Participants must submit proof of other coverage for each member of their tax family on an annual basis.
The City partners with Superior Dental Care to provide eligible employees and family members with quality dental care services. Dental Care Plus offers the same level of coverage out-of-network as in-network, however, an out-of-network provider can balance bill, whereas an in-network provider will not. Participants who wish to minimize out-of-pocket costs should select an in-network provider.
2023 Pre-Tax Monthly Premiums for Dental Insurance:
Employee (10%): $2.92 (Single); $8.89 (Family)
Employer (90%): $26.24 (Single); $79.99 (Family)
Total (100%): $29.15 (Single); $88.88 (Family)
Superior Dental Care Benefit Summary
The City partners with EyeMed to offer eligible employees and family members a quality vision service option. EyeMed offers a broad network of both retail and local optometrist options with its Insight Network.
While there is no City contribution towards the cost of coverage, a group arrangement with EyeMed has been established to offer comprehensive vision care at a competitive rate. The 2023 Pre-Tax Premiums for Vision Coverage are $5.28 per month for Single and $13.48 per month for Family coverage.
EyeMed – Description of Benefits and Covered Services
The City provides Basic Term Life Insurance, as administered by New York Life, to all full-time employees at no cost. The value of this life insurance is equal to the base annual salary plus an equal amount for Accidental Death and Dismemberment (AD&D) coverage.
Employees have the opportunity to purchase additional life insurance through a Voluntary Term Life Insurance Policy on their own life, spouse, and qualifying children through payroll deduction. Rates and availability of optional coverage shall be as specified by the insurance carrier selected by the City. If you are a new hire or within a 30-day special enrollment period, please complete the life insurance enrollment form and submit it to the Human Resource Department.
Flexible Spending Accounts
The Flexible Spending Account (FSA) Program offers eligible employees an opportunity to pay for qualifying medical and/or dependent care expenses with pre-tax dollars. Employees can participate in a Health Care FSA and/or a Dependent Care FSA. The City partners with Navia to administer these accounts.
Employees must annually re-elect participation. Elections do not carry year-to-year and balances are “use it or lose it”. In order to receive reimbursement, eligible expenses must be incurred by December 31 of the plan year. Participants have until March 31 of the following plan year to submit reimbursement. Any remaining balance will be forfeited.
Dependent Care FSA
This FSA provides pre-tax reimbursement for childcare and other dependent care expenses that you incur so that you, and your spouse (if married), can work or attend school full-time. Expenses must be incurred for a child who is under age 13 or for a physically or mentally disabled dependent that lives with you at least eight hours per day. The individual for whom care is provided must be your dependent for federal income tax purposes.
The maximum annual contribution to a Dependent Care FSA is $5,000.
Health Care FSA
This FSA provides pre-tax reimbursement of medical, dental, and vision costs that are not reimbursed by a health insurance plan for you and eligible dependents. These costs may include expenses applied to meet a health plan deductible, copayments, and certain items not covered by a health insurance plan.
Because the City offers a High Deductible Health Plan (HDHP) along with an HSA, two different types of Health Care FSAs are available in an effort to provide employees with more options.
Type 1: General Purpose FSA:
Elect a General Purpose FSA if enrolled in the Silver Plan or waive coverage; and/or have a spouse who contributes to an HSA. This FSA allows you to pay for qualified expenses for yourself, spouse (only if they are not contributing to an HSA), and eligible children.
Type 2: Full-Family Limited Purpose FSA:
Elect a Limited Purpose FSA if you and/or your spouse contribute to a Health Savings Account (HSA). This FSA only reimburses dental and vision expenses.
The maximum annual contribution to any Health Care FSA is $3,050.
- Health Insurance Marketplace Memo and Notice
- Notice Regarding Wellness Programs
- Premium Assistance Under Medicaid and the Children’s Health Insurance Program (CHIP) Notice
- Medicare Prescription Drug Coverage Notice
- Women’s Health & Cancer Rights Notice
- Special Enrollment Notice
- Notice Regarding HIPAA Privacy Practices
These benefit details are for information purposes only and provide a general overview of some of the current benefits for eligible employees. Benefits included here may differ from Union contract language applicable to certain City positions. Language in Union contracts is controlling. This material should only be used as a reference. All benefits are subject to modification or elimination.
Click HERE to Access Medical Insurance Coverage Transparency Data.