Medical & Prescription Plan

Medical

Domestic 

(Member Pays)

In-Network Only

(Member Pays)

Deductible (Single/Family) $0/$0 $1,000/$2,000
Out of Pocket Maximum (Single/Family) N/A

$6,500/$13,000

(per covered individual for EPO providers only)

Medical Coinsurance

Coinsurance 0% 20% after the deductible is met
Preventative Care 0%

20% after $25 copayment.

Deductible is waived at Oak Valley Health Clinics

Inpatient Care 0% 20% after $800 copay
Emergency Room Care 0% 20% after $150 copay
 

Prescription Drug Plan

Prescription Drug

Retail

(Up to 30-Day Supply)

Mail

(Up to 90-Day Supply)

Generic $20 $40
Brand Name $45 $90
Brand Non-Formulary $75 $150
Specialty 20% max $1,000 20% max $1,000

80% in-network coverage for Exclusive Provider Organization (EPO) providers. Note: out-of-network providers are NOT covered under the medical plan, except for emergency admissions. All Sutter providers are considered out of network, and no benefits will be paid to any Sutter facility or provider. This includes emergency care. 80% of covered expenses after deductible for hospital admissions with pre-certification. When you enroll in this plan, you are automatically covered for prescription benefits.

ALL Sutter hospitals and providers — such as Memorial Hospital — may appear on the list, but ARE NOT covered by the medical plan! No Sutter providers are covered by the medical plan.

Dental Care Plan

In-Network

Out of Network

Annual Program Deductible

(Per person/per family)

$50/$150

$50/$150

Excludes Orthodontics

Annual Program Maximum $1,500

$1,000

Excludes Orthodontics

Lifetime Orthodontic Maximum $1,000 Not Covered

Benefits

Diagnostic/Preventive Services 100% 80%
Basic Services 90% 80%
Major Services 60% 50%
Temporomandibular Joint (TMJ) 50% 50%
Orthodontics 50% Not Covered

The dental plan provides the insured with access to any United Concordia-contracted dentists for dental services.  The plan features a low-dollar deductible, preventive care benefits, and Orthodontic coverage (in-network).

Vision Service Plan

Vision Care

In-Network

Out-of-Network

Well Vision Exam Covered in full after co-pay Reimbursed up to $50

Contact Lens Exam, Fitting & Evaluation

(Standard & Premium)

Covered in full after copay, not to exceed $60 Not applicable
Routine Retinal Scanning Covered in full after copay, not to exceed $39 Not applicable

Frames

In-Network

 Out-of-Network

Frames

Covered in full after copay, up to a frame allowance of $250

20% off any amount above the allowance

Extra $20 allowance on Featured Frame Brands

 Reimbursed up to $70
Lenses In-Network Out-of-Network
Single Vision, Lined Bifocal, Lined Trifocal, Lenticular, Standard Progressive Lenses Covered in full after copay Reimbursed up to $50, $75,$100, $125 or $75 respectively-based on selected lens type.
Contact Lenses In-Network Out-of-Network
Elective Covered in full, up to Contact Lens Allowance Reimbursed up to $105
Necessary Covered in full after copay Reimbursed up to $210

Additional Benefits

In-Network

 Out-of-Network

Essential Medical Eye Care

(Supplemental coverage beyond routine care to treat urgent issues/monitor ongoing conditions)

Covered in full after copay, not to exceed $20 Not applicable

Low Vision

(Supplemental testing and coverage for approved low vision aids)

Up to $1,000 every two years

Covers 100% supplemental testing and 75% of approved low vision aid.

Not applicable

VSP Laser Vision Care Program

(Discounted access for laser vision correction services)

Average savings of 15%-20% off retail price or 5% off promotional price. Not applicable
Additional Pairs of Glasses 30% off unlimited additional pairs of prescription glasses and/or non-prescription sunglasses. Not applicable

Sunglasses 

(Use of frame allowance for no-prescription sunglasses for members who have had laser surgery)

Covered in full after copay, up to frame allowance. Not applicable

Supplemental Benefits

In-Network

 Out-of-Network

VSP LightCare

(Non-prescription blue light filtering glasses or sunglasses)

Covered in full after copay, up to frame allowance. Not applicable

Frequency

CoPay & Allowance

Exam – Every 12 months $25 total copay
Lenses every 12 months Lenses are covered in full after co-pay
Frame every 24. months $250 Frame Allowance

Contact Lenses every 12 months

(Instead of lenses and frames)

$120 Contact Lens Allowance
Telecom Primary 360

Teladoc Primary360 Virtual Care is available for all benefited members electing medical coverage with OVHD at no cost to you.  Primary360 gives you easy access to virtual primary care for your physical and mental health by phone or video Teladoc will help you stay healthy, manage conditions, and create a personalized care plan.

Before your visit: Choose a provider, answer a few questions, and get a free blood pressure monitor (which is yours to keep) at no cost to you.

Schedule your $0 visit: TeladocHealth.com/PrimaryCare or download the Teladoc Health app or call 1-800-835-2362

(Mon-Fri 7 a.m. – 9 p.m., Sat 8 a.m. – Noon)

Non-Emergency Care: Available to access 24/7

During your visit: Discuss health goals, concerns, and next steps — all from home.

Care Team: Board-certified doctors, nurses, and coordinators guide you every step.

Labs & Imaging: Your provider can order and review results—in-person or at home (if available). Labs and imaging done at an OVHD facility will be available at no cost to you.

What you get with Primary360

  • Annual checkups and wellness visits by phone or video
  • Dedicated time with your provider to talk through your medical history, challenges, and needs
  • A personalized Care Plan so you can meet your health goals with ease
  • Referrals, prescriptions, and lab orders as needed*

*Referrals and lab orders that are filled at an OVHD facility are available at no cost to you.

Hearing Plan Benefit

Oak Valley Hospital District has partnered with HearUSA to provide Hearing Benefits for all eligible OVHD employees and family members.

Hearing Aids: Expectations & How to Achieve Them:

When properly fitted, hearing aids can vastly improve the quality of life for 95% of people with hearing loss. Your provider is your partner in the process of what, for many, is the equivalent of learning to hear again. The key to success is to establish realistic goals and to work with your hearing care provider to achieve them.

For further information, call HearUSA at 1-800-442-8231, visit www.hearusa.com, or contact the Human Resources Department.

Employee Tuition Reimbursement Benefit

Looking to expand your horizons? Oak Valley Hospital District offers an exciting Tuition Reimbursement Program

Approved programs shall include courses that meet all of the following requirements:

  • Pre-approved in writing by the employee’s manager (once level above the employee’s supervisor), and the applicable Administrative Council member prior to the beginning of the course.
  • Applicable to the employee’s current position (job related) or to a position in his/her immediate department and career path (promotional opportunities).
  • Part of masters, bachelor’s, and associate degree programs offered by accredited colleges or universities. Programs leading to a high school diploma of the GED (General Education Development) exam are also eligible for reimbursement.
  • Please contact OVHD’s Human Resources Department for more information.

Flexible Spending Account

The HC Flex Account allows members to use pre-tax dollars to pay for eligible benefits. You can save 22% or more on your dependent care and health care expenses through the HC Flex Account. Simply choose the Dependent Care FSA and/or Health Care FSA options at Open Enrollment and select how much of your paycheck you’d like to defer to your account tax-free.

Dependent Care Expenses:

  • Expenses for the care of a dependent child (12 years or under)
  • Expenses for the care of a dependent elder (if in your home at least 8 hours/day)
  • Expenses for day camp
  • Housekeeping fees, if part of the fee is for child/elder care
  • Expenses for the care of a physically or mentally disabled dependent

Unreimbursed Health Expenses

  • Deductibles and Co-payments
  • Vision expenses
  • Orthodontia expenses that the IRS considers eligible under Code Section 213

REMINDER- ANNUAL ELECTION IS REQUIRED DURING OPEN ENROLLMENT PERIOD (OR WITHIN 30 DAYS OF BEING ELIGIBLE FOR BENEFITS)

Basic Term Life Insurance

Basic Life Insurance coverage is provided at no cost to you, and you are not required to enroll in any other health and protection program. Basic Life and AD&PL is equivalent to 5 times your salary up to a maximum benefit amount of $500,000.

Please note that OVHD is required by IRS rules to tax you on the amount of coverage exceeding $50,000 per year. While the life insurance benefit is not taxable, the premium required to pay for the excess coverage is. Basic AD&D matches the Basic Life coverage amount and follows a benefit

Accidental Death & Personal Loss

Coma Benefit

If covered employee suffers a bodily injury caused by an accident and as a direct result becomes comatose, a monthly benefit of 5% will be payable for 11 months after the person has been continually comatose for 30 consecutive days. Full principal sum paid after 12 months of continuous coma.

Passenger Restraint and Airbag Benefit

If covered loss of life of the employee occurs as a direct result of a motor vehicle accident and the insured is properly using a passenger restraint and (if the driver) is properly licensed, a benefit will be payable. If airbag is activated as a result of the same accident, an additional benefit will be payable. The benefit provides for $10,000 for use of a passenger restraint and an additional $5,000 if an airbag is activated.

Education Benefit

If covered loss of life of the employee occurs as a direct result of an accident, an education benefit will be payable on behalf of each dependent child and/or surviving spouse for a maximum of 4 years from the date of death with verification of continued enrollment. The benefit provides 5% of employee’s principal sum not to exceed $5,000 per year.

Child Care Benefit

If loss of life of the employee occurs as a direct result of an accident, a benefit will be payable to the guardian of the estate of the child or custodian/care-taker, to cover expenses associated with the dependent child’s enrollment in a legally licensed childcare as of the date of the accident. The benefit provides for 3% of the employee’s principal sum to a maximum of $2,000 per child per year for a maximum of 4 years.

Repatriation of Remains

If a covered loss of life of the employee occurs as a direct result of an accident while he/she is at least 200 miles from home, a benefit of up to $5,000 will be payable for the preparation and transportation of the body to the hometown mortuary.

Short & Long Term Disability

Financial protection for you and your family for unexpected (or expected) illness or injury provides peace of mind. We have worked with The Hartford to provide this peace of mind for you and your family. Premiums for STD and LTD are 100% employer-paid. You are eligible for these plans after your 90-day provisional period.

During your disability, you may be able to receive the following benefits and/or & Long-term resources:

  • Legal Reference Program
  • Rehabilitation
  • Survivor Benefit
Employee Assistance Program (EAP)

The Aetna Employee Assistance Program (EAP) is available for active employees, members of their households, and their children up to the age of 26. The EAP can help you balance the demands of work, life, and personal issues. You can access the EAP 24 hours a day, seven days a week, online, by phone, or by Televideo Conferencing.

Benefits Overview

The EAP offers short-term counseling on all aspects of life at no cost to you, including:

  • Relationship difficulties
  • Emotional/psychological concerns
  • Work or family stress and anxiety
  • Alcohol and drug abuse
  • Personal and life improvement
  • Legal or financial topics
  • Depression
  • Childcare
  • Elder care issues
  • Grief issues
  • Mind Comparison Self-Care Mental, Well-Being Program

Legal & Financial Services

Typical financial consultation for matters including credit counseling, debt and budgeting assistance, tax planning, and retirement and college planning.

  • A free online will, valid in 49 states
  • Detailed will and trust preparation
  • Identity theft consultation
  • Mediation services
  • Telephonic tax consultation
  • Legal and financial library

Confidential assistance is available 24 hours a day, 7 days a week Toll-free: 1-800-342-8111
www.resourcesforliving.com
User name: OVHD
Password: EAP

Retirement

Money Purchase Pension Plan

Oak Valley Hospital District (OVHD) provides a Money Purchase Pension plan at no cost to employees. OVHD contributes 7.5% of your annual salary for your first year of employment. OVHD contributes 15.9% of salary for employees with 2 or more years of service.

Eligibility Requirements

OVHD contributes towards a Money Purchase Pension Plan for all employees. Eligibility for OVHD’s contributions begins on the first day of employment.

Enrollment

You will be automatically enrolled. Please contact your HR Department for additional information.

Vesting Schedule

Vesting refers to the percentage of your account you are entitled to receive upon the occurrence of a distributable event. Rollovers from previous employers are always 100% vested. The value of your employer discretionary match contributions to the Plan, and any earnings they generate, are vested based on years of service with OVHD.

Years of Service: Vested Percentage of Employer Contributions

  • 0 – 1 Year(s) 0%
  • 1 – 4 Year(s) 50%
  • 4 – 5 Year(s) 60%
  • 5 – 6 Year(s) 80%
  • 6 Years and over 100%

Investment Options

A wide array of core investment options are available through your Plan. Each option is explained in further detail in your Plan’s fund sheets. Once you have enrolled, investment option information is also available through the website at empowermyretirement.com or call the Voice Response System toll free at 1-866-467-7756. The website and the Voice Response System are available to you 24 hours a day.

Transfers and Allocation Changes

You can move all or a portion of your existing balances between investment options (subject to Plan rules) and change how your payroll contributions are invested.

Withdrawals

Qualifying distribution events are as follows:

  • Retirement
  • Permanent Disability
  • Severance of employment (as defined
  • by the Internal Revenue Code provisions)
  • Death (your beneficiary receives your benefits)

Ordinary income tax will apply to each distribution. Distributions received prior to age 59 ½ may also be assessed a 10% early withdrawal federal tax penalty. Refer to your Summary Plan Description for more information about distributions. Any transaction related fees will be disclosedduring the withdrawal process.

Plan Fees

Recordkeeping or Administrative Fees

An annual Variable Asset Charge of 0.35% is calculated and deducted daily as a part of the unit value of each of your variable options.

Refer to your Summary Plan Description for more information about plan fees.

FOR MORE THAN FOUR DECADES, OAK VALLEY HOSPITAL HAS CONTINUOUSLY EVOLVED TO MEET THE CHANGING HEALTHCARE NEEDS OF OUR RURAL COMMUNITIES. TODAY, WE PROUDLY OFFER A COMPREHENSIVE NETWORK OF MEDICAL SERVICES—DELIVERED LOCALLY AND CONVENIENTLY.

Considering joining Oak Valley Hospital?

Connect with our Human Resources team for support, plan information, and assistance navigating your benefits.

Human Resources Department
 209-848-5436
 HR@ovhd.com
Monday–Friday – 8:00 AM–5:00 PM

Our team is happy to answer your questions and help ensure you have the information you need.