Alameda County Municipal Code Ch. 3.64 Employee Health and Welfare Benefit Program

The health and welfare benefit program herein provided is adopted pursuant to Section 53200 et seq. of the California Government Code.

(Ord. 96-75 § 1 (part): prior admin. code § 2-6.01)

Those eligible to participate in this program are all elective and appointive officers of the county, judicial districts, and the Alameda County flood control and water conservation district, as well as all employees of the county and the Alameda County flood control and water conservation district who work at least fifty (50) percent of the normal full-time working schedule, and all appointive officers, attaches, and employees of the judicial districts and of the Superior Court who work at least fifty (50) percent of the normal full-time working schedule. The county shall contribute the full cost of the provider's charge for a dental plan for less than full-time employees and for their dependents, provided further however, that the employee works fifty (50) percent of the normal full-time work week for the job classification. To participate such an employee working in a classification normally subject to a forty (40) hour workweek must be on paid status at least forty (40) hours in each and every biweekly pay period. To establish eligibility to participate an employee must have been on paid status at least thirty-seven and one-half (37.5)/forty (40) hours in each of seven consecutive biweekly pay periods. Effective the pay period upon the implementation of the Alcolink System, this paragraph will no longer apply, such that, less than full-time employees and services-as-needed employees will receive dental benefits in the same manner as full-time employees.

Effect of Authorized Leave Without Pay. Employees who are granted leave of absence without pay, whose dental plan coverage has lapsed for a period of seven pay periods or less, and who return to work on paid status of at least thirty-seven and one-half (37.5)/forty (40) hours per pay period shall retain dental plan eligibility as further provided:

A. Full-time employees who were absent on authorized leave without pay, and whose dental plan coverage lapsed for a duration of seven pay periods or less, will be re-enrolled in the dental plan as a continuing member with respect to the application of deductibles, maximums and waiting periods. Coverage will begin on the fifteenth day following the end of the biweekly pay period in which the employee worked one week or more.

Those whose dental plan coverage lapsed for a duration greater than seven pay periods will be re-enrolled in the same manner as is allowed for new hires with respect to the application of deductibles, maximums and waiting periods. Coverage will begin on the fifteenth day following the end of the biweekly pay period in which the employee worked one week or more.

B. Part-time employees and services-as-needed employees regularly scheduled to work fifty (50) percent time or more per pay period who were absent on authorized without pay, whose dental plan coverage lapsed for a duration of seven pay periods or less, who return to work and work fifty (50) percent time or more per pay period, will be re-enrolled as a continuing member in the dental plan with respect to the application of deductibles, maximums and waiting periods. Coverage will begin on the fifteenth day following the end of the biweekly pay period in which the employee worked one week or more.

Those whose dental plan coverage lapsed for duration greater than seven pay periods will be required to re-establish eligibility for the dental plan, and then be re-enrolled in the same manner as allowed for regularly scheduled part-time and services-as-needed new hires with respect to the application of deductibles, maximums and waiting periods. Note: Coverage begins at the tenth pay period, given that the minimum time worked is fifty (50) percent of the full-time schedule for seven consecutive pay periods.

Effective the pay period upon the implementation of the Alcolink System, all full-time, part-time and services-as-needed employees regularly scheduled to work fifty (50) percent time or more per pay period and who are granted an authorized leave of absense without pay, whose dental plan coverage lapsed for a period of seven pay periods or less and who returns to work on paid status at least thirty-seven and one half (37.5)/forty (40) hours per pay period shall retain dental plan eligibility. Said employees, as defined above, will be re-enrolled in the dental plan as a continuing member with respect to the application of deductibles, maximums and waiting periods. Coverage will begin on the fifteenth day following the end of the biweekly period in which the employee worked at least fifty (50) percent of the normal full-time work week for the job classification.

Effective the pay period upon the implementation of the Alcolink System, all full-time, part-time and services-as-needed employees regularly scheduled to work fifty (50) percent time or more per pay period and who are granted an authorized leave of absence without pay and whose dental plan coverage has lapsed for a duration greater than seven pay periods will be re-enrolled in the same manner as is allowed for full-time, regularly scheduled part-time, services-as-needed and new hires with respect to the application of deductibles, maximums and waiting periods. Coverage will begin on the fifteenth day following the end of the biweekly period in which the employee worked at least fifty (50) percent of the normal full-time work week for the job classification.

(Ord. 2002-61 § 2; Ord. 2000-4 § 1; Ord. 96-6 § 1 (part): prior admin. code § 2-6.02)

The Board of Supervisors shall approve health and welfare benefit plans coverage for eligible employees and their spouses (or domestic partners effective February 1, 1996) and eligible dependents. The county offers health maintenance organization (HMO) medical plan options, a dental health maintenance organization (DHMO) dental plan, and a preferred provider organization (PPO) dental plan. Effective February 1, 2022, the county offers a PPO/indemnity medical plan option.

(Ord. 96-6 § 1 (part): prior admin. code § 2-6.03)

(Ord. No. 2019-40, § 1, 10-1-19; Ord. No. 2021-44, § 1, 10-26-21)

Participation in either the comprehensive group health service plan or the group hospital, medical and surgical service plan shall be optional with each eligible officer or employee. Participation in the dental service plan shall be mandatory for all eligible persons, except as otherwise permitted by the contract with the dental service plan provider.

(Prior admin. code § 2-6.04)

A. Medical. The county shall contribute toward the semi-monthly premium for a county-offered medical plan for eligible employees as well as their spouses or domestic partners (effective 2/1/96 and upon submission of a domestic partner affidavit as defined in Section 3.20.170), and eligible dependents. The county and covered employees will share the cost of medical premiums. In no event shall the county contribution exceed the premium of the medical plan option selected, and such contribution shall be prorated each pay period based upon a proportion of the hours the employee is on paid status within that biweekly pay period to the normal full-time biweekly pay period for the job classification, provided that the employee is on paid status at least fifty (50) percent of the normal full-time biweekly pay period for the job classification. If an employee is not on paid status at least fifty (50) percent of the normal full-time biweekly pay period for the job classification, the employee will be responsible for paying the entire semi-monthly premium payment for the benefit.

1. Unrepresented M-Designated Employees.

a. Effective February 1, 2019, for unrepresented M-designated employees, the county shall contribute eighty-seven and one-half (87.5) percent of the total semi-monthly premium for an HMO plan at the corresponding level of coverage (i.e., self, self + one dependent, or family).

b. Effective February 1, 2022, for unrepresented M-designated employees, the county shall contribute eighty-five (85) percent of the total semi-monthly premium for an HMO plan or eighty-five (85) percent of the total semi-monthly premium of the lowest cost HMO plan towards the coverage of a PPO/indemnity plan at the corresponding level of coverage (i.e. self, self + one dependent, family).

2. Unrepresented Non-Management Employees.

a. Effective February 1, 2013, for unrepresented non-management employees, the county shall contribute ninety (90) percent of the total semi-monthly premium for an HMO plan at the corresponding level of coverage (i.e., self, self + one dependent, family).

b. Effective February 1, 2022, for unrepresented non-management employees, the county shall contribute eighty-eight (88) percent of the total semi-monthly premium for an HMO plan or eighty-eight (88) percent of the total semi-monthly premium of the lowest cost HMO plan towards the coverage of a PPO/indemnity plan at the corresponding level of coverage (i.e. self, self + one dependent, family).

B. Dental. The county shall contribute the total semi-monthly premium for a county-offered dental plan at the corresponding level of coverage (i.e., self, self + one dependent, family) provided that the employee is on paid status at least fifty percent (50%) of the normal full-time biweekly pay period. If an employee is not on paid status at least fifty percent (50%) of the normal full-time biweekly pay period for the job classification, the employee will be responsible for paying the entire semi-monthly premium payment for the benefit.

1. Unrepresented M-Designated Employees. For unrepresented M-designated employees, the annual PPO dental maximum allowable shall be one thousand seven hundred fifty dollars ($1,750.00) per plan year ("PY"). Effective PY 2026, the dental maximum allowable shall be one thousand nine hundred dollars ($1,900.00).

2. Unrepresented Non-Management Employees. For unrepresented non-management employees, the annual PPO dental maximum allowable one thousand nine hundred dollars ($1,900.00).

(Ord. 96-6 § 1 (part): prior admin. code § 2-6.05)

(Ord. No. 2009-36, § 4, 7-21-09; Ord. No. 2012-31, § 1, 7-24-12; Ord. No. 2012-39, § 1, 10-2-12; Ord. No. 2018-11, § 3, 3-13-18; Ord. No. 2019-40, § 1, 10-1-19; Ord. No. 2019-54, 11-26-19; Ord. No. 2021-9, § 1, 1-12-21; Ord. No. 2021-44, § 2, 10-26-21; Ord. No. 2022-19, § 1, 3-22-22; Ord. No. 2025-14, § 6, 2-25-25; Ord. No. 2025-42, § 1, 7-22-25)

Notwithstanding the foregoing in Section 3.64.050 of this code, such employees who normally work at least fifty (50) percent of the normal full-time weekly schedule for the job classification, who were on the county payroll for the pay period beginning April 1, 1979, and who received one hundred (100) percent of the county contribution during said pay period, shall continue to be eligible for one hundred (100) percent of said contribution until: (A) a break in part-time service, (B) a break in health plan coverage, (C) a change to full-time service from part-time service even if the employee reverts to part-time service, whichever shall first occur, but in no event shall said contribution exceed the county contribution for coverage of full-time employees in comparable classes.

(Ord. 96-6 § 1 (part): prior admin. code § 2-6.06)

(Ord. No. 2009-36, § 5, 7-21-09; Ord. No. 2012-31, § 1, 7-24-12; Ord. No. 2012-39, § 1, 10-2-12; Ord. No. 2019-40, § 1, 10-1-19)

This program and the payment by the county of its share of the costs thereof and the arrangements for coverage of eligible persons, and other administrative details thereof shall be subject to such agreements as may be made from time to time with the covering providers, and to such administrative regulations as may be necessary to effectuate the intent of this chapter, including coverage of part-time or seasonal employees, or others.

(Prior admin. code § 2-6.07)

Unless otherwise provided in a current, valid memorandum of understanding, and subject to the premium contribution provisions of Section 3.64.050 and Section 3.64.060, and eligibility requirements of Section 3.64.020, the provisions of this section applies to married county employees or domestic partners (effective February 1, 1996 and upon submission of an affidavit as defined in Section 3.24.180), and employees in parent-young adult dependent (YAD) relationships where the YAD employee is under age twenty-six (26), when both parties are employed by the county. The intent of this section is to limit county employees from both covering each other or having duplicate coverage within the same plan.

A. Medical: Married county employees and employees in domestic partnerships, who are both employed by the county, shall be entitled to one choice from the following list of medical plan coverages:

1. Up to one full family HMO plan;

2. Up to one full family PPO/indemnity plan;

3. Up to one full family HMO plan with up to one full family alternative HMO plan; or

4. Up to one full family HMO plan with up to one full family PPO/Indemnity plan.

For county employees in a parent-YAD relationship, the YAD employee cannot have duplicate coverage within the same plan as the parent employee. If the parent employee has the YAD employee on a family HMO plan, the YAD employee cannot select individual coverage on the same HMO plan as the parent employee.

B. Dental: Married county employees and employees in domestic partnerships, who are both employed by the county, shall be entitled to one choice from the following list of dental plan coverages:

1. Up to one full family PPO plan together with up to one PPO supplemental plan;

2. Up to one full family PPO plan together with up to one full family DHMO plan;

3. Up to one full family DHMO plan; or

4. Up to one full family PPO plan.

For county employees in a parent-YAD relationship, the YAD employee cannot have duplicate coverage within the same plan as the parent employee if the parent employee has the YAD employee on a family plan.

(Ord. 96-6 § 1 (part): prior admin. code § 2-6.08)

(Ord. No. 2019-40, § 1, 10-1-19; Ord. No. 2021-44, § 3, 10-26-21)

Notwithstanding Sections 3.64.020, 3.64.050 and 3.64.060 hereof, an employee using the voluntary leave without pay program, as it may from time to time exist pursuant to board action, shall incur no loss in the county contribution toward health and dental coverage for the first twelve (12) days of such approved leave without pay in a fiscal year.

Effective September 1, 1991, employees in positions in classifications which are neither M-designated nor included in an employee representation unit having a recognized employee organization shall be eligible for vision care reimbursement subject to the following criteria:

A. The employee must have completed six months of continuous employment working at least fifty (50) percent time each pay period;

B. The employee shall be reimbursed for the cost of either one pair of lenses and frames or contact lenses specifically prescribed for the employee only, up to a maximum reimbursement of forty dollars ($40.00) per fiscal year; and

C. Reimbursements hereunder are subject to the applicable procedures and requirements of the auditor-controller.

(Prior admin. code § 2-6.09)

Effective January 1, 1996, a long-term disability insurance policy will be made available for the employee only. Coverage can be purchased either through the use of vacation sellback (See Section 7-4 of the Salary Ordinance) or through payroll deduction. This policy is subject to premium costs, eligibility requirements, age limitations, coverage exclusions, conversion rights, and all other provisions set forth in the applicable insurer contracts.

(Ord. 96-41 § 1 (part): prior admin. code § 2-6.10)

(Ord. No. 2025-14, § 6, 2-25-25)

Editor's note— Ord. No. 2025-14, § 6, adopted February 25, 2025, amended the title of § 3.64.100 to read as herein set out. The former § 3.64.100 title pertained to long-term disability insurance policy for unrepresented M-designated persons.

Employees who are eligible for medical benefits as defined in Section 3.64.020 (eligibility) who are regularly scheduled to work at least fifty (50) percent of the normal full-time biweekly pay period for their classification, on paid status at least fifty (50) percent of the normal fulltime biweekly pay period, and have alternate medical coverage, are eligible to enroll in the share the savings plan if they choose to waive their county-sponsored medical coverage or reduce their applicable level of enrollment (i.e., self, self + one dependent, family). The stipend provided by this plan is taxable, payable on a semi-monthly basis, and subject to proration.

For eligible employees regularly scheduled to work less than the normal full-time biweekly pay period, the stipend is prorated each pay period based upon a proportion of the hours the employee is on paid status within that biweekly pay period to the normal full-time biweekly pay period for the job classification, provided that the employee must be on paid status at least fifty (50) percent of the normal full-time biweekly pay period for the job classification. An employee who is not on paid status at least fifty (50) percent of the normal full-time biweekly pay period for that classification will not receive the semi-monthly stipend.

Proration of county-provided share the savings stipend occurs when the employee is on leave without pay or using vacation purchase hours, as provided for in Section 7-14 (additional vacation purchase) of the county salary ordinance. An employee who is not on paid status at least fifty (50) percent of the normal full-time biweekly pay period due to leave without pay will not receive the semi-monthly stipend.

The county's share the savings plan stipend is as follows:

A. Unrepresented M-designated Employees. For unrepresented M-designated full-time employees, the share the savings plan tiers and stipend amounts are as follows:

1. Effective plan year 2019:

• Two hundred fifty dollars ($250.00) for those employees who decline all medical coverage;

• Two hundred dollars ($200.00) for those employees who decline family coverage and elect single coverage;

• One hundred fifty dollars ($150.00) for those employees who decline family coverage and elect two-party coverage; and

• One hundred fifty dollars ($150.00) for those employees who decline two-party coverage and elect single coverage.

2. Effective plan year 2026:

• Three hundred dollars ($300.00) for those employees who decline all medical coverage;

• Two hundred fifty dollars ($250.00) for those employees who decline family coverage and elect single coverage;

• Two hundred dollars ($200.00) for those employees who decline family coverage and elect two-party coverage; and

• Two hundred dollars ($200.00) for those employees who decline two-party coverage and elect single coverage.

B. Unrepresented Non-Management Employees. For unrepresented non-management full-time employees, the share the savings plan tiers and stipend amounts are as follows:

• Three hundred dollars ($300.00) for those employees who decline all medical coverage;

• Two hundred fifty dollars ($250.00) for those employees who decline family coverage and elect single coverage;

• Two hundred dollars ($200.00) for those employees who decline family coverage and elect two-party coverage; and

• Two hundred dollars ($200.00) for those employees who decline two-party coverage and elect single coverage.

(Ord. No. 2019-40, § 1, 10-1-19; Ord. No. 2025-14, § 6, 2-25-25; Ord. No. 2025-42, § 1, 7-22-25)