The City of Fond du Lac currently has a self-insured PPO health plan where levels of benefits provided and employee participation are determined by the City and applicable to state and federal regulations.<\/p>\n
All full-time and part-time City employees who are regularly scheduled a minimum of 20 hours per week are eligible for Single or Family benefits. Married couples, where both individuals are employed by the City of Fond du Lac and are both eligible for health insurance, may each elect single coverage, or one employee may elect family coverage and enroll the spouse and any dependents under that person.<\/p>\n
Enrollment is offered according to the following:<\/p>\n
It is the City\u2019s policy that employees pay 20% towards the monthly premium cost of their health insurance. The City pays the balance of 80%. The City may provide additional incentives for completing a Health Risk Assessment.<\/p>\n
Part-time Employees: The City will contribute towards single coverage plan premiums at the full-time active employee rate for part-time employees who regularly work a minimum of 20 hours per week. Regular part-time employees electing family coverage are responsible for paying the difference between the total monthly family premium and the City\u2019s contribution to the single coverage plan premium for full-time active employees.<\/em><\/p>\n<\/div> Auxiant is the City\u2019s Third Party Administrator that processes claims for the health plan while Health Payment System (HPS) is the company that manages the provider network. Auxiant and HPS work very closely together to provide access to a comprehensive network of medical providers and process claims quickly and efficiently.<\/p>\n The full Summary of Benefits and Coverage explains how the plan distributes costs for covered health care services. This summary can be found through Auxiant or Human Resources. It is also provided in the open enrollment packet each year.<\/p>\n This summary can be found below.<\/p>\n The City believes that the benefits discussed under Wisconsin Statutes \u00a766.0137 (municipalities are required to contribute towards the health insurance premiums for fire fighters and continue to pay those premiums for the spouse and\/or dependent children of a fire fighter who dies in the line of duty) should be extended to the surviving spouse and dependent children of all City employees who die in the line of duty. Therefore, the City provides the following benefits should this occur:<\/p>\n National CooperativeRx is the City of Fond du Lac’s PBM. National CooperativeRx is a not-for-profit, member-owned cooperative made up of employers and coalitions who provide pharmacy benefits to employees and their dependents. They provide high-quality, cost-effective pharmacy benefit management (CVS Caremark) with honest, transparent pricing. Since National CooperativeRx is a large group with high purchasing power, they see more savings, better discounts, rebates, and more fair terms and customization opportunities.<\/p>\n CVS Caremark has convenient and affordable medication options as well as a multitude of digital tools. Save time, keep costs down and stay on top of your prescriptions. See information below or on their website (www.caremark.com\/).<\/a><\/p>\n Specific costs can be found in the Summary of Benefits and Coverage.<\/p>\n As part of our commitment to employee wellness, if you are enrolled in the company\u2019s health insurance plan, you\u2019ll have access to a variety of convenient and cost-effective healthcare services. These include Corporate Care Clinic, Teladoc, Garner Health, and ATI Physical Therapy.<\/p>\n Corporate Care Clinic (CCC): <\/strong>The City of Fond du Lac works with FABOH and the Corporate Care Clinic (920-926-5578) to provide members under the health plan ways to save money. The City\u2019s contract with the Corporate Care Clinic has a set list of several common services that are provided to City health plan members at no cost. (The list includes:<\/p>\n There are other services provided that will be covered by insurance but may be subject to deductible and coinsurance. You can verify what coverage level your visit will likely be set at ahead of time by contacting Human Resources and\/or Auxiant.<\/p>\n Teladoc: <\/strong>Another great option for fast, cost-effective, non-urgent care is Teladoc. This popular program provides employees on the City\u2019s health plan access to licensed physicians by phone, video, and mobile app 24 hours a day, 7 days a week. All services available through Teladoc are provided to members covered under the City\u2019s health plan at no cost.<\/p>\n You can be seen for both medical care and mental health care.\u00a0 For medical care you can be seen typically within 15 minutes.\u00a0 For mental health care you can pick the provider that is best for you and schedule an appointment.\u00a0 You can be seen for the following:<\/p>\nAuxiant & Health Payment Systems <\/u><\/span><\/strong><\/h6>\n
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Summary of Benefits & Coverage<\/u><\/span><\/strong><\/h6>\n
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Surviving Spouse & Dependent Children Health Insurance Continuation<\/u><\/span><\/strong><\/h6>\n
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Comprehensive Health Services<\/strong><\/h2>\n
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