Health Benefits for Alameda County IHSS Providers

Am I eligible for benefits?

If you are an IHSS Provider, and you are paid 80 or more hours per month consistently, you likely meet the criteria for the health benefits coverage. Our group health plan includes medical, dental and vision coverage. This coverage includes all three benefits, they are not offered separately.

To qualify:

• You must first complete an enrollment packet which includes an application for the medical and dental plans (the vision plan is included automatically.) To request an application, please call the Health Benefits Department at: (510) 577-3551.
• You must be issued checks totaling 160 hours over 2 consecutive months, with at least 1 hour in each month.
  • Advanced-pay workers are eligible as well.
  • Spouses and dependents are not eligible

Enrollment & Wait Period

• Don’t wait, enroll today! There is up to a 90-day waiting period that begins when you submit your enrollment forms. Please call and we’ll be happy to mail an application packet to you, (510) 577-3551.
• Don’t wait until after you are paid to complete the application, complete it today. You will receive a benefit confirmation letter when you have met eligibility requirements.

*Example

August	September	October	November
Checks issued for 80 hours	Checks issued for 80 hours	Application received by 10th	Covered!
Checks issued for 159 hours	Checks issued for 1 hour	Application received by 10th	Covered!

Please note: Applications must be received by the 10th of the month to begin the wait period in that month.

Your check issue date (at the top of your paycheck stub) must show in the State’s payroll data base in order for you to get “credit” for those paid hours. For example: if your check issue date is September 15th, you’ll be “credited” in the month of September for those paid hours.

Monthly Premiums (What comes out of your paycheck):

• $20.00 per month – includes medical, dental (HMO style) and vision.
• $45.00 per month – includes medical, dental (PPO style) and vision.

Some examples of benefits:

	Medical Benefits – Alameda Alliance A personal doctor (primary care provider) office visit ($10 co-pay) Preventive care (no co-pay) X-rays and other diagnostic tests (no co-pay) Inpatient care ($100 per admission)) Family planning (no co-pay) Advice nurse, health education, and audio health library (no co-pay) Prescription drugs ($10-$15 co-pay per prescription) Emergency care ($35 co-pay, but $0 if admitted to the hospital) Specialty care ($10 co-pay) Mental health services ($10 for outpatient services, $100 co-pay for inpatient care)
	Dental Benefits – Delta Dental HMO or PPO A choice between two dental plans: HMO style plan PPO style plan Most preventive medical care and basic dental exams, teeth cleaning and x- rays are FREE!
	Vision Benefits -EyeMed Vision Care Vision services – including eye exams Glasses OR contact lenses

What happens to my Health Benefits if I stop working?

Continuation of Coverage (COBRA)

• If you lose your benefits with IHSS due to not meeting eligibility requirements, you may be eligible to continue your same coverage with COBRA for up to 18-36 months. You will receive more information on COBRA during the last month of your grace period.

Timesheets

• Remember: Your eligibility could be at jeopardy if you do not turn in your timesheets on time! We base your eligibility on paid hours data and the check issue date, not the hours worked. Please submit your timesheets as soon as the pay period ends.

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