The Clayton County Insurance office
is responsible for the employee insurance for full-time employees,
retirees, and vested COBRA participants of Clayton County
Government. Office hours are Monday through Friday from 8:00 a.m. -
5:00 p.m.
SPOUSAL SURCHARGE
- If you are covering a spouse on either of the County Medical
plans, the spousal surcharge form (pdf) must be
completed. Failure to complete and submit this form will result in
the monthly surcharge amount of $50.
SELF-FUNDED PRESCRIPTION BENEFIT PROGRAM
- Prescription Benefits SOB
The Caremark benefit program is
available to participants in the Self-Funded Medical Plan. For more
information contact Caremark Customer Service at 1 (866) 260-4646
or you may visit their Web site at www.caremark.com. Caremark Customer
Service Representatives are available 24 hours a day Monday through
Friday, 9:00 a.m. to 8:00 p.m. (EST) on Saturday and 9:00 a.m. to
6:00 p.m. (EST) on Sunday.
The following employee insurances
are handled through this office:
HUMANA AND KAISER
MEDICAL - Enrollment Form (pdf)
SELF-FUNDED MEDICAL PLAN
The Self-Funded Medical Plan utilizes a network of providers to
deliver care at a more affordable cost. For information about the
networks available and to determine if your provider is currently
in the network, please visit www.humana.com. Full-time employees are
required to complete their insurance enrollment forms within two
weeks of their date of employment. Mid-year changes are permitted
within limited provisions as outlined in the plan
document.
SELF-FUNDED MEDICAL PLAN
CLAIMS ADMINISTRATION:
Humana Claims, PO Box 14610, Lexington, Kentucky 40512-4610
The Toll-Free telephone number for Humana is 1-888-357-6787
SELF-FUNDED DENTAL PLAN CLAIMS
ADMINISTRATION:
Humana Dental Claims Office, PO Box 14611, Lexington, Kentucky
40512-4611
The Toll-Free telephone number is 1-800-233-4013
Should you need our help, do not hesitate to let us know at
1-770-477-3590
KAISER PERMANENTE HMO PLAN
For information regarding medical benefits under this plan you may
visit their Web site at http://www.kaiserpermanente.org.
Full-time employees are required to complete their insurance
enrollment forms within two weeks of their date of employment.
Mid-year changes are permitted within limited provisions of the
Flexible Benefits Plan. Questions concerning coverage should be
directed to Kaiser Member Services at (404) 261-2590. Questions
concerning enrollment and eligibility should be directed to the
Clayton County Risk Management/Insurance Department at (770)
477-3590.
KAISER SR. ADVANTAGE HMO - Enrollment Form (pdf)
YOU MUST BE:
- Retired and live in the metropolitan Atlanta area (specific zip
codes only)
- Enrolled in Medicare Part A & B
- No Longer a Working Employee
HUMANA MEDICARE ADVANTAGE - Enrollment Form (pdf)
YOU MUST BE:
- Enrolled in Medicare Part A & B
- No longer a Working Employee
SELF-FUNDED DENTAL PLAN - Enrollment Form (pdf)
For information regarding dental benefits under this plan you may
download the Self-Funded Dental Option 1 and Option 2 Summary
of Benefits (pdf).
LIFE INSURANCE (Active
Employees) - Clayton County provides, at no cost to you,
Basic Life Insurance in the amount of $25,000. Employee
Supplemental Life Insurance in the amount of $25,000, may be
purchased at a current cost of $9.25 per month. Both coverages are
insured through Standard Life Insurance Company and double their
face value in the event of death as a result of a covered accident
while you are an active employee. In addition, both coverages
include some coverage for accidental dismemberment. Upon
retirement, Basic Life and Employee Supplemental Life Insurance
coverages are reduced by 50% and the accidental provision no longer
applies. Certain disabled employees may remain covered by former
our life carrier (Greater Georgia Life Insurance Company) as a
result of that carrier approving them for "Waiver of Premium".
Clayton County also provides
Dependent Life Insurance coverage that enables you to cover your
eligible dependents (legal spouse and dependent children - age 15
days - 19 years or 24 years, if a full-time student). Dependent
Life Insurance in the amount of $3,000, $5,000, $6,000 or $11,000
coverage may be purchased on your dependents. One premium pays for
all eligible dependents to be covered but the amount of coverage is
"per individual". Clayton County pays $.50 towards your applicable
monthly premium. Current Dependent Life premium amounts are:
Amount of
Coverage |
Monthly
Premium
|
Amount of
Coverage |
Monthly
Premium |
| $ 3,000 |
$ .22 |
$ 6,000 |
$ 1.30 |
| $ 5,000 |
$ .94 |
$11,000 |
$ 2.70 |
If you need to make any changes to
your life insurance coverages, download the Life Insurance Application form
(pdf). Complete it in full and return it to the Risk Management
Office.
LIFE INSURANCE (Retirees)
- Your life insurance is reduced by 50% of the amount in force just
prior to your retirement and remains in place, unless you fail to
pay any required premiums. It is important for you to keep your
beneficiary designations up to date and you may do this at any time
during the year. Life Insurance Application (pdf)
LONG TERM DISABILITY (available
only to Active employees) - Clayton County offers a
Voluntary Disability Policy, insured through The Hartford Insurance
Company. Like the other County coverages, you must be employed as a
full-time employee for 3 months before this coverage can go into
effect. This policy permits you to purchase protection in the event
that you are disabled from working. The policy requires that you
must be disabled for 3 months and have exhausted all full-pay
benefits available to you from the County before receiving benefits
from this plan. You may purchase protection of $500 (minimum) per
month or you may purchase up to approximately 60% of your monthly
earnings. The policy contains a "pre-existing condition clause"
that you should read carefully to assure complete understanding.
The cost of this protection varies based upon the amount of monthly
coverage purchased and your age. The cost will increase the year
that you move into another age bracket. Please review all
information about this coverage as this benefit could mean the
difference in whether or not you could be financially secure in the
event of your disability. The premiums for this coverage are paid
with after-tax deductions. Also, please be aware that if you are
already participating in this plan and have enjoyed salary
increases, you may now be eligible for more coverage than you are
currently purchasing. You may wish to increase the amount of this
protection during the Annual Open Enrollment period by completing a
new LTD Application form, requesting the increased amount of
coverage.
Long Term Disability Summary Benefits
(pdf)
Long Term Disability Enrollment Form
(pdf)
Ability Assist Program Information (pdf)
DAVIS VISION - Vision benefits available to enrolled participants.
For more details about the plan, log on to the Open
Enrollment/Discount Plan section of davisvision.com, call 1 (877) 923-2847 and
enter Client Code 7663 or download the Enrollment Application (pdf) and
Summary of Benefits (pdf).
COLONIAL SUPPLEMENTAL LIFE - Accident
insurance, short term disability, cancer insurance, critical
illness and life insurance are a few of the supplemental plans
available through Colonial Supplemental Life. For more information
contact the agent, Felicia Warner, at (404) 668-9440.
AFLAC - Cancer plans, accident/disability
plans, hospital confinement plan, intensive care plan, life
insurance are supplemental plans available through AFLAC. For more
information, contact the agent, Melissa Leedy, at (404)
247-2609.
PREPAID LEGAL - This plan provides
affordable legal insurance to protect employees in many cases. It
utilizes contracted attorneys primarily and is designed to provide
unlimited telephone access to attorneys in many specialized areas
of law. For more information contact Prepaid Legal at 1 (800)
654-7757. You may also call the agent, Wes Greene, at (770)
472-1800 for information.
WORKERS' COMPENSATION (Self-Funded)
- This protection is provided to all county personnel in the
event of injury/illness caused or contributed to during the course
of their employment. If injured at work it is imperative that you
report the injury immediately to your Supervisor whether or not you
believe medical attention is required. If medical attention is
needed, you must choose a physician from the Panel of Physicians
(Official Notice) list (Form C (pdf)). Employees are not permitted to
utilize their own physician. In the event of a life-threatening
emergency, care may be sought from the nearest medical facility. Form C (pdf) - Use to certify coverage to the
panel doctor for the injured workers' first visit. Form B (pdf) is used to show the number of
hours missed and contains the payroll codes Departments should use
when an injured employee has lost time due to a Workers' Comp
injury.
Supervisor's Investigative Report (pdf) - This
form is to be completed by the Supervisor on all employee's that
have a job work related illness or injury. If it appears the
employee will not require outside medical attention and no lost
time from work, this form should be completed in lieu of the First
Aid Report.
Clayton County Official Code Sec. 70-3. Workers'
Compensation (pdf)
Workers' Compensation Bill of Rights for the
Injured Worker (pdf)
Workers' Compensation Official Notice (Panel of
Physicians (pdf) - Additional doctors may be added on a
separate sheet.
GEORGIA ADMINISTRATIVE
SERVICES (G.A.S.)
1775 Spectrum Drive, Suite 100, Lawrenceville, GA 30043
PHONE: (770) 963-7732 / FAX: (770) 963-5813
If additional information is needed
concerning your rights to Workers' Comp benefits, please contact
the Clayton County Insurance/Risk Management Office at (770)
477-3590. The State Board of Workers' Compensation is also
available to answer general workers' compensation questions.
State Board of Workers'
Compensation
270 Peachtree Street, N.W.
Atlanta, GA 30303-1299
(404) 656-3818 or 1 (800) 533-0682
http://sbwc.georgia.gov