City of Dallas
Information for Employees Leaving the City
Thank you for your service to the City of Dallas. Here is some information you may find
helpful as you leave your City employment.
Final Lump Sum
The City Controller’s Office (Payroll Section) will calculate the final payment due to the
employee for any unused Vacation, Sick, Attendance Incentive Leave (AIL), and
prorated Service Incentive Pay (SIP) in accordance with City guidelines, as follows:
Lump Sum Payout of Vacation Leave
Upon retirement, disability retirement, or termination, employees will be paid for
any eligible unused vacation leave balance.
Lump Sum Payout of Sick Leave
Upon retirement, disability retirement, or terminating with 20 years of service, an
employee hired prior to October 1, 2003 will receive lump sum payment of their
eligible unused sick leave up to a maximum of 1,080 hours for 24-hour Firepersons or 720 hours for any other City employee. Please note that if you were
hired after September 30, 2003 you are not eligible for payment of your unused
sick leave balance.
Lump Sum Payout of Attendance Incentive Leave (AIL)
Upon retirement, disability retirement, or termination, all
employees who have accrued AIL time will be paid for their unused time.
eligible
Pro-rated Service Incentive Pay (SIP)
Upon retirement or disability retirement, a civilian employee may be eligible to
receive prorated Service Incentive Pay (SIP) based on the number of whole
months worked since the last regular SIP payment.
To be eligible for this
incentive the employee must have been hired prior to October 1, 2002 and must
not have had a break in service. Employees hired after September 30, 2002
are not entitled to SIP.
All lump sum payments discussed above are subject to federal withholding tax of 25%.
Employees’ Retirement Fund (ERF) contributions will be deducted for lump sum
vacation leave and prorated SIP payments.
However, lump sum sick leave and
attendance incentive leave payments are not subject to ERF contributions.
PER-FRM-212
Rev 5
1/1/2016
Information for Employees Leaving the City
Lump sum payouts are provided as an actual check. Lump sum checks will be paid within 2
pay periods after your termination date (providing you and your department have turned in all
appropriate paperwork and signatures) . Your lump payment will released to your paymaster
unless instructed to either be mailed to your last known address in the HRIS system or
available for pick-up at 4:00 PM, in the City Controller’s Payroll Office, Room L2FS.
W-2
A Wage and Tax Statement (W2) for any wages earned during the year of your termination
will be mailed to you no later than January 31 st of the year following your termination
from the City. To ensure timely arrival of the W -2 form, please provide the City with your
current address at that time. To update your mailing address, please contact Human
Resources at 214-671-MYHR (6947).
If you have any questions about lump sum payouts or if you did not receive a W-2,
please contact the City Controller’s Office - Payroll Section at:
City of Dallas
City Controller’s Office - Payroll
1500 Marilla, Room L2FS
Dallas, TX 75201
Phone: 214-670-3328 or via
email at CCO
payroll@dallascityhall.com
Employees ’ Retirement Fund
At the time of your termination: if you are age 60 or older, you are eligible for a monthly
pension; if you are age 50 and your age plus your pension service credit when added is
equal to or greater than 78, you are eligible to retire; if you have 30 years of pension service
credit you are eligible to retire, however, your pension will be reduced before age 50.
If you have at least five years of pension service credit, you are entitled to a deferred
life-time pension benefit when you reach age 60. If you have at least ten years of pension
service credit and you defer your pension, you are eligible to apply for a disability
retirement should you become totally and permanently disabled before age 60. If you are
younger than 60 and have less than five years of service, you must make an application to
withdraw your contributions from the Fund within three years of your termination. Special
rules may apply if your termination of employment is due to a reduction in force and you
are within two years of retirement eligibility. For questions related to the Employees’
Retirement Fund, contact:
Employees' Retirement Fund
600 N. Pearl Street, Suite 2450
Dallas, Texas 75201
Phone : 214 580 7700
Fax : 214 580 3515 x
Email: retirement_fund@dallaserf.org
Web site: www.dallaserf.org
PER-FRM-212
Rev 5
1/1/2016
Information for Employees Leaving the City
Police & Fire Pension System
Attention:
As you Leave Active Service, contact the Pension Office to discuss your benefit options.
Dallas Police & Fire Pension System
4100 Harry Hines Blvd.
Suite 100
Dallas, Texas 75219
214-638-3863
1-800-638-3861
Fax: 214-638-6403
Deferred Compensation Plans
Once you terminate employment with the City of Dallas, you have some options regarding
your deferred compensation account(s).
•
If you have $1,000 or more in your account, you may leave your funds in the plan.
Alternatively, you may request a lump sum distribution, request periodic payments, or request
a rollover of your funds to another retirement plan.
•
If you have less than $1,000 in your account, you will be required to remove your
funds from the plan. You may request a distribution or a rollover of your funds to another
retirement plan.
•
Cash distributions are subject to ordinary income taxes and a flat 20% will be withheld
from a distribution. If you are under age 59½, you will also have a 10% penalty on 401(k)
cash distributions unless you will be at least 55 in the year you terminate. After-tax
contributions included in a cash distribution are not taxed.
•
If you have a loan, you may pay off the balance or make repayment arrangements.
For questions related to your Deferred Compensation Account(s), contact:
Fidelity Investments Customer Service
800-343-0860
Website: www.netbenefits.com/cityofdallas
For other questions, contact:
Deferred Compensation Office
Dallas City Hall, Room 1BS
Dallas, Texas 75201
214-670-4861 office
214-670-1836 fax
PER-FRM-212
Rev 5
1/1/2016
Information for Employees Leaving the City
Final Records
For additional information or verification of employment, please contact Human
Resources at 214-671-MYHR (6947).
Health and Life Insurance Benefits
Health & Life Benefits Conversion/Continuation
If you have medical coverage through the City, you and your covered dependents
will remain covered until the last day of the month in which your employment ends.
For additional plan information, please review the Annual Benefits & Enrollment
Guidebook online at www.cityofdallasbenefits.org
Consolidated Omnibus Budget Reconciliation Act (COBRA)
You may elect to retain your group benefits through COBRA. This applies to the
health, dental and vision plans you are enrolled in on the date your coverage ends.
COBRA coverage is available for eighteen (18) months for employees and their
covered dependents who terminate or retire from the City.
UnitedHealthcare will notify both the terminating employee and covered dependents
(by letter with proof of mailing) of their respective COBRA rights within approximately
thirty (30) days following your termination.
To elect COBRA coverage, return the completed enrollment form along with
premium payment to UnitedHealthcare at the address shown on the enrollment form.
You have sixty (60) days to apply for COBRA coverage once you are notified of your
right to elect COBRA coverage. COBRA coverage will end on the earlier of: the date
you first become eligible following your termination for other group insurance or
Medicare that does not contain any pre-existing conditions exclusion; the date you
cease to make a required premium payment on time; or at the end of eighteen (18)
months.
For Monthly COBRA Rates, please review the Annual Benefits & Enrollment
Guidebook online at www.cityofdallasbenefits.org
PER-FRM-212
Rev 5
1/1/2016
Information for Employees Leaving the City
Health Insurance Portability of Accountability Act of 1996 (HIPAA)
HIPAA ensures that an individual may move to a new employer and not be
penalized for pre-existing medical conditions. UnitedHealthcare will provide
employees who lose coverage with a certificate of coverage substantiating your prior
health insurance coverage in a City sponsored plan.
The c e r t i f i c a t e wi l l
o u t l i n e t h e t y p e o f coverage you had with the City, the names of covered
dependents, and the length of time you and your dependents were covered. Your
new employer will use this information to determine if you qualify for “credible
coverage” which may reduce, or even waive, any pre-existing conditions exclusion
on your new health insurance.
Employee Medical Spending Plan (EMSP) also known as the Healthcare
Flexible Spending Account (FSA)
An EMSP participant’s coverage will end upon termination of employment. However,
medical expenses incurred up to the last day of employment may be submitted to the
EMSP. The participant may be reimbursed for medical expenses up to the amount
of their actual contribution, less any previous EMSP payments. The participant may
file claims until the end of the first quarter in the calendar year following termination
of employment. Federal law mandates that the participant is entitled to receive
benefits up to the full value of the amount of EMSP contributions specified by the
member for the given plan year.
Dependent Care Assistance Program (DCAP)
A DCAP participant’s coverage will end upon termination of employment. However,
dependent care expenses incurred up to the last day of employment may be
submitted to the DCAP. The participant may be reimbursed for dependent care
expenses up to the amount of their actual contribution, less any previous DCAP
payments. The participant may file claims until the end of the first quarter in the
calendar year following termination of employment.
Life Insurance Conversion
Notice of Possible Port or Conversion Opportunity
With the termination of your Life Insurance coverage under the City of Dallas Group
plan (Group Policy 649116-A), you may have the option to Port or Convert your Life
Insurance through The Standard. If you would like to Port your life coverage to an
individual term life plan, complete the Group Life Portability Application
(http://www.standard.com/eforms/9178_649116.pdf).
The packet explains the qualification requirements and has two forms: one for you
and one for your employer. You will need to complete your form and mail it with your
payment directly to The Standard within 31 days. You will need to submit the
employer form to the City of Dallas for completion. If you have any questions about
Portability, you may call The Standard at 800.378.4668, ext. 6785.
PER-FRM-212
Rev 5
1/1/2016
Information for Employees Leaving the City
If you do not qualify for Portability or you would like to convert this term life policy
into a whole life policy, please complete the Request for Group Conversion Materials
(http://www.standard.com/eforms/1598a_649116.pdf) or call The Standard at
800.378.4668, ext. 6785 for rates and more information. You will need to complete
your application and mail it with your payment directly to The Standard within 31
days.
Steps to Continue Insurance When Retiring
(Employees hired prior to 1/1/2010)
After you have met with your respective pension office (ERF or PFP) and have
decided upon a retirement date, contact the Benefits Service Center (BSC) at
1-855-656-9114 and inform them of your intent to continue coverage (you have
30 days from your actual retirement date to do so).
Note: Depending on the date of your retirement, be prepared to pay one to one
and a half months of premium to continue coverage. You will receive an invoice
via US mail if you make your arrangements over the phone with the BSC. If you
schedule an appointment with COD staff, you may pay on that day. Payment
must be paid in the form of money order or cashier’s check only. For example:
A) If you retire and one pay-cycle has occurred, you will owe another deduction
as an “active” employee. This will continue your coverage through the end of
your retiring month and you will pay the 1st month’s premium at the “retiree” rate.
B) If you retire after two pay cycles have occurred as an “active” employee during
your retiring month, you will only pay the first month’s premium at the retiree rate.
Special Notes:
If you elect to continue coverage, you will keep your current ID card(s) and any
deductible(s) and co-insurance(s) that have been met will carry forward as a
retiree (only the rates will change).
If you elect to waive coverage as a retiree, you must complete the “waiver” form
and submit it to the BSC. Please be aware that if you waive coverage, you can
n o t return to the City ’s health plan an d you forfeit all City sponsored
subsidies . COBRA does not count t a s continued coverage in the City’s
health plan an d will not qualify you for retiree health plan participation.
For information regarding what options are available for retirees upon turning age
65, please see Steps to Continue Insurance when Turning 65 below.
PER-FRM-212
Rev 5
1/1/2016
Information for Employees Leaving the City
Steps to Continue Insurance When Retiring
(Employees after 1/1/2010)
Employees hired or rehired after 1/1/2010 are not eligible for a City subsidy of
retiree insurance; however, they can participate in the retiree health benefit
program and pay the full cost of the health benefits plan.
For additional questions related to Health Benefits contact:
The Benefits Service Center
1-855-656-9114
Steps to Continue Insurance When Turning 65 (after retirement)
(Employees hired prior to 1/1/2010)
Upon turning 65 (approximately 3 months before your 65 th birthday) contact your
local Social Security Administration office to enroll in Medicare Part A
(Hospitalization) and Part B (Other Medical Services).
Part A is free if you have earned 40 or more work credits contributing to Medicare
taxes. If you have not earned at least 30 work credits and you have remained
enrolled in a City sponsored health plan since retiring, the City will pay your
monthly Part A premium of $441.00 (late enrollment monthly premium is $495).
If you have 30-39 work credits, the monthly premium is $248.00 (late enrollment
monthly premium is $272.80). The City covers this option under Medicare Part A.
Part B must be paid d i r e c t l y t o C M S by everyone, the standard rate is
$104.00 (Some enrollees pay more than the standard rate because of the
following: enrolled late, dis-enrolled from Medicare and later re-enrolled, or have
a higher yearly income).
Important Note: If you do not apply for Medicare A/B during the Initial
Enrollment Period – the 7-month period that begins 3 months before your 65 th
birthday and ends 3 months after your 65 th birthday, you will be assessed a late
enrollment penalty (10% for each 12-month period). An exception to that rule is if
you or your spouse is enrolled in an employer group plan after turning age 65.
After you have signed up for Parts A/B, CMS will send a billing notice to your
home address.
Please forward a copy of the billing notice to the Benefits
Department to be added to the City’s list bill and you will no longer receive
quarterly bills from CMS, they will bill the City. The City will pay Part A if
applicable and Part B must be paid to CMS directly. There will be no deduction
from your pension check for Part B.
PER-FRM-212
Rev 5
1/1/2016
Information for Employees Leaving the City
Supplemental Plans from AARP, United Medicare Rx and other companies
Once you have enrolled in Parts A & B and received your Medicare Health
Insurance Claim number (usually your SSN with an alphabet at the end) you
must contact AARP at 800-392-7537 to enroll in a supplemental plan. AARP will
mail an enrollment packet, you must select a plan, sign and date the form and
mail it back to AARP. Upon receipt, AARP will notify the City of your positive
enrollment and plan selection (Rates are published annually in the City’s Annual
Benefits Enrollment Guide).
If you need a prescription drug plan, the City offers Medicare Part D (United
Medicare Rx). Contact the BSC at 855-656-9114 and they will enroll you
electronically (you must have your Medicare Health Insurance Claim number for
this product as well). (Rates are published annually in the City’s Annual Benefits
Enrollment Guide).
Special Note: You may select a Part D plan other than the City sponsored plan
with United Medicare Rx but please beware that premiums can not be deducted
from your monthly pension check; you will be responsible for remitting payment
to the vendor.
If you have detailed plan questions about AARP’s Supplement Plans or Part D,
contact vendors at the numbers listed in The Annual Benefits Enrollment Guides.
How to contact CMS:
Web address: www.socialsecurity.gov
Phone: 1-800-MEDICARE (1-800-772-1213)
Acronyms
AEG – Annual Enrollment Guide
AARP – American Association of Retired Persons
BSC – Benefits Service Center (open M-F 8 am to 5 pm CST. 888-752-9122)
CMS – Centers for Medicare & Medicaid Services
Rx - Prescription
SSI – Social Security Income
SSN – Social Security Number
UHC – United HealthCare
PER-FRM-212
Rev 5
1/1/2016