Employees who work at least half of a full-time regular assignment in one classification may be eligible for health and welfare benefits.

Half-Time Employees
Contract teachers must work half-time as a part-time teacher with the remaining time covered by an approved half-time leave.  The District’s benefits contribution is pro-rated on the hours contracted to work.  The balance of the cost is the responsibility of the contracted employee.

Substitutes
To be eligible, substitutes must have been in paid status the previous fiscal year (July 1 to June 30) and have the equivalent of 100 days or 600 regular hours in certificated service or 800 regular hours in classified service.  If eligible, the District will notify employees in August of enrollment in benefits coverage for the September 1 to August 31 plan year.

Unit F Employees
Teacher Assistants who worked 800 hours or more during the previous school year in any one assignment may be eligible for a health benefits package.  Employees who wish to enroll their eligible dependent(s) are responsible to pay their dependent’s premium through payroll deductions from your semi-monthly paychecks. 

Unit G Employees
Members of bargaining Unit G who worked 1,000 hours or more during the previous school year in any one assignment may be eligible for District sponsored health benefits package in which the employee is responsible for half the cost.  Employees who wish to enroll their eligible dependent(s) are responsible to pay their dependent’s premium through payroll deductions.  Should you and/or your dependent(s) elect health benefits coverage, the premium will be deducted through payroll deductions from your semi-monthly paychecks.

Adult Education Employees
The eligibility rules for adult education employees changed on July 1, 2001.  Adult Education employees may be exempt from the changes if the employee qualified for coverage during the 1979/80 or the 2000/01 school year and maintained continuous eligibility since.

If coverage was lost due to changes in assigned hours or actual hours worked, renewed eligibility may be affected per the revised 2001 rules.

The revised 2001 rules state Adult Education employees are eligible for all benefits if the employee worked at least 120 hours per pay period in one classification in a regular assignment or was in paid status for 1,200 hours during the previous school year as a regular or substitute employee.

If the Adult Education employee worked at least 72 hours per pay period in regular Adult Education assignments or was in paid status for 720 hours during the previous school year as a regular or substitute employee then employee is eligible for medical coverage only and may claim only one dependent.

 

Eligible dependents include legal spouse or qualified domestic partner, dependent children up to age 26, permanently disabled dependent children of any age who were continuously enrolled in the District’s plans before age 19 or who were first enrolled as eligible full-time students prior to the disabling condition, children of domestic partners whom the employee has adopted or has been declared legal guardian (must be registered with the State of California), and court-ordered children who are included in the employee’s tax return.

Coverage for disabled dependents may continue as long as employee remains eligible and disabled dependent meets the medical plan's eligibility requirements.  Please note that if coverage for a disabled dependent is terminated for any reason, the coverage cannot be reinstated.

If the employee wishes to add a dependent for coverage under his/her health benefit plan(s), employee must complete the "Change of Dependent Status" form found under the Related Documents tab below along with the following documentation to verify dependent eligibility.

  • Spouse: copy of marriage certificate issued by the State.  For new spouses, if a registered marriage certificate is received within 45 days of the marriage date, spouse will be covered effective the date of the marriage.

 

  • Domestic Partner: refer to the "Domestic Partner Information, Declaration, and Enrollment" packet found under the Related Documents tab below.  If all required documentation is received by the 10th of the month, coverage will be effective the first of the following month.

 

  • Natural Child: copy of the child’s birth certificate. Newborns must be enrolled within 30 days of birth for continuous coverage.  The complimentary hospital certificate will be accepted in lieu of a birth certificate for newborns to five months of age only.  If the required documents are received after 30 days, the newborn will be covered on the first of the month after the verification was received.

 

  • Adopted/Guardianship Child: copy of the document verifying legal adoption/guardianship (issued by the court).  If required documentation is submitted within 30 days of the adoption/guardianship, coverage will begin on the day of the guardianship/adoption.  If submitted after 30 days, coverage will begin on the first of the month after the required documentation is received.

 

  • Stepchildren: a copy of the child’s birth certificate, a copy of the employee’s marriage certificate issued by the State, and a copy of the employee’s latest income tax return showing the child’s dependent status.

 

  • Disabled Child: a copy of the child’s birth certificate and must meet the disability standards of the medical plan chosen and must be enrolled prior to age 19 or be enrolled as a full-time student prior to the disabling condition.

 

Employees must remain in paid status to continue participation in District sponsored benefits unless unpaid leave of absence was protected through the Federal Family Medical Leave Act (FMLA).  Visit the District’s Integrated Disability Management website to learn more about FMLA and other protected leaves of absence.  If no pay was received in a particular pay period, District contributions for the cost of benefits will stop.

If benefits coverage is lost, a COBRA package detailing the option of continuing coverage out-of-pocket will be mailed to the employee’s home.  If coverage through COBRA is not accepted, employee will need to re-enroll for benefits upon return to work.  Coverage will be effective the first day of the month following the date on which Benefits Administration receives the employee’s completed application.

Substitute employees must work at least one day per pay period to maintain eligibility.  If employee worked the last pay cycle of the school year, May, and received pay in June for May’s work, continuation of health benefits may be available for June, July, and August.

 

 Anthem Blue Cross  Kaiser Permanent  Health Net  
     EPO & HMO           HMO           HMO  

 

Changing Doctors
Employees may contact their plan directly to receive information on electing a different medical provider.

Contact information for each provider can be found on the Benefit Providers page.

 

Active employees who do not wish to be covered by any of the District’s medical plan options may waive coverage and receive $3,000 cash annually.  This amount is considered taxable income.  It is paid in installments through the employee’s regular payroll checks.

If the employee and their spouse/ domestic partner both work for the District, one may elect the medical opt-out cash-back option and be covered as a dependent under the other’s medical election.

Medical Opt-Out Cash Back Attestation
In an effort to comply with the guidelines set forth by the Affordable Care Act, Benefits Administration now requires an annual attestation form to certify that you and your eligible dependents have “minimum essential coverage” through a group health plan and that the minimum essential coverage is not individual market coverage (such as through Covered California).

1. This certification is needed to enroll or continue in the Medical opt-out cash back plan.

2. The Attestation form can be found in the "Active" section of the Forms and Publications page.

3. If you do not submit this Attestation form, you will not receive the $250 monthly opt out amount.

Opting out of medical coverage is not permanent.  Employees may choose to enroll in a medical plan during the annual Open Enrollment period or because of a qualifying event.

Dental and vision coverage are not affected by this option and may still be elected.

 

 

 DeltaCare   United Concordia  Western Dental
       DHMO         PPO   DHMO & Plan Plus

 

  EyeMed VSP

 

Both EyeMed and VSP allow for in-network and out-of-network providers.

Please note that enrolling in a vision plan is a two-year commitment.  If a vision plan is elected in 2015 (to take effect January 2016), eligibility to change plans is not available until 2017 (for the plan to take effect January 2018).

Changing Dentists/Optometrists
Employees may contact their plan directly to receive information on electing a different dental or vision provider.

Contact information for each provider can be found on the Benefit Providers page.

 

Enrollment forms for active employees, eligible dependents, domestic partners, Teacher Assistants, and Half-Time employees can be found under the Related Documents tab found at the end of this page.

The back of each enrollment form specifies the types of supporting documents required to verify eligibility. Make sure to read each carefully.

Changing health plans is permissible only during the District’s annual Open Enrollment period that typically takes place during the month of November.

Mid-year plan changes can only be made because of a qualifying Major Life Event.

Coverage will begin the first day of the month following the date properly completed enrollment applications are received.

Any changes to existing selections made during the annual November Open Enrollment period will take effect January of the following year.

Dual coverage is when an employee/retiree and their spouse/domestic partner each cover the other as dependents on some or all of their Benefits plans (medical, dental, and/or vision). Coverage also applies to their eligible dependent children. Both the employee/retiree and their spouse/domestic partner must be eligible for District-sponsored benefits.

The District will cancel an employee’s health benefits only if the employee is no longer in paid status, is re-assigned to an ineligible status/classification, or is terminated from an assignment.

In such instances, a COBRA package detailing the option of continuing coverage out-of-pocket will be mailed to the employee’s home.

Click here for more information.

To view related documents, please visit the "Active" section of the Forms and Publications page.