27 j employee benefits

27J Employee benefitsYour guide to benefits as an employee

of School District 27J

Who is eligible for benefits?

• The District will contribute a portion of the employee health, dental and vision insurance premiums for each employee working 30 or more hours per week in a regularly budgeted position per the negotiated agreements.

• Any employee participating in district insurance plans has the option to waive health coverage only or to waive health and dental coverage. (No cash in lieu of the benefit.)

• Employees working less than 30 hours per week are not eligible for insurance coverage under the district plans.

Can the employee's dependents be covered under the benefit plans?

• Employees may add eligible dependents (spouse, same-sex or opposite sex domestic partner and children) to their health, dental and vision plans at their own expense.

• Coverage options chosen for dependents must match those of the employee. Employees must enroll dependents within the first 30 days of employment or wait until the annual open enrollment period during the month of May.

• Dependents can be added or removed from insurance coverage due to a "qualifying event" (i.e. status change such as marriage, divorce, birth, death, change in spouse’s employment causing them to lose or gain coverage, gain or loss of coverage with Medicare, Medicaid, CHP or other governmental medical plan, etc.)

• The appropriate District 27J Insurance Change Form and written verification of prior/lost coverage are submitted to the Office for Human Resources within 30 days of the status change.

Once employed, when does insurance coverage begin?

• Insurance coverage begins the first of the month following the first day on the job as a benefited employee (employee working 30 or more hours per week in a regularly budgeted position.)

What is the cost to the employee for insurance benefits?

• Premiums to cover the employee only for the Kaiser DHMO Medical Plan, the Kaiser High Deductible Medical Plan, dental, vision and life/accidental death and dismemberment insurance are paid by District 27J.

• Employees must pay premiums to cover eligible dependents. Employees are only allowed to add dependents to their plans during the first 31 days of employment, during the annual open enrollment period or due to a "qualifying event" as defined by the insurance carriers (i.e. birth, marriage, death, divorce, loss of coverage through a spouse's plan, gain or loss of coverage with Medicaid, Medicare, CHP, or other governmental medical plan, etc.).

• All changes allowed due to a "qualifying event" must be submitted within 30 days of the qualifying event along with the appropriate written documentation otherwise the change cannot be made until the next open annual enrollment period during the month of May. (Dependents are defined as legal spouse, common law spouse, same sex domestic partner and eligible children.)

Kaiser DHMO Plan:

• Kaiser DHMO members will pay a co-payment for doctor office visits ($20 for a Primary care office visit and $40 for a Specialist) and a co-payment for prescription drugs ($10 Generic and $20 Brand name for 30-day supply).

• This DHMO plan will have an annual $1,000 individual deductible with a $3,000 family deductible for most other medical services. After the annual deductible is met, a Kaiser DHMO member will pay a 10% coinsurance until the annual out-of-pocket maximum of $3,000 for individuals and $6,000 for families is met. Per IRS rules, employees enrolled on this DHMO plan cannot have money sent to a health savings account.)

Kaiser High Deductible HSA-Compatible Plan

• The deductibles on the Kaiser High Deductible HSA-Compatible Plan increased to $5,000 for an individual and $10,000 for a family effective July 1, 2012.

• The good news is that the District 27J’s contribution to the employee’s health savings account (HSA) increased significantly from $1,400 annually to $2,500 annually for an individual and from $2,800 annually to $5,000 annually for family coverage.

• The school district contribution to the employees’ HSA covers half the annual deductible! Even though the deductible increased, the potential out-of-pocket cost to the employee was lowered. The increase in district contribution to your health savings account will go a long way towards helping you accumulate savings in future years, as any unspent money in your health savings account is yours to keep even if you leave School District 27J. District 27J will deposit funds into your health savings account in twelve (12) equal monthly installments.