All certificated employees are eligible for Delta Dental Service and Health Benefit Plans.
Can my children be covered?
Yes. Unmarried, economically dependent children may be enrolled. College student may be covered provided they are full time students and under the age of 23.
How much will I pay?
Medical benefits dollar allocation is included in the certificated salary schedule. All certificated employees are eligible to purchase medical benefits. The District provides family dental coverage through Delta Dental at a composite rate. Part-time employees receive pro-rated Delta Dental benefits through the District and pay the balance of the premium.
Will I be billed for my portion?
No. The employee’s portion is automatically deducted from an employee’s paycheck. For non-12 month employees, additional deductions are taken out each paycheck over the 10 month period.
What companies may I choose from?
The PERS program offers two health maintenance organizations (HMOs): Blue Shield and Kaiser. It also offers three preferred provider organizations (PPO): PERS Care, PERS Choice and PERS Select. Most HMOs have standardized benefits such as a co-pay for prescriptions and a co-pay for office visits. Chiropractic care is not standardized. Emergency room visit co-pays vary from carrier to carrier. Typically, physicians belong to medical groups that the employee and his or her dependents must use in order to have 100 percent coverage. Each family member may have his/her own Primary Care Physician and/or medical group.
How do I enroll?
Once you have been hired, Human Resources will provide you with enrollment forms and information. Employees must enroll within 60 days of hire, or change in status, if they qualify. See Health Insurance Portability and Accountability Act (HIPPA) information below.
What if I have medical insurance through my spouse, other employer, or other source?
Employees with outside medical coverage are not mandated to take the District provided medical insurance. A signed waiver for District coverage is required and Proof of insurance must be provided.
May I enroll later?
Yes. The Health Insurance Portability and Accountability Act (HIPPA) allows employees to sign up for insurance with either a 30 or 90-day waiting period, pending the circumstances for requesting enrollment. You may also enroll during Open Enrollment, which usually runs from the end of September through mid October. The health insurance change becomes effective January 1 of the following year. The carrier cannot deny coverage because of the pre-existing condition of any enrollee in any PERS-managed health insurance.
More about HIPPA
Eligible employees may enroll under Special Enrollment or Late Enrollment, both of which allow the employee to enroll during the year, provided the employee has met particular guidelines.
A major family status change may qualify the employee for a special enrollment. Examples:
addition or loss of dependent, loss of coverage by other sources, marriage, divorce. Most other reasons would be covered as a Late Enrollment and require a wait of 90 days for coverage to begin.
Enrolling Family Members
A new spouse or domestic partner can be added to an employee’s health and dental plan if done within 60 days after the date of marriage or registration of domestic partner. A newborn child is covered from the date of birth and must be added to the employee’s health and dental plan within 60 days of the date of birth.