William S. Hart Union High School District

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Health Benefits Open Enrollment

OPEN ENROLLMENT

It is Open Enrollment time for all Wm. S. Hart Union High School District employees and retirees. Open Enrollment will be from May 15th-June 9th 2017 with an effective date of October 1, 2017.

Now is the time to change plans, add/remove dependents and/or terminate coverages for your Wm. S. Hart Union High School benefits through SISC. If you don’t act now, you will have to wait for a future Open Enrollment to make changes unless you experience a qualifying life event.

Changes for October 2017-September 2018

PPO plans

  •  Effective October 1, 2017, all SISC PPO plans will have a $100 co-pay for Ambulance services (Ground and Air)
  • Effective January 1, 2018, the Anthem PPO (70/30) Full Network plan will be HSA complaint. This will allow eligible members to make pre-tax deferrals into a Health Savings Account, with a financial institution, with unlimited year to year carryover.
  • The following plan design changes will also occur on the Anthem PPO (70/30) Full Network plan:
    • All office visits, including the MDLive benefit, will now be subject to the deductible
    • 4th quarter carryover will no longer apply
HMO plans
 
  • There are no changes to the Anthem Blue Cross and Kaiser HMO plan designs.
Dental and Vision

  • Dental rates will be decreasing and plan designs will remain the same.
  • Vision rates and plan design will remain the same.
Solera4Me Diabetes Prevention Program - SISC is pleased to announce a new diabetes prevention benefit for Anthem Blue Cross and Blue Shield HMO and PPO members. It’s a 16 week cutting edge program that can help members with prediabetes lose weight, adopt healthy habits and significantly reduce their risk of developing diabetes. It’s available at no cost to members that qualify. For more information, visit www.solera4me.com.

New Provider for SISC Expert Second Opinion Service - Advance Medical is the new provider for this service as of April 1, 2017. With our new provider, members receiving a medical opinion will have unlimited concierge access to a specialist.
SISC expanded the MDLive benefit to include behavioral health therapy and psychiatrist visits. The behavioral health visits will match the office visit co-pay of the member's medical plan.
This is a passive open enrollment and you are only required to take action if you are making changes otherwise your benefit plans will remain the same for October 1, 2017- September 30, 2018.
There are several health plans available, as well as a dental and vision plan. See chart below.
 
Medical Plans: Dental Plan: Vision Plan:
Anthem Blue Cross HMO Select Network Delta Dental PPO Vision Service Plan (VSP)
Anthem Blue Cross HMO Full Network    
Kaiser    
Anthem Blue Cross PPO Bronze Plan 70/30    
Anthem Blue Cross PPO Select Network 80/20    
Anthem Blue Cross PPO Full Network 80/20    
Anthem Blue Cross PPO Full Network 90/10    
Benefit summaries for all plans:
Rate Sheets for October 1, 2017 - September 30, 2018
If you are not currently enrolled in health benefits and wish to enroll or want to change medical plans, you will need to complete one (1) enrollment form AND one (1) Plan Selection Form.

For all medical plans, except Kaiser, you will use this Enrollment Form:
OR

If you will be enrolling in Kaiser, you will use this Kaiser Enrollment Form:
AND

The Plan Selection Form is a confirmation of the health plan you would like to enroll in.
If you are currently enrolled in health benefits and wish to add/remove dependents and/or cancel coverages, you will need to complete a Membership Change Form.
If you are currently enrolled in health benefits and wish to change plans, you will need to complete a Membership Change Form and a Plan Selection Form. If you are enrolling the same dependents, you will not need to provide documentation again.
Documentation needed to add dependent(s)
 Spouse: Copy of marriage certificate (only if recently married) or 2016 1040 Federal Tax form (first 2 pages only).
 Children:  Copies of Birth certificates and/or adoption paperwork
 Domestic Partner:  Copy of Certificate of Registered Domestic Partnership issued by the Secretary of State of California
 
Need Help? The Benefits office will be available on the following dates and times for help with your Open Enrollment forms and questions:
 
Date and Time Location
May 18th 1:00pm - 4:30pm Annex room 203
May 22nd 1:00pm - 4:30pm Annex room 203
May 23rd 8:30am - 4:30pm Annex room 203
May 26th 8:30am - 4:30pm Annex room 203
May 31st 8:30am - 1:00pm Annex room 203
June 1st 8:30am - 4:30pm Annex room 203
June 2nd 12:00pm - 4:30pm Annex room 203
 
All original signed forms must be returned to the Benefits Department.
You are welcome to send them through District mail or bring them to the District Office.

If you have any questions you can email benefits@hartdistrict.org or call 661.259.0033 x267.

Thank you,
Benefits Department