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. Open Enrollment will be from May 14th-June 8th 2018 with an effective date of October 1, 2018.

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.

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, 2018- September 30, 2019. You should however review your current coverages, new rates, beneficiaries and voluntary life and AD&D coverages through Metlife (formerly Prudential).


Changes for October 2018-September 2019

PPO plans

  • Value-Based Purchasing Benefit Change
  • Carrum- SISC partnered with Carrum Health to provide PPO members with access to an enhanced benefit with selected physicians at Scripps Health in San Diego for Hip Replacements, Knee Replacements and several inpatient Spine Surgeries. Carrum has vetted hospitals and surgeons who provide top-quality care to achieve better outcomes.
HMO plans
 
  • Anthem Blue Cross HMO- Premier 10 HMO- Durable Medical Equipment (DME) coverage is changing from 20% coinsurance to covered at no charge
  • Kaiser- Hearing Aid Benefit- SISC will be adding a hearing aid benefit to all traditional Kaiser, DHMO and Senior Advantage Plans. This benefit is not available on Kaiser HSA compliant plans.
Benefit Maximums:
• $500 Allowance per device
• 1 device per ear
• 2 devices per 36 months
  • Kaiser Dual coverage coordination of benefits- Effective January 1, 2018 members covered by two or more Kaiser HSA plans may be impacted by a new process for coordinating benefits. This is a global Kaiser change and not specific to SISC. Kaiser has been in direct communication with impacted members.

     

    While there is currently no effective date, Kaiser is still in the process of implementing coordination of benefits for all dual covered Kaiser Members. Kaiser will be communicating more information about this change as it becomes available. Member questions may be directed to Kaiser at 800.464.4000.

Dental and Vision

  • Dental rates and plan designs will remain the same.
  • Vision rates and plan design will remain the same.
  • Vision service plan (VSP)- SISC is increasing the contact lens allowance from $105 to $150.
Value Added Services
 
MDLive- Our PPO and HMO members can consult with doctors and pediatricians over the phone or using online video for medical conditions such as cough, cold, fever, sore throat, flue, infection, bronchitis and children's health issues. MDLive physicians can diagnose and prescribe medication when appropriate. Online behavioral health visits are also available for confidential sessions with a licensed therapist or psychiatrist.

SISC EAP- All SISC members may access free resources if they need help with personal concerns- emotional, marital, financial, interpersonal addiction and recovery, legal, stress and more. The EAP is also available for critical incident response and grief counseling for employees.

Costco Free Generics- On most pharmacy plans, our PPO and HMO members can get free generic medications at Costco retail and Mail order (excludes certain pain and cough medications).
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, 2018- September 30, 2019.
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 (EE and children only)    
Anthem Blue Cross PPO Select Network 80/20    
Anthem Blue Cross PPO Full Network 80/20    
Anthem Blue Cross PPO Full Network 90/10    
Additional Programs
 
Gym Membership Discounts- Anthem and Kaiser- ASH Active & Fit- Broad network of participating facilities.

Solera4Me Diabetes Prevention Program- SISC recently introduced a new diabetes prevention benefit for Anthem Blue Cross HMO and PPO members. It is a 16 week cutting edge program that can help member with pre-diabetes lose weight, adopt healthy habits and significantly reduce their risk of developing diabetes. It is available at no cost to members that qualify.

TruHearing for VSP members-TruHearing is making hearing aids affordable by providing exclusive savings to all VSP Vision care members. Members can save up to $2,400 on a pair of hearing aids with TruHearing pricing. Dependents and extended family members are also eligible.
Benefit summaries for all plans:
Rate Sheets for October 1, 2018 - September 30, 2019
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.
Please make sure your forms are complete and you have all the appropriate documentation (if necessary). We will not be accepting incomplete forms.

You will need the following information for your dependents:
  • Social Security numbers
  • Date of birth
Documentation needed to add dependent(s)
 Spouse: 2017 1040 Federal Tax form (first 2 pages only). If you were recently married and have not filed taxes together we can take a copy of your Marriage Certificate
 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
 
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.
 
Need Help? The Benefits office will be available on the following dates and times at the district office for help with your Open Enrollment forms and questions:
 
Date and Time Location
May 14th 2:00pm - 4:00pm AC Board Room
May 15th 10:00am - 12:30pm Conference Room 130
May 18th 10:00am - 12:00pm; 2:00pm - 4:00pm AC Board Room
May 21st 10:00am - 12:00pm AC Board Room
May 22nd 10:00am - 12:00pm; 2:00pm - 4:00pm AC Board Room
May 25th 10:00am - 12:00pm; 2:00pm - 4:00pm Conference Room 130; AC Board Room
May 29th 10:00am - 12:00pm; 2:00pm - 4:00pm Conference Room 130
May 31st 10:00am - 12:00pm; 2:00pm - 4:00pm AC Board Room
June 1st 10:00am-12:00pm AC Board Room
June 5th 10:00am - 12:00pm; 2:00pm - 4:00pm Conference Room 130
June 8th 10:00am - 12:00pm; 2:00pm - 4:00pm AC Board Room
 
If you have any questions you can email benefits@hartdistrict.org or call 661.259.0033 x267.

Thank you,
Benefits Department