What does the Health & Welfare Package include?
Health, Dental and Vision & Life Insurance.
All full-time employees are eligible for health insurance. A part time employee can purchase insurance, which is pro-rated based on the number of hours the employee works per day. Eligibility for part-time classified employees is at least (6) hours per day, certificated employees must work at least 50% of a full time contract.
What is the cost for the various premiums?
Each bargaining unit has at least one plan which requires no contribution on the employee's behalf. There are several "buy–up" plans that do require an employee contribution.
Can I purchase just one part of the medical package?
No. Health, dental and vision are a package and cannot be purchased separately.
If required, how do I pay my portion of the insurance premium?
Employee portion (if required) of premiums are taken through payroll deductions on a 10 month basis. Currently those deductions are taken on the September through June payrolls.
How do I add a new dependent?
What does it cost to add a dependent?
The premiums are a composite fee, which means that the price does not vary as members are added to or removed from the plan. Some additions are subject to Open Enrollment.
At what age do dependents become ineligible to remain on my insurance?
Once the dependent turns 26, what is the exact date the coverage ceases for that dependent?
The dependent is removed the first of the month following their 26th birth month.
When I add a spouse to my coverage how soon does the coverage take effect?
The first of the month following the marriage provided the paperwork is turned into the Insurance Office in a timely manner. Paperwork will not be accepted prior to the marriage. As of January 1, 2005, the employee must provide the District with a copy of the Marriage Certificate. Insurance coverage will not be activated until a copy is on file.
When I add a child how soon does the coverage begin?
A newborn's coverage begins immediately at the time of birth. In the case of adoption, guardianship or custody the effective date begins once the court documents are finalized. Additions are not automatically done; it is necessary for the employee to contact the Insurance Office to add a dependent. Social security numbers on newborns can be added at a later date, since there is often a delay in receiving the documentation. A copy birth certificate or birth record from the hospital must accompany any addition.
How soon do I need to add a dependent?
SISC guidelines states within 31 days.
Can a dependent be kept on the employee's policy if they are under 26 and married?
Yes, but not any family members.
If my minor dependent has a baby are they both covered?
The dependent's coverage continues, as long as the dependent still qualifies, but the baby is NOT covered.
What happens to a dependent that is handicapped and reaches the age of 26?
Coverage may continue for a Dependent child who is mentally or physically handicapped. Proof of the Dependent's handicap will be required, generally every (2) years but can be yearly.
If I adopt a child, does that child qualify as a dependent?
Yes, adoption, legal guardianship or custody is an acceptable reason for coverage. It will be necessary to provide a legal document from the courts in order to add a dependent to the insurance. The dependent still must fall into one of the categories listed above.
Can a parent be claimed as a dependent if I am financially or physically responsible for that parent?
No, their age would prohibit coverage.
Can I claim a sibling as a dependent?
Only if they have been adopted, or the employee has legal guardianship or is the dependent's custodian and they qualify under the terms of the policy. Proof of court documentation is required.
Can a dependent be kept on the employee's policy if in the military?
Can my dependent purchase insurance once he or she loses their eligibility?
SISC offers coverage through COBRA for the period of (36) months. Call Kim [email protected]
(661) 589-3830 ext. 210 or SISC @ (661) 636-4651, 30-days before the termination date.
What if I fail to notify SISC when a dependent no longer qualifies for coverage?
Failure to remove a dependent can have severe consequences; the employee will be responsible for any monies paid out for the dependent and will be required to repay benefits, paid on the dependent's behalf, that occurred after the first of the month following the loss of dependent status.
Can I keep a divorce spouse on my policies?
No, failure to remove can have severe consequences; the employee will be responsible for any monies paid out for the spouse and will be required to repay benefits, paid on the spouses' behalf, that occurred after the first of the month following the divorce.
What if the court orders that I must provide coverage for a former spouse?
Coverage can be purchased through COBRA for a period up to 36 months or the party responsible for providing coverage can buy coverage through a private insurance agent.
Is the domestic partner covered?
As of January 1, 2005 the law was changed to include domestic partners. Effective October 1, 2004, they can be added to the employee's benefit package, if they meet specific qualifications. The benefits are subject to Federal Tax liability, but Not State Tax liability.
How does one qualify as a domestic partner?
The domestic partner must be 18 years of age and same sex. In addition, they must be registered with the State of California, and provide the District with a copy of the Declaration of Domestic Partnership. At the age of 62, the qualification changes to include opposite sex. Insurance coverage will not be activated until a copy is on file.
Does my medical, dental and vision remain active during my pregnancy?
Yes, under The Family Medical Leave Act your insurance is kept intact. If at the time the FMLA began and you were full time, your premiums will continue to be paid on your behalf. If you were part time when you went out on your FMLA, you would be responsible for your portion of the payment.
Am I covered out of the country?
Yes, the Benefit Plan provides for covered services anywhere in the world, although it may be necessary to pay for the services render and then submit a claim once you return to the area. Keep in mind if an out of network provider is used it can result in substantial reduction of covered benefit amounts.
How can I get a current directory of physicians?
Do I have a card for each of my policies?
No, Anthem Blue Cross is the only card that will be issued. This card is also used for prescription purchases. Dental and Vision services do not require a card, only the employee's social security number for all eligible members of the family is necessary.
Insurance Begins and Ends
When does my insurance begin if I am hired for a new school year that begins in August?
If I end my employment, when does my insurance end?
Your insurance will end the last day of the month in which you leave employment or if you are a 10 month employee (August –June) and complete the school year, your insurance will end August 31st.
Can I enroll in insurance any time during the year?
No. You must enroll in the insurance package at the time you are eligible. Otherwise you must wait for the Open Enrollment period, which is the month of September, effective October 1st.
Are there any exceptions to Open Enrollment?
Yes. If your status changes and the employee is given a change of hours, a permanent position or loss of coverage.
If I leave the district when does my insurance end?
If you complete the school year the insurance terms September 1st. If you leave during the year it ends the first of the month following your resignation.
What happens after my insurance ends, is there any coverage available?
Yes, SISC offers COBRA for period of (18) months under the Federal Cobra laws and an additional (18) months under Cal Cobra. Contact the SISC Office @ (661) 636-4651 for price quotes.
What is COBRA?
It is the same insurance that you had while employed by the District. Under Cobra guidelines, Health insurance can be purchased without dental and vision. Payment is made directly to SISC at the Kern County Superintendent's Office. The SISC contact number is (661) 636-4651.
How does the health insurance handle pre-existing illnesses?
Since a pre-existing clause does not appear in the Medical Benefit Summary Plan Description, it is not an issue and will not result in denial of coverage.
Am I covered by state disability?
NO, if you wish to purchase disability insurance, there are several companies the district uses. Please contact Kim [email protected]
(661) 589-3830 ext. 210 for information on these plans.
How do I change my address with my insurance provider?
Address changes are made through the District Office. Please contact Kim [email protected]
(661) 589-3830 ext. 210.