Frequently Asked Benefit Questions
Q. Will there be a deduction taken from my paycheck for my benefit coverage?
A. The district provides a set annual contribution amount towards your benefits based on your medical coverage tier (Employee only, Employee+1, Employee+2 or more, Waive). The district contribution amount is applied towards your medical, dental, vision, and in some cases, long-term disability coverage. Please refer to the “Health Plan Options and Costs” sheet specific to your employee group for more detailed information. Voluntary plans (i.e. flexible spending accounts, life insurance, AD&D) are subject to employee deductions.
Q. What documentation will I need to submit to add a dependent?
A. In addition to their basic information:
- Child dependent - birth certificate
- Spouse - marriage certificate
- Domestic Partner – Affidavit of Domestic Partnership and must meet all of the qualifications of a domestic partner under the state of California.
Q. What is the difference between an HMO and a PPO?
A. HMO (Health Maintenance Organization) offers specific participating network providers that members select for their health care. Providers outside of the network are not covered, unless the provided services are considered emergency in nature. PPO (Preferred Provider Organization) also offers participating network providers, however, a member may access care outside of the designated network. An advantage in utilizing network providers is benefits are covered at a higher rate than non-network providers.
Q. How do I choose my medical and dental plans to ensure that I select the best plan(s)?
A. First review the informational materials in your benefits packet and on the district website to evaluate which plans would meet you/your family’s current medical and dental needs. Some individuals prefer the convenience of having a co-payment and decide to choose an HMO plan. Others prefer to pay deductibles and coinsurance for the flexibility of going to participating and non-participating providers and therefore enroll in PPO plans. Regardless of which plans you choose, keep in mind that all of the plans, whether they are HMO or PPO, are designed to provide comprehensive health coverage to you and your family. The Health Plan Chooser is also available at www.calpers.ca.gov
and provides tools to assist in medical plan selection.
Q. When will I receive my benefit identification cards?
A. Medical plan and Delta Care HMO identification cards will arrive in 2-3 weeks from the date that you complete your enrollments in SmartBen. Delta Dental (PPO) and VSP – Cards are not issued by these carriers.
Please provide your health care practitioners with your social security and your group number.
Q. What if I’m not happy with the medical and/or dental plan? May I change my plans?
A. The opportunity to change our plans is offered during our open enrollment period which is held in the fall each year. Changes made during open enrollment will be for a January 1 effective date.
Q. May I extend my benefit coverage if I leave the District?
A. Yes, you have the option to continue your health care coverage through COBRA. Details on COBRA are mailed to your home address by our COBRA Administrator, Employee Benefits Corporation (EBC).