Welcome to stockton unified school district
Welcome to Stockton Unified
School District
This presentation will explain your benefit coverage. Please ask any questions you may have at the end of the program.
Stockton Unified School District
This presentation is not a contract, but only a
summary of your benefits. Please refer to
the plan brochures for a full disclosure of
SUSD Medical Benefit Plans
Kaiser Permanente (HMO) Plan “A” or “B”
Blue Shield (EPO) Plan “A”, “B”, “C”, or “D”
Kaiser Medical Plans
Doctor office visits
Kaiser Permanente
Glasses/Vision Exams
Kaiser members receive an ophthalmological
exam and one pair of lenses and frames every 24 months.
General Information for Kaiser
Subscribers
All Kaiser subscribers must obtain their benefits at
the Kaiser facility and doctors only.
Stockton Kaiser’s facility is open 7 days week 24 hrs
Dameron hospital is used for emergency treatment
Blue Shield EPO
EPO – stands for
“Exclusive Provider Organization”
Blue Shield EPO offers several other distinct advantages:
You are no longer required to select a “primary care physician”
All members are entitled to see any of the Blue Shield network providers or specialist without a referral. (You no longer will be restricted to receiving services from any particular medical group.)
You have access to the Blue Shield nationwide network. (This may be helpful for those who have dependants who live away from home.)
Blue Shield Medical Plans
Blue Shield Medical Plans
In your packets you’ll find brief summaries of
each plan option which includes prescription drug coverage and the copayments for office visits, urgent care, emergency room, etc.
Vision Benefits
Blue Shield Subscribers
Choose a contracted physician from the
Obtain glasses from listed vendors as noted
Vision Benefits
Blue Shield Subscribers
Annual ophthalmological exam covered at
Frame allowance is $100.00 with contracted
SUSD Medical Benefit Plans
Chiropractic services are provided to Blue
Shield and Kaiser subscribers through ACN
The benefit plan allows 20 visits per year
with a $5.00 copay per visit. The first 3 visits
can be made without prior authorization.
Delta Dental
70% 1st yr – 80% 2nd yr90% 3rd yr – 100% 4th yr
Must go to the dentist each year to increase
Delta Dental
$1,100 lifetime maximum per person for
Special Information
All benefit coverage begins on the first day of
the following month after the month which
A newborn or a new spouse must be enrolled
Special Information
Your coverage cannot begin until your first
You have 30 days from your date of hire to
enroll. If you do not enroll within this period,
you may not enroll until next open enrollment
Special Information
New dependants or spouses are to be enrolled
within 31 days of the event date. If you do not enroll
within this period, you may not enroll them until next
If a child loses their dependant status, come to Risk
Management to delete them off from your coverage.
Special Information
Verification of dependants must be provided at the
Examples: birth certificate, marriage license, or
A dependant can be eligible for up to 25 years of age
with a full time student status of 12 units or be listed as a tax dependant on your tax return.
Special Information
Court order and or adoption decrees must be
provided for all non-biological children.
Office at 933-7110 ext 2550 for information.
Spousal Rebate Program
If you are covered by your spouse’s
insurance, the district offers a monthly medical rebate reimbursement in return for waiver of medical and chiropractic benefits.
Spousal Rebate
The only time you can enroll in the spousal rebate
program is during open enrollment or upon your initial hiring with the district.
Spousal Rebate
You can chose to continue dental and vision.
Spousal Rebate
The spousal rebate program is valid
FOR
ONLY 1 YEAR
You must re-enroll every year during open
enrollment (
NO EXCEPTIONS)
Spousal Rebate
Must provide medical ID card from your
alternative health carrier for our records upon enrollment along with proof of marriage ( a marriage certificate or most recent tax return).
Remember to enroll dependants for vision
and dental if they were not originally covered in your medical plan.
Spousal Rebate
If you do not return to re-enroll during annual open
enrollment period, your medical benefits will automatically be reactivated, and contributions will be required for coverage according to health insurance rates set up for that fiscal year.
Come to the Risk Management office and sign a
waiver to drop the medical coverage if you do not want to continue the plan.
SUSD Health Benefits
Your benefits end on the last day of the month in which you:
125 Flex Plan
Administered by American Fidelity Assurance
The 125 flex plan is structured in three
Layer One
This is known as the “POP” or the premium only plan.
The district removes from taxation any monthly benefit buy-up
cost from your monthly gross and levies payroll taxes only on the
remaining salary. The net effect is that your paycheck stays
larger at the end of the month because your benefit contribution
is not taxed. This all happens in the payroll department. No
money is sent to American Fidelity. A designated form must be
signed to activate the option.
125 Flex Plan
Administered by American Fidelity Assurance
Layer Two
This is known as the medical reimbursement area. You
may claim up to an annual maximum of $3,600 of qualified
reimbursable expenses within this provision. Typical eligible
expenses include braces, lasix eye surgery or over the counter
drug expenses. Employee decides on a certain amount to be
deducted tax free from monthly salary. Employee pays the
expenses with regular income, then files a claim with American
Fidelity. American Fidelity then sends the reimbursement check
to the employee within 7-10 days.
125 Flex Plan
Administered by American Fidelity Assurance
Layer Three
This is known as the
child care/elder care reimbursement area.
You may claim up to an annual maximum of $5,000 of qualified
reimbursable expenses with this provision. Eligible expenses
would be child care charges or elder care charges.
Reimbursement works the same way as described in layer two.
125 Flex Plan
Administered by American Fidelity Assurance
American Fidelity also sells annuities, life
insurance, and disability insurance.
125 Flex Plan
Administered by American Fidelity Assurance
with a
“use it or lose it” provision.
claim expenses for all the money in the American Fidelity trust account,
end of the plan year. There is a
70
day grace period after the end of the
Long Term Disability
This coverage plan is fully paid by SUSD for
CSEA 318 members only.
The disability carrier is American Fidelity
Long Term Disability
Members of all other units who desire
to purchase disability insurance should inquire within their collective bargaining units about group disability coverage.
Long Term Disability
The following disability plan information
applies to
CSEA 318 members only.
This plan pays 66 & 2/3 of your monthly
Long Term Disability
Management office for
CSEA 318 members
only. Return all completed forms including
doctors form to Risk .
There’s a 30 day waiting period or the
expiration of all leaves whichever is greater. This includes vacation and sick leave.
Long Term Disability
At the end of the month you’ll receive two
checks. One for differential pay from the district and the other from LTD carrier. The two checks together equal 2/3rds of your gross pay.
Risk Management must receive a medical
release from you before returning to work.
Workers Compensation
If you sustain an on the job injury which
requires medical treatment you must notify your supervisor immediately.
To assure payment of benefits, a workers
compensation claim form must be completed prior to treatment.
Workers Compensation
Dameron and Kaiser Occupational Medical
Clinics have been selected to treat on the job injuries for SUSD employees.
Initial medical treatment for all on the job
injuries
may not be provided by your
personal chiropractor.
Workers Compensation
Dameron Hospital Occupational Injury Clinic
Workers Compensation
Kaiser Permanente Occupational Injury
Workers Compensation
If you wish to be treated by your own
physician for OJI you must submit a letter of
designation
(must be signed by your
physician) naming your Primary Care
Physician prior to the injury.
Workers Compensation
Your designation
may not be a chiropractor.
Your predesignated physician can only be
your primary care physician as assigned through your private health insurance.
Workers Compensation
You’re
required to bring your return to work
status report and/or release to Risk Management prior to returning to work.
Injured employees with work restrictions
must report to Risk prior to work.
Workers Compensation
“Any person who knowingly presents a false
or fraudulent claim for the payment of a loss
is guilty of a crime, and may be subject to
the state prison for up to 5 years or by a fine up
Safety Handbook
Within the packet of information you received
is a copy of the SUSD Employee Safety Handbook. It is your responsibility to read and adhere to the safety rules listed. To report a safety concern see your supervisor.
Thank You
Please complete your enrollment at the front counter before leaving.
Source: http://www.stockton.k12.ca.us/risk/documents/Benefit%20Orientation%20Slideshow.pdf
STATE OF WISCONSIN VILLAGE OF HALES CORNERS MILWAUKEE COUNTY __________________________________________________________________________ WHEREAS, Section 13.09 of the Municipal Code provides for fees for ambulance WHEREAS, the Committee of the Whole of the Village Board of Trustees has determined that the Village should adopt Advanced Life Support (ALS) rates recommended by the Milwaukee County
R a f a e l E c h e v e r r í a O n t o l o g í a d e l L e n g u a j e Ontología del Lenguaje RAFAEL ECHEVERRÍA R a f a e l E c h e v e r r í a O n t o l o g í a d e l L e n g u a j e CAPITULO 3: LOS ACTOS LINGÜÍSTICOS BÁSICOS * ANTECEDENTES Tal como lo hemos señalado previamente, según nuestra concepción tradicional, el lenguaje describe la realidad. Cuan