Summaries of all benefit plans are posted on the district website, under Staff, Benefits, and then by specific type of benefit (medical, prescription, dental, vision, life insurance, LTD, Flexible Spending, etc.). In addition, summaries are available in BenefitSolver in the Reference Center section.
Benefits Frequently Asked Questions
GENERAL HEALTH BENEFITS INFORMATION
Employees have up to 30 days from hire date to enroll in health benefits through the BenefitSolver web page, www.benefitsolver.com, or during annual Open Enrollment in May. It is the employee’s responsibility to ensure they have completed their enrollment within the 30 day window. Failure to complete enrollment will result in having to wait until the next Open Enrollment period (May of each year).
Please refer to the Benefit schedule provided to you during your new hire sign up. Also, you can refer to your appropriate compensation agreement or collective bargaining agreement for specific details.
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Log into BenefitSolver to view your current benefit elections. You can also print a Benefit Summary from the menu.
If an employee is enrolled in health benefits outside the district and has a loss of coverage, the employee has up to 30 days from the date the other coverage ended to enroll in the District’s benefits. Log into BenefitSolver and Complete a Change My Benefits, Life Event, Loss of Other Coverage. Once you have completed the change in BenefitSolver, you will need to provide the Benefits office with appropriate documentation. This will include a COBRA notice or statement from the other insurance company showing the date coverage is terminated.
Within 30 days from the date of birth, you can add a newborn to your health benefits. Log into BenefitSolver and select Change My Benefits. Under Life Event, select Birth, and follow the screens to add the baby. As soon as you receive the birth certificate and Social Security Card, scan/email or interoffice the documents to the Benefits Office. Note: many times the birth certificate and social security card are received after 30 days. Do not delay in adding the child to BenefitSolver while waiting for these documents. Please note, if you choose to change health plans when adding a newborn, the new plan will be effective back to the birth. Any claims processed under the old plan will be reprocessed under the new health plan.
Within 30 days of the date of marriage, you can add your spouse to health benefits. Log into BenefitSolver and select Change My Benefits. Under Life Event, select Marriage, and follow the screens to add your spouse. Once this is complete, scan/email or interoffice mail a copy of your marriage license to the Benefits Office. If you are also adding any stepchildren, scan/email or interoffice mail their birth certificates as well.
Family members can be added or removed within 30 days of a Qualified Life Event (QLE), by logging into BenefitSolver, and clicking Change My Benefits, or during annual Open Enrollment in May. Dependents added or removed resulting in a QLE may have different effective dates. Please contact the Benefits Office to confirm the effective date. Dependents added or removed during open enrollment will have their change effective July 1. Employees must also provide proof of the QLE and the dependent’s eligibility to the Benefits office.
A change in your situation such as getting married, having a baby, or losing health insurance coverage, can make you eligible for a special enrollment period, allowing you to enroll in health insurance outside the district’s annual open enrollment period. Examples of such Qualified Life Events (QLE) are: birth/adoption/gaining dependent through a qualified medical support court order; marriage; divorce or legal separation; death of the policyholder; involuntary loss of employer sponsored coverage or Medicaid coverage; exhaustion of COBRA.
Proof of Eligibility is required to enroll a dependent in health benefits. For a legal spouse, proof of eligibility is a copy of the marriage certificate that has been properly recorded with the County and/or State (a church ceremony document will not be acceptable if it does not meet these requirements), plus a copy of a ‘joint document' dated in the past 90 days. (Note: joint document is not required for adding a spouse resulting from a recent marriage). Examples of acceptable Joint Documents are a utility bill, mortgage/lease statement, auto insurance statement, property tax statement, or the most recent year 1040 Federal tax form, first page, financial info blacked out. For a dependent child, proof of eligibility is a birth certificate or court document that establishes the relationship between employee and dependent.
Dependent children can remain covered until the end of the month in which they turn age 26. Dependent children will automatically be removed from coverage at the end of the month they turn age 26. No action is required on the part of the employee.
Open Enrollment takes place each year in May, and changes made to your plans/dependents during the open enrollment period are effective July 1.
Contact Karen Zaleta at email@example.com to request the forms necessary to change your address. Once your address is updated in our Human Resources system, the address change will also carry over to all the insurance plans.
QUESTION REGARDING A CLAIM
Contact our Employee Advocate, Matt Young, at 1-866-515-5899 or email Matt_Young@ajg.com.
BENEFITS UPON TERMINATION
Your health benefits will continue until the end of the month of your resignation date. For example, if you resign effective December 3, your health benefits will end at midnight December 31. For all resignations, the Benefits office will calculate the number of months in the current plan year that the employee had coverage versus the amount paid through payroll deduction for that coverage. If an employee has not paid the full amount owed for the number of months they had district coverage, the district will try to recoup any amounts owed in the final paycheck. If the final paycheck is not enough to take the final deductions owed, then the employee will be invoiced.
The district utilizes an outside vendor for our COBRA administration. You will receive a COBRA packet soon after your last date of active employment. You have 60 days to elect COBRA coverage with no lapse in coverage. If you have any questions about this process, please contact the Benefits office.
PLAN SPECIFIC INFORMATION
Log into www.ibx.com. If you have never registered on the site, you will need to complete the registration process. Once you are registered, you can print out a temporary card. If you have lost your card and need a replacement, please contact the Benefits office.
Also, Independence Blue Cross has an app available to download from either the Apple app store or the Google play store. Your ID cards would be accessible through this app.
From the home screen on the Independence Blue Cross website, select the Search button under Find A Doctor.
Our prescription plan is through Caremark. Log onto www.caremark.com to register. On the website you can order and manage prescriptions, check your prescription drug coverage and benefits, and find ways to manage costs and save money.
The amount paid for copays will vary by employee group and medical plan enrollment. Employees enrolled in the medical High Deductible Health Plan will pay full cost for any prescriptions while working toward their deductible. See additional prescription information at https://www.wcasd.net/Page/596.
Ongoing prescription used for chronic, long-term conditions and are taken on a regular, recurring basis.
The first initial two fills can be filled at any in network retail pharmacy. After the two fills, you must use the mail order program or the CVS Retail Pharmacy and obtain a 90 day supply.
The cost for the 90 day supply is 2 copayments.
Log into Delta Dental, www.deltadentalins.com., and refer to the Find A Dentist section on the right-hand corner of the home page
The District’s vision reimbursement plan is through Trustmark/CoreSource. Claim forms and a summary plan description are located on the District website, under Staff, Benefits, Vision. See https://www.wcasd.net/Page/598
Our Vision provider, Trustmark/CoreSource, does not mail vision cards to the home. You can print out a vision card from the Vision link on the district website. Go to Staff, Benefits, Vision, and select Vision Card, link: https://www.wcasd.net/cms/lib/PA02203541/Centricity/Domain/29/Coresource%20Vision%20ID%20Card.pdf.
The district vision plan allows you to visit any provider you wish, pay the provider directly, and then submit a claim form and supporting documentation to Trustmark/CoreSource for reimbursement based upon the reimbursement schedule located in the Summary Plan document. This document is posted in the Benefits section of the district website, under Vision. Link:
The vision claim form is located in the Benefits section, under Vision. See https://www.wcasd.net/Page/598
FLEXIBLE SPENDING ACCOUNTS
FSA accounts offer the opportunity to set aside a portion of your pay pre-tax into a special account. That account can then be used to pay for qualified healthcare expenses (medical FSA), or qualified dependent day care expenses (dependent care FSA).
Log into BenefitSolver and click on the Piggy Bank Icon. From there you can view your FSA election and current balances.
Flexible spending account elections DO NOT carry over from one plan year to the next. During open enrollment in May, you must make an election for the upcoming July 1 thru June 30 plan year. Health Care and Dependent Care FSA - There is a Grace Period to incur claims for 2 ½ months after the end of the plan year (September 15). All claims for a particular plan year whether incurred during plan year or during ‘grace period’ must be submitted to BenefitSolver by December 15 (5 ½ months after the plan year ends).
Your medical FSA is available in full upon the effective date of the plan year. The dependent care FSA can only be used up to the current balance in the account. You can submit claims over the amount in the account and BenefitSolver will reimburse you piecemeal as payroll deductions are added to your balance.
Claim forms are located on the Benefits section of the District website, Staff, Benefits, Flexible Spending Accounts. Claims forms and a portal to upload the forms is also located on the BenefitSolver site. Click the Piggy Bank icon to go to your FSA account information.
For those who elected a medical FSA, BenefitSolver will mail an FSA Visa card to your home address for new enrollees and existing enrollees will have their new annual election added to their existing FSA card. Your annual election will be preloaded and available for use upon the effective date of the FSA. Do not dispose of this card upon exhaustion of your funds as any funds you add in the following plan year will be added to this card.
If you are using your FSA benefits card, the funds will be paid directly to the provider. No claim form is necessary. At times, BenefitSolver requires further documentation in order to process the claim. If this occurs, you will receive an email directly from BenefitSolver. Your account will be in a pended status until you provide the proper documentation to BenefitSolver. If BenefitSolver determines the charge to be ineligible under the IRS FSA rules, you will be required to submit reimbursement for the charge to the Benefits office before your account is reactivated. Please contact the Benefits office for more details. Please note: if a provider charges a credit card fee on top of the fee for the service, the credit card charge is an ineligible expense.
For any manual claims submitted, these are paid via Direct Deposit thru the BenefitSolver portal, Piggy Bank icon. You will need to set up Direct Deposit information in the BenefitSolver portal, and reimbursement funds will be deposited into your account the day after they are approved. If you do not set up direct deposit thru BenefitSolver, your manual claim will remain in a pended status. This will lead to a delay in receiving your reimbursement.
Contact BenefitSolver Flex Administration at 855-883-8541.
HEALTH SAVINGS ACCOUNT (HSA)
The HSA is regulated by the IRS. Employees are required to participate in the High Deductible Health Plan in order to contribute to their HSA. Please note that if you are enrolled in Medicare Parts A and/or B, you are not eligible to contribute to the HSA. However, you may use money that’s already in your HSA after you enroll in Medicare to help pay for deductibles, premiums, copayments or coinsurance. If you contribute to your HSA after your Medicare coverage starts, you may have to pay a tax penalty. If you’d like to continue contributing to your HSA, you shouldn’t apply for Medicare or Social Security.
Contact 1-800-ASK-BLUE and ask for the Spending Account team.
When you enroll in the HDHP medical plan in BenefitSolver, you will also be directed to a screen to elect your own per pay contributions into your HSA account. You can also fund your HSA account directly by sending your personal check to the HSA provider (note: the total of all your contributions whether via payroll deduction, employer contribution or manual contribution by the participant cannot exceed the annual maximums established by the IRS. It is up to the participant to ensure their compliance with the IRS regulations.
Employees age 55 and older are eligible to begin catch-up contributions for an HSA. If eligible, you can contribute an additional $1,000 per plan year above the regular HSA limit set by the IRS. Note, for the plan year in which you turn age 55, your $1,000 catch-up contribution should be prorated. It is up to the employee to make sure they only contribute the appropriate amount per IRS regulations.
Although you may have eligible dependents on your high deductible health plan, HSA funds can only be used for those dependents you declare on your IRS 1040 tax form.
If the district is providing a contribution to the HSA, they will fund the annual contribution approximately 1 month after your initial enrollment (if a new hire), or in July of each year for those electing/re-electing the plan during Open Enrollment. Please refer to your employee group contract for funding amounts. The district can only fund accounts in an ‘active’ status. See “My HSA is not yet active” (below) for more information.
When your HSA account is being set up, the vendor must complete a verification of name and address. If the address you provided the district does not match your driver’s license, your account will remain in a pending status. Contact the Benefits office for help with resolving this issue.
Log into your IBC account and navigate to the Spending Account area. From there you can view your current balance and all transactions.
LONG TERM DISABILITY
Basic Long term disability is a benefit provided by the district at no cost to you. LTD provides for some income protection should you be unable to work. Please refer to your appropriate compensation agreement or collective bargaining agreement for specific details. Employees are able to purchase additional coverage (Buy-Up Coverage) at time of new hire benefit enrollment or during annual open enrollment, and pay for the coverage through payroll deduction.
The district provides group term life insurance per your compensation agreement or collective bargaining agreement. There is no cost to you for this group term life insurance. Beneficiary Designation. Your beneficiary designation for your district’s group term life is housed in BenefitSolver. You can select multiple beneficiaries and stipulate their percentages at your discretion. If you wish to change your beneficiary/ies, log into BenefitSolver and select Change My Benefits. Under Basic Information, select Change of Beneficiary, and follow the screens to make the change. This can be done at any time of the year. If you do not designate a beneficiary, any life insurance proceeds will be paid to your estate.
The district provides for Supplemental Benefits that can be purchased and paid through payroll deductions. Currently, these benefits include Aflac accident and critical illness policies. These supplemental benefits are elected at time of hire or during open enrollment. Please be aware the carrier may request additional information and make a determination as to whether or not an employee qualifies for enrollment in those plans.
SICK DAY TRANSFER
Ask your current/former employee to send a sick day transfer letter to the district’s Payroll department. Up to 25 sick days may be transferred from one district to another. For LTS assignments, the district does not accept sick day transfer or provider sick day transfer letters to the receiving district.
Yes, you can remain enrolled in the district’s benefit plans as long as you are an active employee. Medicare will be secondary coverage and the district plan will be your primary coverage.
Yes, you can continue to cover your spouse on your health benefits as long as you are an active employee. If you spouse enrolls in Medicare, Medicare will be secondary and the district plan will be the primary coverage.
Ideally PSERS (Pennsylvania State Employees Retirement System) would like to begin this process a year before your retirement date. PSERS offers Foundations for Your Future presentations that offer helpful information, whether or not you are sure of your retirement plans. Anyone can attend these presentations. The Benefits office can help you navigate to this information on the PSERS website. Please refer to your Collective Bargaining Agreement or employment contracts for specific information on retirement benefits and notification timelines that are important.
PSERS can be reached at 1-888-773-7748 or at their website: psers.pa.gov.