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Home :: Employment :: Benefits
Benefits
The Benefits Department manages district-wide health benefits enrollment and changes for employees, retirees, and their families.
Administration:
Ellie Winter, Manager, Payroll and Benefits
Phone: (916) 686-7778
Mailing Address:
Elk Grove Unified School District
Compensation and Benefits
9510 Elk Grove-Florin Road
Elk Grove, CA. 95624
Benefits Information
The Elk Grove Unified School District offers various benefits to eligible employees. The information on this page will help employees enroll in or make changes to specific benefits available.
2013/2014 Open Enrollment: May 13, 2013 – June 7, 2013
The annual Open Enrollment is your opportunity to review your current health plan coverage and evaluate if you are interested in making any changes.
All forms must be in the Payroll and Benefits Office by 5 p.m. Friday, June 7, 2013. All changes are effective on July 1, 2013.
Changes for 2013/2014:
- Health Net will no longer be offered as an option for medical coverage. Replacing Health Net will be Western Health Advantage (WHA). Current Health Net members must elect either WHA, Kaiser Permanente, or the Cash Waiver (requires proof of alternative coverage). Employees, who are currently being treated for a serious illness or are pregnant, must speak with a representative from their preferred medical carrier regarding continuity of care.
- The provider for Life Insurance is changing from Principal Life to The Hartford effective July 1, 2013. This carrier change will not affect current group life policy coverage or designated beneficiaries. However, employees should update their designated beneficiary to ensure current information is on file. Beneficiary forms are available below in the Life Insurance section. Plan summaries will be available soon.
- The provider for Flexible Spending Account (FSA) Section 125 is changing from PAYFLEX to American Fidelity Assurance Company effective July 1, 2013. To participate in the pre-tax reimbursement account for dependent care and/or medical expenses, employees must re-enroll each year to continue this benefit. American Fidelity Assurance Company representatives will be available during Open Enrollment meetings and everyday from 2-5 p.m. in the Payroll and Benefits Office to assist employees with enrollment requirements and answer questions.
2013/2014 Open Enrollment Letter (.pdf)
Co-Pay Comparison (.pdf)
Schedule of Open Enrollment Events (.pdf)
Cash Waivers:
Employees currently waiving their medical coverage must renew their waiver during Open Enrollment each year to continue receiving the monthly cash payment for the upcoming year. To renew the waiver, print out the form below, complete the form with name, social security number, and the “Cash Waivers” section of the form. Remember to sign and date the form and send the completed form to the Payroll and Benefits Office by 5 p.m., June 7, 2013. This form needs to be printed on legal size paper.
Cash Waiver Form (.pdf)
If employees wish to make other changes or want to enroll dependent(s) in a medical plan for next year, please contact the Payroll and Benefits Department first. Additional forms and/or proof of dependent eligibility may be required.
See additional information below in the “Cash Waivers” section.
Health Benefits
The Elk Grove Unified School District offers health benefits to qualified employees and their eligible dependents. For qualifications of benefited employees, please refer to the Union Contracts.
Employees who receive medical benefits through EGUSD have the opportunity to earn an Employee Wellness Rebate. For more information please visit the “Your Health, Your Choice” wellness rebate webpage.
Medical
The Elk Grove Unified School District offers two HMO medical plans for eligible employees to choose from along with the opportunity to waive medical insurance if they are currently enrolled in an alternative insurance. EGUSD does not allow married EGUSD employees to be double covered on medical. One spouse must waive their medical. Please see the Cash Waiver section below.
Kaiser Permanente
www.kp.org
(800) 464-4000
Evidence of Coverage (.pdf)
Co-Pay Summary (.pdf)
Western Health Advantage (WHA)
www.mywha.org/egusd
(888) 563-2250
Evidence of Coverage (.pdf)
Co-Pay Summary (.pdf)
Continuity of Care FAQ’s (.pdf)
Continuity of Care Request Form (.pdf)
American Health Care (AHC)
(American Health Care is the pharmacy plan for WHA Members)
www.americanhealthcare.com
(800) 872-8276
Formulary (.pdf)
Dental
The Elk Grove Unified School District offers dental coverage through Delta Dental. For details about the plan, please refer to the Coverage Summary below.
Delta Dental
www.deltadentalca.org
(866) 499-3001
Delta Dental Coverage Summary (.pdf)
Delta Dental Voluntary Plan Coverage Summary (.pdf)
Vision
The Elk Grove Unified School District offers vision coverage through Vision Service Plan (VSP). For details about the plan, please refer to the Coverage Summary below.
Vision Service Plan (VSP)
www.vsp.com
(866) 213-2249
VSP Coverage Summary (.pdf) – This summary includes information for the regular 100% plan (“Buy Up Plan Coverage”) and the Voluntary Plan (“Base Plan Coverage”).
Enrollment/Change Forms
The following forms can be used to make changes to current benefits. All changes are subject to approval from the Benefits Department. Most mid-year changes require a qualifying event (i.e. marriage, domestic partnership, divorce, newborn/adoption/legal guardianship, student status change, loss of coverage). Employees have 30 days from the qualifying event to complete the forms and turn them in to the Payroll and Benefits Office. Proof of the qualifying event will be required with the enrollment/change forms. For more details about what documentation will be required, please contact Michelle Peter in the Benefits Department by phone at (916) 686-7778 Ext. 7677 or by e-mail: mapeter@egusd.net.
EGUSD Enrollment/Change Form (.pdf)
Kaiser Permanente Enrollment/Change Form (.pdf)
Western Health Advantage Enrollment/Change Form (.pdf)
Cash Waivers
Cash Waiver payments of $65 per month will be made to employees who opt to waive medical insurance due to alternative medical coverage. Proof of alternative coverage, via a District Waiver Form, must be completed, signed, and submitted every year during Open Enrollment per IRS Section 125. CalSTRS members prior to January 1, 2013, will have CalSTRS contributions collected from this payment.
EGUSD employees on the highest cost plan whose spouses waive medical insurance through EGUSD will have their premium reduced to the lowest cost plan. Spouses that waive must renew their waiver each year during Open Enrollment to qualify. (Both members must be an EGUSD benefited employee or a benefit qualified EGUSD Retiree)
Effective January 1, 2008, a provision of the John Warner national Defense Authorization Act prohibits the payment of cash in lieu of district sponsored insurance when using TRICARE as primary insurance coverage.
Cash Waiver Form (.pdf)
Group Life Insurance
For benefit eligible employees, the Elk Grove Unified School District offers a Basic Life Insurance Plan through The Hartford Financial Services Group.
The beneficiary form below should be completed when an employee becomes benefit eligible and should be updated as needed. In the unfortunate event of an employee’s death, the district will refer to this form in order to provide payments of specific Death Benefits to surviving beneficiaries.
Along with the Life Insurance plans, The Hartford also offers other services for little or no cost to the employee. Services are detailed in the summaries below.
Section 125 Flexible Spending Accounts (FSA)
Flexible spending accounts (FSA) are a tax-advantaged way to pay for qualified out-of-pocket health care expenses and work-related day care expenses. This benefit allows employees enrolled in Elk Grove Unified School District Group Health Benefits to pay expenses with “pre-tax” dollars. The information summary details how the program works and what expenses are eligible. Enrollment in the FSA program can only occur at time of employment or during Open Enrollment. All employees participating in the FSA program must renew their account every year during Open Enrollment to continue the deduction. All enrollments or changes take place with an American Fidelity Assurance Company representative. Please contact them at the number listed below for more information.
American Fidelity Assurance Company
(800) 365-8306
(916) 683-8306
www.americanfidelity.com
Section 125 Flexible Benefit Plans Summary (.pdf)
Medical Expense Reimbursement Form (.pdf)
Dependent Day Care Reimbursement Form (.pdf)
Reimbursement Direct Deposit Form (.pdf)
Tax Deferred Programs
The Elk Grove Unified School District offers two types of voluntary tax deferred retirement plans to participate in through payroll deduction. Employees may contribute to one or both programs listed below. For more information on both programs, please visit the websites below.
Notice of Eligibility to Participate in a 403(b), 457 Deferred Compensation Program (.pdf)
403(b) – www.calstrs403bcomply.com
(888) 892-7494
All enrollments and changes are processed on this website or by calling this number.
How to Navigate CalSTRS 403(b) Comply Website (.pdf)
For distributions, rollovers, and transfers, please use the above website or use the following forms.
403 (b) Distribution Fax Cover Sheet (.pdf
403 (b) Distribution Form (,pdf)
457 – www.calpers.ca.gov
(800) 260-0659
457 Enrollment Form (.pdf)
457 Beneficiary Form (.pdf)
457 Change Form (.pdf)
For Withdrawal Request information, please use the following forms.
Distribution Request Form (.pdf)
Account Transfer Form (.pdf)
Rollover Form (.pdf)
Direct Rollover Request Form (.pdf)
Inter-Plan Transfer Form (.pdf)
In-Service Withdrawl/Transfer Request Form (.pdf)
Rollover Request Form for CalPERS Service Credit Purchase (.pdf)
Emergency Withdrawal Request Form (.pdf)
Steps To Retirement
Planning for retirement? Please find some general information in the link below to help guide you through this process with EGUSD.
Steps To Retirement (.pdf)
Elk Grove Benefits Employee Retirement Trust
In July of 1995, the Elk Grove Unified School District and the unions representing the employees formed Elk Grove Benefits Employee Retirement Trust (EGBERT) to provide post-retirement health insurance benefits. Please read the Summary Plan Description for details of the trust and the qualifications for eligibility.
Elk Grove Benefits Employee Retirement Trust (EGBERT) Summary Plan Description (.pdf)
Employees who are within two years of retirement and wish to request a current count of health benefited months as an EGUSD employee, please complete the form below and submit to the Payroll Department.
Elk Grove Benefit Trust Health Insurance Eligibility Request (.pdf)
Disability
Active employees have access to disability benefits based on their classification and/or bargaining unit. This summary will give a brief description of those benefits.
Summary of Disability Benefits (.pdf)
Please note, if you change bargaining units, there may be a change in your disability benefits. Please contact Payroll for more information.
Medicare
When an active employee or retiree turns 65 they will need to work with Medicare to get enrolled. There may be certain parts of Medicare that don't require enrollment depending on an employee's status. Please read the information in the document below for more details.
Medicare Tip Sheet (.pdf)
Benefits Staff Directory:
Supervisor: Rosalie Tecson
Office Support: Sandi Foster
Michelle Peter - (916) 686-7778 Ext. 7677
- Active Employee Health Benefits Enrollment
- Health Benefits Changes (i.e., Name/Address Changes, Adding/Removing Dependents)
- Leave of Absence/Family Medical Leave Benefits
- COBRA Enrollment
Linda McGill - (916) 686-7778 Ext. 7672
- Retiree Health Benefits
- COBRA Billing
- CalPERS 457
- 403(b)
- Wellness Rebate
Jeannie Boulet - (916) 686-7778 Ext. 7541
- Payroll Docks
- State Disability Insurance
- Worker’s Compensation
- Section 125 Flexible Spending Account
- Wage Garnishments
Irene Cormane – (916) 686-7778 Ext. 7389
- Payroll Docks
- State Disability Insurance
- Worker’s Compensation
- Wage Garnishments
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