Senior Benefits Analyst
|415.883.2211 ext. 8159
Fiscal Services Director
|415.883.2211 ext. 8160
|Fiscal Services Administration|
Tuesday, May 10, 2016 – Thursday, August 25, 2016
Deadline: Thursday, August 25, 2016, 5 pm to the Benefits Office at Indian Valley Campus
We are pleased to announce the 2016-2017 Annual Open Enrollment for all benefit eligible employees, beginning Tuesday, May 10, 2016.
Any enrollment changes for you or your dependents will go into effect on October 1, 2016, with any employee premium contributions beginning on the September 2016 payroll. The district caps remain unchanged.
If you are satisfied with your current coverage, there will be no action needed.
To Enroll or Change enrollment, you must complete:
Flex Week Open Enrollment Sessions for Health Benefits
Thursday, August 18, 2016 – TBD KTD
Thursday, August 18, 2016 – TBD KTD
Friday, August 19, 2016 – TBD KTD
Friday, August 19, 2016 - TBD KTD
Open Enrollment Guide for Traditional Kaiser Permanente plans
Open Enrollment Guide for Deductible HMO Kaiser Permanente plans
Kaiser Chiropractic Care Benefit
Beginning February 1, 2015 a chiropractic benefit was added to both the Kaiser Traditional HMO and the Kaiser Deductible HMO Plans.
Blue Shield PPO
SISC Blue Shield of California 100% Plan A / $20.00 Copayment (update pending)
SISC Blue Shield of California 80% Plan K / $30.00 Copayment (update pending)
Open Enrollment Guide for Blue Shield PPO plans (2015-2016 Enrollment Guide - update pending)
The following benefit enhancements will be added effective October 1, 2016:
Diabetic Eye Care Program Plus - This program is being added to all VSP plans with no impact to the rates. It provides supplemental eye care for patients with diabetic eye disease, glaucoma, or macular degeneration. Coverage includes glaucoma testing, fundus photography, retinol screening, visual field exams, and medical exams for a $20 co-pay per visit.
Open Enrollment Forms
Step 1: Complete Medical Plan Election Form
Step 2: Complete Enrollment Forms
- Kaiser Enrollment Form (includes dental and vision enrollment)
- Kaiser Senior Advantage Election Form (for Senior Advantage only)
- Blue Shield Enrollment Form (includes dental and vision enrollment)
Step 3: Dependent Eligibility – Required Documents: If you are adding an eligible dependent the following documents are required by SISC:
Spouse, Domestic Partner (AB205), or Domestic Partner (Non-AB205): In addition to the documentation listed below, a copy of the first page of the previous calendar year’s IRS Federal Tax Return for spouse (financial information and first five digits of the Social Security number may be blacked out). If taxes were filed separately, a copy of both returns is required.
- Spouse – Photocopy of the legal Marriage Certificate or officiate-issued certificate.
- Domestic Partner (AB205) – Photocopy of a certified copy of the Declaration of Domestic Partnership that was filed with California Secretary of State.
- Domestic Partner (Non-AB205) – SISC Domestic Partnership Affidavit, if applicable (opposite‐sex domestic partners). Please read the ‘Important Information for Domestic Partner Benefits’.
Dependent Child: Photocopy of the legal birth certificate, hospital certificate, adoption paperwork, or guardianship paperwork issued by a court (documentation must include both child and parents’ names and the dependent relationship to the employee). Grandchildren are only eligible if they are the employee/retiree’s dependent through adoption or legal guardianship.
As a large public entity purchasing pool of educational agencies, SISC requires dependent eligibility documentation to validate each dependent’s legal relationship to the employee. If you do not have copies of the required documents, you may contact the county recorder’s office in which the marriage or birth occurred.
Enrollment information submitted with incomplete forms or missing documents will cause a delay in access to benefits.
- Definitions of AB205 and non-AB205 Domestic Partnerships
- Important Information for Domestic Partner Benefits
- Affidavit of Domestic Partnership
- Certification of Tax-Qualified Dependents
- Affidavit of Termination of Domestic Partnership
Pre-Tax Your Share of Premium:
If you have any out of pocket share toward the premium, you may consider having the deductions taken on a pre-tax basis. By signing up for this option your federal, state and social security deductions will decrease. Please visit the Open Enrollment webpage for the Salary Reduction Agreement. Please submit by August 25, 2016 to the Benefits Office.
Open Enrollment for Pre-Tax Benefit Enrollment - Aflac and WageWorks
What are the employee and district responsibilities regarding spouse/domestic partner and/or dependent children terminations?
It is the employee’s responsibility to notify the district of any changes in eligibility status for their spouse/domestic partner or dependent(s). The district is required to notify SISC in a timely manner of these changes. Paid claims on a non-eligible spouse/domestic partner or dependent(s) will be recovered.
Open Enrollment for Pre-Tax Benefit Enrollment – TDS and Guardian
Flexible Spending Account (FSA) and Guardian Voluntary Plans - For Eligible Employees
Now is the time to enroll for an effective date of October 1, 2016.
The College of Marin provides you with several benefits options that allow you can use pre-tax money to increase your spending power and protect you when unforeseen events put you at risk with loss of income, unanticipated medical expenses and more.
You pick the coverage that best suits you and your family. Supplemental Insurance Programs Offered to College of Marin Employees:
- Flexible Spending Account (FSA) with debit card
- Dependent Care Account
- Transportation Benefit (mass transit or van-pooling)
- Short-Term Disability
- Long-Term Disability
- Term Life Insurance
- Group Cancer Insurance
- Group Critical Illness
- Group Accident Insurance
You can have up to $2,550 withheld annually on a pre-tax basis to pay for any out of pocket medical/dental expenses (Medical FSA) and an additional $5,000 withheld annually for dependent care expenses (Dependent Care FSA) may also be withheld. Click here to start your enrollment.
Commuter Benefits/Transportation Program: This benefit allows you to set aside pre-tax funds, up to $130 per month, to pay for qualified workplace mass transit or van pooling expenses. Transportation Plan Flyer.
- You must register online for these supplemental insurance benefits. Enrollment is optional.
It’s quick and simple, with online education videos and decision support tools to help you make the right choices for you and your family.
Need help? If you have any questions or need assistance, please call 1-800-934-0161. Benefit Counselors are standing by Monday – Thursday 10:30am to 7:30pm and Saturday 8:30am – 12pm.
- Enter Last Name and Last 4 digits of your Social Security Number
- If you have 2 last names please type both names with no space between. Do not use spaces, dashes or apostrophe’s when typing in your last name
- Create a Password
- Select a Security Question and Answer
After you watch the TDS Overview Video, click “Return to Website” on the lower right corner.
Look for the Enroll Now in the upper left corner. Next look for: Enrollment - Step 1: Select Enrollment. Follow the prompts.
At the end of the enrollment process, you will see an Enrollment Summary. You can edit any of your selections from this page. If everything is correct, click the button on the lower right corner: “Save Enrollment”.
Note: You may bypass the videos by clicking on the “Return to Website” on the lower right corner. You will be taken back to a webpage titled: “Enrollment - Step 3: Benefit Selection”. If you do not wish to take the coverage, enter “No Contribution” or $0.00.
Resources and Contact Information
Customer Service: (800) 464-4000.
Customer Service: (855) 256-9404.
Navitus Pharmacy Services: (866) 333-2757
Customer Service: 800-765-6003
Member Services: 800.877.7195
Self-Insured Schools of California (SISC)
Visit web site: http://sisc.kern.org/hw/
For specific questions please contact Ron Owen, Sr. Benefits Analyst at extension 8159 or (415) 884-3159.
Content Responsible: Peggy Isozaki, Director of Fiscal Services, 415.883.2211 ext. 8160
Technical Contact: Katy Bauer, Executive Assistant to the Vice President of Finance and College Operations, 415.883.2211 ext. 8101