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SMC|Human Resources|Human Resources Department|Santa Monica Community College District - 2015 Open Enrollment

Santa Monica Community College District - 2015 Open Enrollment

 Health Open Enrollment - September 15 - October 10, 2014

Santa Monica Community College District 2015 Open Enrollment begins Monday, September 15, 2014 for the following employee groups:

Academic Administrators ​Board of Trustees ​Classified Employees
​Classified Managers Confidential Employees ​Full-time Faculty
​Personnel Commissioners ​Police Officers ​Project Managers

During Open Enrollment you may enroll, change, add or remove eligible dependents from your health benefits for the 2015 plan year. All changes made during Open Enrollment will be effective January 1, 2015. The deadline to make changes to your health benefits is Friday, October 10, 2014.

If you do not wish to make changes to your current health benefits (medical, dental, and/or vision), there is no action to complete. Your current plan elections will remain intact for the 2015 Plan Year.

2015 BENEFITS CHANGES AND IMPORTANT INFORMATION

CalPERS MEDICAL PLAN:

  • PERSCare, PERS Choice, & PERS Select PPO Plans annual out-of-pocket maximums will increase to:
    PLAN 2014 PLAN YEAR 2015 PLAN YEAR
    PERS Care ​$2,000 Individual/$4,000 Family $4,600 Individual/$9,200 Family
    ​PERS Choice $3,000 Individual/$6,000 Family ​​$4,600 Individual/$9,200 Family
    PERS Select ​$3,000 Individual/$6,000 Family ​​$4,600 Individual/$9,200 Family

  • Blue Shield HMO plans will no longer require members to use its Center of Excellence for spinal and hip replacements, and it will eliminate the $250 outpatient hospital co-pay for upper endoscopies, colonoscopies, cataract surgeries and spinal injections.​

  • All HMO Plans will offer acupuncture and chiropractic benefits; 20 combined visits per calendar year.

CLICK HERE FOR THE 2015 PREMIUM RATES

  • Employees who enroll in PERSCare must pay the difference between PERSCare and the second highest CalPERS Medical Plan. The second highest CalPERS Medical Plan for 2015 is Anthem Blue Cross Traditional HMO.

  • Health premium contributions are deducted on a pre-tax basis. This means premium contributions are deducted from your paycheck prior to federal and state tax withholdings, this reducing your taxable income. Employees may waive the pre-tax option by completing the PRE-TAX HEALTH PREMIUM WAIVER FORM.

CalPERS HEALTH PLAN CHOOSER

The Health Plan Chooser is an online tool through CalPERS to assist employees with choosing a medical plan. Employees can view their plan information in one place, access each plan's doctor directory, compare plans side-by-side, and rank each plan based on personal preferences.

When using the tool, employees will need to enter the following information:

  • Type of coverage - select Basic
  • Who will be covered - select your current coverage level (employee only, two-party, or family)
  • Employer monthly premium contribution - use the monthly rates for Anthem Blue Cross Traditional HMO based on your coverage level, this information can be found on the 2015 Premium Rates link above
  • Your zip code - use your home address zip code
  • Employment classification - select Contracting Agency Employee/Retiree
  • If you are an association member - select No Association
  • There will be other questions regarding your medical service use, plan features and key services these questions should be answered based on your personal preference.

DENTAL PLANS:

No changes to Delta Dental PPO and HMO Plans for 2015

VISION PLAN:

Frame allowance for in-network providers will increase from $120 to $140 for wide selection of frames and $160 for featured frame brands. This change will be effective October 1, 2014.

CalPERS DEPENDENT ELIGIBILITY PROJECT:

CalPERS is conducting a Dependent Eligibility Verification project to ensure that all dependents enrolled in CalPERS health plans meet the eligibility guidelines. The verification cycle for school agencies will be conducted from December 2014 - February 2015. Employees will have to provide documentation to verify that the dependent(s) enrolled in their plan are eligible for coverage. More details are forthcoming.

CASH-IN LIEU PROGRAM: (CLASSIFIED EMPLOYEES, FULL-TIME FACULTY, & POLICE OFFICERS ONLY)

Under the contract provisions for the District-CSEA, District-SMCFA, and District-SMCPOA, Classified Employees, Full-time Faculty, and Police Officers who have non-District medical coverage may opt-out of the District's medical plans and receive a cash-in lieu benefit amount up to $2,000 per year. Classified Employees, Full-time Faculty, and Police Officers who are currently participating in the Cash-in Lieu Program will need to renew their declination during open enrollment.

To enroll/renew in the Cash-in Lieu Program, employees will need to complete the SMC Open Enrollment form and provide proof of continuing health coverage (i.e. medical plan card). For more information, see the contract provisions below: 

Classified Employees: District-CSEA CBA Article 12.13
Full-time Faculty: ​​District-SMCFA CBA Article 10.1.1
Police Officers: ​​District-SMCPOA Article 12.12

SECTION 125 FLEXIBLE SPENDING ACCOUNTS: (AMERICAN FIDELITY)

Open Enrollment for the Section 125-Flexible Spending Accounts (FSAs) will be held between the period of October 13, 2014 - October 30, 2014.

FSAs allow employees to set aside pre-tax dollars for out-of-pocket medical expenses and/or dependent care cost into a Health Care FSA and/or Dependent Day Care FSA. 

2015 FSA PLAN MAXIMUM
Health Care FSA ​​Dependent Day Care FSA
$2,500 $5,000
 
New for 2015: Flex Debit Card - Employees will have the option to sign up for a flex debit card if they are enrolled in the Health Care FSA. A flex debit card gives employees direct access to their Health Care FSA funds. It allows employees to pay for eligible medical expenses with the flex debit card instead of paying out-of-pocket.

Employees who wish to enroll in a FSA or continue for the 2015 plan year will need to meet with an American Fidelity representative. More information is forth coming.

Important: Employees who are enrolled in a 2014 Health Care FSA account must submit all medical expenses to American Fidelity by December 31, 2014 for reimbursement. Unused funds up to $500 will carryover into the 2015 plan year. There is no longer a grace period  to submit claims for a Health Care FSA due to the carryover provision.

PLAN INFORMATION

CalPERS MEDICAL PLANS
Plan Resources: 2015 CalPERS Health Benefits Summary CalPERS Health Program Guide

Plan Websites:

Anthem Blue Cross Blue Shield​
CVS Caremark Health Net of California
Kaiser Permanente PERS Care, PERS Choice, PERS Select
United HealthCare

DENTAL PLANS
Plan Resources:
Delta Care USA HMO Plan Highlights Delta Dental Premier PPO Plan Highlights
Plan Website: Delta Dental Of California​

​VISION PLAN ​
​Plan Resource: VSP Benefit Plan Highlights
Plan Website: Vision Service Plan​

​ELIGIBLE DEPENDENTS:
Spouse
​Registered Domestic Partner
​Children up to age 26 (natural, adopted, domestic partner's, or step)
​Children, up to age 26, if the employee has assumed a parent-child relationship and is considered the primary care parent
​Certified disabled dependent children age 26 and older
All Dependents enrolled in District-sponsored insurance are subject to verification of eligibility.

 

HOW TO ENROLL OR MAKE CHANGES TO YOUR BENEFITS

STEP 1:

Complete the SMC Open Enrollment Form

STEP 2:

Complete Health Plan Enrollment Form(s)

STEP 3:

If you are adding dependent(s), you must provide proof of dependent eligibility (i.e. birth certificate, marriage license, certification of domestic partnership, etc.)

STEP 4:

Return the original enrollment forms and supporting documentation (if applicable) to the Office of Human Resources. DEADLINE: OCTOBER 10, 2014

 
FORMS
SMC Open Enrollment Form
CalPERS Medical Enrollment Form
Delta Dental Enrollment Form
Vision Service Plan Enrollment Form
 
For additional information or if you have questions, please contact the Office of Human Resources:
Heather Memarian, Benefits Support Technician – 310-434-4205 / memarian_heather@smc.edu
Olga Vasquez, Benefits Clerk - 310-434-3513 / vasquez_olga@smc.edu
Lugina Rogers, HR Analyst, Leaves & Benefits - 310-434-4060 / rogers_lugina@smc.edu