Health _ Dental Insurances by yaofenjin

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									Health & Dental Insurance



                                 HEALTH INSURANCE


Suffolk Public Schools offers its employees two choices of health insurance plans
through Anthem Blue Cross Blue Shield. The HealthKeepers 10 HMO is
available for those who prefer lower premiums and the highest level of managed
care. The KeyCare 15 PPO is available for those who desire less restrictions and a
broader network of providers. Enrollment in any plan must be completed within 30
days of your official hire date, otherwise you will forfeit participation until the next
plan year, for which open enrollment is held each May. Other qualifying status
changes must also be applied for within 30 days of the change (see “Other
Insurance Facts”). The plan year begins on October 1, 2007 and ends on
September 30, 2008.

Anthem plan information, including provider lists and benefits, is available at all
locations including the School Administrative Offices. This information is also
available on the Anthem web site. Just click on the Anthem logo above.

The monthly rates are paid on a 10-month basis. The dual rates apply when a
married couple are both employed by Suffolk Public Schools, are both eligible for
insurance benefits and are both on the same plan. Below are the employee rates for
the 2007-2008 Plan Year:


                         HealthKeepers 10            Employee
                               HMO                   Per Month
                     Employee Only                        $ 17.72
                     Employee Plus One                     264.60
                     Employee Plus One Dual                 17.72
                     Family                                370.80
                     Family Dual                            17.72
                            KeyCare 15               Employee
                                PPO                  Per Month
                     Employee Only                        $ 83.72
                     Employee Plus One                     404.60
                     Employee Plus One Dual                157.72
                     Family                                560.80
                     Family Dual                           207.72
                                DENTAL INSURANCE



Suffolk Public Schools also offers two choices of dental plans through Delta
Dental of Virginia. The Dental Basic Plan provides services for diagnostic and
preventive care and basic dental care including fillings and oral surgery. The
Dental High Plan includes the above benefits and adds prosthetic and complex
restorative services, including crowns and bridges, and orthodontic services. All
benefits have calendar year deductibles and maximums. Orthodontic services have
a $1,000 lifetime maximum per person and only cover dependent children under 19
years old.

Delta Dental plan information is available at all locations including the School
Administrative Offices and on their web site. You can go to their web site by
clicking on the Delta Dental logo above.

The same rules apply for dental insurance enrollment and changes as discussed
under the health insurance. However, you do not have to enroll in a health
insurance plan to participate in a dental plan.

The monthly rates are paid on a 10-month basis. The dual rates apply when a
married couple are both employed by Suffolk Public Schools, are both eligible for
insurance benefits and are both on the same plan. Below are the employee rates
for the 2007-2008 Plan Year:


                          Dental Basic            Employee
                                                  Per Month
                    Employee Only                       $ 10.56
                    Employee Plus One                     26.48
                    Employee Plus One Dual                15.92
                    Family                                55.02
                    Family Dual                           44.46
                           Dental High            Employee
                                                  Per Month
                    Employee Only                         $22.38
                    Employee Plus One                      47.20
                    Employee Plus One Dual                 36.64
                    Family                                 91.72
                    Family Dual                            81.16
Other Insurance Facts

    Dependent children may be covered under the Employee Plus One or Family
     Plans until the end of the calendar year in which the child turns 23 as long as
     the child can be claimed as a dependent under IRS guidelines. Marriage ends
     a dependent's eligibility for coverage under the parent's contract on the last
     day of the month in which the marriage takes place.

    An employee is only allowed to add or change coverage if there is an
     eligible family status change. Any add/change must be submitted within 30
     days of the qualifying event including proper documentation.

         o Examples of eligible family status changes include:

             The marriage or divorce of the participant
             The birth or adoption of a child by the participant
             The death of the participant’s spouse or a dependent
             The termination or commencement of employment of the
              participant’s spouse
             The switching from part-time to full-time employment status
               (or vice-versa) by the participant or the participant’s spouse
             The taking of an unpaid leave of absence by the participant or the
              participant’s spouse; or
             A significant change in health coverage attributable to the
              spouse’s employment.

   All other changes can only be made once a year during open enrollment.

Current Employee & Medicare Eligible

Important Information on the Medicare Part D Prescription Benefit

In January 2006, Medicare added a new prescription drug
benefit, Part D, for those who are Medicare eligible. Current
employees of Suffolk Public Schools who also participate in
our Anthem health insurance plans do not need to take any
action at this time since your Anthem health insurance is
your primary insurance. It has been determined that your
current prescription benefits are on average at least as good as
standard Medicare prescription drug coverage (creditable coverage). Because of
this determination, you may enroll in the Medicare Part D prescription drug plan
without penalty if you enroll within 63 days after your Anthem health insurance
Current Employee & Medicare Eligible (continued)

coverage ends. If you are interested in the Part D plan when your current
Anthem coverage ends, it is very important to enroll within the first 63 days to
avoid a penalty.


For more information:
 . www.medicare.gov
 . Refer to your copy of Medicare & You handbook
 . Call 1-800-MEDICARE (1-800-633-4227)


Coverage after Retirement

              If eligible, Suffolk Public Schools’ employees may keep their health
              insurance coverage once they retire.

              Retirees may remain on the group health plans to the age of 65 if the
              following qualifications are met:

    Retiree qualifies for regular or disability retirement through the Virginia
     Retirement System.
    Retiree must have been employed with Suffolk Public Schools for a total of
     ten years.
    Retiree must have carried group health insurance with Suffolk Public
     Schools for the twenty-four (24) months prior to retirement. The retiree may
     elect the same or a lower tier of coverage. For example, the retiree may
     change from KeyCare to the HMO, but not the reverse, or from family to
     retiree only, but not the reverse.
    Retiree must execute VRS-78 Premium Deduction & Health Insurance
     Credit Authorization Form which allows VRS to deduct insurance premiums
     from the retiree's monthly VRS retirement check. Only in those cases where
     the VRS monthly retirement check is not sufficient to pay the monthly
     insurance premium will a retiree be permitted to make payments directly to
     Suffolk Public Schools.

The School Board pays a portion of the HealthKeepers 10 HMO retiree only plan.
Health plans, rates and employer shares are subject to change annually by the
School Board. Although retirees are not eligible to remain on our group dental
insurance plans to age 65, retirees may remain on their existing dental plan or a
lower tier dental plan for eighteen months under the federal COBRA law.
Coverage after Separation from Employment (other than retirement)

Under the federal COBRA law, employees losing medical coverage due to
voluntary or involuntary termination (other than for gross misconduct) of
employment or a reduction in hours may continue to maintain their coverage in the
School Board's group at their own expense (current premium plus a 2%
administration fee) for themselves and their dependents for up to 18 months or
until they become covered under Medicare or some other group insurance option
(unless that plan has a pre-existing condition limitation). This does not apply to
employees who have retired. A special continuation period applies to qualified
beneficiaries who are certified disabled under the Social Security Act before their
normal 18 month continuation ends. These individuals are entitled to a total of 29
months of continuation. Dependents of covered employees who would otherwise
lose their coverage due to death, divorce, or legal separation or other loss of
dependent status may continue with the School Board's group at their own expense
(current premium plus 2% administration fee) for up to 36 months or until they
become eligible for Medicare or other insurance coverage.

Phone Numbers for Insurances

      HealthKeepers Product 10 HMO Plan              757-326-5260 (local)

      KeyCare 15 Plan                              1-800-451-1527

      KeyCare 15 Out-of-State Networks             1-800-810-2583

      Delta Dental Basic & High Plans              1-800-237-6060


Questions Regarding any of the above Insurances

Questions concerning any type of health or dental insurance should be directed to
Melissa Gardner in the Finance Department at 925-6756 or by emailing her
through the school system's email system. For additional information regarding
these plans or specific benefit questions, you may contact the health and dental
companies at the above phone numbers or by clicking on their respective logos
above to go directly to their web sites.

								
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