Spring 2020 Enrollment Period for Kaiser Permanente
February 10, 2020 through February 24, 2020 only
To All Adjunct Faculty:
The District is pleased to offer a medical plan for adjunct faculty who qualify. Enrollment for the plan, offered through Kaiser Permanente, is available each semester to employees and their eligible dependents. If enrolled this semester, coverage will be in effect from March 1, 2020 through August 31, 2020. You will be required to re-enroll, if eligible, each semester.
To qualify:
- You must carry at least a 40% cumulative equivalent load of a minimum full-time faculty assignment (either instructional or non-instructional) on February 21, 2020. If your load is reduced after that time or classes are cancelled, you may still be eligible to participate.
- You may not have any other medical coverage and must sign a statement verifying that you have no other coverage.
- You must pay at least 50% of the premium.
In order to be covered by this plan you must sign up between February 10, 2020 and February 24, 2020. LATE FORMS WILL NOT BE ACCEPTED. The coverage period is March 1, 2020 through August 31, 2020.
Eligible dependents may be enrolled at full cost to the employee. (A copy of the first page your 2018 federal tax return is required to enroll your spouse; a copy of your State Registry for Domestic Partners is required to enroll your same-sex domestic partner; and birth/adoption certificates are required to enroll eligible children. Children may be covered until their 26th birthday regardless of their dependent or student status.
Full Monthly Premium thru September 30, 2020:
Employee Only
| Employee + Spouse
| Employee + Child/ren
| Family
|
$826.00
| $1,728.00
| $1,430.00
| $2,471.00
|
Of these amounts, the District will contribute 50% of the monthly Employee Only cost ($413.00).
The pre-tax deduction from your paycheck will be as follows:
| Employee Only
| Employee + Spouse
| Employee + Children
| Family
|
March, April, May & June
| $619.50
| $1,972.50
| $1,525.00
| $3,087.00
|
Those enrolled in this plan will be automatically enrolled in an employee assistance plan, AnthemEAP that offers confidential counseling services, and legal and financial planning assistance to you and anyone living in your household.
If you are currently enrolled in the District's plan (from fall 2019), you MUST submit the following Verification of Eligibility Form to Human Resources on or before 5:00pm on Monday February 24, 2020 to continue your coverage as of March 1, 2020. Please also submit the form if you are no longer eligible or wish to end coverage (by checking the appropriate box). You may fax your form to 408.239.8804 or print, sign, scan and email it to HR.Benefits@sjeccd.edu by the due date above. You may also submit your forms via the Pony or US Mail (40 South Market Street, San Jose 95113). LATE FORMS WILL NOT BE ACCEPTED.
All new or returning enrollees (not currently enrolled in the District's Kaiser Plan) must complete both the Verification of Eligibility Form and a Kaiser Enrollment Form. Electronic signatures are not accepted on the Kaiser Enrollment Form. For your convenience, you may fax your form to 408.239.8804 or print, sign, scan and email it to HR.Benefits@sjeccd.edu by the due date above. You may also submit your forms via the Pony or US Mail (40 South Market Street, San Jose 95113). LATE FORMS WILL NOT BE ACCEPTED. Electronic signatures are not accepted on the Kaiser Enrollment Form. Your enrollment will be rejected if your form does not contain your actual signature.
To enroll, you must submit the following:
Proof of dependent eligibility if enrolling dependents (see page two of the enrollment form)
Participants must recertify each semester to continue coverage.
For more information on the plan design, please click on the links below:
Kaiser Plan Summary (as of 07/01/2018) including Chiropractic & Acupuncture care
Spring '20 Information Letter
EAP Services available for all enrollees, covered dependents and anyone living in the covered employee's household (for more information, please see the EAP section on the Benefits Webpage.)
Flexible Spending Accounts:
All adjunct faculty regardless of their load each year are eligible to enroll in a Flexible Spending Account.
The District offers three accounts:
Medical Spending Account
Dependent Care Account
Transportation Account
2020 Enrollment Form (for all flexible spending account plans)
Click here for additional information related to flexible spending accounts
More flyers are available on the Benefits Webpage by clicking on this link then scrolling down to the Flexible Spending Account section.
If you worked (faculty) at EVC and/or SJCC fall 2019 semester and you did not submit your Flex enrollment form during the special enrollment period in December you may not enroll at this time. However, if you did not work fall 2019 you may now sign up for the rest of 2020.
Each November/December, the District holds a special enrollment period for the following calendar year. Adjunct faculty teaching in the fall who already have an assignment for the following spring semester must enroll during that enrollment window. Those without a spring assignment will be allowed to enroll in February once they have an assignment. Faculty who only work in the fall will be allowed to enroll at that time for the remainder of the calendar year. Flexible Spending Accounts are not for everyone every year so be sure to plan accordingly as there are no refunds provided and accounts can only be closed mid-year under certain circumstances. For more information go to our 3rd Party Administrator's website at
www.goigoe.com or check with the IRS.
If you need information regarding benefits, please contact Arleene Miranda or Michelle McKay at
HR.Benefits@sjeccd.edu or call 408.223.6713
