Personnel Support Services - Benefits

Carin Freitas, Benefits Specialist, Phone: (858) 521-2800 ext. 2897, FAX: 858-485-1355
email: cfreitas@powayusd.com; Christine Gold, Insurance Benefits Assistant at cgold@powayusd.com

2016 INSURANCE INFORMATION

 

Open Enrollment from November 2, 2015 – November 13, 2015

Frequently Asked Questions

 

Need help?

Attend one of our Open Enrollment Help Sessions located at the District Office – Community Room on:

  Monday, November 2, 2015 10:00am – 12:00pm & 4:00pm – 6:00pm
  Thursday, November 12, 2015 4:00pm – 6:00pm
  Friday November 13, 2015 2:30pm – 4:30pm

 

WHAT’S NEW FOR 2016

Kaiser: All Kaiser copays will remain unchanged for the 2016 plan year, however we are happy to report that a Hearing Aid benefit has been added to the Kaiser plan effective January 1, 2016. See pages 20-21 for details.


Aetna/Optum RX: All Aetna/Optum RX copays will remain unchanged for the 2016 plan year, however we are happy to report that a Hearing Aid benefit has been added to the Aetna plans effective January 1, 2016. See pages 20-21 for details.


Delta Dental: While the existing dental benefits will remain unchanged for the 2016 plan year, we are happy to report that a Night Guard benefit has been added to the Delta Dental PPO plan effective January 1, 2016. See page 23 for details.


MES Vision: While the existing vision copays will remain unchanged for the 2016 plan year, we are happy to report that the frequencies for services has changed from once every 24 months to once every 12 months effective January 1, 2016. See page 24 for details.


The Standard Life Insurance: Mandatory standard life insurance policy has increased from $20,000 to $25,000 at no additional cost. Those wishing to elect or increase their voluntary life insurance are being given an Open Enrollment Opportunity during this Open Enrollment without having to submit a medical history statement. See pages 25-27 for details.


Do you need to take action?

You need to take action during Open Enrollment from November 2, 2015 – November 13, 2015 if you want to:

  • Change your plan elections.
  • Elect a different medical plan
  • Add or delete dependent coverage
  • Participate in Medical or Dependent Care Flexible Spending Account (FSA) for plan year 2016.
  • Enroll in Hyatt Metlaw Legal Plan
  • Elect or increase voluntary life insurance
  • Participate or continue to waive benefits/opt-out of coverage and receive cash to warrant


A limited amount of forms can be obtained from your worksite secretary’s Open Enrollment supply box. The interactive pdf PUSD Benefit Enrollment Form, Flexible Spending Enrollment Forms, and Domestic Partner Forms can ALWAYS be found on the District website.

   YOUR “TO-DO” LIST
  Read the material in this Benefits Information Guide
  Review the personalized benefits statement included in your packet for accuracy
  Complete the 2016 Benefits Enrollment Form if opting out
  Decide whether you’re going to make any changes for plan year 2016 or keep the coverage you have
  If making changes follow the directions on page 12

All forms are to be submitted to the Insurance Benefits Department located at the District Office.

NAME OF DOCUMENT / FORM GROUP TYPE
EMPLOYEE BENEFITS INFORMATION GUIDE ACTIVE MEDICAL
EMPLOYEE BENEFITS INFORMATION GUIDE - COBRA ALL MEDICAL
EMPLOYEE BENEFITS INFORMATION GUIDE - RETIREE RETIREE MEDICAL
2016 BENEFITS ENROLLMENT FORM - ACTIVE EMPLOYEE ACTIVE MEDICAL
2016 BENEFITS ENROLLMENT FORM - RETIREE RETIREE MEDICAL
2016 FLEX ENROLLMENT FORM ACTIVE FLEX
2016 PUSD DELTA DENTAL BENEFIT SUMMARY ALL DENTAL
2016 PUSD MES VISION SUMMARY ACTIVE VISION
2016 THE STANDARD LIFE INSURANCE ENROLLMENT FORM ACTIVE LIFE
2016 PUSD AETNA AVN HMO SBC (Summary of Basic Coverage) ACTIVE MEDICAL
2016 PUSD AENTA AVN HMO SUPPLEMENTAL INFO ACTIVE MEDICAL
2016 PUSD AETNA AVN HMO SUMMARY (AETNA VALUE NETWORK) ACTIVE MEDICAL
2016 PUSD AETNA EPO SUMMARY (ELECT CHOICE) ACTIVE MEDICAL
2016 PUSD AETNA FULL NETWORK SBC ACTIVE MEDICAL
2016 PUSD AETNA FULL NETWORK SUPPLEMENTAL INFO ACTIVE MEDICAL
2016 PUSD AETNA FULL NETWORK HMO SUMMARY ACTIVE MEDICAL
2016 PUSD AETNA OAMC SBC ACTIVE MEDICAL
2016 PUSD AETNA OAMC SBC SUPPLEMENTAL INFO ACTIVE MEDICAL
2016 PUSD AETNA OAMC SUMMARY (OPEN ACCESS MANAGED CHOICE) ACTIVE MEDICAL
2016 PUSD KAISER PRINCIPAL BENEFITS SUMMARY ACTIVE MEDICAL
2016 PUSD KAISER CHIRO RIDER ACTIVE MEDICAL
2016 PUSD KAISER TRANDITIONAL PLAN SBC (Summary of Benefits & Coverage) ACTIVE MEDICAL
2016 PUSD KAISER SENIOR ADVANTAGE [KPSA] ENROLLMENT FORM SENIORS MEDICAL
2016 PUSD KAISER SENIOR ADVANTAGE [KPSA] BENEFIT SUMMARY SENIORS MEDICAL
2016 PUSD KAISER SENIOR ADVANTAGE [KPSA] DENTAL SUMMARY SENIORS DENTAL
Payroll Cancellation Form ACTIVE  
Domestic Partner Affidavit ACTIVE  
MES Claim Form ACTIVE EYE
Handicaped Child Attending Physician's Statement Form ACTIVE  
Request for Continuation of Medical Coverage ACTIVE  
MHS HO ACTIVE  
Domestic Partner Agreement Form ACTIVE  
Dependent Day Care Provider Acknowledgement Form ACTIVE  
Optum RX Claim Reimbursement Form ACTIVE RX
Beneficiary Designation Form ACTIVE