Englewood Schools

Belong and Thrive

***2017 Benefits Summary***
 
Changes Effective: January 1, 2017
 
 For more information, please see the 2017 Employee Benefits Summary listed below:
 
 
2017
MEDICAL
 
Kaiser Permanente Benefit Summary -  Two Plan Options:
 
1)     DHMO $1500 Plan
 
  OR
 
 2)     HDHP $3000 Plan with District HSA Monthly Contribution = $110.82
 
 
KAISER PERMANENTE MONTHLY PREMIUMS
DHMO $1500 Plan
Employee: $0.00 
Employee + 1: $491.75
Employee + Family: $925.15
  
HSA $3,000 Deductible with $110.82/mo HSA District Contribution
Employee: $0.00 (Restrictions above apply)
Employee + 1: $383.47
Employee + Family: $721.42
 
The amount allotted for premiums by Englewood Schools: 
DHMO $1500 Plan Monthly Premium:  = $487.12
HSA $3000 Plan Monthly Premium: $379.86 + $110.82 = $490.68

1.0 FTE Teachers: the District will pay the employee’s monthly premium/HSA contributions for those eligible and enrolled.

Admin/Pro/Tech and Classified employees working a minimum of 4 hours per day and 175 days per year: the District will pay the employee’s monthly premium/HSA contributions for those eligible and enrolled.

 

CREDITABLE COVERAGE

Kaiser Permanente has determined the prescription drug coverage offered by the High Deductible plan (prescriptions covered at 100% after deductible is met)  is, on average for all plan participants, expected to pay out as much as standard Medicare prescription drug coverage. Therefore, your coverage is considered Creditable Coverage. Because your existing coverage is Creditable Coverage, you can retain this coverage and not pay a higher premium (a penalty) if you later decide to join a Medicare drug plan.

WOMEN'S HEALTH CARE AND CANCER RIGHTS ACT

Do you know that your plan, as required by the Women’s Health and Cancer Rights Act of 1998, provides benefits for mastectomy-related services including all stages of reconstruction and surgery to achieve symmetry between the breasts, prostheses, and complications resulting from a mastectomy, including lymphedema?
Call your plan administrator for more information. Kaiser: 303-338-3800303-338-3800


COBRA GENERAL NOTICE

Please find the link to the Required COBRA General Notice for all individuals enrolled in Kaiser, Delta or VSP below:
Link to COBRA General Notice
 

KAISER ENROLLMENT FORM

KAISER HEALTH PLAN INFORMATION

HSA ELECTION FORM

HSA INFORMATION

UMB FORMS

CLOSE