Medical:Effective January 1, 2017, preventive services will be covered at 100% for in-network providers (HealthLink Open Access II) only; no preventive benefits for out-of-network providers. Preventive services examples are: well-visits (child); physicals (adults); annual well-woman exam; mammogram (age requirement); lab work - wellness; diabetic education; flu shots; shingle shots to name a few. NOTE: Birth control will be covered at 100% for generic, other birth control prescriptions are copays. The list of covered preventive services is long - visit this website for details: www.healthcare.gov/coverage/preventive-care-benefits/.The District’s medical plan is a self-insured plan administered by CoreSource. The District has contracted with HealthLink, Inc., a preferred provider organization (PPO), to provide services to employees at a higher level of benefit. Make sure you confirm the doctor you are seeing is a HealthLink provider.There is a “no-waiting period” for pre-existing conditions. Coverage begins for exempt (salaried, monthly paid) employees on the first day of employment. Coverage for non-exempt (hourly, bi-weekly paid) employees begins on the first day of the month following 60 days of employment.The links below and to the right highlight the benefits available through Columbia Public School District’s medical plan, subject to certain exclusions and limitations. A complete Summary Plan Description of the medical plan is available by clicking on the link below. If you have questions, contact Employee Benefits located in Business Services at 1818 W. Worley or at 214-3710.
Pre-Certification Requirements - If you are admitted to the hospital
How to find a HealthLink Provider (instructions) - click here to find a provider
The Medical Plan has Enrollment Guidelines for Adding Dependents:Effective Date - Your first day of eligibility depends upon your classification. If you are an exempt employee (salaried, monthly paid), you are eligible on your first day of active work with the District. If you are a non-exempt employee (hourly, bi-weekly paid), you are eligible on the first day of the month following the sixtieth (60th) day of employment.
Age Limit on Dependents - Dependents can be covered up to age 26.Qualifying Event - The employee has 31 days to add or remove their dependents to / from the medical plan under qualifying event rules. A qualifying event is defined as marriage, divorce, birth (or adoption), or if dependents (or part-time employees) lose coverage due to a spouse’s loss of employment.To add or remove a dependent, complete the change form (also found on the right of this page). Click the submit button to submit the form. This will generate an instant confirmation page and email. If you DO NOT receive a confirmation email, the employee benefits office HAS NOT received the form. If you need assistance, contact the employee benefits office. Once the employee benefits office has received the submitted change form, the employee will be contacted via CPS email regarding premium payments, flex, and daycare reimbursements (if applicable).Proof of the event is required to add dependents. The change request to add a dependent due to a qualifying event is not valid until proof of the qualifying event is received by the Employee Benefits office. We recommend emailing, faxing or dropping off the proof to our office instead of mailing, as this is time sensitive information. Proof can be in the form of a HIPAA certificate, letter of credible coverage, signed divorce papers, or a marriage certificate. Proof is not required to add a newborn baby.
Open Enrollment - If the employee fails to enroll dependents as a new employee or under the qualifying event rule, dependents or part-time employees (working 30 hours or more) may be added to the medical plan during the open enrollment period (November) with an effective date of January 1st, the following year. The employee can move from one plan option to the other during open enrollment.
Premium Deduction - All medical and dental insurance premiums will be deducted from your paycheck on a before-tax basis. Per IRS rules, you can only stop premiums during open enrollment, or if you have a qualifying event such as divorce, other coverage available, or emancipation. If you think you will want to stop insurance without having a qualifying event, you can opt-out of the before-tax deduction by contacting the Employee Benefits office and requesting the opt-out form. The opt-out form must be completed annually during open enrollment to continue the after-tax deduction.
ALL PREMIUMS ARE PAID IN ADVANCE. Employees must request to stop coverage in writing via the online change form in the month(s) prior to the date of the qualifying event in order to stop the premium deduction.