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Benefit Information for the period October 1, 2020 to September 30, 2021
Santa Rosa Junior College offers its employees and their eligible dependents a comprehensive fringe benefit package that includes medical insurance, dental insurance, vision care and life insurance. The highlights of the package include:
The District offers a choice of five medical plans through our membership in Self-Insured Schools of California (SISC). Please click on the links below to view the Benefit Summaries of these five plans:
- Kaiser Permanente HMO
- Kaiser Permanente Account Based Health Plan with a Health Savings Account (HSA). This is a deductible plan.
- Blue Shield of California HMO
- Blue Shield of California PPO
- Blue Shield of California Account Based Health Plan with a Health Savings Account (HSA). This is a deductible plan.
2020-2021 Rates – For Contract Faculty, Classified and Management. October 1, 2020 to September 30, 2021. For employees working less than full-time, benefits will be pro-rated
Santa Rosa Junior College offers a self-insured dental plan that includes more than 750 participating dentists. The annual dental benefit provided each benefit year is $1,700.00. Claims are administered by: Arrow Benefits Group, 1 Willowbrook Court, Suite 230, P.O. Box 750758, Petaluma, CA 94975, (707) 544-1801. Click here for the Summary Plan Description and click here for the List of Participating Dentists.
The District provides a Vision Service Plan (VSP) benefit to employees. This vision plan provides an annual exam and an allowance to purchase vision products from participating providers. Click here for the VSP benefits summary.
The District paid basic life insurance benefits are provided by Standard Insurance Company. The benefit amount is $50,000.00 for the employee and $5,000.00 for eligible dependents. These benefit amounts are doubled if an accidental death & dismemberment event occurs. Voluntary supplemental coverage is available at the employee’s expense.
ELIGIBLE DEPENDENT REQUIREMENTS
Employees who enroll a spouse/domestic partner or children on the plans must provide the following documents showing of dependent eligibility:
- Spouse - a copy of a marriage certificate and a copy of page 1 of your most recent 1040 tax return that shows your married status (block out all income and first five digits of SSN)
- Domestic Partner - a certified copy of the State of California Certificate of Registration of Domestic Partnership and a copy of page 1 of each person's most recent 1040 tax return (block out all income and first five digits of SSN)
- Children up to age 26 - a copy of the birth certificate
All enrollment forms should be submitted to Christie Colón in Human Resources
Blue Shield - Use the Blue Shield Enrollment Form to enroll for the first time.
**Blue Shield - HMO – you must select a doctor when enrolling and include the doctor's IPA & PCP numbers on the enrollment form:
IPA is the Group #
PCP is the Primary Care Physician #
Here’s how to search on Blue Shield's website for that information and to select a Blue Shield HMO doctor in your area:
Click on “Primary Care Physician”
Type in your location
Select Specialty, like “Family Practice”, “Internal Medicine”, etc.
*** Blue Shield PPO or HSA – you must write HSA or PPO in the top margin on the enrollment form
Kaiser - Use the Kaiser Enrollment Form to enroll for the first time.
* Be sure to check HMO or Deductible plan in Section A on enrollment form
Making changes to your current medical plan (like adding or deleting a dependent)? Please fill out this Membership Change Form and include the proper dependent documentation (see above for dependent eligibility)
Dental - use this Form
Vision for Faculty and 10-month employees - use this Form
Vision for 12-month Classified and Management - use this Form
Life - use the Beneficiary Change Form to make changes to your plan
Additional medical plan information:
- Employee Assistance Program (EAP)
- Blue Shield PPO plan: Ambulatory Surgery Center option
- Health Savings Account with Optum Bank - FAQs and Guide.
- Additional benefits for employees enrolled in a SISC medical plan include the Employee Assistance Program (EAP), expert medical opinions and 24/7 physician access.
- Optum Bank - Health Savings Account FAQs and Guide
SISC has also implemented new programs to add value and give members access to the best care:
RETIREE HEALTH BENEFITS
Faculty - Click here for information on Retirement Health Benefits
Classified - Click here for information on Retirement Health Benefits
Benefit Summaries for Retiree Medical Benefits 65 and older:
The renewal rates listed are effective October 1, 2020 and will remain in place through September 30, 2021.
KAISER SENIOR ADVANTAGE
• Single Party Sr Advantage (1) over 65 $339.00
• 2-Party Sr Advantage (2) over 65 $678.00
• 2-Party Sr Advantage/Kaiser HMO (1) over 65+ (1) under 65 $1,053.00
• 3-Party Sr Advantage/Kaiser HMO (1) over 65+ (2) under 65 $1,828.00
• Single Party Companion Care (1) over 65 $402.00
• 2-Party Companion Care (2) over 65 $804.00
• 2-Party Companion Care/Blue Shield PPO (1) over 65+ (1) under 65 $1,277.00
Additional Retiree Benefit: Silver & Fit benefits with Kaiser Senior Advantage
Retiree Dental Benefits:
- Santa Rosa Junior College offers a self-insured dental plan that includes more than 750 participating dentists. The annual dental benefit provided each benefit year is $1,700.00. Claims are administered by: Arrow Benefits Group, 1 Willowbrook Court, Suite 230, P.O. Box 750758, Petaluma, CA 94975, (707) 544-1801. Click here for the Summary Plan Description and click here for the Listing of Participating Dentists.
Listed below are annual notices provided for informational purposes.
Income protection coverage for employees is provided through Sun Life Financial. Should you become disabled, after a 60-day waiting period, the benefit payable to you is two-thirds of your monthly salary before tax liability. Depending on your employment status, you are entitled to either a one-year benefit or up to the age of 65.
Employees are eligible for participation in either the State Teachers Retirement System (CalSTRS) or the Public Employees Retirement System (CalPERS) based upon the position classification and/or prior membership. These programs provide a lifetime retirement allowance based upon a retirement system formula which includes five full-time years of service. Adjunct faculty also have the option of participating in Fidelity Investments or the CalSTRS Cash Balance system which do not require any vesting or years of service.
For information on 403(b) and 457 plans, please click here to go to the Payroll department website.
For information on the Flexible Spending plan (FSA) or Health Savings Account (HSA), please click here to go to the Payroll department website.
If you have any questions or need assistance with these documents, please contact Human Resources at 707-527-4954
ADJUNCT FACULTY MEDICAL BENEFITS
The current Enrollment Period for the Adjunct Medical Benefits Program is September 2020 for medical coverage October 1, 2020 through March 31, 2021. Forms are due to Human Resources by 5 p.m. on September 30, 2020.
PLEASE NOTE: There are changes this semester to the process for CONTINUING ENROLLEES.
Click here if you are a CONTINUING ENROLLEE.
Click here if you are a NEW ENROLLEE
If you're enrolling in one of the SRJC Kaiser plans, please click here and submit this enrollment form to Human Resources, along with the other required forms.
To enroll in Blue Shield, please click here to fill out the enrollment form and return it to Human Resources, along with the other required forms.
Required dependent documents:
To enroll a spouse:
• Copy of Marriage Certificate
• Copy of page 1 of your 1040 Federal Tax Return that shows Married filing status
To enroll a domestic partner:
• Copy of the State of California Certificate of Registration of Domestic Partnership
• Copy of page 1 of both partner’s 1040 Federal Tax Returns
To enroll a child:
• Copy of birth certificates for children up to age 26
• OR, if child is adopted or you are the legal guardian: legal adoption documentation or legal court documentation establishing guardianship