Employee Benefits Information

 

 

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Benefit Information for the period October 1, 2019 to September 30, 2020

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:

MEDICAL INSURANCE

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:

DENTAL INSURANCE

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.

 

VISION INSURANCE
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.

 

LIFE INSURANCE
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 your most recent tax return that shows your married status (block out all income and first five digits of SSN)
  • Domestic Partner - a copy of the State of California Registration and a copy of each person's most recent tax return (block out all income and first five digits of SSN)
  • Children up to age 26 - a copy of the birth certificate

 

ENROLLMENT FORMS

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 #

           *** 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:

 

RETIREE BENEFITS - for retirees age 65 and over

FacultyClick here for information on Retirement Health Benefits 

ClassifiedClick here for information on Retirement Health Benefits 

 

Benefit Summaries for Retiree Medical Benefits:

Additional Retiree Benefit: Silver & Fit benefits with Kaiser Senior Advantage and Companion Care

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.

 

Annual Notices

Listed below are annual notices provided for informational purposes.

2018-19 Annual Notices

 

 

ADJUNCT FACULTY MEDICAL BENEFITS


The current Eligibility Period for the Adjunct Medical Benefits Program is September 1 through September 30, 2019 for the benefit period October 1, 2019 through March 31, 2020. For information see the following,

Cover Letter

Declaration of Eligibility & Enrollment Request

Premium Payment Voucher


Long-Term Disability

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.

Retirement Plans
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.

 

HEALTHCARE REPORTING LAW

According to the Affordable Care Act (ACA), when you file your Federal income tax return, you must provide proof that you and your dependents had the type of healthcare coverage that is now required by law or face tax penalties.

How do I provide proof of coverage?

If you enrolled in coverage, you will receive a Form 1095-B from your medical provider. (For Santa Rosa Junior College employees enrolled in coverage, this would come from Kaiser Permanente for Kaiser members, or SISC for Blue Shield members). This form provides details about your coverage, including which members of your family were covered and in which months during 2018. Information from Form 1095-B can be used in completing your Federal income tax return. Employees and retirees who have health coverage through Santa Rosa Junior College should have already received form 1095-B from their medical provider. 

The deadline for employers to provide employees with Form 1095-C is March 4, 2019, so if you are considered a full-time employee under the ACA guidelines, you could expect to receive the 1095-C form at the beginning of March. Retirees will not be receiving a form 1095-C.