Employee Benefits Information

 

 

Photo of Human Resources Staff Photo of Human Resources Staff Photo of Human Resources Staff

Families First Coronavirus Response Act (FFCRA) - Information  ||  FAQs

COVID - 19 Resources from Employee Assistance Program (EAP)

 

2020 OPEN ENROLLMENT

The month of August is the Open Enrollment period for the District’s medical and vision plans. Dental Open Enrollment is every three years, so the next dental open enrollment is in 2021.

If you would like to change your medical coverage from one plan to another, or add eligible dependents to your coverage, August is the time to complete the required forms.

**Documents need to be submitted to HR by Monday, August 31, 2020**

All changes made during Open Enrollment will become effective October 1, 2020. Please review the complete renewal information provided below. Questions about Open Enrollment can be directed to Christie Colón at ccolon@santarosa.edu or 707-524-4304.

Employees eligible to participate in the Open Enrollment include:

  • Contract Faculty
  • Classified employees with an FTE of 50% or greater
  • Management employees with an FTE of 50% or greater
  • Adjunct employees currently participating in the Adjunct Medical Benefits Program (medical only/no vision available). The eligibility period for new Adjunct enrollments is not until September 1, 2020 to September 30. 2020.

 

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:

 

MEDICAL ENROLLMENT FORMS

Enrollment forms should be sent to ccolon@santarosa.edu or mailed to SRJC 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 #

           *** 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

Use the Membership Change Form to make changes to your current medical plan (like adding or deleting a dependent)

 

Rates and additional medical plan information is listed here:

SISC has also implemented new programs to add value and give members access to the best care:

  • Hinge Health: Blue Shield PPO members have free access to a program that provides personalized, interactive physical therapy using the latest technology. With Hinge, members are empowered with tools to address knee or back pain whenever and wherever it works best for them. For more information go to http://www.hingehealth.com/healthyschools.
  • Vida Digital Coaching: Blue Shield PPO members will have access to a virtual care platform that treats a full range of lifestyle, chronic and behavioral health conditions. For more information go to http://www.vida.com/sisc.
  • Enhanced Cancer Benefit at City of Hope: All Blue Shield PPO plans will feature access to an in‐person evaluation with confirmation of diagnosis and development of a customized treatment plan at no charge. For more information go to https://www.cityofhope.org/.
  • Calm: Kaiser Permanente members can access all the great features of Calm at no cost. Calm is #1 app for meditation and sleep, designed to help lower stress, reduce anxiety, and more. For more information go to www.kaisercalmapp.
  •  
  • myStrength: myStrength is a personalized program that helps you improve your awareness and change behaviors. Kaiser Permanente members can explore interactive activities, in-the-moment coping tools, community support, and more at no cost. Members can access myStrength at www.kaisermystrength.

 

 

 

Eligible Dependent Requirements

Employees who enroll a spouse/domestic partner or children on the plans must provide the following documents to Human Resources, along with the enrollment forms:

  • Spouse - a copy of a marriage certificate and a copy 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 copy of the notarized affidavit or 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

 

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.

 

VISION ENROLLMENT FORMS

Vision for Faculty - use this Change Form to add or delete dependents

Vision for Classified and Management - use this Change Form to add or delete dependents

 

2020 OPEN ENROLLMENT FOR RETIREES

 

The month of August is the Open Enrollment period for the District’s retiree medical plans. If you would like to switch your medical coverage from one plan to another, or add eligible dependents to your medical coverage, now is the time to complete the required forms. Dental Open Enrollment is every three years, so the next dental open enrollment is in 2021.

 

Santa Rosa Junior College Retirees who are under age 65 can change to any of the five medical plans offered by the District. Please click on the links below to view the Benefit Summaries of these five plans:

 

Retirees who are over age 65 can make changes to either of their Medicare Advantage and Medicare Supplement plans. Please click on the links below to view the Benefit Summaries of these two plans:

 

ENROLLMENT FORMS

Enrollment forms should be filled out and returned to ccolon@santarosa.edu or mailed to SRJC Human Resources

 

The renewal rates listed below will become 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

 

COMPANION CARE

• 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

 

           

**For questions about Open Enrollment, please contact Christie Colón at ccolon@santarosa.edu or 707-524-4304.

 

 

 

 

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 certified copy of the State of California Certificate of Registration of Domestic Partnership 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

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 #

           *** 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 

Classified - Click here for information on Retirement Health Benefits 

 

Benefit Summaries for Retiree Medical Benefits:

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.

 

Annual Notices

Listed below are annual notices provided for informational purposes.

2019-2020 Annual Notices

 

 

ADJUNCT FACULTY MEDICAL BENEFITS


The current Enrollment Period for the Adjunct Medical Benefits Program is March 1 through March 31, 2020 for medical coverage April 1, 2020 through September 30, 2020. For information see the following:

Announcement

Adjunct Medical Benefits Eligibility and Enrollment Information

Premium Payment Voucher

 

Required Forms:

Declaration of Eligibility Form

Medical Plan Selection Request Form

Verification of Teaching Load Form

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


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.

 

If you have any questions or need assistance with these documents, please contact Human Resources at 707-527-4954