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 medical coverage?
If you enrolled in medical coverage, you will receive a Form 1095-B from your medical provider. Information from Form 1095-B can be used in completing your Federal income tax return. (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 2019.
The deadline for employers to provide employees with Form 1095-C is March 2, 2020, so if you are considered a full-time employee under the ACA guidelines, you could expect to receive the 1095-C form from Santa Rosa Junior College prior to March 2. Retirees do not receive form 1095-C from Santa Rosa Junior College.
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:
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)
- Blue Shield of California HMO
- Blue Shield of California PPO
- Blue Shield of California Account Based Health Plan with a Health Savings Account (HSA)
- 2019 rate chart of all plans effective October 1, 2019 through September 30, 2020
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 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 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
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:
- Employee Assistance Program (EAP)
- Blue Shield PPO plan: Ambulatory Surgery Center option
- Chiropractic and Acupuncture benefits for the Kaiser HMO Traditional Plan
- 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.
RETIREE BENEFITS - for retirees age 65 and over
Faculty - Click 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.
Listed below are annual notices provided for informational purposes.
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:
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
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