CalPERS Health Benefit Information
New employees are given an information packet that provides descriptions of the health plans Turlock Unified School District offers their employees. Enrollment forms for dental, vision and medical are enclosed in the packet – a form is also required in case you decide to opt out of the District medical plan. Please read the information carefully before making your choice. You may wish to call your present physician or dentist to see if he/she is a provider for District plans, as it may help you make your decision as to which plan to select.
Our medical insurance is purchased through the California Public Employees’ Retirement System (CalPERS – www.calpers.ca.gov). Offered plans are:
- HMO plans - Blue Shield of California and Kaiser Permanente.
- PPO plans offered are PERS Select, PERS Choice and PERS Care, all of which are administered under Anthem Blue Cross
All PPO plans have a $500 per calendar year deductible for up to two family members. The premium costs differ according to the number of family members insured.
The District offers four dental plans:
Delta Dental Incentive, United Healthcare-PUD, Delta Dental (PPO), and Delta DentalCare DHMO. Dental insurance is mandatory as our group requires 100% participation. The Delta Dental Incentive and the United Healthcare plans cover your entire family at a composite rate (no change of premiums for Single through Family). The Delta Preferred PPO and the DentalCare DHMO plans both have a three-tier rate structure, and are billed according to the number of family members covered.
Vision Service Plan (VSP) is our vision insurance carrier. The plan requires all new benefit eligible employees to carry this insurance with the option for family coverage at a higher premium.
The Benefit Selection Sheet lists the cost of all plans. After making your choice, you must come to the payroll office at the District Office, (upstairs, room 214) to complete enrollment forms for medical (to enroll or decline), dental and vision insurance. You can determine your approximate cost by completing the Benefit Selection Sheet.
Medical, dental and vision premiums generally increase January 1st of each year. Your payroll deduction will be automatically adjusted when this occurs. If you do not apply for medical coverage at the time you are employed, you may sign up during the open enrollment period which occurs annually. This enrollment period will normally coincide with CalPERS’ open enrollment period, usually ending early October with a January 1steffective date.
Medical insurance is optional, and in the event you decide to decline medical coverage, any left-over monies from your benefit package will be paid to you as taxable income.
If you have a payroll deduction due to health insurance expenses, you may choose to enroll in a premium conversion plan - the IRC Section -125 Plan. All new employees are required to meet with a representative from American Fidelity to either elect or sign-off the Section-125 Plan.
Under the Internal Revenue Code, your deduction for medical premiums is tax exempt; payroll will subtract your medical payroll deduction from your gross income prior to calculating taxes. This will increase your net pay since you will not be paying Federal or State income tax, or Social Security tax if applicable, on your payroll deduction. If you choose not to sign up for the IRC-125 plan, your payroll deduction will be subtracted from your NET pay. Under the IRC-125 Plan we also offer expense reimbursement accounts through American Fidelity Assurance Company. This program allows you to establish an account to reimburse dependent care and/or medical expenses on a tax-exempt basis. The district MUST have your completed American Fidelity forms stating your choice to participate in the plan. Please ask about making an appointment with American Fidelity when you enroll in the health plans.
Under the IRC-125 Plan, the benefit elections made during the enrollment period will remain in effect for the plan year (calendar year). Internal Revenue Code Section-125 prohibits changing health benefit coverage levels during a plan year without a change in family status affecting your need for a benefit. These changes are called “qualifying events” and the event must be consistent with the change in family status that has occurred. The following circumstances are examples of events that qualify as a change in family status: marriage or divorce; birth or adoption of a child; death of a dependent child or spouse; a change in the employment status of the employee or spouse such as the termination or commencement of employment; or going from part time to full time or full time to part time. You will be required to offer proof of your change in status.
When a qualifying event occurs, you have only 30 days to report this change to your employer.
Your coverage is effective on the first of the following month, normally within 30 days after your employment starts. If you have any questions, please contact the payroll department at 667-0645 (ext 2414).