2018-19 Benefits Forms &Open EnrollmentHello! Welcome to the Benefits Forms and Open Enrollment page for DMUSD. Before getting started, please take a moment to look at our DMUSD Employee Benefits Guide for a comprehensive overview of the benefits available through the Del Mar Union School District. All District employees are eligible for any of the voluntary plans offered through participating carriers.
The open enrollment period for 2019 benefits elections will be from September 24 through October 12. This is the one time per year you can make any changes you want to the benefits plans available to you. You may enroll in or drop any of the plans, add or delete dependents, or change medical plans.
We are happy to announce that this year's open enrollment will be administered by American Fidelity Assurance (AFA) through our new online open enrollment system. For the implementation, every employee working 20 hours per week or more will need to meet with an AFA rep on their school site's visitation day. As we are now going paperless, you will need to verify your account information and make any enrollments or changes through the system. Please set an appointment on the scheduled date with your site’s Administrative Assistant. AMERICAN FIDELITY ENROLLMENT SCHEDULEChanges for all benefits plans will be for the effective date of 1/1/2019. Depending on the insurance billing method, you will see the premiums affected in December's or January's paycheck.This year's District Health Fair will be at Ocean Air on Wednesday, October 10 from 1-4pm for free flu shots and insurance information!PLEASE NOTE: Medical, Dental, Vision, and Life insurance enrollments and changes must be done on their individual respective enrollment forms, all available below. Please fill out and scan your forms to Marco Guajardo at email@example.com (858-523-6192).NEW EMPLOYEESFull-time 40 hour per week employees are eligible for the full district-sponsored benefits package. Part-time 30-39 hour per week employees are eligible for the part-time district-sponsored Medical plans. Part-time 20-29 hour per week employees are eligible for the part-time district-sponsored Medical plans after 3 consecutive years of service with the District. See the Medical Insurance section below for information on available plans and rates.You can also see our New-hire Benefits Information packet for a general overview and enrollment forms:EMPLOYEE ASSISTANCE SERVICE FOR EDUCATION (For all DMUSD Staff)EASE is a professional, confidential and free service to help you resolve your personal or job-related problems. The EASE Specialists are licensed, trained therapists who will assess the nature of your problem(s) during one to six (6) face-to-face sessions or telephonic or web-video consultation for problem-solving support per incident, per calendar year. The toll-free phone number 1-800-722-EASE is available 24-hours a day, seven days a week.EASE - Employee Assistance Service for Education (Personal Life Consultations)(858) 277-(3273)MEDICAL INSURANCEMedical Enrollment & Change FormsPlease submit all of the following forms that apply for the corresponding Medical insurance changes:1. DMUSD Election Form - Enroll in a new plan/Change your insurance2. Carrier Enrollment Form - Enroll in a new plan/Change your insurance3. Change Form - For dependent changes (add/drop) & personal information changes4. Required Dependent Documentation - For all dependent enrollmentsMedical Plan Information and GuidesPlease visit the 2017 Benefits Summaries page to view full Medical plan coverage information.2018 Medical Plan Comparison Sheet with Rates (Full-time)2018 Medical Plan Comparison Sheet with Rates (Part-time)Open Enrollment Update:2019 Medical Plan Comparison Sheet with Rates (Full-time)2019 Medical Plan Comparison Sheet with Rates (Part-time)Mid-year Plan ChangesMid-year plan changes may only be processed outside of Open Enrollment if a Qualifying Event occurs. The change and any required documentation must be submitted within 31 days of the qualifying event date. Please see the following list of Qualifying Events and the allowable changes:Don't forget that our benefits administrator, SISC, offers a list of free additional services and benefits to Kaiser and Anthem members:MDLive! (Live Medical Assistance through Anthem!)Advance Medical (World Class Second Opinions)COSTCO (FREE generic RX for Anthem)Health Smarts (Family Health Screenings) - Ask your HR/Benefits DepartmentKaiser Clinics in Target - (Personalized Kaiser care at participating Targets)Employee Assistance Program (All Anthem Members)Medical Coverage for Out of State Dependents & Travelling MembersWAIVE COVERAGEIf you plan to waive the District’s Medical, Dental and Vision coverage for any plan year, you must return a new waiver form with proof of other group (spousal), Military, or Medicare insurance coverage. Full-time employees must waive all plans together if electing to waive.FRINGE BENEFITS (Full-time staff)Dental & VisionEnrollment and changes to Delta and VSP plans for full-time employees
Delta Dental Enrollment Form & EOC- Include all dependents on planVSP Vision Enrollment Form - Include all dependents on planThe Hartford Group Term LifeInsurance policy forms and services for full-time employeesHartford Group Life Enrollment Form - New-hire enrollment or full-time transitionDesignation of Beneficiary - Include with enrollment form and to update beneficiariesClaim Form - Accidental death claim formContinuation of Coverage - Continue policy after termination of employment