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Employee Health Benefits

The Tehama County Department of Education (TCDE) offers a benefits package to eligible employees. Benefits may differ by class and union bargaining unit.

Employees who are eligible for benefits, but work less than full-time, can elect to participate with an additional out-of–pocket cost. Employees must work a minimum of 20 hours per week to be eligible. The employer contribution to part-time employees is proportionate to the number of hours and days worked in relation to full-time equivalent (FTE). All full-time (8 hours per day/12 months per year) or 1 FTE eligible employees are required to participate in the health benefit programs as designated by their unit or group as follows:

2012-2013


2011-2012

Initial enrollments for all plans take place at the time of hire within 30 days. Medical insurance, dental insurance, and vision insurance have a yearly open enrollment period normally April 15-May 15 during which an employee selects the plan option for an effective date of July 1. Employees selecting medical insurance must also participate in the dental insurance. Vision insurance or life insurance may be selected independently of the others.

The deductible year for all plans is January 1 through December 31.

For more information on eligibility, participation requirements, benefits designs, cost, and employer/employee contributions, please contact Human Resource Services.

Medical Insurance

Tri-County Schools Insurance Group (TCSIG) is the district's plan administrator for our medical insurance. Tri-County Schools Insurance Group is a non-profit, joint powers authority working to the mutual advantage of employers and employees by providing each district, county office of education or other public entity health care options, while maintaining the most comprehensive and affordable health care coverage available. Their contact information is as follows:

Tri-County Schools Insurance Group (TCSIG) 1445 Butte House Road, Suite A Yuba City, CA 95993 (530) 822-5299 (866) 822-5299 www.tcsig.com

For information regarding our employee health care plan, please consult the TCSIG Web site for complete details.

To review a summary of your plan benefits including Deductibles and Coinsurance, please see item number 24 on the forms page.

Eligible employees are required to complete an enrollment form and submit it to Human Resource Services within 30 days of hire or within the enrollment period, normally mid-April to mid-May. Late enrollments will not be accepted. If enrolling dependents, the following documentation is required to be submitted with all enrollments:

  • A copy of the marriage certificate is required for all new spouses of current employees and at the time of hire for spouses of new employees.
  • A copy of the Declaration of Domestic Partnership filed with the state will be required for all new domestic partners of current employees and at the time of hire for domestic partners of new employees.
  • A copy of the birth certificate will be required for all newborns of current employees and at the time of hire for all dependents under the age of 19 for new employees.
  • Proof of student status or IRS dependency will be required for all dependents, ages 19-25, of new hires and current employees.

The processing of claims for benefits under the terms of the health care plan is provided through a company contracted by TCSIG and is the designated claims administrator. Our claims administrator is:

Delta Health Systems 1234 West Oak Street P.O. Box 1147 Stockton, CA 95201-1147 (800) 422-6099 (800) 464-7627

If you are having a problem with a referral or with getting a claim paid you should contact TCSIG with the following information:

  1. Social security number
  2. Date of service
  3. Amount of claim
  4. Nature of problem
  5. Name of doctor or provider

If the problem is still not resolved to your satisfaction, please call Human Resource Services at 528-7334.

For more information about TCSIG, please visit their website

Dental Insurance

Tri-County Schools Insurance Group (TCSIG) is the district's plan administrator for our dental insurance. Tri-County Schools Insurance Group is a non-profit, joint powers authority working to the mutual advantage of employers and employees by providing each district, county office of education or other public entity health care options, while maintaining the most comprehensive and affordable health care coverage available. Their contact information is as follows:

Tri-County Schools Insurance Group (TCSIG) 1445 Butte House Road, Suite A Yuba City, CA 95993 (530) 822-5299 (866) 822-5299 www.tcsig.com

TCDE employees working full-time (and their eligible dependents) are provided with dental insurance coverage under Delta Dental PPO. Annual maximum benefits renew every January. It is advantageous to go to a participating provider. Under the Delta Dental PPO, Delta pays 70 percent of the approved fees for covered diagnostic, preventive, basic, cast and crown benefits during the first year you are eligible. This percentage will increase 10 percent each year (to a maximum of 100 percent) for each enrollee, provided that person visits the dentist at least once during the year. If any enrollee does not use the program during a calendar year, the percentage remains at the level reached the previous year. If an enrollee becomes ineligible for benefits and later regains eligibility, the percentage will drop back to 70 percent. If you are thinking about having extensive dental work, Delta Dental will provide a predetermination to its enrollees free of charge. In addition, there is an additional $250 to the annual benefit when you use the services of a Delta DPO/PPO dentist. For an example, if you have an annual maximum of $2,000 you have an additional $250 to use above your annual maximum, if you use a Delta DPO/PPO dentist. Annual maximums are as follows: Office Technical Unit--$1,000 yearly maximum California School Employees Association (CSEA)--$1,500 yearly maximum Tehama County Certificated Employees Organization & Management--$2,000 yearly maximum Additionally, all plans include orthodontics at $1000.00 per person lifetime To view the dental plan document please see item number 24 on the forms page. The processing of claims for benefits under the terms of the health care plan is provided through a company contracted by TCSIG and is the designated claims administrator. Our claims administrator is:

Delta Dental Plan of California P.O. Box 7736 San Francisco, CA 94120 (888) 335-8227 www.deltadentalins.com

To contact Customer Service for claim and benefit inquiries, you may call toll-free 1-866-499-3001 (Monday through Friday from 5 a.m. to 6:00 p.m.), or visit their website at www.deltadentalins.com. At this website, an enrollee may check benefits and eligibility; print a customized ID card; find a nearby dentist or check to see if their dentist is a Delta dentist; get answers to frequently asked questions, etc. The Delta Dental Online Customer Service number for northern California is 1-800-765-6003

For more information about TCSIG, please visit their website

Vision

TCOE employees working full-time (and their eligible dependents) are provided with vision care coverage under Vision Service Plan (VSP). VSP provides a full coverage vision plan that covers one examination every 12 months and a pair of glasses or contacts every 24 months. A $10.00 co-pay for the examination and set allowances for frames and lenses apply. If you choose to see a participating provider, the co-pay is $10 per office visit. If you choose to see a non-participating provider, the cost will be greater. Download the brochure here For customer service, or to find a VSP network doctor, go to www.vsp.com, or call 1-800-877-7195.

Section 125 Plans:

TCDE offers optional benefits which meet the requirements of Section 125 of the Internal Revenue Service code. Under the plan, employees may pay for dependent care costs, unreimbursed medical expenses, purchase term life and disability insurance with pre-tax dollars. New employees must enroll within 30 days of employment and existing employees are eligible to enroll during open enrollment each year (generally in August for an effective date of September 1.) http://www.af-group.com

Tax Sheltered Annuities 403(b) and/or 457 Plans:

TCDE offers optional deferred compensation programs for employees which meet the requirements of section 403(b) and 457 of the Internal Revenue Service code. Under these plans, employees can set aside certain amounts of money each pay period through payroll deductions. Under both plans, the participant reduces the amount of current income taxes while saving for retirement. Participants generally do not pay income tax on these funds until they are withdrawn and interest earned is also not taxed until withdrawal. Certain withdrawal restrictions apply. Generally, these funds may not be withdrawn until the employee attains age 59 1/2. These deferred compensation programs are administered for TCDE by Envoy Plan Services. For more information, visit Envoy Plan Services on the web at the address below: http://www.envoyplanservices.com/client.asp?client=teh.

Life Insurance

All TCDE employees, regardless of working part-time or full-time, are eligible for term life insurance through Reliance Standard in the amount of $50,000. This coverage is terminated on the last day of the month in which the employee resigns or is terminated, however, it may be continued at the individual's expense if converted to an individual policy.

Employee Assistance Program

All TCDE employees and their eligible dependants participating in our medical benefits program have access to an employee assistance program contracted for by our insurance provider, Tri-County Schools Insurance Group (TCSIG). This program provides assistance when your personal problems seem to be taking control of your life and job performance. The services are coordinated by Human Behavior Associates, Inc. (HBA).

For more information , please call 1-800-937-7770 or go to www.callhba.com The services brochure can be downloaded here

Disability Insurance

TCDE makes available a voluntary plan option to provide income protection for wages lost because of a disability that was not caused at work through the American Fidelity Assurance Company. TCDE employees are not covered under State Disability Insurance as administered through the Employment Development Department. Employees may at their own expense purchase an income protection plan through the American Fidelity Assurance Company. Please contact the American Fidelity Assurance Company at (800) 365-8306 or www.af-group.com for more information or Human Resource Services. Further explanation can be found in the employee handbook