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Overview

District health plans are provided to all eligible district employees and their dependents.  Features of the individual plans available are as follow:

DISTRICT HEALTH INSURANCE

I.  BLUE CROSS PPO

  • Calendar Year Deductible - The employee pays the first $200 per individual / $400 per family.       
  • Calendar Year Co-pay Maximum - $400 per individual / $800 per family (In Network).
  • Office Visit - $10 co-pay (Deductible is waived).
  • Professional & Diagnostic Services - 90/10 (In-Network) - 70/30 (Outside Network).
  • Durable Medical Equipment – 90/10 (In-Network) – 70/30 (Outside Network).
  • Prescription Coverage - $10 co-pay Generic / $20 co-pay Brand Formulary / $40 co-pay Brand Non-Formulary.
  • Cost - $25 per month paid by employee for employee and dependents.

II.  BLUE CROSS HMO

  • Calendar Year Deductible – No Deductible.
  • Calendar Year Co-pay Maximum - $1,500 per individual / $3,000 per family.
  • Office Visit - $10 co-pay.
  • Professional & Diagnostic Services – $10 co-pay.
  • Durable Medical Equipment – The employee pays 20% up to $5,000 per calendar year.
  • Prescription Coverage - $5 co-pay Generic / $5 co-pay Brand Non-Formulary.
  • Cost - $25 per month paid by employee for employee and dependents.

III.  KAISER FOUNDATION HEALTH PLAN (HMO)

  • Calendar Year Deductible – No Deductible.
  • Calendar Year Co-pay Maximum - $1,500 per individual / $3,000 per family.
  • Office Visit - $10 co-pay.
  • Professional & Diagnostic Services – No charge.
  • Durable Medical Equipment – The employee pays 20% up to $5,000 per calendar year.
  • Prescription Coverage - $5 co-pay Generic / $5 co-pay Brand Formulary / $5 co-pay  Brand Non-Formulary.
  • Cost - $25 per month paid by employee for employee and dependents.

DISTRICT DENTAL PLANS
The District provides two dental plans for its employees. 

I.  DELTA DENTAL

  • Coverage - The plan pays the usual, customary and reasonable fees for dental services.  Delta Dental will pay 70% of the covered fees for the covered basic benefits during the first calendar year.  The portion that Delta Dental will pay, increases to 80% and 90%, respectively, during the subsequent calendar years.
  • Cost - Premium is paid by the District for the EMPLOYEE ONLY.  Cost share for dependents paid by employee.  Cost for 1 dependent, or 2 or more is subject to change at the beginning of each plan year.

II.  UNITED CONCORDIA DENTAL PLAN 

  • Coverage - HMO dental benefits and coverage without charges, with a co-pay required for some stated principle dental work and for any excluded procedures. You are required to elect a primary dentist.  Members enrolled in the UCCI Plan must use a dentist who is a registered professional provider for UCCI.
  • Cost - Premium is paid by the District for the employee and their dependents.
  • Additional Information:  Subject to applicable benefits, with co-pay limitations on excluded services and/or procedures, all usual customary and necessary dental care is provided under this plan.

DISTRICT VISION PLAN 

  • Summary of Vision Benefits -  Exam $10 co-pay.  Comprehensive Vision Exam one every 12 months.  Lenses - one pair every 24 months*.  Frame - one frame every 24 months.  Contact Lenses one pair every 24 months*.  *Lenses are available at 12 months if there is the following prescription change: a change in prescription of 0.50 diopter or more in one or both eyes; or a shift is axis of astigmatism of 15 degrees; or a difference in vertical prism greater than 1 prism diopter.
  • Cost - Premium is paid by the District for the EMPLOYEE ONLY.  Cost share for dependents paid by employee.  Cost for 1 dependent, or 2 or more is subject to change at the beginning of each plan year.

VOLUNTARY LIFE INSURANCE

Voluntary term life insurance is provided through Lincoln Financial Group (LFG).  This option offers employees the opportunity to buy coverage for themselves and their eligible dependents with the advantage of group term rates and simplified underwriting requirements.

VOLUNTARY SHORT TERM DISABILITY

Voluntary short term disability protects your income in the even you are disabled for longer than 14 calendar day.  LFG covers 35% of your weekly salary to a maximum benefit of $1,500/week.  This benefit is up to 24 weeks of disability.

VOLUNTARY LONG TERM DISABILITY

Voluntary long term disability protects your income in the even you are disabled for longer than 180 calendar day.  LFG covers 60% of your monthly salary to a maximum benefit of $7,500/month.  This benefit is provided to employees until they reach Social Security Normal Retirement Age (SSNRA).

FLEXIBLE SPENDING ACCOUNT PROGRAMS

Each year you must complete a new enrollment form in order to participate

Flexible Spending Accounts 125 Plans

  • Health Care Account up to $2,650 per plan year
  • Dependent Care Account up to $5,000 per plan year

Each year, you must complete a new enrollment/deduction form in order to participate in flexible spending accounts provided by WageWorks.  FOr more information, please attend an Open Enrollment meeting and ask to speak with our benefits broker.

SUPPLEMENTAL PLANS

AFLAC

  • Voluntary Accident Plan
  • Voluntary Hospital Plan
  • Voluntary Hospital Indemnity Plan
  • Voluntary Recovery Plan
  • Voluntary Sickness Plan
  • Voluntary Critical Illness Plan

SchoolsFirst FCU

  • 403(b)
  • 403(b) ROTH
  • 457(b)
  • Tax-Sheltered Annuity (TSA)

For more information, please review the Hawthorne School District Enrollment Guide or contact Rita Encalada, Employee Benefits Technician, at (310)676-2276, ext. 3967 or at rencalada@hawthorne.k12.ca.us.


Open Enrollment is the ONLY time during the year when insurance changes can be made.