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Open Enrollment

Name Contact Responsibilities
Ron Owen
Senior Benefits Analyst
415.883.2211 ext. 8159
rowen@marin.edu
 
Peggy Isozaki
Fiscal Services Director
415.883.2211 ext. 8160
misozaki@marin.edu
Fiscal Services Administration


Monday, June 29, 2015 – Tuesday, August 25, 2015
Deadline: Tuesday, August 25, 2015, 5 pm at IVC

Announcements

We are pleased to announce the 2015-2016 Annual Open Enrollment for all benefit eligible employees. Open Enrollment will be held Monday, June 29, 2015 through Tuesday, August 25, 2015. Any enrollment changes for you or your dependents will go into effect on October 1, 2015, with any employee premium contributions beginning on the September 2015 payroll. The district caps remain unchanged.

GOOD NEWS – For plan year 2015-2016, the overall rate increase is 1.56%.

If you are satisfied with your current coverage, there will be no action needed.

Open Enrollment Memo and Instructions

Medical Plan Election Form

Kaiser Enrollment Form

Blue Shield Enrollment Form

Flex Week Open Enrollment Sessions for Health Benefits

Tuesday, August 11, 2015 – 11 a.m. KTD  (Room TBD)
Tuesday, August 11, 2015 – 1 p.m. KTD  (Room TBD)
Tuesday, August 11, 2015 – 3 p.m. IVC (Room TBD)

Plan Documents

Kaiser

Traditional Plan - Summary of Benefits

Open Enrollment Guide for Traditional Kaiser Permanente plans

Deductible HMO Plan - Summary of Benefits

Open Enrollment Guide for Deductible HMO Kaiser Permanente plans

Kaiser's List of Covered Zip Codes for the Northern California Service Area

Blue Shield PPO

Blue Shield of California 100% Plan A - Summary of Benefits

SISC Blue Shield of California 100% Plan A / $20.00 Copayment (update pending)

Blue Shield of California 80% Plan K - Summary of Benefits

SISC Blue Shield of California 80% Plan K / $30.00 Copayment (update pending)

SISC Blue Shield of California: Minimum Value Plan - Summary of Benefits

Open Enrollment Guide for Blue Shield PPO plans (2015-2016 Enrollment Guide - update pending)

Delta Dental

Active Employees
Retired Employees

VSP

VSP Vision Benefit Summary

Open Enrollment Forms

Step 1: Complete Medical Plan Election Form

Step 2: Complete Enrollment Forms

Step 3: Provide Required Dependent Eligibility Information

Other: Complete Agreement to Save Taxes on Premiums (complete Option 3 on this form)

 

Open Enrollment for Pre-Tax Benefit Enrollment - Aflac and WageWorks

Flexible Spending Account (FSA)

Flexible Spending Account - For Permanent Employees: If you have any out of pocket share toward the premium, you may want to consider having the deductions taken on a pre-tax basis.  By signing up for this option your federal, state and social security deductions will decrease.  Please complete, sign and return the FSA Enrollment form below to the Benefits Office, Fiscal Services at IVC by Tuesday, August 25, 2015.

FSA Enrollment Form

FSA Enrollment Form Example

For additional information on the FSA/Dependent Care Programs, please visit the Wage Works website. If you have additional questions, please call Wage Works Customer Service at 1.800.950.0105; please request to speak with an agent even if you are not a current participant.

Please submit completed forms to the Benefits Office, Fiscal Services by Tuesday, August 25, 2015.

Commuter Benefits Program

Bay Area Commuter Benefits Program:  Claim up to $130 per month of transit or van pooling expenses

Commuter Benefits Enrollment Form

For additional information on the Commuter Benefits Program, please visit the Wage Works website.  If you have additional questions, please call Wage Works Customer Service at 1.800.950.0105; please request to speak with an agent even if you are not a current participant.

Please submit completed forms to Fiscal Services by Tuesday, August 25, 2015.

Aflac Accident and Cancer Plans

If you are a current policyholder you with Accident, Cancer, or Disability Plans, there is no action required.  Your plan(s) will automatically rollover.

If you are not currently enrolled in Aflac Plans, review the information below.

Accident Indemnity Coverage: A cash benefit for injury on or off the job.

Cancer Indemnity Coverage:  Cash benefits in the event of cancer diagnosis and annual cancer screening benefits.

For additional information on Aflac's Accident and Cancer In de mi ties please follow the links above.  If you have additional questions, please contact the District's Aflac Representative, Donna Reeve 415.250.0540.

College of Marin Enrollment Form

Resources and Contact Information

KAISER – Group #554
Get immediate assistance to your routine questions by calling KP Member Services at 800-464-4000.            

Blue Shield
Contact your Member Services Team at 1-800-642-6155.

Delta Dental
Visit web site: www.deltadentalins.com/enrollees

VSP
Call 1-800-877-7195 for details on your vision plan or go to www.vsp.com

Self-Insured Schools of California
Visit web site:  http://sisc.kern.org/hw/

Benefits Office

For specific questions please contact Ron Owen, Sr. Benefits Analyst at extension 8159 or (415) 884-3159.


Fiscal Services Website
Content Responsible: Peggy Isozaki, Director of Fiscal Services, 415.883.2211 ext. 8160
Technical Contact: Melinda Molloy, Executive Assistant to the Vice President of College Operations, 415.883.2211 ext. 8101