Health & Dental Insurance

Health Insurance

Suffolk Public Schools offers its employees two choices of health insurance plans through Anthem Blue Cross Blue Shield.  The HealthKeepers 10 HMO is available for those who prefer lower premiums and the highest level of managed care.  The KeyCare 15 PPO is available for those who desire less restrictions and a broader network of providers.  Enrollment in any plan must be completed within 30 days of your official hire date, otherwise you will forfeit participation until the next plan year, for which open enrollment is held each May.  Other qualifying status changes must also be applied for within 30 days of the change (see “Other Insurance Facts” below).  The plan year begins on October 1st and ends on September 30th of each year.

Anthem plan information, including benefits, provider lists and prescription information are available through the links below.

HealthKeepers (HMO)

KeyCare (PPO)

 

Medical Provider Directory

The monthly rates are paid on a 10-month basis.  The dual rates apply when a married couple are both employed by Suffolk Public Schools, are both eligible for insurance benefits and are both on the same plan.  Below are the employee rates for the 2009-2010 Plan Year:

 

HealthKeepers 10 – HMO

EmployeePer Month

Employee Only

$  24.30

Employee Plus One

293.40

Employee Plus One Dual

  24.30

Family

412.50

Family Dual

  24.30

KeyCare 15 –PPO

EmployeePer Month

Employee Only

$  102.30

Employee Plus One

454.40

Employee Plus One Dual

185.30

Family

630.50

Family Dual

242.30

 

Current Dental Insurance

 

Suffolk Public Schools also offers two choices of dental plans through Anthem Blue Cross Blue Shield.  The Dental Indemnity I (Basic) Plan provides services for diagnostic and preventive care and basic dental care including fillings and oral surgery.  The Dental Indemnity III (High) Plan includes the above benefits and adds prosthetic and complex restorative services, including crowns and bridges, and orthodontic services.  All benefits have calendar year deductibles and maximums.  Orthodontic services have a $1,000 lifetime maximum per person and only cover dependent children under 19 years old.

Anthem Dental plan information, including benefits and provider lists are available through the links below.

Indemnity I (Basic) Indemnity III (High)

Dental Benefits Comparison Chart

The same rules apply for dental insurance enrollment and changes as discussed above under health insurance.  However, you do not have to enroll in a health insurance plan to participate in a dental plan.

The monthly rates are paid on a 10-month basis.  The dual rates apply when a married couple are both employed by Suffolk Public Schools, are both eligible for insurance benefits and are both on the same plan.  Below are the employee rates for the 2009-2010 Plan Year:

Dental Indemnity I (Basic)

Employee Per Month

Employee Only

$  9.50

Employee Plus One

23.78

Employee Plus One Dual

14.26

Family

49.46

Family Dual

39.94

Dental Indemnity III (High)

Employee Per Month

Employee Only

$19.38

Employee Plus One

41.06

Employee Plus One Dual

31.54

Family

80.06

Family Dual

70.54

 

Other Insurance Facts

  • Effective October 1, 2010, health care reform legislation allows young adults to be covered under the Employee Plus One or Family Plans until the end of the calendar year in which they turn 26, regardless of dependent status.
  • An employee is only allowed to add or change coverage if there is an eligible family status change.  Any add/change must be submitted within 30 days of the qualifying event including proper written documentation.  All other changes can only be made once a year during open enollment.
  • Qualifying Status Change

 

Coverage after Retirement

If eligible, Suffolk Public Schools’ employees may keep their health insurance coverage once they retire.

Retirees may remain on the group health plans to the age of 65 if the following qualifications are met:

  • Retiree qualifies for regular or disability retirement through the Virginia Retirement System.
  • Retiree must have been employed with Suffolk Public Schools for a total of ten years.
  • Retiree must have carried group health insurance with Suffolk Public Schools for the twenty-four (24) months prior to retirement.  The retiree may elect the same or a lower tier of coverage.  For example, the retiree may change from KeyCare to the HMO, but not the reverse, or from family to retiree only, but not the reverse.
  • Retiree must execute VRS-78 Premium Deduction & Health Insurance Credit Authorization Form which allows VRS to deduct the insurance premiums from the retiree’s monthly VRS retirement check.  Only in those cases where the VRS monthly retirement check is not sufficient to pay the monthly insurance premium will a retiree be permitted to make payments directly to Suffolk Public Schools.

The School Board pays a portion of the HealthKeepers 10 HMO retiree only plan and applies the amount to other levels of retiree coverage.  Health plans, rates and employer shares are subject to change annually by the School Board.  Although retirees are not eligible to remain on our group dental insurance plans to age 65, retirees may remain on their existing dental plan or a lower tier dental plan for eighteen months under the federal COBRA law.

 

Coverage after Separation from Employment (other than retirement)

Under the federal COBRA law, employees losing medical coverage due to voluntary or involuntary termination (other than for gross misconduct) of employment or a reduction in hours may continue to maintain their coverage in the School Board’s group at their own expense (current premium plus a 2% administration fee) for themselves and their dependents for up to 18 months or until they become covered under Medicare or some other group insurance option (unless that plan has a pre-existing condition limitation).  This does not apply to employees who have retired.  A special continuation period applies to qualified beneficiaries who are certified disabled under the Social Security Act before their normal 18 month continuation ends.  These individuals are entitled to a total of 29 months of continuation. Dependents of covered employees who would otherwise lose their coverage due to death, divorce, or legal separation or other loss of dependent status may continue with the School Board’s group at their own expense (current premium plus 2% administration fee) for up to 36 months or until they become eligible for Medicare or other insurance coverage.

 

Phone Numbers for Insurances

Anthem HealthKeepers Product 10 HMO Plan 757-326-5260 (local)
Anthem KeyCare 15 Plan 1-800-451-1527
Anthem Dental 1-800-453-3622

 

Questions Regarding any of the above Insurances

Questions concerning any type of health or dental insurance should be directed to Melissa Gardner in the Finance Department at 925-6756 or by emailing her through the school system’s email system.  For additional information regarding these plans or specific benefit questions, you may contact the health and dental companies at the above phone numbers or by clicking on their respective logos above to go directly to their web sites.

 

Current Employee & Medicare Eligible

Important Information on the Medicare Part D Prescription Benefit

In January 2006, Medicare added a new prescription drug benefit, Part D, for those who are Medicare eligible. Current employees of Suffolk Public Schools who also participate in our Anthem health insurance plans do not need to take any action at this time since your Anthem health insurance is your primary insurance.  It has been determined that your current prescription benefits are on average at least as good as standard Medicare prescription drug coverage (creditable coverage).  Because of this determination, you may enroll in the Medicare Part D prescription drug plan without penalty if you enroll within 63 days after your Anthem health insurance coverage ends.  If you are interested in the Part D plan when your current Anthem coverage ends, it is very important to enroll within the first 63 days to avoid a penalty.

For more information:

  • www.medicare.gov
  • Refer to your copy of Medicare & You handbook
  • Call 1-800-MEDICARE (1-800-633-4227)
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