2019-2020 Open Enrollment

2019-2020 Staff Benefits Open Enrollment

   2019-2020 Enrollment Forms
are located at the bottom of this page.

The Open Enrollment season for 2019 is upon us. Our Open Enrollment period begins now, with a deadline to submit all forms and documents to HR by no later than May 31, 2019.  Please read this e-mail carefully.  It contains important information regarding benefit elections, deadlines to submit forms, and elections and forms that are required to be submitted every year.  This year, as in the past year, anyone who is enrolled in the District’s health insurance plan, is on Cigna’s “Yellow” Plan, or Consumer-Driven Health Plan (CDHP).  The premium rates for health insurance have been reduced by 3.5% for the 2019-2020 year.  Please contact either myself or Melissa Witherspoon in HR if you have any questions.

We anticipate SchoolCare may conduct a routine audit in the coming weeks.  You may be asked to provide supporting documentation to confirm the eligibility of those who are enrolled in your health insurance plan.  If you have experienced a change in marital status, you must inform the HR Department.  SchoolCare does not allow former spouses, or even those who are legally separated, to be insured on our plan.

Schedule of Open Enrollment Meetings
(you are invited to attend any of these sessions – even if it’s not held in your respective building)

Wednesday, April 17  3:00pm
Christa McAuliffe SchoolConference Room

Tuesday, April 30  3:00pm
Beaver Meadow School Media Center

Wednesday, May 1  3:00pm
Mill Brook School Library

Tuesday, May 7 (Two Meetings)
 Transportation Office  9:00am
Rundlett Middle School  4:00pm – Media Center/Library

Wednesday, May 8  3:00pm
Central Office Board Room

Monday, May 13  3:00pm
Concord High School Media Center/Library


2019-2020 Benefits Election Form – this form must be completed by every employee, every year, regardless of your election(s) of benefits.  It will serve as confirmation for the District that you understand the various benefit options being offered.  It must be returned to the HR Office by no later than May 31, 2019.  This is an annual requirement of the Affordable Care Act.

In addition, you must take the Health Risk Assessment between June 1 and July 31 in order to activate your “Choice Fund” ($1,000 for single plans and $2,000 for 2-Person or family plans). Visit www.mycigna.com to take this assessment.

2019-2020 Health Insurance Enrollment/Change Formthis form needs to be completed if you are making any changes to the level of coverage (single, 2-person, family) or if you are adding or deleting family members from the plan.  It must be completed and returned to the HR Office by no later than May 31, 2019.

2019-2020 Health Insurance Benefit Plan Summary Forms – two documents are attached.  One is required by the Affordable Care Act which provides greater detail, and the other is more of a brief outline of the benefits provided by the CDHP “Yellow” health plan.

Declination Payment Information and Attached Form – if you qualify for this benefit (check your respective collective bargaining agreement for further details) you must submit proof of insurance (a copy of a valid insurance medical card is sufficient evidence), together along with this completed 2019-2020 Declination of Insurance form, both of which must be received in the HR Office by no later than May 31, 2019.  Late submissions cannot be accepted or processed.  You must complete this form every year – it does not automatically renew year after year, even if you received the declination payment this year or in years past.

Dental Insurance And Vision Information and Attached Forms – these forms must be used to make any changes to your dental insurance plan and/or Vision Coverage. 

Flexible Spending (Section 125) Program Information and Form – the 2019-2020 Flexible Spending Enrollment form is attached.  All flexible spending enrollment forms must be received in the HR Office by no later than May 31, 2019.  Forms received after the May 31st deadline cannot be accepted or processed per IRS rules and regulations.

The money you elect to have deducted from your payroll check (over 20 pay periods) is available to you on July 1st, however, if you want to ensure you have access to your funds, you should return this enrollment form to the HR Office as soon as you can.  Please note:

  • Debit cards issued to employees (and spouses) will cost the employee $5. 
  • The maximum amount you can have deducted for medical expenses this year is $2,700.  (Child care maximum remains at $5,000)
  • Rollover amounts must exceed $50.  If you have a balance in your flexible spending account of between $50 and $500 in June 2020, it will be rolled over. 


Voluntary Life Insurance:

Mutual of Omaha Voluntary Life Insurance Enrollment Form – if you are an employee with District-paid basic life insurance (refer to your respective collective bargaining agreement for further details), you have an option during open enrollment to purchase additional life insurance above and beyond what the District pays for.  You can also purchase life insurance for your spouse and/or dependent children.  If you currently have dependent life insurance coverage and your dependent is 19 years old (or up to 26 years of a full-time student), you will need to contact Melissa Witherspoon in order to terminate coverage.   If you are purchasing voluntary life for the first time, please contact Melissa Witherspoon in HR, as you will need to complete and submit to her the evidence of insurability form (attached).

This is a good time to make sure you have listed with us a beneficiary for the life insurance benefit.  If you would like to change your life insurance beneficiary, please complete this form to designate or change a beneficiary.

We strongly encourage you to attend an open enrollment session should your schedule allow.  You may find that you were unaware of certain changes, provisions and benefits, or perhaps you have questions about a particular insurance.  Representatives from SchoolCare and from our Insurance Broker, Borislow Insurance (formerly IPG Employee Benefits), will be on hand at these meetings to answer any questions or concerns you may have.

The 2019 Legal Notices, Marketplace Notice and CHIP Notice can be found on our website at: http://sau8.org/departments/human resources/payroll/notices.

Please contact either Larry Prince or Melissa Witherspoon in HR if you have any questions.

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