COBRA Reimbursement for employees coming Olney and Stetson at the start of 2022-2023 School year

For staff from Olney and Stetson Charter schools who joined the SDP at the start of  2022-2023 school year, the District will reimburse for COBRA expenses to bridge the coverage gap from the end of your coverage through Aspira and the start of coverage with the District.

You should have received your COBRA materials to continue health coverage on a self-pay basis. Their COBRA administrator, Wage Works can be reached at 844-330-7295, option 3 or at COBRAserviceteam2@WageWorks.com

To request Reimbursement,

  1. submit an SEH-195 Complete the following:
    1. Month/Day/Year
    2. Name
    3. Employee ID
    4. School
    5. For Type of Reimbursement Select “Other”, enter”
    6. List each payment by date with a reason for Expenditure of “Medical Coverage Continuation/Olney (or Stetson) Charter”
  2. Provide the following supporting documentation
    1. Proof of payment; a print out of online payment through paycom, printout from COBRA portal showing paid date, cancelled check or other valid proof
    2. Copy of your original COBRA enrollment packet with premium information

If you paid for more than one month of coverage, please submit for reimbursement in one submission for the entire period

If you have enrolled in COBRA, you can view your payment history on their Client Web Portal by going to your profile and looking under “Billing Information”. It will list the payment’s you have made and the date.

If you elected Affordable Care Coverage or other coverage directly from an insurer in lieu of COBRA, the District will reimburse only up to the cost of COBRA coverage.

Documents should be sent for approval to:

OFFICE OF TALENT
Shaniece Bankhead
2ND FLR – PORTAL B – SUITE 202
440 N BROAD ST
PHILADELPHIA, PA 19130
Fax: 215- 400 – 6105
EMAIL: stcollins@philasd.org

Approval may take 5-7 business days before your request is submitted to Accounts Payable.  The have a 7 business day turnaround and will queue the payment to go into your next paycheck process.

Deadline to submit requests is Wednesday, November 30, 2022.