Commonwealth Assoc of School Administrators (CASA)

Employees represented by the Commonwealth Association of School Administrators (CASA) are offered a complete benefits package including Medical, Prescription, Vision and Dental, Life Insurance and Wage Continuation.  Your options, specific to your union, are explained below.

Medical Prescription and Vision Insurance

The School District of Philadelphia offers employees represented by the Commonwealth Association of School Administrators (CASA)  Personal Choice coverage, provided by Independence Blue Cross(IBC). If you begin full-time work by the 15th calendar day of the month, health coverage becomes effective on the 1st of the following month. If you begin after the 15th, coverage becomes effective on the 1st day of the next succeeding month. Information about Personal Choice IBX.com/SDP.

For downloadable medical forms, please see below.

Summary of Benefits

Medical Forms 

When submitting applications for Enrollment please follow the below guidelines:

  • Health and Attestation Application
  • This application is for all SDP provided health plans. Your prescription and vision are included on your Personal Choice ID.  You will receive a separate Member ID you’re your Dental Coverage, that is provided by United Concordia.
  • Complete all sections in entirety.
    • Please refer to General Documentation Required section for a list of documents that may need to accompany your completed application
    • The completed application and documentation, if required, can be faxed in to the Benefits Office at (215) 400-4631 or emailed to benefits@philasd.org.
    • Please call (215) 400-4630 to confirm receipt.
    • Personal Choice Out-Of-Network Claim
    • Request to Remove a Dependent or Spouse

PLAN OPTIONS

As an employee newly represented by CASA, you may enroll in Modified Personal Choice 320. During your first open enrollment (the month of May for July 1 effective date), you are eligible to remain in the Modified Personal Choice 320 plan or elect the the Personal Choice $20 / $30 / 70% plan. The bi-weekly rates for the plans are listed below.

Prescription

Your prescription drug coverage is provided by Independence Blue Cross and membership information will be on your Personal Choice ID card.  The select drug $10/$15/$25  program has both a retail and a cost saving mail order option.  There is no cost to you for this program.

Vision

Included with your medical and prescription plan is a $100 Vision Program managed by Davis Vision. This comprehensive benefits includes routine eye care, frames and lenses.  Benefits are maximized by using Davis Vision Providers. Paid-in-full benefits for eyeglasses with standard lenses are possible when you choose from a select grouping known as the Davis Collection of Frames.
To locate a participating provider, go to www.ibx.com and click on the ‘Find a Doctor’ feature. and select “Vision Provider”.

Premium Co Share

You contribute a portion of the premium for your medical insurance.  Premiums are based on the plan medical selected and the family members (tier) in which you enroll. Deductions are on a bi-weekly basis; the deductions occurs on every paycheck throughout the year. Deductions are made on a pre-tax basis.

Spousal surcharge: Employees covering a spouse or domestic partner on their Medical coverage will be required to sign an Attestation of Spousal/Domestic Partner Form verifying his/her spouse or same-sex life partner eligibility for employer health coverage. If your spouse/domestic partner qualifies for employer health coverage, you will be subject to a surcharge.

 

Tier Level

Modified Personal Choice 320

5% Contribution for those employees who annual salary is less than $60,000

Modified Personal Choice 320

8% Contribution for those employees who annual salary is  $60,000 or more

Personal Choice 20/30/70%

“Buyup” CASA Contribution for those employees who annual salary is less than $60,000

Personal Choice 20/30/70%

“Buyup” CASA Contribution for those employees who annual salary is $60,000 or more

Single  $12.32 $19.70 $46.52 $53.90
Employee & Child  $17.24 $27.59 $65.12 $75.47
Employee & Children  $22.17 $35.47 $83.73  $97.03
Employee & Spouse or Life partner $24.63 $39.41 $93.04  $107.82
Employee & Spouse or Life partner with Surcharge ($75 per pay)****  $99.63 $114.41 $168.04  $182.82
Family  $36.95 $59.11 $139.55  $161.71
Family with Spouse or Life Partner Surcharge ($75 per pay)**** $111.95 $134.11 $214.55 $236.71

 

**** Per the CASA collective bargaining agreement, the spousal/life partner surcharge increased from $40 per pay to $75 per pay effective September 1, 2018.

United Concordia Dental Coverage

This benefit is provided at no cost to you. With most plans, you pay a percentage of the cost for a procedure and your insurer pays a percentage. Using a network provider maximizes your benefit. How these percentages are determined depends on the types of dental services covered.

Members receive one ID card issued in the employee’s name. Our plan has an annual deductible and coverage maximum. The plan year is from December 1 – November 30. The annual deductible is $25.00 for the individual and $75.00 for a family. The coverage maximum is $2,000.00 per plan year. There is also a Lifetime orthodontic maximum of $1,200.00 per person. Cleaning services are not subject to a deductible. Specific coverage is outlined in the United Concordia Summary of Benefits. You can maximize your benefits if you use participating providers. To find a provider use the Find a Dentist select the Advantage Plus Network or contact United Concordia customer service at 1-800-332-0366.

General Documents Required

If you are adding a dependent to your coverage, you must provide documentation.  Refer to the chart below.  In most instances, you will have to provide at least two documents per dependent. Residential address must match address of record of employee. Address changes are handled by the Payroll Department at (215) 400-4490 or payrollhelp@philasd.org.

To cover a: You must provide:
Spouse Marriage Certificate AND ONE of the following:

  • Current* mortgage statement, home equity loan, or lease
    agreement
  • Current* Property Tax documents
  • Automobile registration that is currently in effect
  • Current* credit card or account statement
  • Current* utility bill in spouse’s name
  • Current* designation as the primary beneficiary for
    life insurance(not SDP sponsored life insurance) or
    retirement benefits, or primary beneficiary designation
    under an employee’s will
  • Assignment of a durable property power of attorney or
    health care power of attorney
  • Valid government-issued ID with address matching
    employee address of record
  • Page 1 and signature page of employee’s most recent
    Federal Income Tax Return (1040, 1040A or 1040EZ) as
    filed with the IRS listing the spouse
  • Page 1 and certificate of filing or email confirmation
    of electronic submission of employee’s Federal Income
    tax Return (within two years)(1040, 1040A, or 1040EZ)
    as filed with the IRS listing the spouse

*Current is less than 1 year old.

Same Gender Domestic Partner Commission on Human Relations letter from the City
of Philadelphia or comparable official document AND ONE of
the secondary documents listed above in the “SPOUSE”
section. ity.
Child under the age of 26

Birth Certificate and social security number.

Proof of dependency may be required. Acceptable proofs of
dependency for children differ depending on the
relationship between the child and the employee (and in
some cases, the employee’s marital status).

Disabled child, age 26 or older Birth Certificate, social security number and Certification
by the insurance carrier as an individual with a
disability.
Stepchild under the age of 26 Marriage certificate indicating stepchild’s biological
parent is married to the employee, birth certificate
listing spouse as parent and divorce decree indicating
spouse is primary care giver or a signed statement
attesting to financial responsibility.

Wage Continuation

Wage Continuation is the School District of Philadelphia’s (SDP) short-term disability program. You may elect coverage to protect yourself from sustained salary loss due to an illness or non-work related injury that extends beyond your sick time.

Should you become ill and exhaust all accumulated sick leave, at the conclusion of a short waiting period (5-7 days), you will be compensated a daily amount consistent with 75 percent of your salary for up to 26 weeks, pursuant to SDP approval.  Expectant mothers may use this benefit to continue their salary for 6-8 weeks from the date of birth of the baby.

In order to qualify for the continued salary benefit, you must be enrolled in the program prior to the injury or illness and your absence will be monitored by the Office of Employee Health Services.

*Enrollment in the Wage Continuation program does not guarantee eligibility of use. You must be approved by the Health Services Department for use of this program. Review the How Do I Use the Benefit? for more information.

Who is eligible for this benefit?

This benefit is extended to all salaried or benefits eligible employees, as outlined in the Collective Bargaining Agreement.

When and how can I enroll?

New employees may enroll at the beginning of SDP service; however, you will not be eligible  for the program until after three (3) months of qualified service, at which time your premium contributions will begin to be deducted from your pay.

  • After your first 30 days of hire, you can enroll or disenroll during the Annual Open Enrollment. Open Enrollment period held May 1 to May 31 with an effective date of July 1 or September 1 for 10 month employees.

Before completing the form, we suggest that you review the deduction examples below.  This benefit can be costly, depending on how many sick days you have in your bank.

When does my coverage begin?

Coverage for new employees who enroll at the beginning of SDP service on the first of the month after 90 days from the hire date. At that time, premium contributions will begin to be deducted from your pay.

Coverage for employees who apply during Open Enrollment will begin on July 1 (for twelve-month employees) or September 1 (for ten-month employees). At that time, premium contributions will begin to be deducted from your pay.

What does the deduction look like on my paycheck and how much will I have to pay?

Premiums paid for the Wage Continuation program are non-refundable.

The cost of this indemnity program is dependent upon the amount of your accumulated sick leave, number of years of service, and salary.  All  enrolled employees pay a premium.

Contributions are evaluated at the time of enrollment and at the start of each school year. At that time, you will be placed in the appropriate plan, as detailed in the charts below. Each plan type has an associated premium and “corridor days”.

“Corridor days”, also known as annual waiting period, are the days that you are required to wait between the use of your last sick day and the when your Wage Continuation payments start. The waiting period that must be completed once each school year, and ranges from 5 to 7 work days.

What does it looks like on my paycheck?

Your paycheck includes two indicators of your enrollment in the program. Please refer to this Sample Pay Stub for an example.

There is a box labeled “H.I. PLAN” under the box that contains the “EMPLOYEE NAME”. Enrollment is indicated by a code that shows how many corridor days you have and the range of accumulated sick days which your enrollment was assessed. Here are examples of the code and what it means:

The other indicator of your enrollment is the deduction.  There is a code in the DEDUCTIONS column. That code is “WAGE CON”.

How can I cancel participation?

To cancel coverage, complete the Wage Con Cancellation form and submit during the annual open enrollment in May, effective July 1.

How do I use this benefit throughout the year?

*Enrollment in the Wage Continuation program does not guarantee eligibility of use. You must be approved by the Health Services Department for use of this program.

If you find yourself in a situation where you cannot return to work due to illness or injury (not work related), you must coordinate your absence with the Employee Health Services (EHS) department.  Completing the following steps will ensure a smooth transition:

  • For absences over 3 consecutive days, submit an Extended Illness Form SEH-3  to EHS.
  • You will receive a letter from EHS scheduling an appointment for you to visit the SDP’s physician for review of your absence.
  • You will continue to use all accrued (banked) sick days until you have none left.
  • Upon approval of your continued absence, you will have a waiting period between your last sick day and when Wage Continuation payments begin.  Waiting periods are listed above in the “How much will I have to pay”section and range between 0-7 work days, depending on which plan you are enrolled in.
  • Wage Continuation payments continue until you are cleared to return to work. Payments may continue for up to one year.

You may contact Health Services at (215) 400-4660 or by e-mail at employeehealth@philasd.org Their office is located at 440 N. Broad Street, Rm 134, Philadelphia, PA 19130

How much do I have to pay?

Below are the bi-weekly rate charts and examples calculating premiums.  Important: All premiums paid for the Wage Continuation program are non-refundable.
Refer to the chart below that explains the bi-weekly rate charged for participating in the Wage Continuation Program. The bi-weekly rate is per every $100 of salary.

The “quick” way to find your bi-weekly premium is by doing the following calculation:

Formula:    Biweekly Gross pay ÷ 100 × Rate from chart = Biweekly premium

*Note that the purpose of this formula and calculation is to give an approximate value of the biweekly deduction. Actual biweekly deduction amounts may vary.

Employee’s share rate per $100 gross per paycheck

Wage Continuation Premium Rates

Effective 11/1/2017

Accumulated Sick Leave Waiting Period New Employee Premium per $100 of salary
Less than 10 days 7 $2.95
10 but less than 30 days 6 $1.47
30 but less than 90 days 5 $0.13
90 or more days 5 $0.04

Here is an example of what to expect:

Based on an annual salary of $44,198 and a bi-weekly pay rate of $1,693.41:

  • If you have 0-9.99 personal illness days in your bank, the bi-weekly deduction (each paycheck) would be $49.96 at the $2.95 rate. (i.e. $1,693.41÷100×2.95=49.96)
  • If you have 10-29.99 personal illness days in your bank, the bi-weekly deduction would be $24.89 at the $1.47 rate. (i.e. $1,693.41÷100×2.1=24.89)
  • If you have 30-89.99 or more personal illness days in your bank, the bi-weekly deduction would be $2.20 at the $0.13 rate. (i.e. $1,693.41÷100×0.13=2.20)
  • If you have 30 or more personal illness days in your bank, the bi-weekly deduction would be $0.68 at the $0.04 rate. (i.e. $1,693.41÷100×0.04=.68)

Aetna Life Insurance

Aetna offers two types of Term Life Insurance policies.  The Basic Plan is administered by the Employee Benefits Department (215-400-4630).  The Voluntary Life plan is administered by Benefits Harbor (888-391-3841).  To enroll in the Voluntary Life plan online, please click here:  https://www.memberbenefitlogin.com/ees/psd.html.

You are eligible for a $25,000 policy at no cost.  In the event of your death in active service, your beneficiary will receive this payment amount.

BASIC TERM LIFE INSURANCE

Basic Term Life Insurance is a plan that pays your designated beneficiary (ies) a fixed payment amount in the event of your death.  The School District’s plan pays a Death Benefit only.  There is no cash value associated with the plan.   You are eligible for a $25,000 policy at no cost.

VOLUNTARY TERM LIFE INSURANCE

Voluntary Term Life Insurance is a plan that pays your designated beneficiary (ies) a fixed payment amount in the event of your death.  You can also enroll your spouse and children in policies of their own if you participate in the plan. Call Benefit Harbor at (888) 391-3841 or https://www.memberbenefitlogin.com/ees/psd.html.

A request for life insurance after the initial enrollment period (31 days after hire) requires an Evidence of Insurability approval from our insurance carrier.  See Evidence of Insurability Form.

For downloadable life insurance forms, please visit our Life Insurance page.

For information on Life Insurance Eligibility / AD&D Chart (Accidental Death & Dismemberment) and Retiree Policies (BASIC TERM LIFE), visit our Life Insurance page.

 

Over 65?

This information on Medicare enrollment is intended to be a guide only. You are strongly encouraged to contact Medicare at 1-800-MEDICARE to get definitive information on when you should enroll.

If you or your spouse are Medicare eligible (usually age 65 and older), and are enrolled in our active medical coverage, generally you do not have to enroll in and pay the premium for Medicare Part B. You can enroll in Medicare Part B during a Special Election Period (SEP) following you or your spouse’s retirement.

Because the District is a Large Group Health Plan (LGHP), we cover more than 12,000 employees, our understanding is that for active employees and their dependents, unless they qualify for Medicare based on End Stage Renal Disease (ESRD) the District’s medical coverage is primary over Medicare so it would pay medical claims before Medicare.  As such, you have the opportunity to delay enrolling and paying for Medicare Part B until the time you separate from active service from the District.  At that time the Benefits Office can provide a CMS L-564 Employment Verification Form to document your loss of coverage.  That should provide a Special Enrollment Period (SEP) window to enroll in Part B with no enrollment Penalty.

With respect to Part A, most employees/dependents are automatically eligible and enrolled at age 65 based on their own or their spouses work history and contributions to Medicare (FICA MED).  Most people get Part A premium-free. If you didn’t enroll in Part A when you were first eligible, you can sign up when you start receiving Social Security or during the General Enrollment Period between January 1–March 31 each year.  Your coverage will start July 1.

There are several helpful publications and references on the Medicare website that should provide clarification to your questions.  You may be able to request printed copies.

Medicare and You
When can I sign up for Part A & Part B?