Local 634 UNITE HERE!

Benefits to be added.

Local 634 UNITE HERE!

The School District of Philadelphia offers eligible employees represented by Local 634 Keystone HMO, administered by Independence Blue Cross(IBC). If you are a food service worker scheduled five or more hours, Keystone medical coverage will become effective on the 90th day of employment. If you are a food service worker scheduled for less than 5 hours a day or in a student climate position, you are not eligible for medical coverage.

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  SDP provided medical coverage, Keystone 15.
  • 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  or email benefits@philasd.org to confirm receipt.
  • Prescription, dental and vision benefits are administered by your union, Local 634. Associate Administrator  can be contacted at 833-228-9212 or Local 634 at 215-440-0245.  Click Local 634 HW Benefit Summary 2019 for more information.
  • Information about dental benefits can be found at http://lpma-pa.com/.
  • For prescription coverage, contact Benecard at 1-888-907-0070.

PLAN OPTIONS

As a newly benefits eligible employee with the SDP, you are eligible to enroll in a health maintenance option (HMO), Keystone 15, on the 90th calendar day of
service.  This is medical coverage only.

Keystone 15 has no deductible, no coinsurance, and a $15 co-payment for primary care physicians (PCP) as well as a $25 co-payment for specialist visits when receiving a
referral from your PCP. Employees working more than 7 hours per day may add his or her spouse and eligible dependent children onto their coverage. If you work fewer than 7 hours per day, but at least 5 hours, you may only add eligible dependent children; spousal coverage is not permitted for employees working less than 7 hours per day

Medical Insurance Opt-Out Program
If you have medical coverage available from another source, such as a spouse, you are eligible to receive compensation for not enrolling in the School District’s Keystone medical plans. If you are not currently enrolled in our medical coverage, you are still eligible for the program. You are not permitted to Opt-Out if another School District employee is currently covering you. You must complete your probation period before being eligible to participate in the Opt-Out program.

Employees on probation are not eligible until their probation is completed. If you work fewer than 7 hours per day, but at least 5 hours, you may receive Opt-Out compensation for eligible dependent children;  Opt-Out compensation for spouses is not permitted for employees working less than 7 hours per day.  Opt-Out  materials must be submitted annually.

Universal Opt Out Application 11-17

Premium Co Share

Premiums for Keystone HMO for eligible employees is 100% employer paid.

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.
 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.

 

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?

Wage Continuation

General Information

Wage Continuation is the School District of Philadelphia’s (SDP) salary continuation 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 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 completion of your probation, at which time your premium contributions will begin to be deducted from your pay.

  • Employees who wish to enroll in the program after 30 days from their hire date may apply during Open Enrollment.  An application must be completed and submitted to the Benefits Office during the Open Enrollment Period (the month of May) and it is effective July 1.
  • Wage Continuation payroll deductions will begin July 1 (for twelve-month employees) or the beginning of the contract year (for ten-month employees).
  • 10 month based employees do not have Wage Continuation payroll deductions in July and August.

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 after probation. 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 beginning of the school year (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.

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:

You can also view your Wage Continuation balance through the Employee Payroll Application portal by following the below instructions:

You can view your leave balance through the Employee Payroll Information application. Your School District of Philadelphia email name and password are used for access. If you do not know the name and password, call the Technology Help Desk at (215) 400-5555 for assistance. Please note that the balances shown are all subject to a post separation audit. Your paycheck references this.

From the School District of Philadelphia main website (http://www.philasd.org) go to the Employee Portal. In the Employee section, enter your email name and password.  Your email user name should exclude the “@philasd.org” designation.

Launch the “Payroll Information” application. Enter the last four digits of your social security number when prompted.  You can then select Leave Balances tab.

How can I cancel participation?

You can cancel Wage Continuation coverage during the annual open enrollment from May 1 through May 31, 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 six months.

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
Example        $1,693.41                   ÷ 100×           $0.31          =       $5.25

*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

 

Accumulated Sick Leave H.I.
PLAN CODE
Total Annual
Waiting Period (corridor days)
Premium per $100 of Salary % of premium paid by SDP
Less than 10 days HI 0-9 7 $2.95 50%
10 but < 30 days HI 10-29 6 $2.10 50%
30 but < 60 days HI 30-59 5 $0.31 65%
60 but < 90 days HI 60-89 4 $0.00 100%
90 but < 120 days HI 90-119 3 $0.00 100%
120 but < 150 days HI 120-149 2 $0.00 100%
150 but < 180 days HI 150-179 1 $0.00 100%
Greater than 180 days HI 180+ 0 $0.00 100%

 

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).  You are entitled to a term life insurance policy of $20,000, through Aetna U.S. Healthcare at no cost to you.  You are not required to undergo a medical examination if you enroll within the first 31 days of your employment. However, if after such time you wish to elect life insurance coverage, you will be required to complete an Evidence Of Insurability.  In the event of your death in active service, your beneficiary will receive this payment amount.

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 visit 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.