Student Climate Staff Special Enrollment
APPLICATION DEADLINE EXTENDED TO THURSDAY, OCTOBER 15, 2020
Student Climate Staff (SCS) or Early Childhood Food Service Workers (ECFSW) scheduled 5.0 or more hours per day are eligible to enroll in the School District’s Independence Blue Cross KEYSTONE HMO $15 medical coverage. Coverage is offered to you and dependent children up to age 26. Spouses are not not eligible for coverage.
Coverage is 100% paid by the school district; there is no employee payroll contribution. You will be responsible for co-pays on certain services. You must also select a Primary Care Physician (PCP) and will need referrals from your PCP for non-emergency services. You must use a Keystone participating provider. There are no Out-of-Network benefits for the Keystone plan.
Review the summary at Keystone HMO 15
Competed applications and supporting documentation returned by Friday, August 14 will be enrolled effective September 1. Applications and supporting documentation received between August 15 and Tuesday, September 15 will be enrolled effective October 1.
UNITE Here Local 634 will continue to handle your Prescription, Dental, and Vision benefits.You must contact Associated Administrators Associated Administrators can be contacted at 833-228-9212. Continue reading below for some frequently asked questions and important information.
How do I enroll in medical coverage?
We are providing 2 ways to complete your enrollment to make it easier. Please choose only one option.
Option 1: Complete an online google form application here. You must be logged into a google account in order to complete the form. Supporting dependent documentation (if applicable) can be uploaded directly in the google form under section 4.
Option 2: We are mailing an application to your home address on file with the District, but it is also available by clicking Student Climate Staff Special OE.
Completed applications and supporting documents can be sent to email@example.com, or faxed to 215-400-4631. Forms can be mailed to our office, but delays are likely to occur:Employee Benefits 440 N. Broad Street Suite G-10 Attn: Local 634 Special Enrollment Philadelphia, PA 19130
If submitting by fax or mail, please contact our office at firstname.lastname@example.org or leave a message at (215) 400-4630 to ensure it has been received. Our office is NOT open for walk-in customer service during the pandemic.
NOTE: Dependent children cannot be removed from District medical coverage unless the child has gained alternate medical coverage. You must notify the Benefits Office within 30 days of the effective date of the alternate coverage and proof of the coverage will be required.
What if I don’t enroll at this time?
If you do not enroll at this time, you can only enroll if you lose other coverage or experience a Qualifying Life Event, such as marriage or the birth of a child. These changes must be reported to the Employee Benefits Office within 30 days of the life event. Otherwise, changes can only be made during the annual Open Enrollment in May, effective July 1.
NOTE: Even if you don’t enroll in our coverage, you will no longer be covered by the UNITE HERE Local 634 medical services at the Philadelphia City Health Centers
If we do not receive an enrollment form from you by September 15, 2020, we will assume you have chosen to waive medical coverage.
What documents are required to enroll my children?
Birth certificates or adoption decrees are required for children. Additional documentation is required for step-children. More detailed information on the requirements is available at the Dependent Eligibility page.
How do I complete the application or upload documents?
Review the Resources page for helpful tips on completing a PDF application, scanning an item from your smartphone or logging into your District google account.
What if my scheduled hours change?
Please contact the Benefits Office, email@example.com, if your scheduled hours were to change to below four hours a day.