The vendor is required to provide that health insurance plan services requirements are summarized as follows:
• Full-time employee: Employees who work or are hired to work an average of more than 28 hours per week for all paid jobs and assignments through the school year or fiscal year (for year-round fiscal year employees).
• Employee eligibility: Any full-time employee who works, or is initially hired to work, an average of more than 28 hours per week through the measurement period of 12 months is eligible for insurance benefits.
• 12-month standard measurement period: for the district's insurance coverage plan year September 1st through august 31st, the district uses a 12-month eligibility measurement period from July 1st through June 30th.
• 60-day administrative period. for the district's insurance coverage plan year September 1st through august 31st, the district uses a 60-day administrative period from July 1st through august 31st (with open enrollment).
• 12-month standard coverage stability period. for the district's insurance coverage plan year September 1st through august 31st, the district uses a 12-month coverage stability period from September 1st through august 31st.
• Look back method. the district utilizes the look-back method for measuring eligibility for insurance benefits: Under this method, eligibility for ongoing employees is based upon looking back over the past 12 past months to determine eligibility for insurance benefits based upon actual work hours.
• Initial eligibility measurement periods: newly hired employees may be eligible for insurance benefits if the job opening was advertised as a position requiring an average of more than 28 hours per week for the current year July 1st through June 30th.
• The initial measurement period for determining eligibility of newly hired seasonal, part-time, or variable-hour employees is the 12-month period starting on the employee's start is excluded from the calculation that an employee who averages more than 28 service hours per week for nine months (school year), and no hours for three months (summer), would still be considered eligible for insurance.
• Administrative period to determine eligibility: Once the measurement period ends, the district reviews actual work hours from the measurement period to determine coverage for the next plan year, which is the standard coverage stability period. open enrollment occurs in august each year, and the plan coverage year begins September 1st.
• Plan coverage year (coverage stability period) and open enrollment: Open enrollment for the next plan coverage year occurs in august. eligible employees receive insurance benefits and coverage beginning on September 1st of each year, and coverage ends august 31st.
• New employee beginning coverage date. coverage for new employees begins on the first work day if employed during the plan year. coverage for new employees who begin work on the first day of school begins September 1st (new plan coverage year); newly hired employees may be eligible for insurance benefits if the job opening was advertised as a position requiring an average of more than 28 hours per week for the current year July 1st through June 30th.
• Existing employee coverage ending date - employment termination: for existing eligible employees, insurance coverage ends on the last day of the month for which the last day employment ends.
• Qualifying events for coverage change during plan year: Employees or covered dependents experience a qualifying event may change their coverage during the plan.
• HR within 30 days of the event. qualifying events include: Loss of dependent coverage (including spousal coverage through employer), marriage, divorce, legal separation, birth of child, adoption or change in custody, death.
• Current plan year employee benefits guide. to obtain the district’s current year employee benefits guide, contact the individual below; guide summarizes the types of plans and benefits the district currently offers to its eligible employees, current year premium rates, and other plan-related information. the district is seeking proposals that are equal to or similar to current year plan benefits as explained in the employee benefits guide.
• Trend information - prior years’ benefits guide. to obtain the employee benefit guides for the prior three years, contact the individual below: These guides provide multi-year trend information for the types of plans and benefits the district offered in previous years to its eligible employees, prior year premium rates, and other prior-year plan-related information.
• References: Proposers should provide full contact information to other organizations the carrier currently provides health insurance plans for.
• Preferred experience and references: The district reserves the right to give preference in the decision-making process to carriers that are currently providing health insurance plans to other state school districts, charter schools, or other local government entities; however, this is not required to submit a proposal.
• Conflict of interest disclosure: All proposals must list agent or other relationships between the proposer and any company, contractor, or other agency where the potential for a real or perceived conflict of interest may arise in the course of providing assistance to the county.