Active benefits eligible employees Frequently Asked Questions

1. What is the Open Enrollment Period?

The Open Enrollment period is a period of time, determined by your employer, during which you are allowed to make any changes to your current benefits.

 

Note: No changes are allowed after the commencement of a new plan year (see Change in Status section for exceptions).

 

2. Must all eligible employees enroll for benefits effective January 1, 2015?

No. You only need to re-enroll during this Open Enrollment period if you are making a change to your current benefits.

 

3. What happens if I do not re-enroll by the enrollment deadline?

Note the following:

Your current healthcare coverage will continue.

Your dependent(s)’ healthcare coverage will continue.

Your disability benefit will continue.

Yours and your dependent(s)’ flexible benefits will continue December 31, 2015.

If you are opting out of healthcare, this election will continue and you will have to submit proof of other group or state-funded healthcare coverage.

If you are currently enrolled in Cigna OAP 10, your current deductions will automatically be adjusted.

 

4. How will I know when I can enroll?

You will be permitted to enroll during your Bargaining Unit’s Open Enrollment Period. You will receive an email specifying your Bargaining Unit’s enrollment dates.

 

5. When is the last day to make change for benefits effective January 1, 2016?

If making changes, you must complete your online enrollment selections by 10 p.m. on December 2, 2015.

 

6. When is the online enrollment application available?

The application is available during the Open Enrollment period from 7 a.m. to 10 p.m.

 

7. What if I do not have a computer or Internet access available?

During the Open Enrollment period: if you do not have access to the Internet, you may visit an Open Enrollment Representative for assistance at;

School Board Annex Building

1501 NE 2nd Avenue, Room 325,

Miami , Florida 33132

(8:00 am – 4:00 pm)

 

or

 

Miami Killian Senior High School

10655 SW 97th Avenue, Teachers’ Lounge

Miami , Florida 33176

(7:30 am – 3:30 pm).

 

Additionally, representatives will be at selected work locations through the District to assist you with your enrollment.

 

After the enrollment period: you may visit the Office of Risk and Benefits Management at 1501 N.E. 2nd Avenue, Suite 335, Miami, Florida 33132.

 

8. What if I enroll and I want to change my benefits selections?

You may log into the enrollment site and change your benefits selections as many times as you want throughout the Open Enrollment period. Your last saved and submitted selections will be your benefits, effective January 1, 2016. Changes made during the Open Enrollment period of November 17, 2015 through December 2, 2015 will be effective January 1, 2016. For full-time employees, the first deductions will be taken on the payroll date January 9, 2016.

 

9. What changes can I make during Open Enrollment?

During this period, you may purchase benefits, delete, or add dependent. Any dependent child who turned 26 in the year 2015 (born in 1989) cannot be covered or added for 2016 as a regular dependent. See the Dependent Eligibility section for provision for adult dependents (age 26-30). If a covered dependent is disabled, proof must be submitted in order for coverage to continue beyond 26 years of age.

 

10. Can I select coverage for myself through one healthcare plan and another for my family?

No. You and your eligible dependent(s) must be covered with the same healthcare plan.

 

11. Can I select coverage for myself through one flexible benefit plan provider and another for my family?

No. You and your eligible dependent(s) must be covered with the same flexible benefits plan and provider.

 

12. Can I decline healthcare coverage?

Yes. You may decline healthcare coverage. You must provide proof of other group or state-funded program coverage. Enrollment in an individual healthcare plan does not qualify. Additionally, you must agree to the provision set forth in the affidavit. Refer to the Declination Information section of this guide.

 

13. If I decline healthcare coverage, what happens to the Board contribution toward my healthcare coverage?

In lieu of healthcare coverage, you will receive $100 per month paid bi-weekly through the payroll system, based on our deduction pay schedule (subject to withholding and FICA) as follows:

10-month employees will receive their payments in 20 pay checks.

11-month employees will receive their payments in 24 pay checks.

12-month employees will receive their payments in 26 pay checks.

 

If  you do not provide proof of other group healthcare coverage, you will be automatically assigned to the Cigna LocalPlus (Employee-only) healthcare plan and standard Short-term Disability.

 

If electing to decline healthcare coverage during this Open Enrollment, you are required to submit proof of enrollment in another group or state-funded program, even if previously submitted.

 

14. Will I be able to view and print a confirmation of my 2016 benefits selections?

Yes. Everyone is able to view and print their Benefits Confirmation Statement online, immediately after benefits selections are successfully saved. A benefits notice is automatically generated and presented at the end of your enrollment sessions.

 

Additionally, prior to enrollment you can view your 2016 Benefits Confirmation Statement and verify you are enrolling in the benefits you need for the next year. The 2016 Benefits Confirmation Statement will reflect the new rates for 2016.

 

15. What do I need to submit to ensure that my dependent(s) will have coverage?

If not previously submitted, you will need to submit dependent eligibility verification before the start of the 2016 Plan Year. Otherwise, your dependent’s coverage may be terminated. (See the Dependent Information section for the list of acceptable documents.)

 

16. If I take a Board-approved leave of absence, whom do I contact about my benefit?

Once your leave is approved and the Office of Risk and Benefits Management receives notification, you will be eligible for applicable benefits in accordance to your Bargaining Unit and type of leave. You will be billed for employer-paid benefits in accordance to the type of leave and labor contact. Additionally, you will be billed for all employee-paid benefits.

Miami-Dade County Public Schools implements the Family and Medical Leave Act of 1993 (FMLA) through provisions contained in the School Board Rules and collective bargaining agreements.

 

For questions regarding your benefits while on leave, please call 1-305-995-7129 and ask to speak with a Leave Billing Specialist.

 

17. What happens to my benefits if I terminate employment?

Your coverage will cease at the end of the calendar month in which employment terminates. Benefits will remain in effect through August 31st for 10-month employees who terminate employment during the last month of the school year.

 

Note: An individual who loses coverage under the plan becomes entitled to elect COBRA. The individual has the right to continue his or her medical, dental, and vision coverage under COBRA law for a period of 18 months and/or Medical Expense FSA deposits until the end of the plan year following termination of employment. The individual must notify the COBRA specialist at the Office of Risk and Benefits Management.

 

18. If I am hired during this Open Enrollment period, must I enroll for the current plan year as well as the next plan year?

For 2015 Plan Year, you will be automatically assigned to Cigna LocalPlus (employee-only). However, you must enroll during this Open Enrollment period for benefits effective January 1, 2016.

 

19. Is there a free healthcare option being offered?

Yes. The Cigna LocalPlus Plan is being offered at no cost to all benefits eligible employees.

 

20. Will OAP 10 and OAP 20 continue to be offered at a cost to the employee for employee-only coverage?

Yes. OAP 10 and OAP 20 will continue to be offered with an employee cost share, based on the employee’s benefits salary.

 

21. If enrolling in the Cigna LocalPlus Plan, will I be required to select a Primary Care Physician?

No. You are not required to select a Primary Care Physician. However, we encourage all covered members to establish a relationship with a physician. If you do not have a physician, choose a participating in-network physician and schedule your appointment in 2016.

 

22. How do I view the Cigna Healthcare or Flexible Benefit Plan provider directories?

To view participating providers in Cigna: log in to www.cigna.com and click on “Find a Provider.”

 

To view participating providers in the Flexible Benefits Plans: log in to www.dadeschools.net, click on “2016 Benefits” and click on the "Resources" links under each benefit.

 

 

Enrollment Helpline:

1-305-995-2777

7 a.m. to 8 p.m. ET /

Seven days a week

Enrollment Website:

www.dadeschools.net

Benefits Inquiry:

FBMC Service Center

Mon - Fri, 7 a.m. to 8 p.m. ET

1-855-5MDC-PS4U (1-855-632-7748)

Office of Risk and Benefits Management

1501 N.E. 2nd Avenue, Suite 335

Miami, Florida 33101

Mon - Fri, 8 a.m. to 4:30 p.m. ET