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Arlene Steward, Insurance Analyst: 577-0208
Victoria Nolte, Insurance Specialist: 577-0207
Monica Sayles, Insurance Specialist: 577-0328
The NCSD insurance plan is a self-funded plan that covers 2,290 active and retired employees and their dependents. Monthly premium deductions are determined by the claims paid out and operating costs.
Employee eligibility
All employees who work for the District at least 17 1/2 hours per week on a permanent contract are eligible.
Employees who are hired after Dec. 31 on a non-permanent basis are not eligible.
You will be insured on the first day of the following month after enrollment is completed.
If you enroll more than 31 days after your first day on the job, you will be allowed to enroll within 31 days after the time you lose coverage with another carrier. You also may enroll during the “Open Enrollment” period in the spring, with an effective date of coverage to begin July 1.
It is YOUR responsibility to enroll.
Dependent eligibility
A dependent will be insured on the first day of the following month after enrollment is completed so long as it is done within 31 days of eligibility.
If you enroll dependents more than 31 days after the first day of eligibility, the dependent must follow the same guidelines as the employee.
Pre-Admission Review (PAR)
You must call PAR Services for any in-hospital confinement lasting 18 hours or longer. A penalty of $200 or more may be assessed for failure to do so. PAR should be notified in the early stages for maternity benefits intervention. If a newborn is to be covered on the District’s health plan, please register with the insurance office also. (See the Health Plan Booklet for PAR and Preexisting Conditions explanations.)
Insurance premiums
The District pays 100 percent of the employee’s group health and life coverage (equivalent to your base salary) and 65 percent toward the dependent’s cost. The District also pays preventive dental coverage for all covered persons.
Deductibles
The district offers two deductibles for employees to choose between: $1250 ($2500 family) and $2000 ($4000 family). The deductible year begins every January 1 and ends December 31.
Benefit payment
After the deductible is met, the health plan pays 80 percent of covered charges up to $20,000 ($40,000 per family).
After that, the plan pays 100 percent of covered charges for the calendar year. The lifetime maximum is unlimited. Refer to the Dental Plan Booklet regarding dental benefits.
The plan has limited mental health and substance-abuse benefits.
Emergency room deductible
There is an additional $25 deductible for each emergency room visit. If you are hospitalized at the time of the visit, this deductible is waived. The emergency room deductible does not count toward the the calendar year deductible.
Claim filing
The Cigna Health Care Company and the Delta Dental Company are your primary insurance carriers; therefore, you must file charges with them before filing with a secondary carrier (for dependents, refer to the Health Plan Booklet).
When filing a claim for a student (full-time students ages 19 through 23) submit an official statement from his or her registrar verifying student status.
Flexible Spending Accounts
The District offers all active, insurance-eligible employees a Cafeteria Plan that allows participation in Flexible Spending Accounts on a before-tax basis (a payroll deduction) to cover non-reimbursed medical, dental and vision expenses (Medical Reimbursement Accounts); day-care expenses (Dependent Care Account); and premium payments (Insurance Premium Account). | |
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