Open Enrollment
Basics
Eligibility
You are eligible for benefits if you work 30 or more hours per week. You may also enroll your eligible family members under certain plans you choose for yourself. Eligible family members include:
Your legally married spouse.
Your registered domestic partner (RDP) and/or his/her children, where applicable by state law.
Your children who are your biological children, stepchildren, adopted children or children for whom you have legal custody (age restrictions may apply). Disabled children age 26 or older who meet certain criteria may continue on your health coverage.
Annual Election
Due to IRS regulations, you cannot change your elections until the next annual Open Enrollment period, unless you have a qualified life event during the year. Following are examples of the most common qualified life events:
Marriage or divorce
Birth or adoption of a child
Child reaching the maximum age limit
Death of a spouse, RDP, or child
You, your spouse or child loses coverage under your spouse’s/RDP’s plan
You gain access to state coverage under Medicaid or CHIP
Effective Date
You may make changes to your 2023-2024 benefit plans during Open Enrollment. No changes will be made after 07/31/2023 unless you have a qualifying life event.
Changes made during Open Enrollment are effective July 1 , 2023 - June 30, 2024.
Riverside Preparatory Schools Open Enrollment forms will be accepted 05/11/23-06/09/23
Mojave River Academy Open Enrollment Forms will be accepted 05/11/23 - 06/09/23
To Do
Please submit one benefit selection form, any necessary enrollment forms and dependent verification to Nicole Griego either by email or hard copy to the District Office.
This year employees will not be required to complete the confirmation process and verify dependents that have previously been enrolled.
Medical Plans
Available to all employees working 30 or more hours per week.
Kaiser Plans
With Kaiser HMO plans, you must use Kaiser facilities and providers for your medical and pharmacy neds. Services received outside of the Kaiser Network are not generally covered, except when directed or in the case of emergency medical care.
Aetna Plans
HMO plans require that your care be coordinated with a Primary Care Physician (PCP) from the Traditional or Select Network. Service rendered outside of the Network are not covered, except in the case of emergency medical care. PPO plan offers you the freedom to seek care from the provider of your choice.
Kaiser Plan Designs 23/24
Kaiser Traditional HMO Plan Design 23 24.pdfKaiser Traditional HMO
Kaiser Bronze Deductible Plan Design 23 24.pdfKaiser Bronze Deductible HMO
Aetna Plan Designs 23/24 (Medical only)
23 24 Aetna Full HMO Plan Design.pdfAetna Full Network HMO
Aetna Value Network HMO Plan Design 23 24.pdfAetna Value Network HMO
Aetna Whole Health Plan Design 23 24.pdfAetna Whole Health HMO
Aetna AVN HMO High Deduct Plan Design 23 24.pdfAetna Deductible Value Network HMO
Aetna POS Plan Design 23 24.pdfAetna Open Access Managed Choice POS
Opt Out of Medical
Available to all employees working full-time/40 hours per week.
403-B Retirement Savings Account
Accounts must be established with an authorized vendor (full list can be found at https://www.403bcompare.com/Vendors/Browse )
Flexible Spending Account-Health Care or Dependent Care
Established by meeting with District American Fidelity representative by appointment
Health Savings Account
Established by meeting with District American Fidelity representative by appointment
Cash Option
All amounts paid in cash are subject to state and federal income taxes and will be reported as earnings in your W-2, but will not be counted as STRS credit.
Dental Plan
Available to all employees working full-time/40 hours per week regardless of if you opt in for medical or not.
CSEBA - Delta Dental PPO
Offers you the freedom and flexibility to use the dentist of your choice. However, you will maximize your benefits and reduce your out-of-pocket costs if you choose a dentist who participates in the network.
In Network Only
Deductable (per calendar yr)-None
Benefit Maximum-$2,500
Preventive and Basic Services provided at no charge
Major Services-80%
Child Orthodontia- 50%; $1,000 Max Lifetime Benefit
Out-of-Network and all specific details can be found within the Benefit Summary PDF below.
Delta Dental Customer Service.pdfDelta Dental Mobile app.pdfDelta Dental Smileway.pdf
Delta Dental Value Added Features.pdfdelta dental 1.pdfVision Plan
Available to all employees working full-time/40 hours per week regardless of if you opt in for medical or not.
Aetna 2.pdf
Aetna Vision PPO
Freedom to seek care from the provider of your choice. However, you will maximize your benefits and reduce your Out-of-Pocket costs if you choose a provider who participates in the Aetna Vision Network.
In Network Only
Routine Exam-$10 Copay
Materials-$10 Copay
Eyeglass Lenses (in lieu of Contacts, every 12mos) No charge after $10 material copay
Eyeglass Frames (one every 24mos)-$130 Allowance & 20% off remaining balance
Contact Lens Exam Fitting Covered in full after Contact Lens Exam Copay
Contact Lenses (once every 12mos in lieu of glasses)-$130 Allowance & 15% off remaining balance/if elective, covered in full/if medically necessary
Out-of-Network and all specific details can be found within the Benefit Summary PDF below.
Aetna 1.pdfDistrict Paid Life Insurance
Available to all employees working full-time/40 hours per week regardless of if you opt in for medical or not.
Basic Group Term Life & AD&D
Life Insurance- provides your named Beneficiary(ies) with a benefit in the event of your death
Accidental Death & Dismemberment- provides specified benefits to you in the event of a covered accidental bodily injury that directly causes dismemberment. In the event that your death occurs due to a covered accident, both the Life and the AD&D benefit would be payable.
Benefit Amount-Flat $50,000
Full plan details can be found within the Benefit Summary PDF to the right.
Other Information
11 Month Employees Only-July Payback Line
A line was added within the deductions area for payroll to help identify the employee contribution being made for the month of July (July 31/Aug 1 payday). As seen in the reference photo, there are no employee deductions for the month of July, due to the fact 11 month employees do not receive a regular paycheck for that month.
In order to keep benefits active year-round, the District pre-pays benefits for July based on the selections made during open enrollment.
If the employee exceeds the employer contribution on a monthly basis ($1,436.05 Cap), the amount is then paid as an employee deduction. In the example to the left, that amount is listed in the August month at $513.36. This additional amount still needs to be paid for the July month. With that being said, it is divided by 11, then entered into the employee deduction for the 'July Payback' line.
Optional Benefits
If you are interested in any of the additional benefits below, please reach out to the Nicole Griego.
EAP Program Flyer.pdfF_EAP_FAQ_EE_GRO_T.pdfEmployee Assistance Program
Personal Insurance
American Fidelity Representative for OGSD
Pebble Arnick; Lic# 0G54437 Executive Account Manager Direct 951-397-4816 / 800-365-9180 Ext. 388 951-600-0202 fax / 951-600-0122 office
pebble.arnick@americanfidelity.com
Discount Programs
Employee discount programs that can help you save on thousands of items-
2023-24_Oro Grande School District_eGuide_rev 5 9 23_CODED.pdf2023/2024 Benefit Guide
Please click on the PDF to the left to see plan cost comparisons and a summary of coverage.
Benefit Spot Info..pdfBenefit Spot: Mobile Benefits Resource Button
Enrollment Forms
All corresponding enrollment forms Kaiser (medical only), Aetna (medical & vision), Delta Dental & MetLife are attached to each Benefit Selection Form link.
Returning/New (40 Hours) Benefit Selection Form
Please click on the link below to access forms
Benefits Selection Form- New/Returning
Part Time (30 - 39 Hours) Benefit Selection Form
Please click on the link below to access forms
Opt - Out Benefit Selection Form
Please click on the link below to access forms
Benefits Selection Form- Opt-Out