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Questions & Answers

Who is eligible for LCSB insurance coverage?

All full-time benefit eligible employees working 30 hours or more per week and regular part-time employees working a minimum of 20 hours per week (18.75 hours for teachers) are eligible for coverage. INSTRUCTIONAL employees working a minimum of 18.75 hours per week are only eligible for the supplemental insurance products NO health insurance is offered.

Do I have a waiting period before my HEALTH insurance coverage begins?

Coverage for health insurance begins the first day of the month following a 60-day waiting period based on the first day you begin working in a benefited position. The Risk Management/Insurance Benefits Department must have received a completed health insurance enrollment form within 15 calendar days from your 1st day on the job.

Do I have a waiting period before my SUPPLEMENTAL insurance(s) (i.e. dental, vision, disability, etc.) coverage begins?

Coverage for supplemental insurances begin the first day of the month following a 30-day waiting period based on the first day you begin working in a benefited position.  The Risk Management/Insurance Benefits Department must receive completed enrollment applications for each supplemental insurance plan within 15 calendar days from your 1st day of the job.

My current coverage ends before my LCSB insurance becomes effective. What should I do in-between these periods?

One option would be to continue your current coverage through your previous employer through COBRA.

Can I add my spouse and child(ren) to my insurance plan when I initially enroll?

Yes - Your spouse and your dependent child(ren) can be added to your insurance plan.

1.            A dependent child is eligible to remain on the covered employees’ HEALTH insurance plan through the calendar year in which they attain the age of 26.

2.            A dependent child is eligible to remain on the covered employees’ DENTAL and VISION insurance plan through the end of the month in which they attain the age of 26

3.            A dependent child is eligible to remain on the covered employees’ HEALTH insurance plan through the calendar year in which they attain the age of 26 – 30 if:

a.) is unmarried and does not have any dependents of their own

b.) is a Florida resident or a full-time or part-time student

c.) is not enrolled in any other health coverage

d.) is NOT entitled to benefits under Title IVIII or The Social Security Act unless the child is a handicapped dependent

Written verification of student/disability status is required. If a dependent is already enrolled in a LCSB medical plan and is totally disabled, he/she is eligible for coverage regardless of age.

 Can I add my spouse and/or children to my plan at any other time?

You can add dependents to your plan each year during the annual open enrollment (currently in May with a September 1st effective date for the health insurance and supplemental products) or in the event of a “change in family status” (example: marriage, birth, adoption, etc.). In the event of a “change in family status” during the plan year, it is important to remember that you only have 30 days in which to complete the paperwork to make your change and you will need to provide proof of the “change in family status”.

If I do not elect to cover my dependents on my health insurance plan, can I add them to any of my supplemental insurance plans?

Yes, you can add your dependents to any of your supplemental insurance plans even if they are not on your health insurance plan.

If I do not elect to have health insurance, can I elect to have the supplemental insurance products?

Yes, you do NOT need to be enrolled in the health insurance plan to elect to have coverage with the supplemental insurances.

Does the health insurance cost the same for one child as it does for multiple children?

The cost for children is the same regardless of how many children are covered on the plan.

Can I cover my parents, siblings, ex-spouse, fiancé or partner on my health insurance plan if they are dependent on me?

NO, only your spouse and dependent children are eligible dependents for the health insurance.

Will my pre-existing condition be covered right away?

Please review the individual plan information regarding pre-existing coverage.

What is the difference between the “plan year” and “calendar year”?

The plan year for health and supplemental insurance product is September 1 through August 31; the calendar year is January through December 31.

How much life insurance does LCSB pay for?

LCSB pays the life insurance premium for a term life insurance policy which is equal to one time your annual base salary.  The policy becomes effective the first day of the month following a 30-day waiting period based on the first day you begin working in a benefited position.

What is the Section 125 Plan?

The LCSB Section 125 Plan allows you to purchase certain optional insurance coverage with pre-tax dollars. Federal income tax and social security taxes are not deducted from the amount you pay in premiums on a pre-tax basis under the Section 125 Plan. Your take home pay will be higher by participating in the Section 125 Plan compared to purchasing insurance coverage with after tax dollars. Once you are enrolled in the Section 125 plan, coverage can not be dropped until the next annual open enrollment (unless a change in family status occurs).

What is Disability Insurance?

Disability insurance replaces a portion of your income if you become disabled and are unable to work. You may select the benefit level you wish to receive and your premiums will be based on the level of protection you select. Your benefit level cannot exceed your annual salary. 

How does Disability Insurance work?

The waiting period is the length of time of continuous disability due to sickness or injury that must be satisfied before you are eligible to receive benefits. The duration of benefits is based on your age when the disability occurs. Benefits are available from $300 to $7,500, up to 66 2/3 percent of your salary. You also choose the waiting period, so that benefits will begin after 14 or 60 days. NO benefits are payable for disabilities that commence within 12 months of your effective date that are caused by, contributed by or resulting from a pre-existing condition. A pre-existing condition means a condition for which you received medical treatment, consultation, care or services, including diagnostic measures, or took prescribed drugs or medicine for the disabling condition in the 6 months just prior to your effective date.

What is a Flexible Spending Account (FSA) and how does it work?

A Flexible Spending Account (FSA) is an account you set up to pre-fund your anticipated, eligible medical services, medical supplies and dependent care expenses that are normally not covered by your insurance. You can choose from two accounts: Medical Expense FSA and Dependent Care FSA.

Not only are your Medical Expense FSA funds available to you in one lump sum at the beginning of the plan year, but your FSA funds are deducted before federal and state taxes are calculated on your paycheck.

With either FSA, you benefit from having less taxable income in each of your paychecks, which means more spendable income to use toward your eligible medical and dependent care expenses.

Once you decide how much to contribute to your Medical Expense and/or Dependent Care FSA, the amount is deducted in 20 equal amounts from your paychecks during the plan year. You have a 60-day run out period after the plan year ends to submit reimbursement requests for all eligible FSA expenses incurred DURING the plan year.  With both accounts, it is important to estimate your contributions conservatively.

°         Medical FSA with a remaining balance of $500 or less from the prior plan year will roll over to the new plan year. Any funds over $500 that are not used during the plan year for eligible expenses will be forfeited.

°         Dependent Care FSA any funds that are not used during the plan year will be forfeited; there is NO carryover option on a dependent care FSA.

Flexible Spending Accounts do NOT roll over from year to year; you MUST RE-ENROLL IN THE FSA plans every year during the open enrollment period

What are the Annual Contribution limits for the FSA plans?

For Medical Expense FSA:

·       Minimum Annual Deposit:

 

$ 250

 

·       Maximum Annual Deposit:

$2,700

For Dependent Care FSA:

·       Minimum Annual Deposit:

 

$ 250

 

·       Maximum Annual Deposit:

Depends on your tax filing status.

$2,500 for married filing separately

$5,000 for married filing jointly, single or head of household

What is the plan year for the Flexible Spending Accounts?

The plan year for Flexible Spending Accounts is September 1 through August 31 with a grace period through October 31.

I am an employee who only receives paychecks ten months of the year. How will I pay for coverage during the summer months when I am not receiving a paycheck?

Deductions (including additional adjustments if necessary) for all insurance plans are taken out semi-monthly over ten months (August – June) each plan year for twelve months of coverage for all employees.

If I do not return the next school year, when will my insurance end?

If you work until the end on your contract, your insurance will terminate on August 31.

If I resign or retire in the middle of the school year, when will my insurance end?

If you resign or retire during the middle of the school year, your insurance will terminate on the last day of the month in which you resigned or retired on.

LCSB Health & Wellness Centers who is eligible?

Employees and dependents (12 and older) who are covered on the Florida Blue Health Insurance plan with LCSB are eligible to utilize the Health & Wellness Centers. For more information on what the Health & Wellness Centers offer, please go to the LCSB Website > Departments > Health & Wellness Centers.

Where is the Risk Management / Insurance Benefits Department office located and what are their hours?

The Risk Management / Insurance Benefits Department office is open from 7:30 – 4:00 Monday through Friday and is located at 201 West Burleigh Boulevard, Tavares, FL 32778.  The telephone numbers are 352-253-6661, 352-253-6662 and 352-253-6664; the fax number is 352-253-6674 and e-mail address is Benefits@lake.k12.fl.us.