Our providers will continue to be  PacificSource for medial, dental and vision and United Heritage for life, accidental death & dismemberment, and long-term disability. The $1000 Deductible plan is now a $1500 Deductible plan and the $1500 HSA plan is now a $2000 HSA plan. You will not need to complete any forms unless you are new or would like to change plans, add or delete dependents.

2019-2020 PREMIUM RATES

2019-2020 EMPLOYEE BENEFIT RESOURCE GUIDE-Summary Plan Descriptions

2019-2020 GROUP HEALTH ENROLLMENT FORM

2019-2020 Plan Selection Form  – Only Changing Plans (no dependent changes)

LIFE/LTD/STD INFORMATION

2019-2020 Life, LTD and STD Enrollment Form

HEALTH STATEMENT – FOR ADDITIONAL LIFE INSURANCE COVERAGE

PACIFICSOURCE PHARMACY NETWORK

FIND A DOCTOR

WHA (Benefit Service Team)

BENEFIT VENDOR CONTACTS

RETIREE BENEFIT GUIDE

SELF PAY – COBRA BENEFIT GUIDE

VEBA Enrollment Form
HSA Salary Reduction Arrangement
 Waive Coverage

Flexible Spending Account (FSA)

REQUIRED NOTICES

SBC – $5000 Deductible

SBC – $2000 HDHP (HSA)

SBC – $1500 Deductible

SBC – PSN $1000 Deductible

COBRA Notice

Medicare Creditable Coverage Notice

Medicare Non-Creditable Coverage Notice for $1500 HDHP

CHIPRA Notice

Women’s Health and Cancer Rights Notice

HIPAA Notification

Market Exchange Notice

Summary Plan Description

2020 403(b) Notice

 

HEALTH SAVINGS ACCOUNTS

Health Savings Account Enrollment Form

FLEXIBLE SPENDING ACCOUNT

Flexible Spending Account

 

403(b) PLAN
Click here for information specific to the District’s 403(b) Tax Sheltered Annuity Plan (TSA) including vendor lists and enrollment forms.  Carruth Compliance Consulting (CCC) provides compliance assurance and plan administration services to the District on a contractual basis. CCC serves as a clearing house for administration of the District’s Plan, providing employees with the information they need to take advantage of this tax deferred retirement savings plan.

Salary Reduction Agreement

Vendor List

 

2019 403B TSA Announcement

2020 403B TSA Announcement

QUESTIONS?

If you have any questions about employee benefits, please contact either 

payroll@fernridge.k12.or.us or

Quanah Bennett in the Business Office at541-935-2253 x1202  –  or Dani Hughes at 541-935-2253 x1204 

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February 2020

Feb 9 EHS Winterfest Dance

 

Feb 10 School Board Mtg 6:30pm

 

Feb 17  No School in honor of President’s Day

 

District Calendar

Print Calendar 2019-2020

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