Employee Benefits

INSURANCE:

OPEN ENROLLMENT: Our providers will continue to be PacificSource for medical, dental and vision and United Heritage for life, accidental death & dismemberment, and long-term disability.

Open enrollment period starts September 1st and ends September 30th. If you do not want to make any changes for 2023/2024, you do not need to do anything.

If you would like to change your plan election, please complete a plan change form. If you are new to insurance, please complete the new enrollment form. If your form is received in the Payroll Office by September 11, 2023, the new out-of-pocket/contribution amount will be deducted/contributed from your paycheck beginning September 20, 2023. If your form is received after September 11, 2023, the new out-of-pocket/contribution will be deducted/contributed from your paycheck beginning October 20, 2023 and will include an adjustment to correct your September payroll deduction/contribution.

If you have other group coverage and would like to waive coverage in the group plan offered by the District, you must complete a new enrollment form (specifying that you wish to waive or decline coverage) and return to the payroll office by September 11, 2023.

Evidence of Insurability (Complete if applying for additional life insurance above and beyond group policy)

Short Term Disability – Enrollment Form

MASA – Medical Transport Employee Enrollment Application

OTHER BENEFIT INFORMATION:

Change My HSA contribution Form

HRA VEBA – Medical Care Expenses

HRA Basics

PACIFICSOURCE PHARMACY NETWORK

FIND A DOCTOR

WHA (Benefit Service Team)

REQUIRED ANNUAL NOTICES

SBC – $2500 HDHP (HSA) 22-23

SBC – $6,000 (VEBA) 22-23

SBC – $2,000 PPO 22-23

COBRA Notice

Medicare Creditable Coverage Notice

Medicare Non-Creditable Coverage Notice for $2500 HDHP

CHIPRA Notice

Women’s Health and Cancer Rights Notice

HIPAA Notification

Market Exchange Notice

2023 403(b) Notice

FMLA/OLFA:

FMLA Responsibilities

OFLA Responsibilities

OFLA FAQ

Employee Medical Leave

Family Medical Leave

PAID LEAVE OREGON:

The Hartford – Oregon Paid Family and Medical Leave Insurance

Paid Leave Oregon Equivalent Plan Guide

Paid Leave Oregon Poster – Equivalent Plan

Paid Leave Oregon Benefit Highlight Sheet

Claims Process

Claim Form

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. Carruth Compliance main contact page.

Salary Reduction Agreement

Vendor List