Current Benefit Rates
Introduction Medical Plans Dental Plans Vision Plans Disability Plans Life Insurance, Accidental Death & Dismemberment Insurance
Employee Assistance Program Flex Spending - American Fidelity Liability VOYA Voluntary Group Term Life Insurance Program Workers Compensation
Medical Forms Cigna Dental General Forms American Fidelity
COBRA Coverage for COBRA Participants What Is a Qualifying Event? Can I Have More Than One Qualifying Event? Do I Have to Notify the District of Any Qualifying Events? What Is Continuation Coverage? How Do I Elect Continuation Coverage? How Long Can I Continue Coverage? Do I Have to Pay for My Continuation Coverage? Are there any Special Provisions Regarding Continuation Coverage? Can the District Terminate My Continuation Coverage Before the Maximum Coverage Period Ends? Who Can I Contact If I Have Questions About Continuation Coverage? May I Obtain Conversion Coverage When My Continuation Coverage Terminates? Do Special Provisions Apply to the Disabled?
2017 Retiree Coverage Information Retiree Useful Links Retiree FAQ
Frequently Asked Questions Urgent Care Information Useful Website Links Safety In the Workplace BlueCross Health Matters Leave of Absence VEBA Resources
Insurance Staff Health Care Providers Contact Information

Employee Assistance Program (888)625-4809

Access Code: VEBA

*Depression or stress

*Substance abuse

*Child/elder care

*Adoption

*Legal consultation

*Budget planning/debt management

Address Change

Please make sure to keep your address up-to-date with the Insurance Department. If you have recently moved we will need the applicable forms, medical/vision and/or dental, completed to update your ...more

Life Events

Did you recently have a qualifying life event?

  • Marriage
  • Divorce
  • Have/adopt a child
  • Gain other insurance coverage (proof required)
  • Lose other insurance coverage (proof required)

These are qualifying events ...more

Open Enrollment changes are effective January 1, 2017

Carrier Contact Information

Depending on the benefit plans you enroll in, you may have benefits from the carriers listed below.  Click here for the carrier websites or to contact customer service about:

• Getting information about your benefits

• Request an ID card

• Find a provider

• Get health information

• Get discounts on health and wellness products

• And much more!

 

UHC 24 hour Advice Nurse - 866-747-4325

 

Kaiser 24 hour Advice Nurse - 888-576-6225
 

Health Benefit Carrier Information:

Visit the following carrier websites or contact customer service to:

  • Get information about your benefits

  • Request an ID card

  • Find a provider

  • Get health information

  • Get discounts on health and wellness products

  • And much more!

 

United Health Care - 888-586-6365

 

Active Employees/United Healthcare Group Numbers:

  • HMO Network 1: 246459-VHE

  • HMO Network 2: 246459-VIK

  • HMO Network 3: 246459-VNO

  • HMO Alliance: 248775-VH8

  • PPO Select Plus: 0714846-0702

COBRA Participants/United Healthcare Group Numbers:

  • HMO Network 1: 246461-VHH

  • HMO Network 2: 246461-VIL

  • HMO Network 3: 246461-VPO

  • HMO Alliance: 248777-VL8

  • PPO Select Plus: 0714846-0704

 

Retiree Participants/United Healthcare Group Numbers:

  • HMO Network 1: 246460-VHE

  • HMO Network 2: 246460-VIK

  • HMO Network 3: 246460-VNO

  • HMO Alliance: 248776-VH8

  • PPO Select Plus: 0714846-0703

  • PPO Choice Plus (Out of State): 0714846-0606

 

Kaiser HMO – 800-464-4000
Kaiser HMO Appointment Line: 888-988-2800

www.kp.org

Group Numbers:

  • Certificated  227101-0

  • Classified 227101-1

  • COBRA 227101-7000

  • Retiree 227101-2

 

Cigna Dental 800-244-6224
www.cigna.com

All Groups - 3215164

 

VSP – 800-877-7195
www.vsp.com

Group Number:

Signature Plan – 12081045

 

VEBA Advocacy: 888-276-0250

 

Best Doctors - 888-362-8677

www.bestdoctors.com

 

Employee Assistance Program (EAP) - 888-625-4809

www.liveandworkwell.com

Access Code: VEBA

 

Express Scripts - 800-918-8011

expressscripts.com

Frequently Asked Questions for Active Employees

 

Q: I am a new employee.  When do I have to return the Health Benefit enrollment paperwork?

A: 30 days from date of hire.

 

Q: I am a new employee.  When will my Health Benefits become effective?

A: The first day of the month following the completion of a 30-day waiting period.

 

Q: Do I have to enroll in medical, dental, and vision?

A: No, you can enroll in any combination of the three health benefits.  Please be aware that whatever you as the employee are enrolled in, all dependents must be enrolled in the same.  Example, if you are enrolled in medical only, your dependents will be medical only as well.  

 

Q: What qualifies a child as a dependent?

A: Natural children, legally adopted, or stepchildren.

 

Q: Who does not qualify as an eligible dependent?

A: Ex-Spouse/Partner, former stepchildren, parents, nieces/nephews, siblings, aunts/uncles, and grandparents.

 

Q: What is a qualifying event that would allow me to add or drop coverage for a child or spouse outside of Open Enrollment?

A: Marriage, filing a domestic partnership, having a baby, divorce, loss of other coverage, eligibility for coverage for employee or dependents under spouse’s coverage.

 

Q: What is the time frame I have to add or delete a dependent (child / spouse)?

A: Within 30 days from date of birth, marriage, divorce or eligibility for/loss of other coverage.

 

Q: When does coverage begin or end when adding or deleting a dependent (child/spouse)?

A: First of the month following the event date.

 

Q: What is required to add/delete a dependent (child/spouse)?

A:  Medical/Vision Change form, Cigna Dental Change form and the acceptable documentation or divorce decree

 

Q: At what age do my dependent children drop off my coverage?

A: 26

 

Q: Do my dependent children need to be financially dependent on me for support, claimed as dependents on my tax return, residents of my household, enrolled as students, or unmarried?

A: No

 

Q: Is it my responsibility to notify the Insurance Department when a dependent (child/spouse) becomes eligible or ineligible?

A: Yes

 

Q: Will I be responsible for the District portion of insurance premiums paid if ineligible dependents have not been deleted from my plan?

A: Yes

 

Q: How do I change my address/name with the Insurance carriers?

A: Change forms are required.

 

Q: Where do I find change forms?

A: www.capousd.org – departments – Insurance – forms.

 

Q: If I do not make changes within appropriate time frame, when will the next opportunity be?

A: During Open Enrollment.

 

Q: When is Open Enrollment?

A: Usually occurs the end of October/ beginning of November with the changes taking effect January 1.

 

Q: Where can I see what health benefit plans I am enrolled in?

A: From any district computer you can visit MyCUSD to view your plan selections and dependents.

 

Q: How do I check my paystub to make sure the correct deductions are being taken?

A: Please visit the Payroll Department website at  https://capousd-ca.schoolloop.com/payroll

 

Q: I don't have a VSP insurance card, how can I use services?

A: VSP is a paperless service, to find a provider please call them at 800-877-7195 or visit www.vsp.com

 

Q: I don't have a Cigna Dental PPO insurance card, how can I use services?

A: Cigna PPO is a paperless service, to find a provider please call them at 800-244-6224 or visit www.cigna.com

 

Q: I'm trying to pick up a prescription with United Health Care and it says I'm not covered, what do I do?

A: United Health Care uses Express Scripts for prescription coverage.  If you do not have an Express Scripts ID card please call them at 800-918-8011 to order one.  

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VEBA Newsletter

Health Matters

Non-Discrimination Statement

The Capistrano Unified School District prohibits discrimination, harassment, intimidation, and bullying in all district activities, programs, and employment based upon actual or perceived gender, gender identity, gender expression, race, ethnicity, color, religion, ancestry, nationality, national origin, ethnic group identification, sex, sexual orientation, marital or parental status, pregnancy, age, physical or mental disability or on the basis of a person’s association with a person or group with one or more of these actual or perceived characteristics. Reference: AR 1312.3, BP 1312.3 and BP 5183.

Rich Montgomery, Executive Director, Human Resource Services/Compliance
33122 Valle Road, San Juan Capistrano, CA 92675
(949) 234-9200

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