Medical Applications

Employee Benefits

Should you need accommodations, please contact Frances Garza, Benefits Coordinator at (559) 243-7133.

Welcome to the State Center Community College District (SCCCD) Employee Benefits webpage. SCCCD strives to provide a comprehensive and valuable benefits package to our employees and eligible dependents. Here you will find information pertaining to the different health plans the District offers, along with voluntary benefits available.

The District currently offers four (4) medical insurance plan options - Modern Care PPO plan, Bronze PPO plan, Kaiser Permanente High Traditional HMO plan and Kaiser Permanente Low Deductible DHMO plan.

The District also offers a dental plan, vision plan, life and AD&D insurance, an employee assistance program, and voluntary long-term disability insurance.

The plan year runs from October 1st through September 30th of each year. Deductibles and out-of-pocket maximums run calendar year, January 1st through December 31st of each year. 

Additionally, employees can elect to have their medical plan monthly employee payroll deduction taken out pre-tax through the Section 125 -Flexible Spending Account plans. Employees can elect this option at time of hire or during the annual open enrollment period For more information on the Section 125 plans, please visit the Supplemental & Voluntary Insurances section below.

Eligibility

Health benefits eligibility is administered in accordance with the bargaining unit agreements, board policies/administrative regulations, and the Affordable Care Act (ACA) regulations. The following employees are eligible and required to enroll in the District sponsored group health benefits:

  • Full-time management and confidential employees
  • CSEA classified employees working 30 hours or more per week
  • SCFT full-time faculty employees
  • POA classified employees working 40 hours or more per week
  • ACA eligible employees

Eligible employees will complete the intiial benefit enrollment process through their onboarding portal (NeoGov or TalentEd). For questions, please contact the District Human Resources Office for assistance. 

Employees who experience a qualifying life event mid-plan year may request to make changes to their health benefits within 30-days following the life event date. Qualifying life events include birth of a child, adoption, marriage, divorce, etc. Please contact the Benefits Technician at (559) 243-7134 to discuss. 

Eligible dependents can be enrolled onto the health plans within 31-days from date of hire (including date of hire), 31-days from qualifying event date (including event date), and/or during the annual open enrollment period. Dependent eligibility is administered in accordance with the individual health insurance plan guidelines.

Dependent Eligibility Verification Memo   

Health Insurance Plans

For plan year 2019-2020, the employee monthly payroll deduction for the Modern Care PPO plan is $239 and for the Bronze PPO plan is $71.

With a PPO plan, each time you need care, you choose whether to receive your care from a PPO (in-network) or non-PPO provider (out-of-network).

The Modern Care and Bronze PPO health plans use the Anthem Blue Cross provider network nationwide for medical benefits and services.

Telemedicine services, a weight management program and professional pregnancy support are also available under this plan.

Important things to know with the PPO plans:

  • The PPO plans are self-funded plans, which means the District along with the EdCare Group assume the risks and costs associated with the plans.
  • Always ask the provider if he/she is a "contracted provider" with Anthem Blue Cross. If yes, then that provider is in-network.
  • Medical claims are handled by Delta Health Systems. Should you have questions about claims, bills, benefits, etc, please contact Delta Health Systems or log into your member portal.
  • Mental Health and Substance Abuse services are managed by Halcyon Behavioral and there is a separate network of providers.
  • Chiropractic, physical therapy, occupational therapy, and speech-language therapy benefits are managed by PhysMetrics and there is a separate network of providers.
  • Prescription drug benefits are managed by Integrated Prescription Management (IPM).

Benefit Summaries

Modern Care PPO Benefit Summary 2019-2020

Bronze PPO Benefit Summary 2019-2020

Summary Plan Document

Modern Care and Bronze PPO Plans Summary Plan Document

PPO Plan Resources

How to search for a PPO provider

LiveHealth Online Frequently Asked Questions

Sample Explanation of Benefits (EOB) Form - Always review your EOBs against your provider bills to ensure the claim was processed correct and your financial responsibility matches.

Delta Health Systems Member Portal Instructions - Register and access your medical claims, print a temporary medical ID card, and much more.

Prescription Drug Coverage Resources

IPM Member Portal Guide - Access your prescription claim history, view the drug formulary, refill prescriptions with BK Pharmacy, etc.

Prescription Drug Formulary

Step Therapy Information

Prior Authorization Listing

With the Kaiser HMO/DHMO health plans, all care and benefits are through the Kaiser Permanente hospitals and facilities. There are no out-of-network benefits, as all care is handled with the Kaiser Permanente system.

The Kaiser HMO high plan is considered a traditional plan. There is no annual deductible, no co-insurance. The monthly employee payroll deduction is $706.31.

The Kaiser DHMO low plan is considered a deductible plan. There is an annual deductible for benefits and services in relation to the hospital (lab tests, emergency room, urgent care, etc.). The monthly employee payroll deduction is $35.

Kaiser offers telemedicine services, health and wellness classes, and a weight management program.

Important things to know with the HMO plans:

  • Part of the Northern California region
  • California Kaiser Service areas only
  • No out-of-network benefits, nor out-of-state benefits unless there is a true medical emergency.
  • There is a Kaiser Fee Schedule available to determine costs for those on the Kaiser Low DHMO plan.

Benefit Summaries

Kaiser High HMO Plan Benefit Summary 2019-2020

Kaiser Low DHMO Plan Benefit Summary 2019-2020

Evidence of Coverage Documents

Kaiser High HMO Plan Evidence of Coverage 2019-2020

Kaiser Low DHMO Plan Evidence of Coverage 2019-2020

The District's dental plan provider is Ameritas PPO. The District pays 100% of the premium.

Ameritas pays all providers, both in-network and out-of-network, the Ameritas PPO discounted fee, which means if you use an out-of-network provider you may pay more out-of-pocket for services.

All new employees and eligible dependents start at the 70% incentive level. In order for the annual incentive level to increase, members and their eligible enrolled dependents must use the benefits at least once per year.

Benefit Summary and Summary Plan Document

Dental Plan Benefit Summary 2019-2020

Dental Plan Summary Plan Document

The District's vision plan provider is Vision Service Plan (VSP). The District pays 100% of the premium.

The plan provides exams once every 12 months, frames every 24 months, lenses every 12 months, and contacts (in lieu of glasses) every 12 months, including other extra benefits.

Benefit Summary and Summary Plan Document

Vision Plan Benefit Summary 2019-2020

Vision Plan Summary Plan Document

The District offers eligible employees a $50,000 Life Insurance and Accidental Death and Dismemberment (AD&D) plan through VOYA. Eligible dependents enrolled on the medical plan receive a $5,000 life insurance policy.

Full-time management and confidential employees also receive an additional employer-paid, age-based benefit under the life insurance plan.

Along with the plan, eligible members can take advantage of additional services such as funeral planning, estate planning and travel assistance.

The District pays 100% of the premium.

Benefit Summary and Summay Plan Document

Life and AD&D Insurance Benefit Summary

Life and AD&D Insurance Summary Plan Document

Additional services/benefits

Emergency Travel Services

Estate Planning

Funeral Planning

The Employee Assistance Program (EAP) is offered through Halcyon Behavioral.

EAP is a confidential counseling service available to eligible district employees and anyone within the eligible employee’s household.

Eligible employees and members of their households are allowed 6 free sessions per year, per issue. The EAP plan can be used 24 hours a day, 7 days a week.

The District pays 100% of the premium.

Benefit Summary

Halcyon EAP Benefit Summary

The District provides all benefit eligible employees hired on or after September 1, 2013, the opportunity to purchase voluntary long-term disability (LTD) insurance coverage offered through VOYA.

Long-term disability insurance can provide a monetary benefit should an employee be deemed disabled and unable to work, causing a loss of income.

The employee pays 100% of the premium.

Benfit Summary and Summary Plan Document

Voluntary LTD Benefit Summary

Voluntary Benefits and Deductions

American Fidelity is the District's Section 125-Flexible Spending Accounts plan administrator.

The Section 125 plan year runs October 1st through September 30th.

Section 125 Flexible Spending Accounts (FSA) are governed by the IRS and allow eligible employees to pre-tax the monthly employee payroll deduction and set aside money from your paycheck each month, on a pre-tax basis, to use for qualified medical expenses and dependent day care expenses.

  • Dependent Care Account allows you to contribute pre-tax dollars to qualified dependent day care expenses. The maximum amount you may contribute each year is $5,000 (or $2,500 if married and filing separately).
  • Healthcare Flexible Spending Account allows you to set an amount of pre-tax dollars each year into a HFSA account for medical expenses (medical, dental and vision). Then throughout the year as you use services you reimburse yourself by filing a claim. The current maximum amount you may contribute is $2,650.
  • Use It or Lose It Rule - Under IRS regulations, if you do not use your full election amount during the plan year, the remaining funds are forfeited.

To learn more about flexible spending accounts, please visit American Fidelity.

American Fidelity Flexible Spending Guide

Already have an FSA set up with American Fidelity? Log into the AFA Member Portal to find claim information, balance summaries, submit claims, etc.

Employees may elect to purchase voluntary products such as supplemental life insurance, short-term disability insurance, accident insurance, cancer insurance, critical illness insurance, etc.  

Life Insurance

Texas Life through American Fidelity – (559) 230-2107

AFLAC – (559) 224-5004

Accident, Short-Term Disability, Critical Illness, Cancer Insurance, and other Miscellaneous Insurance Products

American Fidelity – (559) 230-2107

AFLAC – (559) 224-5004

403(b)/457 Tax Sheltered Retiree Savings Plan

Eligible employees have the option of electing to contribute to a tax-sheltered annuity, such as a 403(b) plan and/or 457 plan.

The District's third-party administrator for the 403(b) plans is TCG Administrators. For more information regarding the 403(b) plans, please review  CalSTRS 403b Comply and/or contact TCG Administrators at (800) 943-9179. 

457 plans are offered through CalPERS. Please review the CalPERS Supplemental Income 457 Plan Enrollment Kit for more information on the 457 plans. 

Retirement

State Center Community College District offers retirement pension options to eligible employees through different systems – CalPERS, CalSTRS, and Public Agency Retirement Services (PARS). Unsure of which system you are participating in? You can check on your monthly paystub or contact District Payroll at (559) 243-7100. 

Eligible employees also have the option of electing to contribute to a tax-sheltered annuity, such as a 403(b) plan and/or 457 plan. Please review the Supplemental and Voluntary Insurances Section above. 

CalPERS

California Public Employees’ Retirement System (CalPERS) manages pensions for California public employees, retirees and their beneficiaries.

Resources

CalPERS School Member Benefits Guide

myCalPERS registration instructions

SCCCD Retirement Process Checklist for CalPERS  

CalSTRS

California State Teachers’ Retirement System (CalSTRS) provides retirement, disability and survivor benefits to California public school educators and their beneficiaries.

Resources

Welcome to CalSTRS benefit and services for new educators guide

About myCalSTRS

SCCCD Retirement Process Checklist for CalSTRS  

PARS

Public Agency Retirement Services (PARS ARS) is a retirement account for part-time, seasonal, and temporary employees who work for public agencies.

Resources

PARS Plan Information Sheet

Retiree Health Benefit Options for Eligible Employees

Medical insurance benefit options may be available to eligible employees based on the applicable bargaining unit agreement, board policy and/or administrative regulation.

SCCCD Retirement Process Checklist for CalSTRS  

SCCCD Retirement Process Checklist for CalPERS  

Outside Retirement Benefits

Social Security Retirement Benefits

Medicare Benefits

Child Care

There are several Child Development Centers (CDC) within our District. The District does not offer any benefits toward child care and there may be a waitlist at the individual CDC sites. For more information, please visit the individual childcare center webpages below:

Clovis Community College CDC

Fresno City College CDC

Madera Community College Center CDC

Reedley College CDC