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Health Benefits Eligibility
  • Employee Eligibility

    Employees who work at least half of a full-time regular assignment in one classification may be eligible for health and welfare benefits.

    To Remain Eligible: Must be in paid status within the assignment basis each month.

    Employees must remain in paid status to continue participation in District sponsored benefits unless unpaid leave of absence is protected through the Federal Family Medical Leave Act (FMLA).  Visit the District’s Integrated Disability Management website to learn more about FMLA and other protected leaves of absence.  If no pay was received in a particular pay period, District contributions for the cost of benefits will stop.

By Classification:

Half-Time Employees

Contract teachers must work half-time as a part-time teacher with the remaining time covered by an approved half-time leave.  The District’s benefits contribution is pro-rated on the hours contracted to work.  The balance of the cost is the responsibility of the contracted employee.

 

Substitutes

To be eligible, substitutes must have been in paid status the previous fiscal year (July 1 to June 30) and have the equivalent of 100 days. This equates to 600 regular hours for certificated service and 800 regular hours for classified service and early child education.  If eligible, the District will notify employees in August of enrollment in benefits coverage for the September 1 to August 31 plan year.

Substitute employees must work at least one day per pay period to maintain eligibility.  If employee worked the last pay cycle of the school year, May, and received pay in June for May’s work, continuation of health benefits may be available for June, July, and August.

 

Teacher Assistants and Playground Aides

Effective January 1, 2024: Teacher Assistants (Unit F) and Playground Aides (Unit G) who are assigned to work a regular schedule of 4 or more hours per day and/or 80 or more hours per month in any one classification are eligible.

Exception: Playground Aides with the status of substitute, temporary, extra, exchange, or relief status do not qualify for health benefits.

 

Adult Education Employees

The eligibility rules for adult education employees changed on July 1, 2001.  Adult Education employees may be exempt from the changes if the employee qualified for coverage during the 1979/80 or the 2000/01 school year and maintained continuous eligibility since.

If coverage was lost due to changes in assigned hours or actual hours worked, renewed eligibility may be affected per the revised 2001 rules.

The revised 2001 rules state Adult Education employees are eligible for all benefits if the employee worked at least 120 hours per pay period in one classification in a regular assignment or was in paid status for 1,200 hours during the previous school year as a regular or substitute employee.

If the Adult Education employee worked at least 72 hours per pay period in regular Adult Education assignments or was in paid status for 720 hours during the previous school year as a regular or substitute employee then employee is eligible for medical coverage only and may claim only one dependent.

If eligible, the District will notify employees in August of enrollment in benefits coverage for the September 1 to August 31 plan year. 

  • Dependent Eligibility

    Eligible dependents include legal spouse or qualified domestic partner, dependent children up to age 26, permanently disabled dependent children of any age who were continuously enrolled in the District’s plans before age 26, children of domestic partners whom the employee has adopted or has been declared legal guardian (must be registered with the State of California), and court-ordered children who are included in the employee’s tax return.

    Coverage for disabled dependents may continue as long as employee remains eligible and disabled dependent meets the medical plan's eligibility requirements.  Please note that if coverage for a disabled dependent is terminated for any reason, the coverage cannot be reinstated.

    Spouse: copy of marriage certificate issued by the State.  For new spouses, if a registered marriage certificate is received within 45 days of the marriage date, spouse will be covered effective the date of the marriage.

    Domestic Partner: refer to the "Domestic Partner Information, Declaration, and Enrollment" packet found on the Forms/Publications page.

    Natural Child: copy of the child’s birth certificate. Newborns must be enrolled within 30 days of birth for continuous coverage.  The complimentary hospital certificate will be accepted in lieu of a birth certificate for newborns to five months of age only.  If the required documents are received after 30 days, the newborn will be covered on the first of the month after the verification was received.

    Adopted/Guardianship Child: copy of the document verifying legal adoption/guardianship (issued by the court).  If required documentation is submitted within 30 days of the adoption/guardianship, coverage will begin on the day of the guardianship/adoption.  If submitted after 30 days, coverage will begin on the first of the month after the required documentation is received.

    Stepchildren: a copy of the child’s birth certificate, a copy of the employee’s marriage certificate issued by the State, and a copy of the employee’s latest income tax return showing the child’s dependent status.

    Disabled Child: a copy of the child’s birth certificate and must meet the disability standards of the medical plan chosen and must be enrolled prior to age 26.