544R-B - Health Insurance

    1. Eligibility

      1. Full-Time Employees

        All full-time employees of the Frederick County Public Schools are eligible to participate in the health insurance plan. Full-time employees are defined as those who work 32.5 or more hours per week, and who are employed for a minimum assignment-term of 180 days per year. Participating full-time employees are responsible for the designated employee contribution toward the premium for the coverage selected.

      2. School Bus Drivers, Bus Aides and School Nutrition Staff

        Regular route school bus drivers, bus aides and school nutrition staff working 4.5 or more hours per day are eligible to participate in the health insurance plan. Participating employees are responsible for the designated employee contribution toward the premium for the coverage selected.

    2. Coverage and Participation

      1. Premiums for additional insurance coverage are the responsibility of the employee and may be deducted monthly from their pay.

      2. Employer contribution toward health insurance coverage will commence on the first day of the month following the employee’s first payroll. The employer contribution toward health insurance coverage will be reviewed annually.

      3. In order to be eligible for health insurance coverage, employees must complete the insurance application within 30 days of their eligibility date. The eligibility date is defined as the first day of the month following the employee’s hire date.

      4. New employees may participate in the Frederick County Public Schools’ health insurance plan prior to the first payroll if the employee assumes responsibility for the full cost of the coverage. If the employee elects to participate, the employee may do so effective the first day of the month following or coincident with the employee’s hire date.

      5. Generally, coverage contribution by the Frederick County Public Schools will begin on September 1 for 10-month and 11-month employees, and August 1 for 12-month employees.

    3. Period Covered by Premium Payments

      All premium contributions for insurance coverage (school board or employee) are on a prepaid basis. For example, the premiums allocated for September insurance coverage are prepaid by the school board and employee deductions against the August payroll.

    4. Retired Employees

      Eligible retirees may continue their participation in the group health insurance plan at their own expense until they become covered under another health plan, i.e. through other employment, through a spouse, or becoming eligible for Medicare. To be eligible for Retiree-Option benefits, an employee must meet the following requirements:

      1. be a Virginia Retirement System member and meet the eligibility requirements for VRS disability retirement, full retirement or early retirement with reduced benefits;

      2. have been a participant in the health insurance plan for a minimum of twelve (12) months;

      3. elect to continue participation under the Retiree-Option within 60 days following notice to the employee of his Retiree-Option/COBRA rights to continue coverage;

      4. authorize VRS to deduct their monthly health premiums from their retirement annuity. If the retirement annuity is not sufficient to deduct the full amount of the required premium, retirees will be responsible for payment by personal check;.

      It should be understood that dependent coverage is only available if elected at retirement. Employees who elect to continue medical coverage under the Retiree-Option, will not be allowed to change their original election unless a life status change occurs.

      If, pursuant to school board policy, continuation of health insurance coverage under the Retiree-Option is elected by a retiring employee, such continuing coverage shall be counted toward, and run concurrently with, the maximum number of months for which the employee and the employee’s spouse and dependents are eligible under COBRA. If a retiring or retired employee's dependents are enrolled under family or subscriber-plus-one coverage at the employee's date of retirement, the retired employee's dependents who were enrolled at the employee's date of retirement may continue participation at their own expense for so long as the retired employee participates. Upon the retired employee’s death, the retired employee’s spouse and dependents who are participating as of the date of the retired employee’s death may continue to participate until the earlier of the following occurs:

      1. The last day of the 36th month following the month of the retired employee’s death;

      2. The last day of the month in which the spouse or dependent obtains other health coverage; or

      3. The last day of the month in which the dependent no longer meets the requirements for dependent status as defined by the group insurance contract.

      The foregoing periods of coverage for retirees, spouses and dependents will be extended if required by COBRA. The last date of coverage as paid by the school board (or the last day of the month following the month of retirement for full-time/part-time employees not eligible for employer-paid coverage) shall be deemed the qualifying-event-date for determining the duration of eligibility under the Retiree-Option and COBRA.

      The school board shall periodically review experience ratings, premiums, and other factors to determine whether the standard group contract for active employees or a retiree-only plan shall be available to retirees. Premiums are based on usage. The school board expressly reserves the right to modify or terminate the Retiree-Option for health care coverage, in whole or part, without notice to retirees or dependents, to the extent not inconsistent with COBRA.

    5. Termination of Coverage

      1. School board coverage for a separating employee shall end on the last day of the month in which separation occurs.

      2. School board coverage for 10-month and 11-month employees who complete their contract or assignment term and do not request a lump-sum salary separation payment shall end on August 31. Coverage for 12-month employees who complete their contract or assignment term shall end on July 31.

      3. School board coverage for employees retiring before the end of their assignment-term will cease at the end of the month following the month of retirement.

      4. If an employee elects continuation of group health insurance pursuant to leave of absence or reduction in force policy, such continued coverage shall be counted toward the maximum number of months for which the employee is eligible under COBRA provisions. The employee is responsible for the full cost of the coverage while on a leave of absence.

      5. School board coverage for employees on leaves of absence who discontinue payments or end their leave status, shall end on the last day of the month.

    6. Coverage at Reduction in Assignment Term

      In order not to interrupt continuous coverage, the school board shall maintain the employer’s share of the payment of provided coverage during the transitional months when an 11-month employee is reassigned to a 10-month term, or a 12-month employee is reassigned to a 10-month or 11-month term.

     

    Approved: April 7, 1970
    Amended: September 7, 1976
    Amended: September 1, 1990
    Amended: August 1, 1991
    Amended: July 1, 1993
    Amended: July 1, 1995
    Amended: July 6, 1999
    Amended: June 13, 2000
    Amended: April 3, 2001
    Amended: May 7, 2003
    Amended: June 22, 2007
    Amended: July 1, 2015
    Amended: July 3, 2018
    Amended: June 23, 2021 (Effective July 1, 2021)