2012-2013 HEALTH BENEFIT SURVEY
Please complete the 2012-2013 Health Benefit Survey by clicking on the link below:
Health Insurance (Dental & Optical Included)
2012-2013 Each full-time employee receives $684 per month (all year) in cafeteria dollars to select the health insurance plan that best meets their needs. Part-time employees receive a pro-rated cafeteria amount based on their full-time equivalency (FTE). A summary of health insurance plans available is attached below. Other cafeteria plan offerings are also available, such as Life Insurance and Disability Insurance. The District's Cafeteria Plan also allows pre-tax dollars to be set aside for items such as child and/or dependent care, health insurance premium and health care expenses not covered by the District's health insurance. Please contact the Personnel Benefits Office with any questions. healthbenefittableforbothplans12-13.pdf (134.4 KB)
Health Plan Document
We recommend that you read the plan document below carefully, before incurring any medical expenses. If you have specific questions regarding coverage or benefits, you are urged to refer to the Plan Document.
As a result of the Federal government currently writing rules for the new health care reform laws, there maybe a need for required plan changes during the year. Therefore the Plan Document and Summary Plan Description will not be provided in paper format until all rules are made for the new legislation. The most recent up-to-date Plan Document and Summary Plan Description is posted below in electronic format and it can be downloaded.
300684HelenaSchoolDistPDSPD2012-13.pdf (495.6 KB)
If you wish, you may call or write to Allegiance or the Personnel Benefits Office (324-2008) regarding any detailed questions you may have concerning the Plan.
Mid Year Changes
Health Benefit Plan
Employees are able to add/delete dependents during the plan year only if they experience a "qualifying event" and make their change within sixty (60) days of the event. The following are considered qualifying events:
Marriage - Birth of a child - Adoption/Pre-Adoption placement - Loss of other coverage - Court Order - Qualified Medical Child Support Order - Divorce - Legal Separation - Death
You may print the Request For Enrollment Change below, complete, sign and return to the Health Benefit Office at the May Butler Center. If you are enrolling/adding a dependent and they had prior insurance coverage you will need to request and submit a Certificate of Credible Coverage from the enrollees prior insurance carrier along with the Request For Enrollment Change.
If the enrollment change affects your cafeteria payroll withholding (Example: adding your spouse would change your payroll withholding from Employee Only to Employee and Spouse) you will also need to complete the Cafeteria Benefit Selection Form below and submit it along with the forms above. Contact Donna Fisher @ 324-2008 if you have any questions. RequestForEnrollmentChange2012-13.pdf (64.4 KB)
Cafeteria Benefit Selection Form
2012-2013 If the enrollment change affects your cafeteria payroll withholding (Example: adding your spouse would change your payroll withholding from Single to Single + Spouse) you will make this change in the employee portal during open enrollment. Once open enrollment is closed all enrolled employees having a change in payroll deductions will have to complete the Cafeteria Summary Form below. The only change in benefit selection on this form is the Health Insurance portion at the top of the form. All other benefits stay the same throughout the plan year. Make sure that you mark the new insurance plan box and complete the bottom of the form in its entirety. Contact Donna Fisher @ 324-2008 with any questions. 2012-13CafeteriaSummaryFormFront(2).pdf (31.6 KB)
PHARMACY CLAIM FORM
If you use Costco or other retailers who will not submit pharmacy claims you will need to complete and submit a claim. I have attached a claim form from CIGNA for you to complete and submit. CIGNAPrescriptionClaimForm.pdf (217.8 KB)
FLEX Benefits (125 Plan)
The final date for incurring expenses for the 2011-2012 FLEX Medical Spending Account was December 15, 2012. All participants of this plan have until March 15, 2013 to submit their valid claims to Allegiance for reimbursement. Under the “use-it-or-lose-it” rule, any money remaining in your account after this date will be forfeited.
Below is the Medical Expense Reimbursement Form. You may print this form, complete it and fax it to Allegiance along with legible copies of the medical receipts. All forms relating to FLEX can also be found at the above link. MedicalExpenseReimbursementRequest.pdf (102.6 KB)
Allegiance Benefit Plan Management, Inc. Web-site
Employee/Participants - If you have never logged into the Allegiance web site before, click Register New User to create a login Username (ID). You will then be e-mailed a temporary password. If you have already received your temporary password letter, enter the Username (ID) you created during the registration and the password you have received. Be careful to enter the password EXACTLY as it appears in your e-mail, as this site is case sensitive. If you have accessed our site with a login prior to November 2006, then your Username will be your SSN or Alt ID and your password will be the same, just be sure to type your password in ALL CAPS. If you have any issues logging in, contact Allegiance at 800-877-1122.
Dependents - If you have not yet logged into our new website you will need to re-request your PIN by clicking on Register New User.
Secured and encrypted, the Allegiance website allows participants access to up-to-date health and flexible benefits plan information twenty-four hours a day.
1. Go to: http://www.abpmtpa.com
2. Click on “Login” - then “Employee Login.”
3. Enter Group Number: 3000684
4. Directly below the login information and directly above the note: in red there is a link to the Employee Guidebook—click on the link and all the instructions you need to navigate the Allegiance website are available. Print it out for easy use and reference.
IF YOU ALREADY HAVE USER NAME AND PASSWORD
5. Enter: USERNAME and your PASSWORD (case sensitive). A menu of the available services will be displayed.
TO FILE A FLEX CLAIM ONLINE: https://www.abpmtpa.com/flexonlineclaims/SubmissionType.aspx
Wellness Health Screening Information
To make an appointment for the Wellness Health Screenings please see the July 2012 Health Benefit Newsletter at the link below. It contains the Fall 2012 and Spring 2013 clinic dates. You can find a listing of all the school Wellness Coordinators with their phone numbers on the last page of the newsletter. The Wellness Coordinator for each school will be making the Health Clinic appointments for their designated school.
Prior to your Wellness Health Screening please complete the Wellness Health Assessment questionnaire at the website link below. This website is a secure website through St. Peter's Hospital that will keep your information confidential. You must complete the Wellness Health Assessment along with your Health Screening in order to receive the 40 points for the Wellness Incentive Program.
Call Well Now! staff at 406-444-2128 for information to take the online health assessment.
Health Benefits Newsletter
The Health Benefits Newsletter July 2012, contains information regarding; Wellness Coordinators and their contact information for the fall and spring Health Screening Clinics, and contact information for Allegiance, among other things. February 22, 2013 is the deadline to submit any suggested plan changes to the Health Benefit Committee, we welcome your comments and concerns regarding our Health Benefit Plan. July2012Newsletter.pdf (90.6 KB)
As a subsidiary of the State of Montana all of our employees are required to belong to either the Montana Public Employees Retirement System (MPERS) or the Montana Teachers Retirement System (MTRS). More information about these retirement systems is available through the personnel office or you can access the following websites.