Health & Benefit Plans

Santa Monica Community College District - Open Enrollment

 

2025 Benefits Open Enrollment
September 16 - October 11, 2024

The 2025 Open Enrollment begins Monday, September 16, 2024, for the following employee groups:

  • Academic Administrators
  • Board of Trustees
  • Classified Employees
  • Classified Managers
  • Confidential Employees
  • Full-time Faculty
  • Personnel Commissioners
  • Police Officers
  • Project Managers

During Open Enrollment, you may enroll, change, add or remove eligible dependents from your health benefits for the 2025 plan year. All changes made during Open Enrollment will be effective January 1, 2025. The deadline to make changes to your health benefits is Friday, October 11, 2024, by 5 p.m.

If you do not wish to make changes to your current health benefits (medical, dental, and/or vision), there is NO ACTION to complete. Your current plan elections will remain intact for the 2025 Plan Year.

2025 Benefit Plans Information

CalPERS Medical Plans

CalPERS Health Plans Changes for the 2025 Plan Year.

  • There is NO Employee Cost for ALL CalPERS MEDICAL Plans for 2025. The premiums for all medical plans the District offers through CalPERS are 100% District paid. (Except for part-time employees, who will contribute according to their full-time equivalency for any health plan)
  • There are NO CHANGES to co-pays, co-insurance or deductibles for all CalPERS Medical Plans in 2025.
  • Doula Benefit -  All pregnant and postpartum members can receive health education, advocacy, physical and emotional non-medical support before, during and after pregancy, including abortion, miscarriage, and stillbirth.
  • Travel Benefit - Standardize travel and lodging coverage for eligible medically necessary services including, but not limited to abortion services, gender affirming care, complex surgeries, and cancer care that cannot be accessed within 50 miles from the member’s residence for all plan members. This includes cost for transportation, lodging, and meals for the member and a companion (both parents/guardians when patient is under 18), up to $5,000 per occurrence.
  • CalPERS PPO Plan Changes - PERS Gold and PERS Platinum will be administered by Blue Shield of California for the 2025 plan year. CalPERS will automatically transition employees enrolled in PERS Gold and PERS Platinum plans to Blue Shield of California. If you want to remain of the PPO plans there is NO ACTION to complete. Watch and learn more about the CalPERS New PPO Administrators: Blue Shield and Included Health 
    • Included Health will help PPO members to find the care they need using the Blue Shield's network of doctors and hospitals. Included Health will be available 24/7 by phone, online or mobile app to assist PPO members with the following:
      • Finding a Doctor - Included Health can assist with finding a doctor in the Blue Shield's network or confirm if your current doctor(s) are in-network.
      • Continuity of Care Eligibility - If your doctor or hositipal is not in-network with Blue Shield you may be eligible to continue to receive care with your existing provider for up to one year.
      • Understanding your Benefit - Included Health can answer questions regarding your claims and assist with complex case management.
    • If you have questions or need assistance regarding the PPO plan changes to Blue Shield, please contact Included Health: Member Services - 855-633-4436 or online - Included Health

Plan Resources

Plan Websites

Note: Health premium contributions are deducted on a pre-tax basis. This means your premium contributions are deducted from your paycheck prior to federal and state tax withholdings, thus reducing your taxable income. Employees may waive the pre-tax option by completing the Pre-Tax Health Premium Waiver Form.

Delta Dental Plans

  • There are NO CHANGES to Delta Dental PPO and HMO Plans for the 2025 Plan Year.

Delta Care USA HMO:

Delta Care USA HMO provides all reasonable and customary dental care if care is rendered by a selected Delta Care dentist. The participant must select a dentist/dental network upon enrollment. There is no cost for covered service except for co-payment on certain procedures.

Delta Dental PPO:

Delta Dental PPO has an annual maximum towards dental service of $2,000. Basic services, diagnostic & preventative care, and crowns & cast restorations are covered at 100% coverage level. Participants enrolled in the plan are able to see in-network and out-of-network dental providers.

Plan Resources

Plan Website

VSP Vision Plan

  • The frames allowance is increasing from $150 to $180 for the Vision Service Plan (VSP) for the 2025 Plan Year.

VSP provides for one Wellvision eye examination, one prescription eyeglass frame (up to $180 allowance) or contact lenses (up to $150 allowance) per 12-month period. When visiting a VSP provider, participants pay a $10 co-payment. If participants receive services from a non-VSP provider, it is a lesser benefit. The plan offers extra discounts and savings on additional glasses and sunglasses, contact lens, exams (fitting and evaluation) and laser vision correction.

Plan Resources

Plan Website

Cash-in-Lieu Program

Classified Employees, Full-Time Faculty, & Police Officers Only

Under the contract provisions for the District-CSEA, District-SMCFA, and District-SMCPOA, Classified Employees, Full-time Faculty, and Police Officers who have non-District medical coverage may opt-out of the District's medical plans and receive a cash-in-lieu benefit amount up to $2,000 per year. Classified Employees, Full-time Faculty, and Police Officers who are currently participating in the Cash-in-Lieu Program will need to renew their declination during open enrollment.

To enroll/renew in the Cash-in-Lieu Program, employees will need to complete the SMC Open Enrollment form and provide proof of continuing health coverage (i.e. copy of medical plan card). For more information, see the contract provisions below:

Voluntary Benefits

(Ameriflex/ Colonial Life/ Pacific Educators)

Open Enrollment for Voluntary Benefits will be held between the period of September 30 - October 11, 2024.

Section 125-Flexible Spending Accounts (FSAs)

Ameriflex administrators Section 125 - Flexible Spending Accounts (FSAs). FSAs allow employees to set aside pre-tax dollars for out-of-pocket medical expenses and/or dependent care cost into a Health Care FSA and/or Dependent Day Care FSA. Below are the annual plan maximums for 2025.

2025 FSA Plan Maximum

  • Health Care FSA$3,200
  • Dependent Day Care FSA$5,000

Important Information:

  • For the 2025 plan year, there will be an additional employee administrative fee of $4.20 (tenthly) for FSA account(s). Part-time Faculty the fee is prorated at $5.25/eighthly.
  • Employees currently enrolled in an FSA account(s) for 2024 and will like to continue their election into 2025, you must complete a FSA Enrollment form to re-enroll for the 2025 plan year.
  • Employees who are enrolled in a 2024 FSA account(s) must submit all expenses to AmeriFlex by no later than March 31, 2025, for reimbursement. Unused funds up to $640 for the medical FSA account will carry over into the 2025 plan year.

Plan Resources

How to Enroll in FSA Accounts:

THE ENROLLMENT PROCESS FOR THE 2025 PLAN YEAR. To enroll in an FSA account for 2025, employees will NOW complete an Ameriflex Enrollment form below.  Return the enrollment form to the Office of Human Resources as a scanned attachment via EMAIL to BOTH Lugina Rogers (rogers_lugina@smc.edu) and Demi Rodriguez (rodriguez_demi@smc.edu) scanned attachment must be sent from your SMC email.  IMPORTANT: Please complete ALL highlighted sections of the enrollment form.

Other Voluntary Benefits Options:

You have the opportunity to review and apply for other voluntary benefits through Colonial Life and Pacific Educators. The following voluntary benefits are offered for purchase during the enrollment:

  • Disability Insurance
  • Term Life Insurance
  • Universal Life Insurance
  • Whole Life Insurance
  • Accident Insurance
  • Cancer Insurance
Plan Resources

How to Enroll in Other Voluntary Benefits

To enroll or make changes to your supplemental policies with Pacific Educators or Colonial Life for the 2025 plan year, you will be able to meet with representatives separately to discuss plan options and rates.

Eligible Dependents

  • Spouse
  • Registered Domestic Partner
  • Children up to age 26 (natural, adopted, domestic partner's, or step)
  • Children, up to age 26, if the employee has assumed a parent-child relationship and is considered the primary care parent
  • Certified disabled dependent children age 26 and older

All Dependents enrolled in District-sponsored insurance are subject to verification of eligibility.

How to Enroll or Make Changes to Your Benefits

  1. Complete the SMC Open Enrollment Form; and
  2. Complete Health Plan Enrollment Form(s)
  3. If you are adding dependent(s), you must provide proof of dependent eligibility (i.e. birth certificate, marriage license, certification of domestic partnership, etc.)
  4. Return the enrollment forms and supporting documentation (if applicable) to the Office of Human Resources as a scanned attachment via EMAIL to BOTH Lugina Rogers (rogers_lugina@smc.edu) and Demi Rodriguez (rodriguez_demi@smc.edu) scanned attachment must be sent from your SMC email.

Forms

Deadline: Friday, October 11, 2024, by 5 p.m.

Contact

For additional information or if you have questions, please contact the Office of Human Resources:

Lugina Rogers, HR Analyst-Leaves & Benefits - 310-434-4060 / rogers_lugina@smc.edu

Demi Rodriguez, Employee Benefits Coordinator (WOC) - 310-434-4928 / rodriguez_demi@smc.edu