- Monroe One
- Employee Benefits
- Medical/Health Insurance
Employee Handbook
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- Table of Contents
- What is Monroe One BOCES?
- Policies and Procedures
- Payroll/Personnel
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Employee Benefits
- Dental Insurance
- Employee Assistance Program (EAP)
- Flex Spending 125/HRA 105/HSA
- Longevity Payments
- Medical/Health Insurance
- Mutual of Omaha Life Insurance (BOCES-Paid)
- Optional Insurance Products
- NYS 529 College Savings Program
- NYS Retirement Systems (ERS and TRS)
- Tax Sheltered Annuities
- Tuition Reimbursement
- Attendance
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Employee and Employer Responsibility for Safety
- General Safety and Security Reminders
- Emergency Planning
- Health & Safety: Written Plans and Information (Opens in New Window)
- Pesticide Notice and Form
- Radon Testing of School Buildings
- Water Quality Testing Results (Opens in New Window)
- Emergency Closing Information
- Fire Drills and Inspections
- Annual Right to Know Trainings and GCN Website
- Campus Technology
- Additional Information
Health Insurance
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Types of Medical Coverage
There are four (4) types of medical coverage:
- Single Plan—Self
- Sponsor Plan—Self and spouse
- Family Plan—Self and spouse and child(ren)
- Head/House—Self + 1 or more children
Dependents can be covered up to age 26.
Medical Plans Available:
The plans listed are HMOs so you must select a primary care doctor when enrolling:
- RASHP 2 Select ($15 copay)—This plan includes a Health Reimbursement Account (HRA) bank plan. Please refer to your union contract for the exact amount contained in the HRA.
- RASHP 2 Value ($20 copay)—This plan also includes the HRA. Again, please refer to your union contract.
Monroe One also offers a High deductible called RASHP 2 HDHP:
- $0 payroll deduction for employees
- National PPO network of providers (may live or use plan anywhere)
- Preventative care services covered in full
- Employee pays 100% medical and Rx costs until the annual Deductible is met (Deductible is $1800/single or $3600/family)
- Employee pays 10% of expenses after Deductible is met (copay for Rx services after Deductible is met ($5/$35/$70))
- Excellus pays 100% of covered services after Out of Pocket Maximum is reached (Out of Pocket Maximum is $3600/single or $7200/family
- Deductible starts over each January 1st
- Health Savings Accounts available for some unions. Check your contract for more details.
Frequently Asked Questions (FAQs)
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When is my insurance effective?
Health insurance is effective your date of hire. If you resign, your coverage will end the day you resign. (Please note, 10 month employees who work through their last day of program in June, may be eligible to continue coverage through August 31st.)
- Example: Hire date is October 18th. Health/Dental insurance will start October 18th.
- Example: Resign date is November 3rd. Health/Dental insurance will end November 3rd.
For any questions or specifics, please reach out to Tracy Birge, Benefits Clerk.
- Example: Hire date is October 18th. Health/Dental insurance will start October 18th.
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Does my Health insurance deduction come out of every paycheck, even in the summer?
Your Health insurance deduction is taken over 20 pays from September through June. There are no deductions taken in July and August. To cover the summer months of July and August, an additional deduction is taken from January through June.
To calculate what that additional amount is, take your pay period amount on your Benefits Summary sheet and multiply it by 4. Take that amount and divide by 12.
Example:BPA RASHP Value Single is $41.05 a pay period.
$41.05 x 4 = $164.20; then $164.20 /12 =$13.68.
$13.68 is the amount that would be taken in addition to the $41.05 pay period amount.
For the months of January through June, $54.73 would be your health insurance deduction. -
What is an “HMO”?
HMO stands for Health Maintenance Organization, and with an HMO you must have a primary care physician that you see first for all medical issues.
If they are unable to treat you, you will be sent to a specialist within a network of health care providers (doctors, hospitals, etc.).
All of our RASHP 2 plans (RASHP 2 Value, RASHP 2 Select) are HMOs. -
How do deductibles work with the Signature High deductible Plan?
Employees pay 100% of their medical and prescription costs until the deductible is met—which is $1800 for a single plan and $3600 for a family plan starting January 1st of each year.
Once the deductible is met, the employee pays 10% of medical expenses and prescription co-pays of $5/$35/$70 until the maximum paid by the employee is met.
The maximum for single is $3600 and Family is $7200. After the max has been paid out, Excellus pays 100% of covered services. -
When can I change Health insurance plans if I don’t like my current one?
Employees can change Health insurance during Open Enrollment, which lasts from November 1 through November 30th every year.
The plan you changed to will start the following January 1st. -
Can I transfer to BOCES coverage if it is not Open Enrollment?
You may be able to transfer to BOCES coverage within 30 days of a “qualifying event”, which allows enrollment in insurance plans due to loss of coverage, marriage, birth of a child, etc.
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I have a domestic partner. Can my partner be on my Health insurance?
You need to complete an affidavit with specific qualifications.
Once your eligibility is verified, your partner can be on your coverage. You will be responsible for the FICA/Medicare taxes on the difference in costs between insurance for yourself and insurance for you and your partner. You’ll receive a letter with that amount and a deduction will be taken every pay period. -
What if I already have insurance through my spouse’s employer?
BOCES will pay you a stipend according to your contract in June and December once you have completed the Opt Out Form and provided proof of insurance. This amount will be prorated based on start date and part time.
Proof of insurance can be a medical card with your name on it or a letter from the employer stating that you and your dependents are covered.
We need the Opt Out Form and proof of insurance every calendar year. -
I am under 26 years old and still on my parents’ insurance. What happens when I turn 26 and can no longer stay on their insurance?
When you are terminated from your parents’ policy, you will be eligible to transfer to BOCES’ insurance. This can happen because you have a “qualifying event”, which allows enrollment in insurance plans due to loss of coverage, marriage, birth of a child, etc.
You need to submit your paperwork (Enrollment/Change Form) to transfer within 30 days of your 26th birthday. -
When do the rates change for insurance?
Our Health insurance rates change January 1st of every year, and they can increase, decrease or even stay the same.
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What happens with my coverage if I leave Monroe One?
You may continue coverage after leaving Monroe One through a federal law called COBRA. However, you will pay full cost plus a 2% administrative fee to Excellus.
Related Files
Individual Plan Summary
Summary Benefit Coverage and Uniform Glossary
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Uniform Glossary
Glossary of Health Coverage and Medical Terms