Benefit Reference Guide - The School District of Palm Beach County

Overview for 2012
Employee Premiums
Your premiums will be deducted through payroll deductions over
22 or 24 pays, depending on your paycheck schedule. Changes
to your paycheck schedule will impact your premium amounts
accordingly. Some plan premiums are based upon your age and/or
earnings. Premiums for these plans are also subject to change.
Enrollment of any children and a Domestic Partner will be the
equivalent of the above rates. The deductions will be reflected as
the Employee Only pre-tax rate and the balance of the deduction
will be taken on an after-tax basis.
IMPORTANT TO NOTE: Employees who receive 26 paychecks will
have deductions taken only twice during the months when three
checks are issued. Premiums displayed in this booklet may vary
slightly from your actual payroll deductions due to rounding.
401(a) Dollars
When an eligible employee waives medical coverage, the District
will make a deposit of these 401(a) Dollars into a 401(a) Special
Retirement Plan in your name.
If you have medical coverage other than a District plan (i.e. under
another employer’s plan or a retirement plan), you may waive
the School District’s coverage and receive 401(a) Dollars valued
at $100 per month ($50 per month if you are a part-time eligible
employee). However, you are not eligible for the 401(a) Dollars
if you are covered as a dependent by another District employee.
Please refer to page 35 for more detailed information and complete
the required form.
Plan
Monthly 401(a) Dollars
Full Time Part Time*
Waive Medical $100 $50
Coverage Levels
You will be able to purchase medical and dental benefits at the
following levels:
1. Employee Only
2. Employee + Child(ren)
3. Employee + Spouse
4. Employee + Family
5. Employee + Domestic Partner
6. Employee + Domestic Partner + Children (partner’s child(ren)
and/or Employee’s Child(ren)*
This provides you with maximum flexibility to custom build your
benefits plan. You may select medical, dental and vision coverage
separately. For example, you may need medical coverage for just
you, but dental coverage for you and your family.
* A Domestic Partner must be covered in order for their children
to be covered.
Over Aged Adult Children
A separate application and premium are required to enroll eligible
adult children who meet the state’s requirement and are between
the ages of 26 and 30 years of age.
Did you read about...
• Your responsibilities?
• The premium deduction information?
• The 401(a) dollar overview?
• The coverage level outline?
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