Personnel Support Services - Benefits

Carin Freitas, Benefits Specialist, Phone: (858) 521-2800 ext. 2897, FAX: 858-485-1355 email: cfreitas@powayusd.com
Christine Gold, Insurance Benefits Technician email: cgold@powayusd.com

2016 INSURANCE INFORMATION

 

 


New IRS Forms – Coming Soon!
In 2016, you will receive a new IRS tax form (Form 1095-C) from Poway Unified School District.  Employees who were full-time for one or more months during 2015 will receive a Form 1095-C (part-time employees and even some non-employees may also receive a Form 1095-C).  This form provides information about the medical coverage offered to you by Poway Unified School District, and may also include information on who is enrolled for coverage under our plan.
Depending on the type of coverage you were enrolled in during 2015—you may receive a similar Form from your insurance carrier (Form 1095-B) or from the Marketplace (Form 1095-A).
Keep all of the 1095 forms that you receive—you may use them to substantiate what you report for health coverage on your 2015 personal income tax return.
 

What is a Form 1095-C?
Health Care Reform legislation requires that health plan sponsors (employers) and insurers provide a statement each year to eligible employees describing the medical coverage available to them.  The 1095-C is the form created for employers by the IRS for this purpose. Everyone who is eligible for health coverage with Poway Unified School District will receive a form, even if coverage is waived.
 
When and How Will I Get It?

Similar to a Form W-2, the Form 1095-C will be mailed to your permanent address on file. The Form 1095-C will be receive by March 31.  Poway Unified School District is also required to send the IRS copies of all Forms issued.
 

Do I Need the Form to Prepare my Income Tax Return?
For the 2015 tax year it is not a requirement to have Form 1095-C in order to file your U.S. Individual Income Tax Return in 2016. The government has provided an opportunity for employees to
self-report coverage for the 2015 tax year, attesting that the employee (and any dependents, if applicable) had “minimum essential coverage” throughout the year.
 

What Will This Form Be Used For Then?
If you receive your Form 1095-C prior to filing your taxes in 2016, you may use the information on the Form to file your Federal income tax return for 2015. If not, then your Form 1095-C will be used as proof that you indeed had coverage in 2015 if you are audited by the Internal Revenue Service in the future.  In either situation, the 1095-C Form will be used to substantiate that you (and any dependents) had minimum essential coverage for each month of the year. If you or your dependents did not have coverage, you may qualify for an exemption. Otherwise, you will have to pay a penalty. 
 
In addition, the IRS will also use this Form to ensure that Poway Unified School District has complied with the Employer Shared Responsibility rules and will be used to determine whether or not individuals who applied for Marketplace coverage were actually eligible for premium tax credits. 
 

What Information is on the Form?
  • Part I, Employee and Employer Information - includes your specific information, as well as details about Poway Unified School District.
  • Part II, Employee Offer and Coverage - includes information about the coverage offered to you, your spouse and dependents for each month of 2015.
  • Part III, Covered Individuals (if applicable) - lists each person covered on your plan, as well as what month(s) they had coverage.
 
Will each person on my plan receive a Form?

No. Poway Unified School District is only required to send the Form to employees.
 

Who is required to have health coverage under the individual shared responsibility provision?
All U.S. citizens living in the U.S., all permanent residents and all foreign nationals who are in the U.S. long enough during a calendar year to qualify as a resident alien for tax purposes are required to have minimum essential coverage.  Foreign nationals living in the U.S. may need to file a federal tax return, but if they have not been here long enough to become a resident alien for federal income tax purposes then they are not subject to this mandate.
A U.S. citizen who is not physically present in the U.S. for at least 330 days in a 12-month period is treated as having minimum essential coverage for that period, as are U.S. citizens who are bona fide residents of a foreign country for an entire tax year.
See a tax advisor or contact the IRS with questions specific to your situation.

 
Who do I call for questions?

Visit www.healthcare.gov or www.irs.gov, talk to your tax advisor or contact the Insurance Benefits Department with questions.   
 


Now that Open Enrollment has ended your next opportunity to make benefit changes will be during the fall of 2016 with a January 1, 2017 effective date unless you experience a midyear qualifying event. Making changes to your benefits outside of the Open Enrollment period is permitted ONLY if you have a qualified change in status as defined by the IRS.

 

Examples include:

  • Marriage, divorce or legal separation
  • Birth or Adoption of a child
  • Death of a dependent
  • You or your spouse’s / unregistered domestic partner’s loss or gain of coverage through our organization or another employer
  • Unpaid leave of absence for you  or your spouse / unregistered domestic partner causing a loss of other group coverage
  • Child’s loss in dependent status, such as attainment of maximum age
  • Change in residence affective eligibility or access
  • Change in employment status where you have a reduction in hours to an average below 30 hours of service per week, but continue to be eligible for benefits, and you intend to enroll in another plan that provides Minimum Essential Coverage that is effective no later than the first day of the second month following the date of revocation or your employer sponsored coverage
  • You enroll, or intend to enroll, in a Qualified Health Plan (QHP) through the State Marketplace (i.e. Exchange) and it is effective no later than the day immediately following the revocation of your employer sponsored coverage
If you have experienced a midyear qualifying event and wish to make benefit changes, simply complete the 2016 Enrollment Form listed below and attach proof of the life event.
 
For a complete explanation of qualified status changes, please refer to the Legal Information Regarding Your Plan section of the 2016 Employee Benefits Information Guide.


All forms are to be submitted to the Insurance Benefits Department located at the District Office.

 
INSURANCE GUIDES/FORMS GROUP TYPE
EMPLOYEE BENEFITS INFORMATION GUIDE ACTIVE MEDICAL
EMPLOYEE BENEFITS INFORMATION GUIDE - COBRA ALL MEDICAL
EMPLOYEE BENEFITS INFORMATION GUIDE - RETIREE RETIREE MEDICAL
2016 BENEFITS ENROLLMENT FORM - ACTIVE EMPLOYEE ACTIVE MEDICAL
2016 BENEFITS ENROLLMENT FORM - RETIREE RETIREE MEDICAL
2016 FLEX ENROLLMENT FORM ACTIVE FLEX
2016 PUSD DELTA DENTAL BENEFIT SUMMARY ALL DENTAL
2016 PUSD MES VISION SUMMARY ACTIVE VISION
THE STANDARD LIFE INSURANCE ENROLLMENT FORM ACTIVE LIFE
2016 PUSD AETNA AVN HMO SBC (Summary of Basic Coverage) ACTIVE MEDICAL
2016 PUSD AENTA AVN HMO SUPPLEMENTAL INFO ACTIVE MEDICAL
2016 PUSD AETNA AVN HMO SUMMARY (AETNA VALUE NETWORK) ACTIVE MEDICAL
2016 PUSD AETNA EPO SUMMARY (ELECT CHOICE) ACTIVE MEDICAL
2016 PUSD AETNA FULL NETWORK SBC ACTIVE MEDICAL
2016 PUSD AETNA FULL NETWORK SUPPLEMENTAL INFO ACTIVE MEDICAL
2016 PUSD AETNA FULL NETWORK HMO SUMMARY ACTIVE MEDICAL
2016 PUSD AETNA OAMC SBC ACTIVE MEDICAL
2016 PUSD AETNA OAMC SBC SUPPLEMENTAL INFO ACTIVE MEDICAL
2016 PUSD AETNA OAMC SUMMARY (OPEN ACCESS MANAGED CHOICE) ACTIVE MEDICAL
2016 PUSD KAISER PRINCIPAL BENEFITS SUMMARY ACTIVE MEDICAL
2016 PUSD KAISER CHIRO RIDER ACTIVE MEDICAL
2016 PUSD KAISER TRANDITIONAL PLAN SBC (Summary of Benefits & Coverage) ACTIVE MEDICAL
2016 PUSD KAISER SENIOR ADVANTAGE [KPSA] ENROLLMENT FORM SENIORS MEDICAL
2016 PUSD KAISER SENIOR ADVANTAGE [KPSA] BENEFIT SUMMARY SENIORS MEDICAL
2016 PUSD KAISER SENIOR ADVANTAGE [KPSA] DENTAL SUMMARY SENIORS DENTAL
DOMESTIC PARTNER AFFIDAVIT ACTIVE  
PAYROLL DEDUCTION CHANGE ACTIVE  
MES Claim Form ACTIVE EYE
Handicaped Child Attending Physicians Statement Form ACTIVE  
Request for Continuation of Medical Coverage ACTIVE  
MHS HO ACTIVE  
Domestic Partner Agreement Form ACTIVE  
Dependent Day Care Provider Acknowledgement Form ACTIVE  
Optum RX Claim Reimbursement Form ACTIVE RX
Beneficiary Designation Form ACTIVE  
     
     
     

 

 

The Poway Unified School District (PUSD) is an equal opportunity employer/program and is committed to an active Nondiscrimination Program. PUSD prohibits discrimination, harassment, intimidation, and bullying based on actual or perceived ancestry, age, color, disability, gender, gender identity, gender expression, nationality, race or ethnicity, religion, sex, sexual orientation, or association with a person or a group with one or more of these actual or perceived characteristics. For more information, please contact the Title IX/Equity Compliance Officer, Associate Superintendent of Personnel Support Services, Poway Unified School District, 15250 Avenue of Science, San Diego, CA 92128-3406, 858-521-2800, extension 2761. View Annual Notification of Parents’/Students’ Rights | Annual Notification of Employees’ Rights

POWAY UNIFIED SCHOOL DISTRICT | 15250 Avenue of Science, San Diego, CA 92128 | (858) 521-2800