Personnel Support Services - Benefits

Carin Freitas, Insurance Benefits Specialist, email: cfreitas@powayusd.com
Christine Gold, Insurance Benefits Technician, email: cgold@powayusd.com
Shannon Wolff, Insurance Benefits Technician, email: swolff@powayusd.com

Dependent Verification Review

To:                      All Benefit-Eligible Employees
From:                 Brian Morris, Director of Human Resources
Subject:             District Dependent Verification Review, 2nd Employee Notice

Poway Unified School District is implementing a Dependent Verification Review (DVR). This review will ensure only eligible dependents are covered under the District’s insurance plans which include medical, dental and vision.
 
This review is required for all full-time and part-time employees who have dependents on medical, dental or vision plans offered through Poway Unified School District.  If you have opted out of the District’s health benefits and/or do not have dependents enrolled under your medical, dental or vision coverage, you are not required to schedule an appointment.  However, you are welcome to schedule an appointment to learn about the new supplemental insurance benefits as well as to correct any discrepancies in our records.
 
We have asked American Fidelity to assist with the DVR and will ensure your conversations remain confidential. The American Fidelity representative will only review information showing which dependents are eligible. They will not make copies or retain any dependent information. During this review, you are required to meet with an American Fidelity representative and bring all relevant documentation to your appointment which will be scheduled between October 14th and December 13th, 2019. If you do not meet with a representative, your dependents may be removed from your insurance plans.
 

Scheduling an Appointment

First:   View the attached DVR schedule to find the date representatives will be at your site.
Second:  Schedule your review by visiting https://benefits.americanfidelity.com/poway-unified-school-district/ (if you experience difficulty scheduling your appointment online, please call (800) 365-9180 ext. 0).  To minimize classroom disruption, a roving sub will be provided for staff at school sites.  During your appointment you will need to provide the original or copy of the original applicable documents for each dependent on your plans. After a visual verification, the documents will be returned. 
 

Documentation

In addition to providing social security numbers for all dependents, review this chart to determine the documents you will be required to bring to your appointment.
 

Spouse: First page of the 2018 Federal Tax Return (Form 1040) with spouse listed. If tax return does not list spouse you may bring a Government-issued marriage certificate/license. (Copies will be accepted if they show the embossed seal).
§ Only lines 1-6d of the tax return will be viewed. Black out any financial information if you choose not to share.
Same-Sex Domestic Partner or Opposite Sex Domestic Partner A new Poway Unified School District Domestic Partner Affidavit must be completed (attached) and brought with you at the time of your appointment. A new affidavit must be completed for this verification and we cannot use the one that may already be on file with your benefits department.  Please see attached Domestic Partner Form, print and complete prior to your appointment. 
Birth Child The first page of 2018 Federal Tax Return (Form 1040) or original Birth Certificate for children not appearing on the tax return. Only the original birth certificate with state embossed seal or copy of the original birth certificate will be accepted. Hospital certificates are only acceptable if the child is under the age of six months. (Copies will be accepted; birth certificate must show the embossed seal).
Stepchild(ren) First page of the 2018 Federal Tax Return (Form 1040) with spouse listed. If tax return does not list spouse you may bring a Government-issued marriage certificate/license. (Copies will be accepted if they show the embossed seal).
AND Birth Certificate of stepchild listing employee’s current spouse as the parent of the stepchild(ren). Only the original birth certificate with state embossed seal or copy of the original birth certificate will be accepted. (Copies will be accepted; birth certificate must show the embossed seal).
Adopted, foster, legal guardianship or grandchildren The first page of 2018 Federal Tax Return (Form 1040), birth certificate and court document showing legal responsibility for the child(ren). Only the original birth certificate with state embossed seal or copy of the original birth certificate will be accepted. (Copies will be accepted; birth certificate must show the embossed seal).
Handicapped or disabled dependent age 26 or older The first page of 2018 Federal Tax Return (Form 1040) or original birth certificate for children not appearing on the tax return and one of the following: physicians statement attesting to the disability of the dependent or Medicare Eligibility Card. (Copies will be accepted, birth certificate must show the embossed seal).
 
The following sites can help you order documents you may need. Order today. It can take several weeks to process and receive your requested item(s).
   (However, PUSD’s Affidavit for Enrollment of Domestic Partner is required for enrollment of Domestic Partners see attached)
 
Additional Benefit Offerings
During this appointment, you will also have the opportunity to discuss voluntary insurance benefits available to you and your family. There is no obligation to hear a presentation or purchase any American Fidelity products.
 
For additional questions regarding the DVR, please contact our American Fidelity representative at:
American Fidelity, 800-365-9180 ext. 0
PUSD Benefits Office, 858-521-2800, ext. 2897
 
Thank you for your cooperation & support!
 

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 race, color, ancestry, national origin, nationality, immigration status, ethnicity, ethnic group identification, age, religion, marital or parental status, physical or mental ability, sex, sexual orientation, gender, gender identity, or gender expression or association with a person or a group with one or more of these actual or perceived characteristics. For more information, please contact: Title IX/Equity Compliance Officer, James Jimenez, Associate Superintendent of Personnel Support Services, Poway Unified School District, 15250 Avenue of Science, San Diego, CA 92128, 1-858-521-2800, extension 2761, jjimenez@powayusd.com

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