- Health Insurance Coverage for Full-Time Employees
- Health Insurance Coverage for Hourly (Part-Time) Employees
- Health Insurance Option for Substitutes
- Find an In-Network Provider
- Continuation of Benefits (COBRA)
- Payment of Premiums for Part-Time Employees and Substitutes
- Online Payments
Mesquite ISD participates in the state health plan with TRS ActiveCare, which is administered by Aetna/CVS Caremark and Scott & White Health Plan. The district contributes $2,292 or $2,664 per year toward the cost of your health insurance coverage (depending on which plan you select), and the state contributes $900 per year.
There are four health care plans available to Mesquite ISD employees through TRS ActiveCare.
Scott & White HMO
The Mesquite Employee Health Center (MEHC) is not a part of this network.
The Teacher Retirement System (TRS) allows hourly/part-time Mesquite ISD employees who work between 10 and 19 hours per week to enroll in the state's health insurance plans; however, because these employees are not members of TRS, the district does not contribute to the cost of the employee's health insurance. Employees who elect this coverage must pay 100 percent of their health premiums in advance each month (see Payment of Premiums below).
All hourly/part-time employees must either enroll in a Mesquite ISD health plan or decline the coverage. This is done within 31 days of your hire date for your NEW HIRE ENROLLMENT opportunity and/or each August during the BENEFITS ANNUAL ENROLLMENT opportunity. If you are not enrolling in the Mesquite ISD health insurance, you must decline it each plan year! To enroll in the MISD health insurance, you must complete paperwork in the Benefits Office within your enrollment opportunity. The Benefits Office is located in the Administration Building at 3819 Towne Crossing Blvd., Mesquite, TX 75150.
Hourly/part-time enrollees in the health plan will not receive a monthly bill, invoice or payment reminder. Upon enrollment, health insurance rates will be determined by the plan you select. Payment receipts will be furnished upon request.
Mesquite ISD will offer health insurance to substitute employees who have a reasonable expectation of working a minimum of 10 hours per week. Because subs are not members of TRS, the district contribution will not apply to the health insurance. Subs who elect this coverage must pay 100 percent of their health premiums in advance each month (see Payment of Premiums below). For rate and plan summary information, see RELATED LINKS.
ALL subs must either enroll in a Mesquite ISD health plan or decline the coverage. This is done within 31 days of your hire date for your NEW HIRE ENROLLMENT opportunity and/or each August during the BENEFITS ANNUAL ENROLLMENT opportunity. If you are not enrolling in the Mesquite ISD health insurance, you must decline it each plan year! To enroll in the MISD health insurance, you must complete paperwork in the Benefits Office within your enrollment opportunity. The Benefits Office is located in the Administration Building at 3819 Towne Crossing Blvd., Mesquite, TX 75150.
Substitute enrollees in the health plan will not receive a monthly bill, invoice or payment reminder. Upon enrollment, health insurance rates will be determined by the plan you select. Payment receipts will be furnished upon request.
This notice applies to you and your eligible dependents should you elect coverage under the Mesquite ISD’s group health, dental, and/or vision insurance plan(s).
The notice outlines covered participants' potential future options and more importantly your notification obligations under the federal Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) should you ever lose your health, dental, and/or vision insurance in the future for certain reasons.
Please read the notice carefully. It is important that each individual covered under the plan read the notice and be familiar with the information. Should you add additional dependents in the future, notice to the covered employee and spouse at this time will be deemed notification to that newly covered dependent as well.
If there is a covered dependent whose legal residence is not yours, you are required to provide in writing to the benefits department the appropriate address so a separate notice can be sent to them as well. Please use the COBRA Address Notification Form located at the end of this notice for this purpose. Should you ever move in the future, please use this form to keep us informed so you can receive future information if needed.
Understand Your Notification Obligations! Under the terms of the group health, dental, and vision plan(s), only a spouse and eligible dependents, as defined by the insurance policy, can be covered under the plan. Therefore, under the rules of the policy and federal law, you or a covered spouse/dependent are required to notify the plan administrator of a divorce/legal separation or if a covered dependent ceases to be a dependent under the terms of the group plan. Please take special note of the section in the notice that details your notification obligations and the appropriate steps to take when making this notification. Should you fail to follow the outlined notification procedures; any available rights will be lost.
Place this notice in your records for future reference. Should you have any questions concerning this notice or your notification obligations, please do not hesitate to call the benefits department at 972-882-7359.
General Notice of COBRA Continuation Coverage Rights
IMPORTANT INFORMATION PLEASE READ
It is important that all covered individuals (employee, spouse, and dependent children, if able) take the time to read this notice carefully and be familiar with its contents. If there is a covered dependent whose legal residence is not yours, please provide written notification with the Address Notification Form to the benefits department so a notice can be sent to them as well.
Under federal law, Mesquite ISD is required to offer covered employees and covered family members the opportunity for a temporary extension of health, dental, and/or vision coverage (called "Continuation Coverage") when coverage under the health, dental, and/or vision plan would otherwise end due to certain qualifying events. This notice is intended to inform all plan participants, in a summary fashion of your potential future options and obligations under the continuation coverage provisions of the COBRA law. Should an actual qualifying event occur in the future, the plan administrator will send you additional information and the appropriate election notice at that time. Please take special note, however, of your notification obligations which are highlighted at the bottom of this page!
Qualifying Events For Covered Employee –
If you are the covered employee, you may have the right to elect this health, dental, and/or vision plan continuation coverage if you lose your group health, dental, and/or vision coverage because of a termination of your employment (for reasons other than gross misconduct on your part) or a reduction in your hours of employment.
Qualifying Events For Covered Spouse –
If you are the covered spouse of an employee, you may have the right to elect this health, dental, and/or vision plan continuation coverage for yourself if you lose group health, dental, and/or vision coverage under Mesquite ISD because of any of the following reasons:
- A termination of your spouse’s employment (for reasons other than gross misconduct) or reduction in your spouse’s hours of employment with Mesquite ISD;
- The death of your spouse;
- Divorce from your spouse; or
- Your spouse becomes entitled to Medicare.
Qualifying Events For Covered Dependent Children –
If you are the covered dependent child of an employee, you may have the right to elect continuation coverage for yourself if you lose group health, dental, and/or vision coverage under Mesquite ISD because of any of the following reasons:
- A termination of your spouse’s employment (for reasons other than gross misconduct) or reduction in your spouse’s hours of employment with Mesquite ISD;
- The death of the employee of Mesquite ISD;
- Parent's divorce;
- The employee of Mesquite ISD becomes entitled to Medicare; or
- You cease to be a "dependent child" under the terms of the health, dental, and/or vision plan.
Employee/Qualified Beneficiary Notification Responsibilities
Under group health, dental, and/or vision plan rules and COBRA law, the employee, spouse, or other family member has the responsibility to notify Mesquite ISD of a divorce or a child losing dependent status under the plan. This notification must be made within 31 days from whichever date is later, the date of the event or the date on which health, dental, and/or vision plan coverage would be lost under the terms of the insurance contract because of the event.
If a divorce occurs or a dependent ceases to be an eligible dependent under the terms of the plan, return the enclosed COBRA Qualifying Event Notification Form by first class mail to the address stated on the form. If this notification is not completed according to the above procedures and within the required 31-day notification period, then rights to continuation coverage will be forfeited. Continuation coverage rights under COBRA are contained in the online Benefits Booklet from the Plan Administrator (www.trsactivecareaetna.com) and in the MISD employee benefits booklet (www.mesquiteisd.org***EMPLOYEES***Benefits Department).
Election Period And Coverage - Once the plan administrator learns from you that a qualifying event has occurred, the plan administrator will notify covered individuals (also known as qualified beneficiaries) of their rights to elect continuation coverage. Each qualified beneficiary has independent election rights and will have 60 days to elect continuation coverage. The 60-day election window is measured from the later of the date health, dental, and/or vision plan coverage is lost due to the event or from the date of notification. This is the maximum period allowed to elect continuation coverage as the plan does not provide an extension of the election period beyond what is required by law. If a qualified beneficiary does not elect continuation coverage within this election period, then rights to continue health, dental, and/or vision insurance will end and they cease to be a qualified beneficiary.
If a qualified beneficiary elects continuation coverage, they will be required to pay the entire cost for the health, dental, and/or vision insurance, plus a 2% administration fee. Mesquite ISD is required to provide the qualified beneficiary with coverage that is identical to the coverage provided under the plan to similarly situated nonCOBRA participants and/or covered dependents. Should coverage change or be modified for nonCOBRA participants, then the change and/or modification will be made to your coverage as well.
Length of Continuation Coverage - 18 Months. If the event causing the loss of coverage is a termination of employment (other than for reasons of gross misconduct) or a reduction in work hours, then each qualified beneficiary will have the opportunity to continue coverage for 18 months from the date of the qualifying event.
Social Security Disability - The 18 months of continuation coverage can be extended for an additional 11 months of coverage, to a maximum of 29 months, for all qualified beneficiaries if the Social Security Administration determines a qualified beneficiary was disabled according to Title II or XVI of the Social Security Act on the date of the qualifying event or at any time during the first 60 days of continuation coverage. In the case of a newborn or adopted child that is added to a covered employee's COBRA coverage, then the first 60 days of continuation coverage for the newborn or adopted child is measured from the date of the birth or the date of the adoption. It is the qualified beneficiary's responsibility to obtain this disability determination from the Social Security Administration and provide a copy of the determination to Mesquite ISD within 60 days after the date of determination and before the original 18 months expire.
Secondary Qualifying Event –An 18-month extension of coverage will be available to spouses and dependent children who elect continuation coverage if a second qualifying event occurs during the first 18 months of continuation coverage. The maximum amount of continuation coverage available when a second qualifying event occurs is 36 months. Such second qualifying events may include the death of a covered employee, divorce or separation from the covered employee, the covered employee’s becoming entitled to Medicare benefits (under Part A, Part B, or both), or a dependent child’s ceasing to be eligible for coverage as a dependent under the Plan. These events can be a second qualifying event only if they would have caused the qualified beneficiary to lose coverage under the Plan if the first qualifying event had not occurred. You must notify the Plan within 60 days of the later of (1) the date on which the qualifying event occurs; or (2) the date coverage would have been lost as a result of the qualifying event.
Length of Continuation Coverage - 36 Months. If the original event causing the loss of coverage was the death of the employee, divorce, Medicare entitlement, or a dependent child ceasing to be an eligible dependent, then each dependent qualified beneficiary will have the opportunity to continue coverage for a maximum of 36 months from the date of the qualifying event.
Premiums - A qualified beneficiary will have to pay all of the applicable premium plus a 2% administration charge for continuation coverage. These premiums will be adjusted during the continuation period if the applicable premium amount changes. In addition, if continuation coverage is extended from 18 months to 29 months due to a Social Security disability, Mesquite ISD can charge up to 150% of the applicable premium during the extended coverage period. Qualified beneficiaries will be allowed to pay on a monthly basis. In addition there will be a maximum grace period of (30) days for the regularly scheduled monthly premiums. Mesquite ISD does not provide a conversion plan at the end of your coverage.
Cancellation Of Continuation Coverage - The law provides that COBRA continuation coverage will end prior to the maximum continuation period for any of the following reasons:
- Mesquite ISD ceases to provide any group health, dental, and/or vision plan to any of its employees;
- Any required premium for continuation coverage is not paid in a timely manner;
- A qualified beneficiary first becomes, after the date of COBRA election, covered under another group health, dental, and/or vision plan that does not contain any exclusion or limitation with respect to any preexisting condition of such beneficiary other than such an exclusion or limitation which does not apply to or is satisfied by such beneficiary by reason of the Health Insurance Portability and Accountability Act of 1996;
- A qualified beneficiary first becomes, after the date of COBRA election, entitled to Medicare;
- A qualified beneficiary extended continuation coverage to 29 months due to a Social Security disability and a final determination has been made that the qualified beneficiary is no longer disabled;
- A qualified beneficiary notifies Mesquite ISD they wish to cancel COBRA continuation coverage.
- For cause, on the same basis that the plan terminates the coverage of similarly situated nonCOBRA participants.
Notification Of Address Change -To ensure all covered individuals receive information properly and efficiently, it is important you notify Mesquite ISD of any address change as soon as possible. Failure on your part to do so will result in delayed notifications or a loss of continuation coverage options. Complete a Cobra Address Notification Form, sample located at the end of this notice.
Any Questions? - Remember, this notice is simply a summary of your potential future options. Should an actual qualifying event occur and it is determined that you are eligible for continuation of coverage, you will be notified of all your actual rights at that time. If any covered individual does not understand any part of this summary notice or has questions regarding the information or your obligations, please contact the Mesquite ISD Benefits Office at 972-882-7359.
COBRA ADMINISTRATION CONTACT INFORMATION
Health continuation of coverage: If you have any questions concerning your rights to health continuation of coverage, you should contact WellSystems at COBRA@wellsystems.com, 1-844-752- 5146 (Monday – Friday from 7 a.m. to 4 p.m. Central Standard Time) or WellSystems TRS Team, PO Box 1390, Brandon, FL 33509. If you want to talk to someone about the insurance or prescription benefits or the Aetna or Caremark network, please call 1-800-222-9205. Aetna also has complete information available on its website at http://www.trsactivecareaetna.com/.
For more information about your rights under ERISA, including COBRA, the Health Insurance Portability and Accountability Act (HIPAA), and other laws affecting group health plans, contact the U.S. Department of Labor’s Employee Benefits Security Administration (EBSA) in your area or visit the EBSA Web site at www.dol.gov/ebsa. (Addresses and phone numbers of Regional and District EBSA Offices are available through EBSA’s Web site.)
Dental continuation of coverage: If you have questions concerning your rights to dental continuation of coverage, you should contact Mesquite ISD Benefits Office at 972-882-7359 or write to Mesquite ISD Benefits Office, 3819 Towne Crossing, Mesquite, TX 75150.
Vision continuation of coverage: If you have questions concerning your rights to vision continuation of coverage, you should contact Mesquite ISD Benefits Office at 972-882-7359 or write to Mesquite ISD Benefits Office, 3819 Towne Crossing, Mesquite, TX 75150.
Health insurance premiums must be paid in advance for the upcoming month's coverage. Premium payments are due or postmarked to the Benefits Office by the 30th day of each month. If the 30th falls on a weekend or holiday, payment is due on the last working day of the month. You are responsible for paying for coverage that you are enrolled in. Payments may be made by check or money order (payable to Mesquite ISD), MasterCard, Visa or Discover.
FYI – Non payment of premiums will not automatically cancel your insurance. You MUST come into the Benefits Office to cancel your policy. You ARE responsible for premiums due in the same month of cancellation.
- Auto/Home Insurance
- Cancer Insurance
- Dental Insurance
- Disability Insurance
- Employee Assistant Program
- Flexible Spending Accounts for Medial Expenses and/or Dependent Care
- Group LIfe Insurance and Accidental Death & Dismemberment Insurance
- Health Savings Accounts
- Health Indemnity Insurance (GAP)
- ID Shield
- Legal Insurance
- Lone Star 925 Plan
- Long-Term Care Insurance
- MedBridge (GAP) Group Hospital Confinement Indemnity Insurance
- Retirement Plans
- Vision Coverage
- Voluntary Permanent Life
Mesquite ISD has partnered with Liberty Mutual Insurance. This program offers employees special benefits and savings on home and auto insurance to Mesquite ISD employee and retirees. Purchase insurance when and where you want and take advantage of flexible payment options. Call your Liberty Mutual representative Steven Wyatt at 214-459-8601, Client #5423 or Gerry Hernandez at 214-459-8540 ext 08837. You can enroll at any time.
Auto/Home insurance is also offered through MetLife. Mesquite ISD employees are eligible for discounts on premiums through this program and they are payroll deductable. For a free, no-obligation quote: Call 1 800 GET-MET 8 (1-800-438-6388) and provide them with MISD's employee code B46, or visit www.metlife.com/groupaccount or contact your local agents: Kira Boone at 972-747-7944 or www.kiraboone.metlife.com or Cissy Fierro at 682-220-7608 or firstname.lastname@example.org. You can enroll at any time.
You may use your own dentist or use a dentist from the Voluntary Preferred Dentist Program (PDP) with the Standard (Ameritas) dental plan. The agents are David Crook or Tom Crook at 972-288-3700. For additional information and to locate a dentist, visit the Standard website at https://www.standard.com/individual/insurance/group-dental or call at 1-800-547-9515. Your dental network is Ameritas, and it is a Classic (PPO) network. Customer/Group #648015.
Sometimes called salary continuation insurance, this benefit is administered by TheStandard. The agents are David Crook or Tom Crook at 972-288-3700. TheStandard’s customer service department can be reached at 1-800-368-1135. Employees are allowed to enroll in disability insurance within 31 days of hire date or during benefits annual enrollment. Disability insurance may not be added or dropped at any other time. Note: pre-existing condition limitations do exist and excludes coordination of benefits with workers compensation claims.
EAP is a free service available for all Mesquite ISD employees and their legal dependents. Call Aetna Resources for Living at 1-800-492-4357 for family/marital concerns, job related issues, legal/financial resources, depression/anxiety, or alcohol/substance abuse. For additional information, visit www.mylifevalues.com (user name: mesquite isd, password: 8004924357).
Both are available through The Standard and the agents are Tom Crook or David Crook at 972-288-3700. Visit the Standard website at www.standard.com or call customer service at 1-800-633-8575. These are the group policies, so the policy information is posted online (see links below).
For all Plan 1HD health plan participants, a health savings account can be set up with H.S.A. Bank. Funds are payroll deducted, pre-tax. Monies are available to participants 3 days after the monthly Mesquite ISD payroll. Upon enrollment in the program, H.S.A. Bank sends plan participants a debit card and account guidelines in a Welcome Kit. [Note – employees that are actively contributing to an H.S.A. account are not eligible for the office visit and Rx discounts at the MEHC until the health plan deductible has been met for the plan year.] If you have any questions about your H.S.A., please contact the Client Assistance Center at 1-800-357-6246 Monday – Friday, 7 a.m. – 9 p.m., CT. Or visit www.hsabank.com.
Health Savings Booklet
Hospital Indemnity is available through MetLife. This coverage can help safeguard your finances by providing you with a lump-sum payment (one convenient payment all at once) when you or your family need it most. A flat amount is usually paid for a hospital admission and a per-day amount for your entire hospital stay. The payment is made directly to you, in addition to any other insurance you may have. To access information on how to file a claim (paper or online): go to www.mesquiteisd.org, Departments, Benefits, Insurance/Beneficiary/Name Change Forms. If you have any questions, please call MetLife at 1-800-438-6388 and talk with a benefits consultant.
Protect your identity by protecting your information. ID Shield monitors your identity, provides counsel when you need it, and is the only company with an exclusive partnership with Kroll who will help restore your identity completely if it is compromised. ID Shield is available with LegalShield. Employees may enroll in this benefit at any time throughout the year (changes effective 1st of month following signature date on paperwork); however, you may only cancel coverage during an enrollment opportunity (annual enrollment or Section 125 life change event). For additional information, please contact your ID Shield representative Kimberley Royal at email@example.com or 214-735-5777.
Legal Insurance is available with Hyatt Legal Plans, A MetLife Company. The plan covers you, your spouse, and dependent children for $15.50 per month. This is a group benefit; therefore, you can only enroll (or cancel) in the legal plan during a benefits enrollment period. Once you are enrolled, go to www.legalplans.com or call Hyatt Legal Plans toll free at 1-800-821-6400, Monday through Friday from 8 a.m. to 7 p.m. (Eastern Time). A Client Service Representative will confirm that you are eligible to use the plan, and will give you the address and telephone numbers of the attorney(s) located most conveniently to you, as well as a case number. Once you have this information, you may contact the attorney direct to schedule an appointment.
GAP is available through Colonial Life. This coverage helps provide a lump-sum benefit for a covered hospital confinement or a covered outpatient surgery. It can assist with costs that your medical plan may not cover. For more information, speak to a Colonial Life benefits counselor at 1-800-325-4368 or visit www.visityouville.com/mesquiteisd. Please note that effective date of coverage is 1st of month following enrollment (not 1st of month after hire date).
Notice of voluntary tax-deferred retirement accounts to all MISD employees: The IRS allows school district employees the option of opening a voluntary tax-deferred retirement account and requires that Mesquite ISD inform you of this available option. Employees need to seek the advice of a financial advisor or other agent in regards to opening a tax deferred retirement account. Salary Reduction agreements for payroll deductions can be found on National Plan Administrator's website at www.natlplan.com. Click on "For Employees." Select your State and Employer under "Tax Sheltered Accounts (TSA)." For more information, please contact NPA's 403b Department at 1-800-880-2776.
This benefit is offered through Texas Life Insurance Company. For additional information, visit www.texaslife.com or contact Texas LIfe Customer Service at 1-800-283-9233. The agents are Tom Crook or David Crook at 972-288-3700.
NOTE: ALL INSURANCE PAYMENTS ARE PAYROLL DEDUCTED AT NO SERVICE CHARGE TO THE EMPLOYEE.