All contracted full-time and part-time employees are eligible to participate in the SCPS benefit programs described in this handbook.  However, if you have a part-time contract, you pay higher contribution amounts, and you are not eligible to participate in the retirement or life insurance programs.

You have 30 days from the start of your contract to complete your ESS Benefits enrollment.  Following this 30-day window, changes can only be made during the annual open enrollment period or within 30 days of a qualifying life event.

You also have 30 days from the start of your contract to select guaranteed coverage through our Optional Group Life Insurance program, without completing evidence of insurability forms.  Following this 30-day window, there is no other time to have a guaranteed election of Optional Group Life Insurance.

You may enroll, add, or cancel coverage for yourself or your dependents, or change your health care benefit and FSA participation during Open Enrollment.  Late enrollments for these programs are not accepted.

At any other time during the year, you may only enroll, add, or cancel coverage for yourself or your dependents, or change your health care or dental coverage and FSA participation if you experience a status change or qualifying event as defined by IRS regulations.  You must notify the Benefits office and complete your ESS Life Event to change your benefits’ enrollment within 30 days of the qualifying event.  However, Stafford County Public Schools processes July, August and September payroll checks for 10- and 11-month employees prior to the end of the fiscal year which is June 30th.  As a result, no changes can be made to these checks after June 15th of each year regardless of qualifying life event per policy and regulation 4705-R.  The next opportunity for changes to payroll deductions, direct deposit accounts, health and dental insurance or addresses to be made effective is September 1st for 11 month employees and October 1st for 10 month employees.    (The only exception is the addition of a newborn to insurance in which case the parent will pay with a personal check for the premium increase.) 

If you experience a life event – like marriage, a birth, divorce, death or change in employment – you may change your health and/or dental benefits and participate in the Flexible Spending Account (FSA) program. You must notify the Benefits office and complete your ESS life event to change your benefits enrollment within 30 days of the qualifying event.

These life events are also called status changes or qualifying events.  They are detailed in the Regulations for Section 125 of the Internal Revenue Code governing plans. 

The following events are examples of Section 125 status changes or qualifying events:

• Loss of health coverage
• A move that causes loss of eligibility
• A significant cost change, a significant coverage curtailment, a significant improvement, a new option, or a change in coverage under your, your spouse’s or your dependent’s plan
• Entitlement to or loss of Medicaid
• Entitlement to Medicare

You

• Marriage or divorce

You may not drop coverage for a spouse if you are legally separated; you may drop coverage upon your divorce.

• Changing from a full-time to a part-time position or a part-time to a full-time position
• Beginning or returning from an unpaid leave of absence

Your Spouse

• Spouse’s or other dependent’s change in employment status that affects his or her eligibility for medical and/or dental benefits
• Death of a spouse

Your Child

• Birth or placement of a child for adoption 
• Becoming the legal guardian of a child
• A court order requiring you to cover a child or an order requiring someone else to cover your dependent
• Dependent reaching age 26 if enrolled under Stafford Schools insurance policy
• Death of a child

The 30-Day Rule

If you are a new employee, you must enroll for health, dental and FSA benefits within 30 days of your contract date.  Late enrollment is not allowed.

If you are a current employee, you have 30 days from the date of a status change or qualifying event to change your health, dental and FSA benefits.  Most benefit changes take effect on the first of the month following the event, except for a birth or adoption placement, if notification is in accordance with established monthly payroll processing deadlines. (See page 30 for list of monthly processing deadlines.)

• Coverage for a birth takes effect on the first of the month when the baby is born.
• Coverage for an adoption placement takes effect on the first of the month in which the child is placed with you or the first of the month in which you receive a formal legal document stating that you are responsible for the child’s health coverage.  As an adoptive parent, you do not have to wait until the adoption is final to add your child to your health plan.
• Your participation in the FSA program takes effect on the first day of the month following your employment date or the first of the month in which you receive a paycheck, if appropriate paperwork has been submitted.

Examples: 

• You are married April 13 and you add your spouse to your health plan on May 5.  Your spouse’s coverage takes effect June 1. 
• You have a baby on May 7, and you add your baby to your health plan on May 19.  Your baby’s coverage begins on May 1. (New babies are added retroactively.)
• Your baby is placed with you for adoption on September 20, and you add him or her to your health plan on September 29.  His or her coverage begins on September 1.

It is your responsibility to inform the Payroll & Benefits Office about a status change by completing an ESS Life Event . You must also provide written proof of the change in eligibility for situations other than the birth of a new baby.

If you fail to notify Stafford Schools within the 30-day period, you may not enroll, cancel, or change coverage until Open Enrollment. 

If you miss the 30-day deadline for a status change or qualifying event that results in the cancellation of coverage or a reduction in your employee contribution (like a divorce or your child turns 26), Stafford Schools will not refund your contributions.

Life Events and the 30-Day Rule

• If you marry, you may change your enrollment as an individual, employee plus spouse, or family.
• If you divorce, you may change your enrollment as an individual, employee plus child or employee plus children.  Once you are divorced, your former spouse no longer qualifies for Stafford Schools health/dental insurance.  A separation agreement is not a legal event in Virginia, and you cannot drop your spouse due to a separation.

In addition to submitting an ESS Life Event, you must also provide documentation of the event.

• If you and your spouse have a baby, adopt a baby, or gain legal guardianship of a child, you can add the new dependent and change to family, employee plus child, or employee plus children coverage.
• If you have a child and participate in the Dependent Care Flexible Spending Account (FSA) plan, and you add a new child to the family, you may increase or cancel your dependent care account contribution.
• If your son or daughter “ages out”- that is, the month he or she turns age 26 – he or she is no longer eligible for Stafford Schools coverage as a dependent.

Required documentation includes:

• Adoption papers or legal papers indicating placement for adoption
• Court order regarding legal guardianship of a child
• Marriage certificate stating date of marriage
• Divorce decree signed by the judge (applicable pages)
• Death certificate
• Letter from your spouse’s or dependent’s Human Resources Department or insurance plan with insurance cancellation date
• Letter from your spouse’s or dependent’s Human Resources Department or insurance plan explaining circumstances regarding a significant cost change (min. 35% change), a significant coverage curtailment, a significant improvement, a new option or a change in coverage
• Court order requiring you to cover a child or an order requiring someone else to provide coverage for your dependent
• Copy of your Medicaid card

Employment Changes

You must notify the Payroll & Benefits Office and complete your ESS Life Event to change your benefits enrollment within 30 days of an employment change that meets the criteria of a qualifying event:

• If you are enrolled through a health plan with your spouse’s employer and your spouse loses coverage, you and your family may enroll in an Stafford Schools plan
• If your spouse’s new employer offers health benefits and you join your spouse’s plan, your eligibility for that plan will allow you to cancel your Stafford Schools coverage
• If you return to active employment from a leave of absence and are eligible for benefits, you must enroll within 30 days.

*All changes must be made prior to end of fiscal year payroll processing deadline (June 15th for 10- and 11-month employees) per policy and regulation 4705-R.