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Mission Statement

Students will graduate prepared and motivated to succeed in their choice of career and higher education and to contribute to the common good. ×

Benefits- Certificated

 

CERTIFICATED, MANAGEMENT AND CONFIENTIAL EMPLOYEE BENEFITS

Welcome to Palm Springs Unified School District! We are pleased to provide a wide range of options to support and help our employees and their eligible dependents stay healthy.

This information is specific to Certificated, Management, and Confidential employees. The following links can be used to navigate through the information.


Rates

2016-2017 CERTIFICATED RATES

2016-2017 CONFIDENTIAL AND MANAGEMENT RATES


Certificated, Confidential and Management Benefits Guide

2016-2017 CERTIFICATED, CONFIDENTIAL AND MANAGEMENT BENEFITS GUIDE


Managing your Benefits

MyCVT Website is an enrollment system to assist members in the process of enrollment

Registration Link: https://mycvt.cvtrust.org

CVT has created a site for our employees to find information about their benefits at  http://www.cvtrust.org/welcome-palm-springs-unified , but make sure you also visit other areas on their website where you can find useful tools and information to maximize the use of your benefits. A good starting place would be www.cvtrust.org/member.

MyCVT quick steps for account set-up


Tools

Benefit Calculator / Health Costs

http://www.cvtrust.org/benefit-calculator

Understanding Deductibles, Copays, Coinsurance, and Out-of-Pocket Maximums

http://video.burnhambenefits.com/terms/

Flexible Spending Accounts (FSA)

http://video.burnhambenefits.com/fsa/

HSA Plan overview

http://video.burnhambenefits.com/hdhp/

Blue Shield of California Summary of Benefits and Coverage (SBC)

http://www.cvtrust.org/sbc/blue-shield

Kaiser Permanente Summary of Benefits and Coverage (SBC)

http://www.cvtrust.org/sbc/kaiser

 

Who is Eligible for Employee Benefits?

All Certificated employees, working 51% or more, and their dependents, may participate in Palm Springs Unified School District’s benefits program.

Eligible dependents include:

  • Spouse of employee (Marriage Certificate is required)
  • Domestic Partner (State Registration Certificate is required)
  • Child of an enrolled employee or domestic partner under 26 years of age:
    • Natural child - (Birth Certificate is required for enrollment) 
    • Adopted child - (Final Adoption Papers are required for enrollment)
    • Step child - (Birth Certificate is required for enrollment)
    • Child of an eligible, covered domestic partner - (Birth Certificate is required for enrollment)
    • Unmarried child under legal guardianship - A dependent child under a court ordered legal guardianship of the employee is eligible for coverage, provided they meet all other eligibility requirements. Please note: eligibility ends on the date of expiration of the court awarded guardianship or upon the 18th birthday of the child, whichever comes first. (Legal Guardianship Papers are required)
  • Permanently disabled child - A permanently disabled dependent who is married will lose their coverage at age 26; and a permanently disabled dependent who is single will continue to be covered past age 26 until he or she marries or is no longer certified as permanently disabled.

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When You May Enroll

Eligible employees may enroll at the following times:

  • As an eligible new hire
  • When a current employee has an increase in hours making them eligible for benefits
  • Each year during annual open enrollment
  • Within 30 days of a qualifying event

As a new hire, the effective date of coverage is provided to you by the Human Resources Department.


Changes to Enrollment

Each year, there will be an annual open enrollment period where you can make new benefit elections for the following plan year. Once you make your benefit elections, you cannot change plans; however you may add or remove a dependent if you experience a qualifying event. Examples of qualifying events include, but are not limited to the following:

  • Marriage, divorce or annulment
  • Birth or adoption of a child
  • A qualified medical child support order
  • Death of a spouse or child
  • A change in your dependent’s eligibility status
  • Loss of coverage from another health plan

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California Value Trust (CVT)

The Palm Springs Teachers Association (PSTA) elected California Value Trust  as the administrator for the medical plans, which includes medical, mental health, an employee assistance program and prescription coverage.

Being a member of CVT brings you many different partners in the healthcare industry. As a result, you may see many different products and provider names associated with your benefits, but it’s important to note they are your partner through CVT.


Medical Benefits

California Value Trust (CVT) administers the medical benefits for Certificated and Management/Confidential employees. A variety of medical plans are offered to provide options that meet the diverse needs of active employees and retirees. 

Medical Plan Information

With the Blue Shield of California Health Maintenance Organization Access+ (HMO) plans, you will be required to select a Primary Care Physician (PCP) within the Blue Shield Access+ HMO network. Your PCP will coordinate all of your medical care and refer you to specialists when needed. You will receive benefits from the doctors, clinics and hospitals that belong to the medical group in which you are enrolled. While this will be the way you will use this plan, there are allowable circumstances that you are able to go outside your medical group:

  • An emergency
  • Away From Home 
    • Coverage for dependents that go to school or have work assignments that require them to work and live out of state for extended periods of time
    • Available in most states but not all. For information please call 1.800.622.9402

You can receive referrals from your PCP or, with the Access+ Specialist feature, you can choose to self-refer to a specialists within your PCP’s medical group for a higher copay. All HMO plan options offer prescription drug benefits through Blue Shield Pharmacy. For information on pharmacies and the formulary, please visit https://blueshieldca.com/bsca/pharmacy..

Summary of Benefits and Coverage:

For more detailed information, the Evidence of Coverage and Disclosure Form booklet describes the terms and conditions of coverage of your Blue Shield health Plan:

The Blue Shield of California Preferred Provider Organization (PPO) plans allow you to direct your own care. Please visit providers in the Blue Shield of California PPO network and you may self-refer to specialists. If you receive care from a physician who is a member of the PPO network, a greater percentage of the entire cost will be paid by the insurance plan. You may also obtain services using a non-network provider; however, you will be responsible for the difference between the covered amount and the actual charges and you may be responsible for filing claims.

Blue Shield offers a High Deductible Health Plan (HDHP) PPO Medical Plan: This type of plan is similar to a PPO in that it requires you to meet an annual deductible before your insurance will pay anything. However, HDHP's carry higher deductibles and you need to meet meet the amount before medical and prescription drug benefits are covered. You’ll pay only 20% of the cost after you have met the deductible. The District will continue to contribute $1,200 in the month of July and $1,200 in the month of January for each year. This plan also meets the requirements for a Health Savings Account (HSA). Call the Benefits Department for additional details.

You also have the option to select our Blue Shield PPO Wellness Medical Plan. You’ll gain access to wellness resources and have the opportunity to earn up to $400 in wellness credits which can reimburse you for deductible and coinsurance expenses.

Alere's

Alere’s Health Management Program:
PPO members and dependents with qualifying chronic conditions are eligible to participate in Alere’s Health Management Program. This program will provide you with the facts you need to know about your condition to help you slow disease progression, lessen the effects, and help you live a healthier life. It’s personal, private and it’s available to you at no additional cost. Start today by calling (877) 864-1327.

MDLIVE
Blue Shiels PPO plans includes MDLIVE, a 24/7/365 service where you have access to doctors and pediatricians to help you anytime, anywhere about your medical care. You can register by calling MDLIVE toll free at 888-632-2738 or going on the internet at www.mdlive.com/cvt.. Be prepared to provide your name, the patient’s name (if you are not calling for yourself), the last 4 digits of your Social Security Number, your date of birth, and the patient’s phone number.

Services are provided either through online video, where you see a doctor using your computer over the internet, over the telephone or through secure email. You will be required to pay a $5 co-payment for each visit.

The doctor will ask you some questions to help determine your health care needs. Based on the information you provide, the advice will include general health care and pediatric care of you or your dependent’s condition.
When to use MDLIVE:

  • If you are considering the ER or urgent care center for non-emergency medical use.
  • Your primary care doctor is not available.
  • Traveling and in need of medical care.
  • During or after normal business hours, nights, weekends and holidays.
  • To request prescriptions or get refills.

Note: Refer to your MDLIVE I.D. card for the name and contact information.

The copay for PPO members is $5 and $38 for HDHP members.

MDLive overview

Blue Shield PPO Summary of Benefits and Coverage:

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Find a Provider - Blue Shield Plans

Step 1. To find a provider for Blue Shield plans, you would go to www.blueshieldca.com, Find a Provider page you will log in if you are registered or enter your plan information. If you have an HMO select Access+ HMO for the Plan and SubPlan. If  you have a PPO Plan, select Blue Shield of California PPO Network (no subplan is needed).

Step 2. Select the kind of provider that you need. You can select either Doctors or Facilities if you are on a PPO plan (the other items are not part of your Blue Shield Plan). If you have an HMO plan you can select Doctor's, Facilities, and Pharmacies.

You can also use the advanced features to filter your search.

Find a Mental Health Provider

Mental health services for Blue Shield members is provided through MHSA Participating Providers and is available through the Mental Health Services Administrator (MHSA) network. To find an approved caregiver, you will follow the instructions above but you will select Mental Health Caregiver on the doctor type or specialty.

A pop-up window will appear and you will select Search or Visit  the MSHA Network option.

Follow the prompts under "Begin Your Search" and select the BSC MHSA, then click on "Non Medicare Providers" and enter your zip code.

You will be provided with the network caregivers that meet your criteria.

Please note: If you are a PPO Plan member, your coverage is through your Blue Shield Medical Plan and your caregiver/doctor will need to contact HealthComp at (800) 442-7247 for verification.

If you are an HMO member, Blue Shield of California has contracted with an MHSA to underwrite and deliver all Mental Health Services through a unique network of Mental Health Participating Providers. All Non-Emergency Mental Health Services, except for Access+ Specialist visits, must be arranged through the MHSA. Members do not need to arrange for Mental Health Services through their Personal Physician.

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Find a Provider While Traveling

To locate a provider, go to blueshieldca.com/findaprovider and select the Providers Outside of California link under Traveling. This takes you to the BlueCard Doctor and Hospital Finder on the BlueCard Program's website. Or you can call BlueCard Access at (800) 810-BLUE (2583), seven days a week, 24 hours a day. 


BlueCard® Program For Blue Shield Members 

As a Blue Shield member, you have access to coverage through the BlueCard® Program, no matter where you live or travel. Providers in more than 200 countries belong to the BlueCard Worldwide® Network, and 85% of providers in the United States belong to BlueCard's national network. Note that you will need to get prior authorization for certain services, including inpatient surgeries, hospital stays, and outpatient surgeries.

For PPO  plan members

If you're a member of a PPO plan you may use the BlueCard Program for access to covered benefits, except dental and vision care, and prescription drugs.

For Blue Shield HMO members

HMO plan members have coverage for emergency and urgent care services, or authorized medical follow-up care, when they are out of their HMO service area. In case of a life-threatening emergency, call 911.

if you are in the U.S., or go immediately to the nearest medical facility, and then get the necessary authorization when it's possible for you to do so.

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Blue Shield PPO Plan Prescriptions

CVT provides a CVS Caremark Card for prescription drug needs for each Subscriber and their eligible dependents enrolled in a CVT PPO Plan.

You can expect to receive your combination medical and pharmacy benefit card from CVT and CVS Caremark in approximately three to four weeks. If you do not receive your card or you need to visit a doctor or pick up a prescription before you receive your card, you or your provider can call CVT's Member Services toll-free at 800-288-9870.

PPO plan members, your card is only in your name, but it may be used for all eligible dependents.

If you ever misplace your card or would like to order additional cards for family members, please call CVT's Member Services.

Click on the image for a pdf file in a new tab or window:

CVT PPO Prescription Drug Coverage - CVS Caremark

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Kaiser Permanente HMO Plans

With the Kaiser Permanente Health Maintenance Organization (HMO) plans, services must be obtained at a Kaiser facility, except in the case of emergency. Kaiser integrates all elements of healthcare such as physicians, medical centers, pharmacy and administration in one convenient facility. To get started you can view the  Kaiser offers online tools so you can email your doctor’s office, make appointments, refill prescriptions, and more.
:

Kaiser HMO Wellness Medical Plan: This plan combines traditional health coverage along with resources to help you make healthy changes. Plus, you’ll have the opportunity to earn up to $400 in rewards.

Kaiser HMO plans include Chiropractic & Acupuncture Supplemental Coverage through ChiroMetrics.

ChiroMetrics


Find a provider - Kaiser Permanente

Finding a provider for your Kaiser plan is very simple:

  1. Go to kp.org/newmember
  2. Click on “Choose a Doctor,”
    1. Browse doctor profiles, see what languages they speak, their education and what their interests are.

From the kp.org/newmember you are also able to register on the website. This will allow you to securely email your doctor’s office, refill most prescriptions, schedule routine appointments, and lots more.

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Employee Assistance Program (EAP)

VALUEOPTIONS EMPLOYEE ASSISTANCE PROGRAM

The Employee Assistance Program (EAP) through ValueOptions provides employees and their family members with free, confidential assistance to help with personal or professional problems that may interfere with family or work responsibilities and obligations.
Services include:

  • Counseling Sessions: Employees and their family members can receive up to 6 counseling sessions per person, per year (maximum of 2 episodes/courses of treatment)
  • Telephone Referrals: Services are available 24 hours a day, 7 days a week via a toll-free nationwide number
  • Work/Life Services: Specialists refer employees to options and provide support, guidance, and informational materials to empower them to make informed choices about child care, elder care and assistance with other daily life issues
  • Legal-Financial Solutions: Referral services, a free 30 minute legal consultation (either face-to-face or telephonic) and a 25% discount if further services are needed
  • Achieve Solutions Website Access: A dynamic online resource with information, tools and other resources on more than 200 topics, including depression, stress, anxiety, alcohol, marriage, grief and loss, child/elder care and work/life balance

Accessing the EAP:
To access EAP benefits, go to www.achievesolutions.net/cvt or you may call (877) 397-1032 to be immediately connected to an EAP counselor.

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Wellness Programs

Each medical plan includes a wellness component that promotes the mental and physical wellbeing of the employees. To complement those programs, PSUSD offers a Fit for Life program, providing access to services including

  • Flu Shots – free of charge at local CVS pharmacy

  • Health screenings hosted at annual health fair: total cholesterol & high density lipids (TC/HDL), blood pressure, body mass index (BMI) and glucose.

  • “Lighten Up” is our staff weight loss competition held in the fall and spring each year. The three-month program consists of teams of two, three or four working together to lose those unwanted pounds. Prizes for the winners each month and cash prizes at the end of each competition for winning individual and teams. Fall session will launch at Eat Smart, Play Hard Festival in October. Our staff members have lost nearly 5,000 pounds over the past five years.

  • Health and wellness seminars on various topics are held during the year. Watch for email information.

  • Desert Regional Hospital will be providing free flu shots in the fall for all interested staff members. The immunizations will be provided at our Eat Smart Play Hard Festival in October.

  • Our annual Eat Smart, Play Hard Festival is a staff health and fitness fair featuring more than 25 local medical providers including free health screenings, dental providers, chiropractic care, fitness facilities and non-profit health and wellness organizations as well as food samples, competitions and entertainment. The Festival is held in October each year at one of our middle schools.

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