SISC Benefits

HMO Plans

• Blue Shield Access+ Full Network HMO $10-0 RX 5-20 (2024-25)
• Blue Shield Trio HMO - $10 office visit; RX $5-20 (2024-25)
• Kaiser HMO - $0 office visit; RX $5 (2024-25)
• Kaiser HMO - $15 office visit; RX $5-20 (2024-25)
• Kaiser Evidence of Coverage (2024-25)

PPO Plans

• Blue Shield 90G - $20 office visit; RX $5-20 (2024-25)
• Blue Shield 100A - $10 office visit; RX $5-20 (2024-25)
• Blue Shield 2-Tier HSA (2024-25)

Available to All Enrollees:

• SISC Health and Member Resources
• Additional SISC Programs and Services
• Mental Health Resources

Prescription Coverage

• Navitus Website
• Navitus Customer Care
• Navitus - Vaccinations
• Costco Pharmacy
• Costco - Flu Shots

 

Available to Kaiser Enrollees:

• Find a Doctor
• Kaiser Care Away From Home - Travel Benefit
• Kaiser Hearing Aid Benefit
• Kaiser Mobile App
• Kaiser Self-Care Apps

 

Available to Blue Shield Enrollees:

• Blue Shield Mobile App
• Blue Shield Plan Features and Member Benefits
• Blue Shield Print ID Card
• Carrum Health - Surgery Benefit (PPO only)
• Eden Health - Virtual Healthcare Team (PPO only)
• Find a Doctor
• Hinge Health - Back and Joint Pain Benefit (PPO only)
• Lantern - Cancer Support
• Maven - Virtual Maternity & Postpartum Support (PPO only)
• MDLive - Virtual Office Visits
• Midi - Menopause Care (PPO only)
• Quest Diagnostic Kit (PPO only)
• Vida - Digital Health Coaching

HMO Plan

• Delta Dental - DeltaCare USA (2024-25)
• Find a Dentist - DeltaCare USA

PPO Plans

• Delta Dental - PPO 1500 (2024-25)
• Delta Dental - PPO Incentive Unlimited (2024-25)

• VSP - Vision Care (2024-25)

• MetLife Plan Benefits (Basic and Supplemental Life Insurance)
• MetLife Enrollment Form
• MetLife Statement of Health Form
• MetLife Beneficiary Form

Mt. San Antonio Community College District has partnered with American Fidelity Assurance Company to provide supplemental health insurance benefits and financial services to our employees*.

Services

Section 125 Cafeteria Plan offers: Section 125, a program available, to help employees save money on taxes.  An employee is allowed to deduct needed benefits from gross earnings before taxes are computed.  This means that current after-tax expenses such as insurance products and benefits, can now be paid for with pre-tax dollars. 

• Dependent Day Care Flexible Spending Account (FSA)
• Health FSA (Unreimbursed Medical Expenses)

Retirement/Annuities

• 403(b) Tax-Deferred Annuity
• Roth IRA
• After-Tax Annuity

Supplemental Insurance Benefits

• American Fidelity Benefits Overview
• Accident Insurance
• Cancer Insurance
• Critical Illness Insurance
• Disability Income Insurance
• Texas Life Insurance

How to Enroll

• Eligible newly hired employees will be eligible to enroll at time of benefits onboarding.

• Eligible employees may enroll during annual enrollment** and will be notified by the Benefits office of the dates and times. 

*Employees must be eligible for health benefits to enroll in the services and benefits offered by American Fidelity Assurance Company.  Please contact Benefits to determine whether or not you are eligible for health benefits. 
**Changes to an election plan during the plan year can only be made if an employee experiences an allowable election change event. 

Employee assistance programs are available to employees and their immediate family members - paid for by the District that offers confidential help (no charge to you) for matters such as:

• Family troubles with spouse or children
• Emotional distress
• Drug/alcohol problems
• On-the-job anxieties and stress
• Grief, loss, and transitions

 

EASE Program

• Employee Assistance Service for Education (EASE) Program
• Employee Assistance Program Overview
• Employee Assistance Program Brochure
• Emotional Wellness
• Emotional Well-Being Resources

 

MetLife Grief and Beneficiary Support

• MetLife & Empathy: Support for Your Loss, Beyond the Claim

• MetLife & Empathy Demo

What is the Health Reimbursement program?

An agreement through CSEA 262 and the District to create a reimbursement program for out-of-pocket health expenses. Effective October 1, unit members working in a less than 50% FTE assignment shall receive the annual benefit amount of $1,200 deposited into a District-managed CSEA 262 health reimbursement account each benefit year.

You can use your funds to pay for a wide variety of health care products and services for you, your spouse, and your dependents. Allowed expenses may include insurance copayments and deductibles, qualified prescription drugs, insulin, medical devices, and more.

 Important Dates

Health Reimbursement Account Benefit Year: October 1 – September 30

• Health receipts for reimbursement must be incurred during the benefit year.
  
  

Monthly Deadline: 15th of the month

• Claims submitted by the 15th of each month will be processed for that month’s pay warrant (end of the same month).
• Submissions after the 15th of the month will be reviewed and processed the following month.
  
  

Annual Deadline – Use It or Lose It: October 15

• All submissions for the benefit year ending on September 30 must be submitted no later than this date.
• Any remaining unused funds left in your health reimbursement account will no longer be available for reimbursement after September 30.
  
  

Health Reimbursement Eligible Expenses

The IRS determines which expenses can be reimbursed by a flexible spending account (FSA) which is used under the District sponsored health reimbursement account.

For a list of eligible expenses and guidelines please visit the following link: American Fidelity FSA Eligibility List.

How to Submit for Reimbursement

1. Complete the CSEA 262 Mt. SAC Health Reimbursement Submission Form
2. Attach the required documentation to the form per the guidelines outlined below.
   
   

You will receive a status confirmation via email once your submission has been reviewed.

Receipt Requirements

Unit members may submit receipts for reimbursement of health expenses incurred between October 1 and September 30, or beginning their first date of eligible permanent employment, whichever occurred last. 

You must have a receipt or an explanation of benefits from your insurance carrier for each health care claim you submit against your account. Credit card receipts, canceled checks, and balance forward statements do not meet the requirements for acceptable documentation.

To expedite processing, please ensure the five pieces of information below are included on your official receipt:

1. Patient's Name – name of the person who received the service or for whom the item was purchased. (For retail store purchases, this information may be excluded.)
2. Provider's Name – provider that delivered the service or the merchant where the item was purchased.
3. Date of Service – date when services were provided or the item was purchased.
4. Type of Service – a detailed description of the service provided or item purchased. (A pharmacy prescription receipt is sufficient for prescriptions.)
5. Expense Amount – amount paid for the service or product and/or the portion that is not reimbursed through your insurance carrier.
   
   

Reminder: Student Health Center Access For Less Than 50% Unit Members

Unit  members  in  paid  status  in  a  less  than  50%  assignment  shall  be permitted access to the campus Student Health Center for basic medical services,  subject  to  the  limitations  and  capabilities  of  the  facility  and staff.  The cost of services provided by the Student Health Center shall be charged against the unit member’s medical reimbursement account. Costs  in  excess  of  funds  available  in  the  unit  member’s  medical reimbursement account will be the responsibility of the unit member.