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Frequently Asked Questions About Your Benefits

Frequently Asked Questions About Your Benefits

This section is designed to answer some frequently asked questions about your benefits with PGCPS.  It is provided for illustrative purposes only and is not a contract.  It in no way changes or affects the policy as actually issued.  In the event of any difference between this document and the summary plan document, the terms of the summary plan document applies. If you are unable to find an answer to your question(s) contact the Benefits Services Office. All forms are in PDF.

 As a new hire, how long do I have to enroll in medical, prescription, dental, vision, and Flexible Spending Accounts (FSA’s, Medical and or Dependent Care)?

  • You must enroll within 35 days of your date of hire or during Annual Open Enrollment.
  • Enrollment information can be found at New Employee Benefits.

How do I enroll in the benefits program?

  • New employees can enroll using Benefitfocus. You must have a valid PGCPS username and password to log into Oracle.
  • Coverage begins the first day of the month following the date of hire.
  • Coverage for eligible dependents (spouses, children) is also effective the first day of the month following the date of hire. Benefitfocus will provide employees with instructions on how to submit supporting documentation.

 If I do not enroll in benefits within the 35 day enrollment period, can I enroll at a later time?

  • You will need to wait until Annual Open Enrollment or until you have a qualifying event/family status change during the plan year.
  • You can designate beneficiaries for the basic life insurance at any time.

What is a “qualifying event” or “family status change”?

  • A "qualifying event" or "family status change" allows you to make changes to your benefits during the plan year within 35 days.  Following are examples of “qualifying events” or “family status changes”:
    • Birth or adoption of a child
    • Marriage or divorce
    • Death of a dependent
    • Loss or gain of other coverage by you or a covered dependent
    • Covered dependent turns age of 26
    • Eligibility for Medicare by you or a covered dependent

When is Open Enrollment for health insurance and Health and Dependent Care FSA?

  • Open Enrollment for health insurance and Health and/or Dependent Care FSA is held during October. Coverage is effective for the calendar year (January - December)
    •   Employees that elect to participate in Health and/or Dependent Care FSAmust re-enroll during Open Enrollment.

 Can I change my coverage(s) during the plan year?

  • If you have a qualifying event, which is a change in family status between the close of Open Enrollment and the beginning of the new plan year, you can make changes to your benefits within 35 days of the qualifying event.  Otherwise, you will have to wait until the next Open Enrollment.

 If I make changes when do they become effective?

  • Changes made during Open Enrollment become effective January 1.
  • Changes made during the plan year because of a qualifying event become effective the first day of the month following the date the changes are made in Oracle Self Service and the required supporting documentation is verified.

When will I receive my benefits card(s)?

What is the age limit for coverage of eligible dependent children?

  • Dependent children up to age 26, regardless of their student or employment status, are eligible for coverage.

How do I submit supporting documentation (marriage certificate, birth certificate, etc.)?

  • Benefitfocus will provide employees with instructions on how to submit supporting documentation.

Are my deductibles calendar year or fiscal year?

  • The deductibles that you pay are based on the calendar year.

If I separate from PGCPS, when does my active coverage end?

  • Your coverage will end on the last day of the month in which you separate from PGCPS or when you are no longer eligible for coverage under the plan.  You will be offered the opportunity to continue your benefits through the Consolidated Omnibus Budget Reconciliation Act (COBRA) coverage.

What is HIPAA?

  • The Health Insurance Portability and Accountability Act of 1996 (HIPAA) protects you from being denied group health insurance coverage based solely on your health status. It also provides workers who change or lose jobs better access to health insurance; limits exclusions for pre-existing conditions; and guarantees renewability and availability of health coverage to small employers and individual members.

 Do I have health insurance coverage when I travel outside the United States?

  • Yes, to receive round-the-clock help with a medical emergency abroad call:
  • From the United States: 1-800-810-BLUE (2583)
  • International: Dial local operator and reverse charges or call collect (001) 804-673-1177

What if someone in my family is going to be out of the Home Network, for example for extended out-of-town business or travel, semesters at school, or families living apart?

  • Contact the CareFirst BlueChoice (Home) Away From Home Care (AFHC) Coordinator at 1-888-452-6403 for more information

What is the difference between the free-standing CareFirst BlueVision Plus and the Discount Vision Program (core) which is included with my medical coverage?

  • The free-standing Optical Care Plan pays a set dollar amount for covered optical care services from any provider.  The “included” Discount Vision Program offers you a 25% discount on routine optical care services, if you use a network provider.  The two programs may not be coordinated.  

 What is Life Insurance?

  • Life Insurance pays your beneficiary a benefit when you die while you are covered.

What is a beneficiary?

  • Your beneficiary is the person (or persons) or legal entity (entities) who receives a benefit payment if you die while you are covered by the policy. You must select your beneficiary when you complete your enrollment application; your selection is legally binding.

How do I designate or change my beneficiary?

  • You may designate or change a beneficiary using Benefitfocus.
  • You may designate or change a beneficiary by doing so in writing on a Beneficiary Designation Form and filing the form with the Prince George's County Public Schools Benefit Department.  Only satisfactory forms provided prior to your death will be accepted.  Beneficiary designations will become effective as of the date you sign and date the form, even if you have since died.  Beneficiary may not be changed by a Power of Attorney.

Can I change my beneficiary at any time?  

  • Yes, you can change your beneficiary at any time during the year.  You do not have to wait until Open Enrollment or a qualifying event.

To whom will benefits for my claim be paid?

  •  Life Insurance Benefits will be paid in accordance with the life insurance Beneficiary Designation.

If no beneficiary is named, or if no named beneficiary survives you, benefits may be paid to the executors or administrators of your estate; or to your surviving spouse; or if your spouse does not survive you, in equal shares to your surviving children; or if no child survives you, in equal shares to your surviving parents.

If a beneficiary is a minor, no benefits can be paid on behalf of the minor child until a legal guardian of the minor’s estate is appointed. 

 Am I eligible for Basic Life Insurance coverage?

  • You are eligible for Basic Life insurance if you are an active full time employee on an annual salary, working 15 hours or more per week and eligible for membership in the Maryland State Retirement System.

 When can I enroll in Basic Life Insurance coverage?

  • You are automatically covered by Employee Basic Life Insurance; you do not have to enroll. You must designate a beneficiary as described above. 

 What is the Basic Life Insurance benefit?

  • For Active Employees, your Basic Life benefit is equal to 2 times Your annual Earnings, not including bonuses, commission or overtime pay, rounded to the next higher $1,000 if not already a multiple of $1,000 to a maximum of  $600,000.

Do I pay for Basic Life insurance?

  • The Basic Life Insurance benefit is provided by Prince George’s County Public Schools at no cost to you.  The Supplemental Life program is a voluntary program made available to you and if you enroll in the program, you pay the full cost of the Supplemental Life option you elect through payroll deductions.

 If my Basic Life insurance is fully paid by PGCPS, why do I have to pay taxes in excess of $50,000?

  • The value of Company-paid life insurance coverage in excess of $50,000 is considered by the IRS as taxable income to you.

When is the Basic Life insurance effective?

  • Your basic life insurance coverage will be effective on your date of hire.

 When will my Basic Life insurance coverage end?

  • Coverage will end on the earliest of the following:  the date the policy terminates; the date you are no longer in a class eligible for coverage (i.e. actively not at work); the date your employer terminates your employment; or the date you are no longer actively at work.

Are there situations when my Basic Life insurance coverage can continue beyond when it would otherwise end?

  •  Yes. Coverage can be continued beyond the date it would otherwise terminate if certain conditions are satisfied.  See below.

Leave of Absence:  If you are on a documented leave of absence, other than Family and Medical Leave or Military Leave of Absence, coverage (including Dependent Life coverage) may be continued for up to 12 month(s) for Support Staff and 24 months for Teachers from the date the leave of absence commenced.

Military Leave of Absence:  If you (or your dependent) enter active military service and are granted a military leave of absence in writing, your coverage (including Dependent Life coverage) may be continued for up to 12 week(s) for Support Staff and Teachers.

Sickness or Injury: If you are not Actively at Work due to sickness or injury, your coverage (including Dependent Life coverage) may be continued for a period of 12 consecutive month(s) from the date you were last Actively at Work.    If this absence is in accordance with state and/or federal family and medical leave, the combined continuation period will not exceed 12 consecutive months.

Family Medical Leave:   If you are granted a leave of absence, in writing, according to the Family and Medical Leave Act of 1993, or other applicable state or local law, your coverage (including Dependent Life coverage) may be continued for up to 12 weeks, or longer if required by other applicable law, following the date your leave commenced for Support Staff and Teachers.

Sabbatical: If you are on a documented sabbatical receiving at least 50% of pay, your coverage (including Dependent Life coverage) may be continued for up to 24 month(s) from the date the sabbatical commenced.

When do I convert or port my Basic Life insurance coverage?

  •  Your life insurance should be converted when you 1) terminate from employment, 2) when you retire or 3) when you have not been actively at work for 9 months.  Upon termination or retirement, The Hartford will automatically send the Application Notice for Conversion privileges.  You must contact Absence Management if you have not been actively at work to obtain the Application Notice for Conversion.

If you do not port or convert your coverage your beneficiaries will not receive a benefit at the time of your death.

Does Basic Life insurance coverage continue if I am Disabled?

  • Waiver of Premium is a provision which allows you to continue your and your Dependent’s Life Insurance coverage without paying premium, while you are disabled and qualify for Waiver of Premium.  Waiver of Premium is available on your Supplemental Life Insurance and your Dependent Life Insurance.   For Waiver of Premium purposes disabled is defined as being unable to perform any work for which you are or could become qualified by education, training or experience, or you receive a life expectancy from your physician of less than 6 months.

Does the Prince George's County Public Schools plan have an Accelerated Death Benefit available?

  • For Active Employees - in the event that you or your dependent are diagnosed as terminally ill (less than 12 months life expectancy) an Accelerated Benefit may be available. If diagnosed as terminally ill you may request a minimum Accelerated Benefit amount of $3,000, and a maximum of $500,000. However, in no event will the Accelerated Benefit Amount exceed 80% of the terminally ill person’s amount of life insurance.

 What Supplemental Life benefit options are available to me?

  •  Active Employees have the option of enrolling in the Supplemental Life program at time of hire or at annual enrollment each fall.  You may elect coverage in increments of $50,000 (with a minimum of $50,000) to a maximum amount of coverage of $500,000.  The amount you elect can not exceed 5 times your annual earnings.  Evidence of Insurability (Personal Health Application) will be required during annual open enrollment.

Can I cover my spouse and/or children under the life insurance plans? 

  • The Basic Life plan is available for employees of Prince George's County Public Schools. In order to cover your spouse and children, you must first enroll yourself into the Employee Optional Life plan.   You may elect to cover you spouse in incremental amounts of $5,000, subject to a maximum of $50,000.  You may elect to cover your dependent children between the ages of 15 day(s) and 26 years in increments of $2,000 to a maximum of $10,000.
  • You may not elect coverage for your dependent (spouse or child) if such dependent is covered as an employee under the policy.  No person can be insured as a dependent of more than one employee under the policy.

How do I enroll for Supplemental Life insurance coverage?

  • To enroll for Supplemental Life Insurance, you must complete and sign a group insurance enrollment form for your coverage and your dependent's coverage.  If you do not enroll for coverage for yourself and your dependents within 35 days after becoming eligible (date of hire), and later choose to enroll, you may enroll for your coverage and/or your dependent's coverage only during an annual enrollment period or within 35 days of the date you have a change in Family Status.   Any enrollment during annual enrollment or Family Status changes will require a satisfactory Personal Health Application and Designation of Beneficiary form.

What is Evidence of Insurability (Personal Health Application)?

  • Evidence of Insurability is medical underwriting that must be completed by yourself and your spouse before coverage can be issued.   The Hartford’s medical underwriting process consists of a paper application (Personal Health Application) that asks medical questions.  Depending on your answers, additional information may be required such as lab work, medical records and/or an examination.   If you are electing coverage at annual enrollment and require additional tests or lab work, the cost of this examination must be paid for by you.

When is Supplemental Life insurance effective?

  • Your supplement life insurance coverage will be effective on the first day of the month, following approval from MetLife.

 If my coverage under the policy ends, do I have a right to convert or port my insurance?

  • If life insurance coverage or any portion of it under the policy ends for any reason, you and your Dependents may have the right to convert or port the coverage that terminated to an individual conversion policy without providing Evidence of Insurability.

How do I convert or port my coverage or coverage for my Dependents?

  • You are entitled to written notice of your conversion and portability rights or your dependents' conversion and portability rights.  To convert or port your coverage or coverage for your dependents, you must complete a Notice of Conversion Right form.  The completed form must be signed by an Absence Management representative, and returned to the insurance company with 31 days of the date your insurance terminated.  After the insurance company verifies eligibility for coverage, you will receive a Conversion Policy proposal. You must complete and return the request form in the proposal; and pay the required premium for coverage within the time period specified in the proposal.  Contact Absence Management to request the Notice of Conversion Right form.

Who does my family notify to collect life insurance benefits upon my death?

  • Your family will need to contact the Benefits Services Office, 301-952-6600. They will need a certified copy of the death certificate in order to submit a claim form for life insurance benefits.

What recourse does my Beneficiary or I have if a claim is denied?

  • On any claim, the claimant or his or her representative may appeal for a full and fair review. To do so, he or she must request a review upon written application within 180 days of receipt of claim denial or 60 days of receipt of claim denial if the claim does not require a determination of disability; and may request copies of all documents, records, and other information relevant to the claim; and may submit written comments, documents, records and other information relating to the claim.

How do I start, change or cancel my Tax Sheltered Annuity (TSA) payroll deduction amount? 

How to Rollover (Incoming and Outgoing) funds into your TSA?

How to Transfers funds between to different vendors?

How to request a 403(b) Hardship Withdrawals?

How to request a 457(b) Unforeseen Emergency Withdrawals?

 How to withdraw my Maryland State Retirement Agency contributions?

 Can I borrow funds from my Maryland State Retirement Pension?

  •  No, you can not borrow funds from your Maryland State Retirement Pension.