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La Frontera, EMPACT - SPC offers an extensive benefit package. We also offer many benefit allowances to assist with
medical, dental, flexible spending account (FSA) and 403(b) premiums and contributions.
Open Enrollment For Benefit Eligible Employees
• You can enroll or make changes for medical insurance, dental insurance, voluntary vision, voluntary life/short term
disability (STD) insurance, and if participating, elect your Flexible Spending Account (Health and/or Dependent Care)
contributions—for the coming plan year 1/1/17 through 12/31/17.
• Enrollment will be completed online.
FAILURE
to enroll on a timely basis will result in waiver of benefits. You will
not be able to enroll until next open enrollment.
• Remember, your benefit elections will remain in place throughout the entire plan year (1/1/17 to 12/31/17) unless
you experience a qualifying event. Please see HR if you have questions or will experience a Qualifying Event. You
have 30 days to complete paperwork from a Qualifying Event to enroll.
• New enrollment in voluntary life/short term disability may require additional forms. Please see Human Resources
Department for details.
• All employees enrolling in the FSA plans
must
complete a BASIC enrollment form. Contributions are deducted from
payroll on a pre-tax basis.
New Hire Enrollment
• Regular employees classified as 3/4 (30-39 hours) or full time (40 hours) are eligible for insurance benefits. Coverage
begins on the first of the month following 30 days of continuous employment.
• Remember, your benefit elections will remain in place throughout the entire plan year (1/1/17 to 12/31/17) unless
you experience a qualifying event.
• You may elect Medical, Dental, Vision, Supplemental Life and various voluntary insurance options for yourself and
eligible dependents (Domestic Partners are not eligible for supplemental life). Eligible dependents include:
• Your spouse or domestic partner.
• Your dependent child(ren) up to age 26, with no other source of coverage (for medical and dental coverage only).
• Your dependent child(ren) up to age 19, or 23 if full-time student.
FSA Conditions:
• All employees enrolling in the FSA plans
must
complete the Flexible Spending/Dependent Account form.
• Contributions are deducted from payroll on a pre-tax basis.
La Frontera, EMPACT - SPC will offer a contribution of $1,000 annually (pro rated based on plan year) into a flexible spending
account to employees not electing our company medical plan. Proof of other medical coverage must be presented to be
eligible to receive La Frontera, EMPACT - SPC funds.
Domestic Partners
• You may enroll your domestic partner in your insurance benefits to include medical, dental and vision if all IRS
requirements are met.
• The requirements are listed on the Domestic Partnership Affidavit, which can be obtained from your HR Department.
The Affidavit will need to be completed and signed by you and your partner.
• The portion of premium payroll deducted for Domestic Partner coverage cannot be deducted pre-tax.
• Domestic Partners are not eligible for continuation of coverage under COBRA.
Qualifying Events
• Medical, dental, vision and flexible spending accounts allow these benefits to be paid with pre-tax dollars; IRS has
certain rules about when you can make changes.
• In most cases, you may only make benefit changes during open enrollment. However, you may make changes during
the year if you experience a qualifying event - an event that causes you or a covered dependent to gain or lose
eligibility for coverage.
• For a complete list of qualifying events contact your HR Department.
The following are some examples of Qualifying Events:
You MUST notify HR within 30 days of a qualifying event
• Marriage
• Legal separation
• Divorce
• Birth
• Adoption
• You, your spouse, or dependent has a change that
affects eligibility for benefits
• Death