STATE HEALTH BENEFIT PLAN
RATE SHEET
JANUARY 2009 – DECEMBER 2009
The Forsyth County Board of Education pays $49.38 for all employees participating in the health insurance program through the State Health Benefit Plan. Any premiums in excess of the $49.38 are listed below and will be deducted from your monthly paycheck.
United HealthCare Plan Options / Employee / Employee + Child / Employee + Spouse / FamilyUnited HealthCare Definity HRA / $ 7.46 / $119.12 / $124.26 / $129.30
HRA – Tobacco Charge / $47.46 / $159.12 / $164.26 / $169.30
HRA – Spouse Charge / $154.26 / $159.30
HRA – Tobacco & Spouse Charge / $194.26 / $199.30
United HealthCare High Deductible / $ 0.00 / $106.40 / $111.06 / $115.72
HDHP – Tobacco Charge / $40.10 / $146.40 / $151.06 / $155.72
HDHP – Spouse Charge / $141.06 / $145.72
HDHP – Tobacco & Spouse Charge / $181.06 / $185.72
CIGNA Choice Fund HRA / $ 7.46 / $119.12 / $124.26 / $129.30
HRA – Tobacco Charge / $47.46 / $159.12 / $164.26 / $169.30
HRA – Spouse Charge / $154.26 / $159.30
HRA – Tobacco & Spouse Charge / $194.26 / $199.30
CIGNA Open Access Plus High Deductible / $ 0.00 / $106.40 / $111.06 / $115.72
HDHP – Tobacco Charge / $40.10 / $146.40 / $151.06 / $155.72
HDHP – Spouse Charge / $141.06 / $145.72
HDHP – Tobacco & Spouse Charge / $181.06 / $185.72
State Health Benefit Plan United Healthcare CIGNA Healthcare
404-656-6322 (877) 246-4189 (800) 633-8519
www.dch.georgia.gov www.myuhc.com www.cigna.com
If an employee and spouse are both employed with the Forsyth County School System, please ask about our discounted rates for family coverage.
For enrollment and changes please contact the Forsyth Benefits Office.
Janet Clack (770)887-2461 ext. 202136
Shelia Panter (770)887-2461 ext. 202141
MEMORANDUM
TO: New Employees for 2009 School Year
FROM: Business Office
SUBJECT: Eligibility Coverage
You are eligible to enroll yourself and your eligible dependents for State Health Benefit coverage if you are:
· A certified public school teacher who works half time or more, but not less than 18 hours a week.
· A non-certified service employee of a local school system who is eligible to participate in the Teachers Retirement System. You must also work at least 60% of a standard schedule for your position, but not less than 20 hours a week.
· An employee who is eligible to participate in the Public School Employees’ Retirement System. You must also work at least 60% of a standard schedule for your position, but not less than 15 hours a week.
To be eligible for all other benefits you must work at least 20 hours per week.
Forsyth County Board of Education
Employee Benefit Effective Dates
Hire Date / Benefits Effective DateDecember 2, 2008 – January 2, 2009 / February 1, 2009
January 3, 2009 – February 2, 2009 / March 1, 2009
February 3, 2009 – March 2, 2009 / April 1, 2009
March 3, 2009 – April 1, 2009 / May 1, 2009
April 2, 2009 – May 1, 2009 / June 1, 2009
May 4, 2009 – June 1, 2009 / July 1, 2009
June 2, 2009 – July 1, 2009 / August 1, 2009
July 2, 2009 – August 3, 2009 / September 1, 2009
August 4, 2009 – September 1, 2009 / October 1, 2009
September 2, 2009 – October 1, 2009 / November 1, 2009
October 2, 2009 – November 2, 2009 / December 1, 2009
November 3, 2009 – December 1, 2009 / January 1, 2010
Your employee benefits begin on the first day of the month following one full calendar month of employment.