All employees who work a minimum of 30 hours per week are eligible for insurance.
District 55 insurance is administered by the South Carolina Public Employee Benefit Authority (SC PEBA). The school district and state are committed to providing the best possible insurance benefits at the greatest possible value. Coverage is competitive with that of other states and the private sector.
Insurance options, plans, rates, and other information can be accessed through the following link. Should you need assistance, please contact Benefits Administrator Becky Nobles at 864-984-8116 or by email at email@example.com.
Following are the requirements for employee eligibility of insurance:
The employee must be employed with Laurens County School District #55 in a permanent and full-time basis working 30 or more hours per week.
Part-time employees may be eligible based on their position.
The employee must complete appropriate election forms within 31 days of the date of employment or status change.
Enrollment deadline is 31 days from the hire date.
Coverage of the state health plan begins on the first day of the following month after the hire date of employee.
Example: Hired on August 24, 2020, coverage begins September 1, 2020.
Open Enrollment is held each year in October for a January 1st benefit effective date. Please note that the dental plan is only available during open enrollment in odd-numbered years for a January 1st benefit effective date.
Spouse and children younger than 26 are - eligible dependents may be added to coverage
No pre-existing conditions for health plans
State Standard Health Plan and Savings Plan
Worldwide access to network hospitals/physicians through the Blue Card Program.
Making Changes to Insurance Program
Eligible employees may make certain changes to benefits during designated enrollment periods and within 31 days of a family status change or special eligibility situation.
Marriage - If you, as a covered subscriber, wish to add a spouse because you marry, you can do so by completing an NOE and submitting a copy of your marriage license within 31 days of the date of your marriage. You may enroll yourself and your spouse and eligible children/stepchildren to your health, dental, vision and life insurance by submitting a completed Notice of Election form and proper documentation of dependent eligibility to your benefits office. You may also enroll in or increase your Optional Life by up to $50,000 and enroll in or change contributions to Medical or Dependent Care Spending account.
A subscriber can enroll his spouse, without medical evidence, in $10,000 or $20,000 in Dependent Life-Spouse coverage with 31 days of the marriage. Subscribers can also enroll eligible dependent children in Dependent Life-Child coverage within 31 days of the marriage.
Legal Separation - If you and your covered spouse separate, your spouse may remain on your health, Dental/Dental Plus, State Vision Plan and Dependent Life-Spouse coverage until the divorce is final.
If you do not participate in the MoneyPlus pretax premium feature, you can remove your spouse from your coverage when you separate. If you remove your spouse from one of these programs: health, dental or vision coverage, you must also remove him from the other two programs.
Divorce - If you divorce, you must remove your spouse and former stepchildren from your coverage by completing an NOE and submitting a complete copy of the divorce decree within 31 days of the date stamped on the divorce decree. Coverage for your divorced spouse and former stepchildren will end the last day of the month after the divorce decree is stamped. If you fail to drop your divorced spouse or former stepchildren within 31 days of the date the court order or divorce decree is stamped by the court, the change in coverage is effective the first of the month after your signature on the NOE dropping your former dependents.
Adding Children - Eligible children may be added by completing an NOE within 31 days of the qualifying event.
Date of birth (effective on date of birth)
Marriage of the subscriber to the child’s parent (effective on the date the marriage)
Adoption or placement for adoption (effective on the date of adoption or placement for adoption)
Placement of a foster child (effective on the date of placement)
Loss of other coverage (effective on the date of loss of coverage)
The Health Insurance Portability and Accountability Act (HIPAA) requires SC PEBA Insurance Benefits to notify you of a very important provision in its health insurance plan. You have the right to enroll in SC PEBA Insurance Benefits health insurance plans under its “special enrollment provision” if you acquire a new dependent or if you decline coverage under SC PEBA Insurance Benefits’ health insurance plans for yourself or an eligible dependent while other coverage is in effect and later lose that other coverage for certain qualifying reasons. The newly eligible child must be offered health, Dental/Dental Plus and State Vision Plan coverage. The subscriber and all other previously enrolled family members may change health plans. A child who is eligible, but not newly eligible, cannot be added at this time. However, a spouse may be added.
Appeals - If you are dissatisfied after an eligibility determination has been made, you may ask SC PEBA Insurance Benefits to review the decision.
If you are an employee, a Request for Review should be submitted through your benefits office. Your BA may write a letter or use the Request for Review form, which is available online at the SC PEBA Insurance Benefits website. If the request is denied, you may appeal by writing to the SC PEBA Insurance Benefits Appeals Committee within 90 days of notice of the decision.
Health Insurance Cards
Insurance cards are issued by the vendor within three weeks of enrollment.
Enrolling in a health plan will require certification as a tobacco or non-tobacco user. If only the employee is enrolled and use tobacco, there will be an additional $40 per month surcharge added to the health premium. If dependents are covered (even if only one out of the group uses tobacco), an additional $60 per month surcharge will be added to the health premium.
As an active employee, SC PEBA Insurance Benefits considers you a transfer if you change employment from one participating group to another with no break in insurance coverage or with a break of employment of no more than 15 calendar days.
A transfer is not a new hire for insurance purposes. The employee must remain enrolled in the same insurance benefits in which he/she was enrolled at the former employer.
Members are encouraged to notify Medi-Call during the first trimester of a pregnancy and to participate in the Maternity Management Program; however, the State Health Plan no longer financially penalizes a member for failure to do so. Please note that members are required to pre-authorize any hospital admission. This includes hospitalization related to having a baby. Failure to do so will result in the insured being financially penalized, For details, see the Insurance Benefits Guide.
MoneyPlu$ is a program that allows employees to have insurance premiums deducted from their pay pre-tax. Medical Spending Accounts allow employees to set aside pre-tax dollars to help offset out-of-pocket medical, prescription, dental, and vision expenses. Child Care Spending Accounts allow employees to set aside pre-tax dollars for child care expenses.
All permanent employees are required to join one of the two South Carolina Retirement Plans:
SCRS - a defined benefit plan - retirement benefit is based on years of service and twelve highest quarter earnings.
ORP - a defined contribution plan - retirement is based on how well investments grow.
Basic Retirement Plan - The South Carolina Retirement System (SCRS)offers the option of a defined benefit plan to all Laurens School District 55 employees. All employees -- except bus drivers, temporary employees, and substitutes -- are required to contribute at the specified rate of nine percent (9%). Employee contributions are on a pre-tax basis. Benefits and vesting rights are defined by SCRS. For details, visit PEBA Retirement Benefits.
Optional Retirement Plan (ORP) - The State Optional Retirement Plan is another option available to Laurens School District 55 employees. The ORP is a defined contribution plan administered by four contracted investment providers.