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FSA Mid-Year Plan Changes & Enrollments

April 12, 2021 through April 30, 2021

 

Please review the handbook before enrolling or making any changes.

  o After reviewing the handbook, please read the Important Benefits Information: FSA Plan changes below.

 

To change your election or start participating in the 2021 FSA Plan, please complete the 2021 Mid-Year FSA Election Change Form. The form should be scanned and uploaded to the CBIZ (Pension Dynamics) secure website:  https://secure.pensiondynamics.com/ .

 

Click here for the 2021 Mid-Year FSA Election Change Election Form

 

For plan information/clarification assistance, please contact CBIZ.

 

CBIZ acquired pension Dynamics; however, the same team is here to assist you with your account. You can continue to contact them directly by phone at (925)956-0514 or email at PHCBenefits@cbiz.com.

 

Announcement emailed April 12, 2021 below:

 

Important Benefits Information: FSA Plan Changes

 

To provide pandemic relief, recent federal legislation (the Consolidated Appropriations Act of 2021) included allowances for employers to make optional changes to Flexible Spending Account (FSA) rules. Peralta Community College District is allowing the following changes to our Healthcare and Dependent Care FSAs.

 

These changes are effective January 1, 2021 and will remain in effect as noted below.

 

Opportunity to Make Mid-Year Election Changes: April (12th – 30th), 2021

 

For Healthcare FSA Only

 

Carry Over 100% of Unused Balance

  • In the past, the Healthcare FSA allowed up to $550 (as indexed for 2020) of unused funds to carry over to use in the following year; any excess balance would be forfeited. Due to the recent Act, the cap on the carryover amount has been removed. 100% of unused Healthcare FSA balances may carry over from the plan year ending in 2020 to the plan year ending in 2021 and from the plan year ending in 2021 to 2022 plan year. Carrying over a balance does not affect your enrollment for a subsequent year. You will still be allowed to contribute up to the maximum contribution limit set by the IRS.

    EXAMPLE

Maria enrolled in the Healthcare FSA for 2020. She had $700 left in her account at the end of the year. She is able to carry over the entire balance to use in 2021. Maria expects higher healthcare expenses in the coming year, so she elected to contribute $2,750 to her FSA for 2021, for a total of $3,450 in her account. If she does not use that entire amount in 2021, she will be allowed to carry over all of her remaining balance to use in 2022.

 

For Dependent Care FSA Only

 

Grace Period Extended to 12 Months

  • Peralta to allow the change for the 2020 plan year. The grace period is an extra amount of time after the end of the plan year that participants have to incur expenses reimbursable by the Dependent Care FSA. The grace period is being extended from 2 ½ months after the end of the plan year to 12 months after the end of the plan year with respect to unused benefits or contributions for a plan year ending in 2020.

EXAMPLE

Sam enrolled in the 2020 Dependent Care FSA for January 1 – December 31, 2020. Due to the pandemic, Sam’s child care expenses were less than he expected, and he had $1,000 left in his FSA at the end of the year. Sam may continue to use the $1,000 balance in his FSA to get reimbursed for eligible dependent care expenses incurred through December 31, 2021. Any balance remaining at the end of the 12 month grace period will still be forfeited.

 

Dependent Care FSA Contribution Limit

Contribution Limit Increase to $10,500 in Plan year 2021.

 

Dependent Maximum Age – For Dependents who “Aged Out” During the Pandemic

  • The maximum age for eligible dependents is temporarily extended from “under age 13” to “under age 14”. If you participated in the Dependent Care FSA during the 2020 plan year, AND your dependent(s) turned 13 between January 1 – December 31, 2020, you may continue to receive reimbursement from your Dependent Care FSA for their eligible expenses. You may continue to use any carryover balance for their care until they reach age 14, at least through the end of the 2021 plan year.

EXAMPLE

Alex enrolled in the Dependent Care FSA for the plan year effective January 1 – December 31, 2020. He elected to contribute $2,500 for before and after school care for his daughter. The pandemic caused temporary changes in the family schedule, and Alex spent less than he anticipated on care in 2020, resulting in a $1,200 balance in his FSA. Even though his daughter turned 13 on August 11, 2020, due to the age extension, Alex can continue to use his FSA balance to pay for his daughter’s care until she turns 14 in 2021.

 

This email constitutes a Summary of Material Modifications (SMM) to Peralta Community College District’s Flexible Spending Account. This is merely a summary of the most important changes to the Plan and information contained in the Summary Plan Description (“SPD”) previously provided to you. It supplements and amends that SPD so you should retain a copy of this document with your copy of the SPD. If you have any questions, contact the Administrator. If there is any discrepancy between the terms of the Plan, as modified, and this Summary of Material Modifications, the provisions of the Plan will control.

 

 

Important Links

 

2020 Employee Open Enrollment Benefits Newsletter/Announcement

2020 Retiree Open Enrollment Benefits Newsletter/Announcement

2020 – 2021 PCCD Employee Benefits Guide with Monthly Contribution Rate Matrix

2020 – 20201 PCCD Retiree Benefits Guide

PCCD Required Documentation Matrix

Registration and login online instructions for BenefitBridge

BenefitBridge Secure Enrollment Portal

403 (b) & 457 (b) Plan Information

Voluntary Benefits

 

For BenefitBridge technical assistance only, please contact BenefitBridge Customer Care at 800.814.1862;

Mon – Fri, 8:00 AM – 5:00 PM, PST or email benefitbridge@keenan.com

For assistance with your benefits questions, please contact the District, Benefits office at 510.466.7229;

Mon – Fri, 8:30 AM – 5:00 PM, PST or email benefits@peralta.edu

 

 

 

 

 

 

Benefits Resource Libraries -Current & Previous Plan Years

*Located under the Navigation tab top left of webpage.

 

 

Current Plan year ( July 1, 2020 – June 30, 2021 ) Resource Library Below

 

  

 

Medical Plans

 

 

Kaiser HMO Plans 

 

2020-2021 Kaiser Traditional Plans Summary of Benefits & Coverage

Peralta-Community-College-Kaiser-HMO-10  SBC 

Peralta-Community-College-Kaiser-HMO-15 SBC 

Peralta-Community-College-Kaiser-HMO-0 SBC

 

 

2020-2021 Kaiser Senior Advantage Plans Summary of Benefits & Coverage

 

Peralta Community College 65 HMO $0 SR ADV Benefit Summary

Peralta Community College 65 HMO $10 SR ADV Benefit Summary

Peralta Community College 65 HMO $15 SR ADV Benefit Summary

 

Kaiser Permanente Senior Advantage (HMO) Enrollment Form

  

Universal Benefit Enrollment Form – Retiree & Exceptional Processing

*Retirees enrolling in a Kaiser Permanente Senior Advantage Plan must complete the Kaiser Permanente Senior Advantage Enrollment form (above) and mail to the address on the form. If you are changing your medical plan during open enrollment also complete the Universal Benefit Enrollment Form (above) and mail to the PCCD Benefits Office at the address on the form along with any required dependent documents if applicable. Remember to enclose a copy of the Kaiser Permanente Senior Advantage Form mailed directly to Kaiser.

 

PCCD Kaiser Permanente Reimbursement Form

Kaiser Reimbursement Form

 

 

 

Anthem PPO Traditional & PPO Lite Self-funded Plans Administered by Trustmark

 

 

2020-2021 Summary of Benefits & Coverage

 

Peralta Self Funded Traditional PPO SBC $15 Plan (Local 1021 & Confidentials)

Peralta Self Funded Traditional PPO SBC $10 Plan (PFT, Management & Trustees)

Peralta Self Funded Traditional PPO SBC $15 Plan (Local 39)

Peralta Self Funded Lite PPO SBC $15 Plan (Local 1021 & Confidentials)

Peralta Self Funded Lite PPO SBC $10 Plan (PFT, Management & Trustees)

Peralta Self Funded Lite PPO SBC $15 Plan (Local 39)

 

Universal Benefit Enrollment Form – Retiree & Exceptional Processing

*Retirees changing medical plans during open enrollment must complete the Universal Benefit Enrollment Form (above) and mail to the PCCD Benefits Office at the address on the form along with any required dependent documents if applicable.

 

 

CASH IN-LIEU OF MEDICAL & DENTAL BENEFITS FORM

If you are an active employee waiving medical and dental benefits please uploaded the completed form with all required insurance verifications during your BenefitBridge online enrollment.

 

 

 

Dental

 

 

Dental PPO

 

Delta Dental PPO Plan – Plan Summary 

 

 

UHC Dental DHMO – Direct Compensation Dental Plan

 

UHC DHMO – Direct Compensation Dental Plan Evidence of Coverage

UHC DHMO – Direct Compensation (DC) Contributory CA250/covered dental services CA D1065

 

 

Vision (Bundled With Medical Plans)

 

 

Kaiser Vision Plan & UHC Vision Plans – Benefits Summary

 

 

Voluntary Vision

 

 

VSP (Voluntary Vision) – Benefits Summary

 

District-Paid Life Insurance

 

Life Insurance Certificate

 

District-Paid Disability Insurance

 

Long Term Disability Certificate

 

Employee Assistance Program (EAP) Administered by MHN

 

EAP Evidence of Coverage

 

Flexible Spending Medical and Dependent Day Care Expenses under IRS Code 125

*Open enrollment occurs annually November 1-30 for the following plan year (January – December).

 

Current year forms & Documents:

CBIZ FSA – Transition Guide

CBIZ FSA Handbook with Enrollment Form- 2021

Flexible Spending SPD: 2014-spd-003

PENSION DYNAMICS FSA Claim-form Plan Year 2020

CBIZ FSA Claim-form Plan Year 2021

CBIZ Direct-deposit-authorization

CBIZ FSA Change in Status or Termination Form

 

Pre-tax Commuter Expense under IRS Code 132

 

 

The maximum amount you may contribute to each account cannot exceed the maximum amount specified in Code Section 132(f).

 

The maximum amounts are:

 

Parking Expenses $270/month

Transportation Expenses $270/month (Public transportation/vanpool)

  

CBIZ COMMUTER – Transition Guide

CBIZ Pre-Tax Commuter Handbook with Enrollment Form – 2021

Pre-Tax Commuter SPD: peralta-132-doc

PENSION DYNAMICS Pre-Tax Commuter Claim Form (Eligible expenses prior to 12/31/2020

CBIZ PRE-TAX COMMUTER (PARKING ONLY) Claim-form Plan Year 2021

*CBIZ debit card must be used for eligible transit expenses starting 1/1/2021.

CBIZ Direct-deposit-authorization

 

Medicare Downloads

 

Medicare A, B & D Premium Reimbursement Plan Summary Plan Description (SPD) 2015

Medicare-A-and-B-and-D-Premium-Claim-Form-Revised-11-24-20

Medicare Reimbursement Plan Policy Statement 10.2015

 

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THE HUB NEWSLETTER

Volume 3 

Volume 2

Volume 1

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  • Benefits & Medical Information

    Saturday 17 April 2021
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  • Peralta Community College District

    The District comprises four colleges serving northern Alameda County.
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