FILE:  EGA

Cf:  GBQ

EMPLOYEE INSURANCE

The Lincoln Parish School Board may make available to its eligible employees, retirees, and/or their spouses and dependent children, health, hospitalization, life, vision, disability, and other benefit insurance programs.  The School Board may pay any portion of an employee’s, spouse’s, dependent’s, or retiree’s premium it so determines.

Healthcare provisions and other program aspects regarding the School Board’s health and hospitalization coverage shall be outlined in the Lincoln Parish School Board Health Benefit Plan.

EMPLOYEE/RETIREE INSURANCE PREMIUMS

The Lincoln Parish School Board shall require employees to pay their insurance premiums one month in advance for coverage in effect prior to January 1, 2022, and in the month of coverage for each month thereafter.  Retirees shall be required to provide necessary banking account information in order for their premiums to be deducted directly from their account each month.  Active employees shall have their premiums deducted from their monthly pay.

Whenever the School Board is faced with retirees and active employees who have insufficient banking funds to cover the amount of the insurance draft, the School Board is charged a fee for the return of the draft or check.  It is illegal for the School Board to advance funds to pay employee or retiree premiums.  Therefore, if there are not adequate funds available to cover the insurance payment (leave without pay, worker’s compensation, FMLA, etc.), the employee must remit the required amount to the School Board.  On the first returned draft/check, the retiree/active employee shall be notified and required to pay the premium due and the charge for the returned draft/check.  On the second returned draft/check the retiree/active employee shall be required to pay the premium due and the charge for the returned draft/check, along with a fifty dollar ($50) penalty.  On the third returned draft/check, the retiree’s/ active employee’s insurance shall be terminated.  The retiree/ active employee shall be notified of the termination by certified mail.  All correspondence shall be maintained in the retiree’s/active employee’s insurance file.

MEDICARE ADVANTAGE PLAN

The Lincoln Parish School Board may contract to offer a Medicare advantage plan as another health insurance option for its retirees.  At the time of retirement a retiree may choose to enroll in either the School Board’s regular health plan or Medicare Advantage Plan, if eligible.  The plan year for the School Board’s Medicare Advantage Plan shall run concurrent with other School Board-sponsored health plans.  A retiree shall not be enrolled in the School Board’s Medicare Advantage Plan and another School Board-sponsored health plan concurrently.

A retiree will be eligible to enroll in the School Board’s Medicare advantage plan upon initial enrollment in Medicare Part A and Part B.  A retiree’s spouse will be eligible to enroll in the School Board’s Medicare Advantage Plan upon initial enrollment in Medicare part A and Part B only if the Retired employee is enrolled in the Medicare Advantage plan concurrently.  After initial enrollment of the Retiree in the Medicare Advantage Plan, participation is required to be maintained through the end of the current plan year.  During an annual enrollment period designated by the Lincoln Parish School Board each year, the retiree may elect to switch insurance coverage between the School Board’s Medicare Advantage Plan or other School Board-sponsored health plan.

The Medicare Advantage plan may not coordinate with benefits of other private health plans or other employer-sponsored health plans.  It is the responsibility of the retiree to research and investigate the affects enrollment in the Medicare Advantage Plan will have on other health insurance coverage the retiree or spouse may have.

Cancellation of Medicare Advantage Plan enrollment.

Participation in the School Board’s Medicare Advantage Plan requires each retired member to maintain continuous Medicare Part A and Part B coverage.

1. Termination of Medicare Part B Coverage.  If Medicare Part B coverage is cancelled voluntarily by the retired member or involuntarily for non-payment of the Medicare Part B premium, the retiree’s coverage under the Medicare Advantage Plan will terminate at the time Medicare Part B coverage ends.
   
   

2. Enrollment in a non-School Board Medicare Advantage Plan.  If a retiree enrolls in another Medicare Advantage Plan that is not offered through the School Board, enrollment in the School Board’s Medicare Advantage Plan will terminate on the effective date of the retiree’s enrollment in the new Medicare Advantage Plan.

Sixty (60)-day re-enrollment period.  If the School Board’s Medicare advantage plan coverage is terminated as described in (i) or (ii) above, the retiree will have sixty (60) calendar days from the date of termination to re-enroll in the School Board’s Medicare Advantage Plan.  The retired member(s) will be uninsured until Medicare Advantage Plan coverage is restored.  If coverage is not reinstated within sixty (60) days, termination is final.

If participation in the School Board’s Medicare advantage plan terminates before the end of the current plan year, and coverage is not restored prior to the end of the plan year, the retiree is not permitted to enroll in any other School Board health plan and has lost eligibility to participate in annual enrollment to regain health coverage under any School Board health plan.

If the termination of the School Board’s Medicare Advantage Plan is effective at the end of the current plan year, the retiree may enroll in another School Board health plan for the next plan year.  Enrollment must occur during the preceding Annual Enrollment period designated by the School Board.  Eligibility and enrollment in another School Board sponsored-health plan, is subject to the terms and conditions stated in the related health plan document.

Ref:    La. Rev. Stat. Ann. §§17:1233, 23:1034, 23:1081, 23:1472, 32:861, 32:862, 32:863, 32:864, 32:865, 32:900, 42:821, 42:851

Israel v. Gray Ins. Co., 720 So.2d 803 (98-525 La. App. 3 Cir. 10/28/98)

Board minutes, 12-1-81, 5-6-08, 4-10-12, 11-2-21

Lincoln Parish School Board