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2025 Open Enrollment
Open Enrollment began October 14th and ended November 1st.
We hosted two informational meetings. These were not meetings to complete Open Enrollment selections.
Open Enrollment was a virtual process for Active Employees and was accessible through MyCUSD (in the future, if you cannot login to your MyCUSD account, please contact TIS Radar at 949-234-5500). Retirees and COBRA participants were able to complete Open Enrollment with a paper enrollment/ changes form. Any changes made during Open Enrollment will become effective January 1, 2025.
However, if you were not looking to make any changes to your Medical, Dental, and/ or Vision coverage, then no action was necessary. Your 2024 health benefit enrollments will rollover into 2025.
As a reminder, the UHC Harmony w/ HRA medical plan is the same as the UHC Journey w/ HRA in the Open Enrollment platform. If you currently are covered under a UHC Alliance medical plan, have Memorial Care as your medical group, and were not looking to make any changes, you will be automatically transitioned to the corresponding UHC Harmony medical plan (UHC Alliance $10 to UHC Harmony $10 and UHC Alliance w/ HRA to UHC (Journey) Harmony w/ HRA), effective January 1st. No action is necessary.
- Medical Plan Side-by-Sides
- How to Find a Primary Care Physician
- 2025 Rates
- VEBA
- Health Care Definitions
- Virtual ID Cards
- Health Benefit Contacts
- Acceptable Documents to Verify Dependent Eligibility
- Adding dependents will require supporting documentation to be submitted to our insurance department via fax, district mail, US mail, or in person by no later than December 20, 2024. Please do not send documents via email.
- Adding dependents will require supporting documentation to be submitted to our insurance department via fax, district mail, US mail, or in person by no later than December 20, 2024. Please do not send documents via email.
However, if you are currently enrolled in American Fidelity’s Flexible Spending or Dependent Care accounts, you will have to reenroll to continue coverage into 2025. New enrollment or reenrollment must be completed in American Fidelity’s external platform because they are an external entity. Their Open Enrollment took place October 21st through November 15th. Please scroll down to open the tab designated to American Fidelity.
American Fidelity Assurance
The Flexible Spending Account (FSA) and Dependent Care Account (DCA) are Section 125 plans managed by our third-party administrator, American Fidelity. The funds for these accounts are pre-tax and can be used for medically related expenses or childcare expenses.
- 2025 Open Enrollment
- CUSD's enrollment period with AF began October 21st and ran through November 15th, for plan year January 1, 2025 through December 31, 2025. Virtual appointments were available to review your benefits.
- Pre-Enrollment Flyer
- Self Enrollment Flyer
- Virtual Appointment Scheduler
To speak with an American Fidelity representative about the FSA or DCA programs call their customer service line: (800) 365-9180
Flexible Spending Account (FSA) - Designate up to $3,200 annually per household for medically-related expenses, such as prescriptions, co-pays, co-insurance and selected other expenditures. For more information view the flyers below:
- Details of Program: Flexible Spending - How it Works
- File a claim: Ready to file a claim?
- Mobile App: AF Mobile App
- Direct Deposit: AF Direct Deposit Form
- Reimbursement Voucher: AF Health FSA Reimbursement Voucher
Dependent Care Account (DCA) - Designate up to $5,000 annually per household for childcare expenses for your children ages 12 and under. Daycare must be with a licensed daycare provider.
- Details of Program: Dependent Care - How it Works
- Reimbursement Form: AF Dependent Care Reimbursement Form
Classified (CSEA), Teamsters (TEAM), and Management (CUMA) Employees
- Disability benefits don't automatically adjust to correspond with salary increases. If your salary has increased since your last enrollment and you have AF Disability Income Insurance, it's important that you review your current coverage with an AF account manager to help protect your income.
- Healthcare flex spending accounts and dependent care accounts allow you to save part of your paycheck, before tax, to pay for eligible costs throughout the year. Since your money is taken out pre-tax, it reduces your taxable income, allowing you to take home more money in each paycheck. These accounts do not automatically renew each year. Meet with an AF account manager each year to ensure you continue taking advantage of these tax savings.
Certificated (CUEA) Employees
- Healthcare flex spending accounts and dependent care accounts allow you to save part of your paycheck, before tax, to pay for eligible costs throughout the year. Since your money is taken out pre-tax, it reduces your taxable income, allowing you to take home more money in each paycheck. These accounts do not automatically renew each year. Meet with an AF account manager each year to ensure you continue taking advantage of these tax savings.
VEBA and RPA Dependent Audit
If you received something in the mail from VEBA (the trust that administers our insurance) and RPA regarding a dependent audit, these are legitimate documents and separate from CUSD's Open Enrollment.
All employees, retirees, and COBRA participants with dependents are required to participate. However, biological and adopted children who have been verified in a previous audit (approximately six years ago) are exempt in this audit.
Please follow the instructions they have included. Be sure to blackout all social security numbers, account numbers, and financial information.
We sent out an email on October 30, 2024 to all staff regarding an update.
The final due date was November 4, 2024 and has been extended to January 31, 2025 for those that have not responded by December 2, 2024.
The audit is not being run through our district department, therefore, we are unable to provide any other information. Additional questions can be directed to (619) 961-2045 (Monday - Friday, 8am - 5pm) or questions@vebaonline.com.
VEBA Advocacy
Who is VEBA and how can their Advocacy team support me?
- VEBA is the trust that administers our insurance and their advocacy team facilitates communication between you and the insurance carrier.
- For quicker member validation and Advocacy team response, please complete the VEBA online contact form. It will allow you to securely provide protected health information.
VEBA Advocacy Contact Information
- Online Contact Form
- Phone: (888) 276-0250
California Schools Benefit Trust: VEBA
- Guest ID: CAPUSD
Updates and Information
Mental Health & Well-Being Information
- Accessing Behavioral Health Benefits
- New Well-Being Program
- Mental Health & Well-Being Resources for All Employees
TalkSpace offers therapy for Emotional Wellbeing Solutions (EWS) for beneficiaries when you need it - NO APPOINTMENT IS NECESSARY. Connect virtually with a licensed, in-network provider including unlimited text messaging and real-time audio/ video appointments. To get started, call (888) 625-4809 to obtain an authorization code before registering (first visit only), then choose a provider and message anywhere, anytime.
Need help finding a doctor? Have an issue you can't resolve with the health insurance carrier? Reach out to VEBA Advocacy by calling (888) 276-0250 or complete their online contact form.
MyVEBA and the VEBA Resource Center
Qualifying Life Events
What is a qualifying life event?
- An event that takes place outside of Open Enrollment or an employee's new hire period that allows an opportnity to enroll or disenroll from coverage.
- Examples of qualifying life events:
- Marriage or Divorce
- Birth or Adoption
- Gain or Loss of Coverage
What do I need to prove I had a qualifying life event?
- Qualifying life events are only valid for thirty days from the event.
- Example: If you are not enrolled in any CUSD health benefits because you held external coverage. The external coverage termination became effective December 1, 2024. You have thirty days from the loss of coverage date to provide proof of the loss of coverage (a letter from the insurance carrier, or insurance department that details who was on the coverage, what type of coverage was held, and when the loss of coverage took place), dependent documentation (if applicable), and an enrollment and changes form. You would have until December 30, 2024 to submit documents. Since you lost coverage on December 1, 2024, the coverage would be retroactive to December 1, 2024.
- We can accept copies of documents. Per board policy (1340a), if you bring in an original document without a copy, we can make a copy for $0.25 per page (cash only).
- If you are outside of the thirty day timeline, you will have to wait for open enrollment or another qualifying life event to take place.
Where do I send all of my completed documents to make the qualifying life event change?
- Our internal email system is not secure, which means it is not safe to send sensitive documents via email.
- Documents that contain sensitive information (such as SS #'s) can be sent via fax, district mail, US mail, or in person.
- However, if your documents do not contain sensitive information, please send an email to one of our department contacts.
- Our department is open Monday - Friday, 8:00am - 4:30pm.
- No appointments are necessary.
Personal Information Changes
It's important that all of your contact information is up to date with CUSD departments. If you have a personal information change (such as address, phone number, or email), please complete this form and return a copy to both Human Resource Services and our Insurance Department (via fax, district mail, US mail, or in person).
You can also email Human Resource Services (hrservices@capousd.org) and cc one of our Insurance Department contacts.
If you have a name change, please contact Human Resource Services Department to find out what documentation is required. Once the change is made in their database, we will be able to update your information in our databases and with the insurance carriers.
CUSD Cares
CUSD Cares is a District-wide effort to support the well-being of students and staff members.
Click here to access helpful employee resources for mental health, fitness and more!
OPTUM Emotional Wellbeing Solutions (EWS)
For Help With:
- Depression or Stress
- Substance Abuse
- Childcare and Elder Care
- Grief and Loss
- Money Management
- Legal Consultation
- Mental Health Emergencies (Call 988)
- OPTUM Emotional Wellbeing Solutions (formerly known as Employee Assistance Program)
- Accessible to employees enrolled in current Medical coverage
- What is Emotional Wellbeing Solutions resource?
- Call: 1 (888) 625-4809
- Access Code: VEBA
- "Browse as a guest" and enter code VEBA
- Register for an Employee Portal through Optum to schedule a virtual or in person appointment (Kearny Mesa - San Diego).
- UNUM EAP
- For all Employees who are not enrolled in Medical coverage
- Call: 1 (800) 854-1446
- Work/ Life Balance
- TalkSpace offers therapy for Emotional Wellbeing Solutions (EWS) for beneficiaries when you need it - NO APPOINTMENT IS NECESSARY. Connect virtually with a licensed, in-network provider including unlimited text messaging and real-time audio/ video appointments. To get started, call (888) 625-4809 to obtain an authorization code before registering (first visit only), then choose a provider and message anywhere, anytime.
DOMESTIC VIOLENCE RESOURCES
Fitness Memberships
KindBody
Workers' Compensation
INTRODUCTION
The Workers' Compensation Program at Capistrano Unified School District is permissibly self-insured. This means that CUSD pays all of the expenses associated with workers' compensation claims.
The District makes every attempt to provide a safe and healthful work environment for all employees. Job specific safety training is also provided to help employees reduce the possibility of being injured on the job. Unfortunately, accidents do happen that may require an employee to obtain medical care.
The District Insurance Office has staff dedicated to workers' compensation administration to assist you and may be reached at (949) 234-9401 or workcomp@capousd.org.
If you are an active employee and would like more information about the workers' compensation process, please access your information via Tilt and MyCUSD. You will have to login to your MyCUSD account to access the information. If you are having trouble logging in, you will need to contact TIS Radar at (949) 234-5500.
California State Law governs the procedures all employers must follow in the administration of workers' compensation claims. Workers' compensation laws are complicated, which can make navigating the workers' compensation system confusing and frustrating for both injured employees and employers. If you have questions, or if you are unsure as to whether or not you may have a claim, please feel free to call the District Insurance Office.
District Workers' Compensation Claims Administrator:
Athens Administrators
P.O. Box 696
Concord, CA
94522
If you have additional questions regarding the state of California worker's compensation program, please contact:
Workers' Compensation Appeals Board
Information and Assistance Officer
28 Civic Center Plaza, Room 451
Santa Ana, CA 92701
Information and Assistance Officer
28 Civic Center Plaza, Room 451
Santa Ana, CA 92701
(714) 558-4597
FRAUD NOTICE:
Any person who makes or causes to be made any knowingly false or fraudulent material statement or material representation for the purpose of obtaining or denying workers' compensation benefits or payments is guilty of a felony. Such persons may be punished by imprisonment and/or a fine (Labor Code Section 3820; Penal Code Section 549; Insurance Code Section 1871).
FAQ's, Insurance Carrier Information, and MyVEBA
FAQ's, Insurance Carrier Information, and MyVEBA
FAQ's, Insurance Carrier Information, and MyVEBA
2025 Insurance Carrier Group Plan Numbers (Pending)
Guest ID: CAPUSD
