FILE:  EGA

Cf:  DJED, GBRIB

INSURANCE COVERAGES FOR ACTIVE EMPLOYEES,

RETIREES AND DEPENDENTS

HEALTH INSURANCE

The Lafayette Parish School Board shall offer a Group Health Insurance Plan for its eligible active employees, retirees, and/or their eligible spouses and children.  The School Board may pay any portion of an employee's premium it so designates, provided the School Board’s portion meets the minimum contribution required by the Louisiana Office of State Group Benefits and funds are available to make such contributions.  Active and retired members shall be responsible for payment of all portions of their Group Health Insurance premiums not paid by the School Board.

For the purpose of this policy, an active employee shall be either:  (1) any School Board employee whose membership in either the Louisiana School Employees’ Retirement System (LSERS) or the Teachers’ Retirement System of Louisiana (TRSL) is mandatory; or (2) any School Board employee who elects to participate in another qualified state retirement system in lieu of either LSERS or TRSL; or (3) certain contract employees who meet and maintain eligibility under the Affordable Care Act (ACA); or (4) any elected Lafayette Parish School Board member who elects to participate.

Any active employee currently covered by a School Board-sponsored Group Health Insurance Plan outside of these criteria shall be allowed to continue in it until termination of employment or until the loss of eligibility.

Any active employee who terminates his/her service with the School Board shall cease to be covered by the School Board's Group Health Insurance Plan.  However, any active employee who terminates employment with the School Board may apply for continued health care coverage in accordance with regulations of the Consolidated Omnibus Budget Reconciliation Act (COBRA).  Any retired member who terminates coverage post-retirement shall not be eligible to return to the Group Health Insurance Plan sponsored by the School Board.

DEPENDENT ELIGIBILITY

The Lafayette Parish School Board shall determine Group Health Insurance dependent eligibility.  Members seeking to enroll dependents must provide the below documentation:

1. A current marriage certificate shall be required for a spouse
   
   

2. A joint document shall be required for married couples showing proof of relationship
   
   

3. A birth certificate or legal guardianship document shall be required for children
   
   

4. An attestation shall be required verifying the authenticity of the information provided
   
   

5. Other qualifying documents as determined by the Lafayette Parish School System

Detailed guidelines and specific requirements regarding dependent eligibility are governed by the applicable plan documents.

RETIRED MEMBERS AND/OR DEPENDENTS

Effective May 8, 2024, Medicare eligible retirees and their covered dependents must enroll in Medicare Parts A and Part B within ninety (90) days of Medicare eligibility.  The Medicare eligibility period is defined as the 65th birthday or upon retirement during the Special Enrollment period post age 65.  Upon enrollment in Medicare Parts A & B, the member must notify the Lafayette Parish School Board Insurance & Benefits Department and provide the necessary documentation verifying the member's transition to Medicare primary.  In order to maintain continuous Group Health Insurance coverage with the District, Medicare Parts A & B must be maintained.  Once members are enrolled in the District’s Medicare Part D program for pharmacy benefits, enrollment in a plan outside of the District’s insurance programs is not permitted.

Effective October 9, 2024, Medicare eligible retirees and dependents, hired on/after January 1, 2025, are required to enroll in the Lafayette Parish School System Medicare Advantage Plan offered by the District.

Detailed guidelines and specific requirements regarding retired members and/or dependents are governed by the applicable plan documents.

SURVIVING SPOUSE/DEPENDENT COVERAGE

Detailed guidelines and specific requirements regarding surviving spouse/dependent coverage are governed by the applicable plan documents.

VESTING FOR GROUP HEALTH INSURANCE

Vesting refers to the amount of time active employees of the Lafayette Parish School System and their eligible dependents must be enrolled in the LPSS Group Health Insurance Plan prior to retirement in order to be eligible for post-retirement employer contributions towards premiums.

In order to be vested and eligible for active employee Group Health Insurance Plan continuation post-retirement, the employee must be enrolled in the LPSS Group Health Insurance Plan five (5) or more consecutive years immediately prior to retirement.  Employees and their eligible dependents, who enroll after January 1, 2026, will earn (1) year of vesting credit for every twelve (12) consecutive months of LPSS Group Health Insurance enrollment.  Vesting credit cannot be earned post-retirement.

For eligible active employees considered vested, Lafayette Parish School Board will pay the employer's share of the Group Health Insurance premiums post-retirement.

Grandfathering refers to those employees, and their eligible dependents, who are exempt from the five (5) year vesting requirement because they are considered compliant on January 1, 2026.

Active employees and their eligible dependents, who are enrolled and effective in the Group Health Insurance Plan on January 1, 2026, shall be exempt from other vesting requirements and shall be considered grandfathered.  All Grandfathered policy members must maintain continuous Group Health Insurance coverage with LPSS until the employee's retirement.

After January 1, 2026, Grandfathered employees who experience a mid-year HIPAA Special Enrollment Qualifying Event or Open Enrollment election shall be permitted to enroll the eligible dependent.  The newly added dependent shall be required to vest for five (5) or more consecutive years to be eligible for full benefit continuation at the time of the employee's retirement.  Should the vesting criteria not be met, an additional lifetime monthly premium surcharge may be applied post-retirement.

VESTING FOR RETIREE LIFE INSURANCE

The Lafayette Parish School System provides all active employees a District paid Basic Life insurance policy following thirty (30) days of employment.

Active employees hired on/after January 1, 2026, are eligible for employer-paid Basic life insurance benefit continuation post-retirement if the member was actively employed by the Lafayette Parish School System for at least five (5) consecutive years immediately preceding retirement.  Active employees hired before January 1, 2026, are grandfathered if there is no break in service prior to retirement after grandfathering has occurred.

Detailed guidelines and specific requirements regarding retired members and/or dependents are governed by the applicable plan documents.

EMPLOYEES ON APPROVED LEAVE WITHOUT PAY

Any Lafayette Parish School Board employee who is granted leave without pay by the School Board shall be obligated to pay 100% of the Group Health Insurance premium during the period of leave until the first of the month following the member’s full-time return to active duty.  The Lafayette Parish School Board shall not continue contributions for any portion of the premium.  Exceptions:  employees using sick leave for maternity leave purposes, extended sick leave for maternity purposes, sabbatical leave, or persons on sick leave who receive pay through accumulated sick leave shall not be affected by this provision and the School Board shall continue to pay the necessary premiums.

CHANGE IN COVERAGE

HIPAA Special Enrollment Events, that occur outside of the annual open enrollment period, allow the employee/retiree to make a mid-year change.  It shall be the members responsibility to notify the Lafayette Parish School Board Insurance Department within thirty (30) days of the event occurrence.

It shall be the responsibility of the member to notify the Insurance Department of the Lafayette Parish School Board of any change or error in classification of coverage or any other error affecting his/her contribution amount toward the payment of premium for any member Group Health Insurance benefit administered through the School Board.  Such a change in classification may be due, but not limited to: a change in marital status, a change in a dependent’s eligibility, a change in classification due to a change in premium structure which grants a refund to qualified employees, or a change in classification due to the death of a spouse or other dependent.  Any failure to report such a change in classification within thirty (30) days after the change occurs shall be corrected on the first of the month following the date the change is reported to the Insurance Department.  All refunds of contributions are at the discretion of the Insurance Department’s practices at the time of notification and shall be limited to three (3) months from the date the notice is received by the Insurance Department.  All claims and administrative fees for the unreported ineligible spouse/dependent shall be the responsibility of the primary member of the Group Health Insurance contract.

Detailed guidelines and specific requirements regarding retired members and/or dependents are governed by the applicable plan documents.

VOLUNTARY SUPPLEMENTAL INSURANCE

All voluntary employee supplemental insurance benefits provided by companies approved by the School Board shall be administered through a third party and paid 100% by the employee.  Voluntary employee supplemental insurance benefits may include, but are not limited to, cancer, dental, vision, critical illness, hospital indemnity, accident, disability and life.  The School Board, at its discretion, may add to or remove from the list of voluntary employee supplemental insurance benefits providers.  Some Voluntary Supplemental Insurance benefits may permit post-retirement benefit continuation for qualified retirees of the Lafayette Parish School System.  It is the responsibility of the retired member to ensure with voluntary providers benefit continuation within the first thirty (30) days of District retirement.

EMPLOYER RESERVATION OF RIGHTS

Lafayette Parish School System reserves the right to terminate, amend, or make adjustments to the eligibility and provisions of any benefits provided by Lafayette Parish School System from time to time as necessary to prudently discharge its duties.  Nothing contained herein shall be construed to guarantee benefits for any plan participant except as otherwise provided by law.

UNEMPLOYMENT COMPENSATION

The School Board shall use the reimbursing employer method of participating in financing the School Board's share of unemployment compensation as permitted by state law

Ref:    29 USC 2601 et seq. (Family and Medical Leave Act)

La. Rev. Stat. Ann. §§17:1201, 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)

Louisiana Administrative Code, Title 32, Employee Benefits, Louisiana Division of Administration

Board minutes, 9-1-75, 1-20-82, 8-19-98, 11-4-15, 7-24-25

Lafayette Parish School Board