Participation in the District Benefit Program 

Be aware that when you participate in the District Benefit Program, you are making the following affirmations:

• You authorize the District to deduct premiums for the benefits rolled over or elected for the plan year.
• You certify that the information you supplied on the online enrollment website is true and complete to the best of your knowledge.
• You understand that health, dental, vision, and Flexible Spending Account(s) contributions will be pretax to the extent possible and that your income subject to federal income tax and Social Security withholding (FICA) will be reduced, and that this may affect your Social Security benefits in the future.
• You acknowledge that you cannot stop or change benefits paid for on a pretax basis during the plan year unless you experience a relevant qualifying event. 
• All benefits are subject to change. All benefits are subject to the provisions and exclusions of the master contract.
• You understand that a Section 125 Flexible Spending Account (Medical Expense and Dependent Care) can be used only to reimburse payment of eligible expenses incurred during the plan year while participating in the plan, and that any amount remaining in either spending account that is not used during the plan year will be forfeited. Funds in one spending account cannot be used to reimburse expenses covered by another account. Expenses for which you are reimbursed cannot be claimed.
• You understand and agree that the District and the Third Party Administrator (TPA) will not incur any liability resulting from failure to read all rules pertaining to benefit enrollment or benefit elections; enroll online accurately or to submit elections; or in the administration of your flexible spending accounts. You also understand that elections for benefits on a pretax basis are irrevocable and cannot be changed after the established deadline date. Subsequent changes can only be made upon experiencing a qualifying event.
• You agree for yourself and covered members of your family under District insurance plans to be bound by the benefits, deductibles, copayments, exclusions, limitations, eligibility requirements and other terms of the plan contracts, agreements and plan documents for the plans in which you enroll.
• Chapter 207-251 Laws of Florida requires agencies to notify individuals of the purpose(s) that required the collection of Social Security numbers. Duval County Public Schools collects Social Security numbers (SSNs) of employees and dependents for enrollment in health insurance, life insurance, and other miscellaneous insurances. The Social Security numbers of all current and former employees are confidential and exempt from s. 119.07(1) and s. 24(a), Art. I of the State Constitution.
• Your contributions to the Flexible Benefits Plan do not reduce your future Florida Retirement System (FRS) benefits or current contributions to FRS. Any salary directed to your Flexible Benefit Plan is included in the compensation reported to the FRS.
• Social Security consists of two components: FICA and Medicare. A separate maximum wage to which the tax is assessed applies to both tax components. The maximum taxable annual wage for FICA varies from year to year. There is no maximum taxable annual wage for Medicare. If your annual salary, after salary reduction, is below the maximum wage cap for FICA, you are reducing the amount of taxes you pay and your Social Security benefits may be reduced at the time of your retirement.

Employee Responsibilities

Open Enrollment is the one time of year employees are allowed to make changes to current benefits. Please make sure that you review and verify all benefits elected prior to the end of Open Enrollment. Coverage cannot be changed unless an appeal is submitted and approved or you have a qualifying event that would allow a Mid- Year change.

Your responsibilities include:

• You are responsible for participating in and completing the online web enrollment process. You may do this on your own or with a Benefits Counselor.
• You are responsible for entering your enrollment data, including your beneficiaries, dependents full name as it appears on their Social Security card, dependents’ dates of birth, and Social Security number within the established enrollment time frames.
• You are responsible for providing required documentation to satisfy the eligibility criteria for all enrolled dependents.
• You are responsible for carefully reviewing your data to make sure that the information in the system is what you have elected. The benefits you elect will remain in effect until the end of the plan year.
• It is your responsibility to make sure your employer has your current personal information, such as your address and telephone numbers.
• You are responsible for reviewing your paycheck stub to ensure your elected benefits are being deducted correctly.
• You are responsible for notifying Employee Benefits immediately (within 30 calendar days of the effective date of your benefits) if payroll deductions are taken for elections you have not made or if elected benefits are not deducted from your pay.
• You are responsible for notifying Employee Benefits immediately (no later than 60 calendar days) when a covered dependent no longer meets the eligibility requirements as defined in the Eligibility and Coverage section.
• Benefit elections are irrevocable during the plan year, unless you experience a valid Change in Status and provide written documentation of the event. Approved pretax deductions will be made prospectively on the first day of the month after the receipt of the benefits change form and supporting documentation showing that your request is consistent with, and on account of, the event.
• Waiving medical coverage requires that an election be made. Otherwise, default enrollment in the employer paid Non- Contributory single coverage medical plan, Group Term Basic Life Insurance and $250 Flex will be processed.
• Outside of the annual Open Enrollment period, waiving medical coverage is only an option for those who have medical coverage provided by another employer plan or government funded plan (i.e. Medicaid, Medicare, TRICARE). During Open Enrollment, you may waive medical coverage without proof of other medical coverage.
• Enrollment appeals are granted under very limited circumstances and generally are not permitted in the case of accidentally enrolling in a plan or adding/deleting a dependent in error. It is important that you confirm your elections and entries prior to the end of your enrollment period.