Business Services / Payroll & Benefits
PAYROLL & BENEFITS
New Hire Permanent Employees:
IRC125 Unreimbursed Medical Expenses (Flexible Spending Accounts), Dependent Care Expenses, and/or Pre-tax medical premiums, save taxes, Optional, not an automatic enrollment.
Contact Reps: Oma.Haidarzada@americanfidelity.com & Dave.Hume@americanfidelity.com
IRC125 Unreimbursed Medical Expenses (Flexible Spending Accounts), Dependent Care Expenses, and/or Pre-tax medical premiums, save taxes, Optional, not an automatic enrollment.
Contact Reps: Oma.Haidarzada@americanfidelity.com & Dave.Hume@americanfidelity.com
2020 Open Enrollment (Health, Dental, and Vision)
NEW, effective 01/01/2020: MUSD will migrate from medical plans from Anthem Blue Cross to United Healthcare (UHC) 888-641-9142, www.uhc.com. Anthem Blue Cross will be terminated effective 12/31/2019. Employees who are currently an Anthem member must choose another medical plan either with UHC or Kaiser Permanente. Please process your medical enrollment during Open Enrollment period: 10/01/2019-11/30/2019, no exceptions, no extensions, changes are effective 01/01/2020. You will not be enrolled automatically into UHC or Kaiser Permanente.
NEW, effective 01/01/2020: MUSD will migrate from medical plans from Anthem Blue Cross to United Healthcare (UHC) 888-641-9142, www.uhc.com. Anthem Blue Cross will be terminated effective 12/31/2019. Employees who are currently an Anthem member must choose another medical plan either with UHC or Kaiser Permanente. Please process your medical enrollment during Open Enrollment period: 10/01/2019-11/30/2019, no exceptions, no extensions, changes are effective 01/01/2020. You will not be enrolled automatically into UHC or Kaiser Permanente.
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Health, Dental, and Vision Online Enrollment and Changes, go to https://www.workterra.net
Enrollment must be completed within 30 days of hire date/increase in work hours (permanent employees from <.50% to >.50+%FTE) or a qualifying (life changing) event outside the Open Enrollment month (e-mail notification from workterra Administrator@ebsbenefits.com).
Enrollment must be completed within 30 days of hire date/increase in work hours (permanent employees from <.50% to >.50+%FTE) or a qualifying (life changing) event outside the Open Enrollment month (e-mail notification from workterra Administrator@ebsbenefits.com).
2020 Matrix Rates (Medical, Dental, and Vision)
Effective 01/01/2020: District Medical cap will increase from $920.87 to $971
| 2020 Matrix Rates - Certificated/Classified/Management (.50%+FTE) |
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In-network providers: www.deltadentalins.com
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In-network providers: www.vsp.com
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| 2020 OPTUM Bank_PPO HSA Employee Guide |
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Insurance Carriers:
United Healthcare (UHC): 888-641-9142 | www.uhc.com | Kaiser Permanente (KP): 866-454-8855 | www.kp.org
Delta Dental (DD): 888-335-8227 | www.deltadentalins.com | Vision Service Plan (VSP): 800-877-7195 | www.vsp.com
Insurance Broker Agency: JPA www.sccsig.org | Broker: www.willistowerswatson.com
United Healthcare (UHC): 888-641-9142 | www.uhc.com | Kaiser Permanente (KP): 866-454-8855 | www.kp.org
Delta Dental (DD): 888-335-8227 | www.deltadentalins.com | Vision Service Plan (VSP): 800-877-7195 | www.vsp.com
Insurance Broker Agency: JPA www.sccsig.org | Broker: www.willistowerswatson.com
COBRA Continuation (optional, self-pay premium) must enroll within 60 days of eligibility period. COBRA is not an automatic enrollment:
https://www.dol.gov/sites/default/files/ebsa/about-ebsa/our-activities/resource-center/faqs/cobra-continuation-health-coverage-consumer.pdf
https://www.dol.gov/sites/default/files/ebsa/about-ebsa/our-activities/resource-center/faqs/cobra-continuation-health-coverage-consumer.pdf
Monthly Premium Calculation (MTA CTA, exclude MTA Adult Ed, CSEA and Management)
Work hours conversion into percentage: divide your 4 hours per day by 8 hours = 50% Full-time equivalent (FTE). This is your base to multiply from the district's medical cap (see example above), dental and vision premiums. Employee's monthly pro-rated contribution is the difference between monthly premiums minus Employer's = Employee's (see example below).
- 100% Full time employee (FTE) Medical Cap eligibility is up $920.87 (ends 12/31/19); new cap of $971 begins 01/01/2020
- **Part time (between 50% and 99.99%), employee Medical Cap is pro-rated. For example, if employee works 4 hours or 50%, then, the medical cap is calculated as follows: $971.00 x 50% = $485.50 monthly District medical pro-rated contribution. Employee pays the difference between the district's and the premiums. ** Adult Ed calculation is based from 24.50+/.8166+% minimum per week
- 100% Full time employee Delta Dental and Vision Service Plan, the District pays for the monthly premiums
- **Part time (between 50% and 99.99%), Delta Dental and Vision Service Plan is calculated as follows: $Premium x .50% = district's monthly contribution. Employee pays the difference between the district's and the premiums. **
- CONVERSION (from hours to percentage) based on your job title and the required minimum hours to be eligible for benefits:
- CSEA Classified permanent work hours minimum requirement = 4 hours per day; 4 hours divided by 8 = 50% FTE; Full-time is 8 hours per day
- CDCTeachers permanent work hours minimum requirement = 3.5 hours per day; 3.5 hours divided by 7 hours per day = 50% FTE; Full-time is 7 hours per day
- Regular non-CDC permanent work hours minimum requirement = 3 hours per day; 3 hours divided by 6 hours per day = .50%; Full-time is 6 hours per day
- Adult Ed Certificated permanent work hours minimum requirement = 24.50 divided by 30 hours = 81.66%; Full-time is 6 hours per day
Work hours conversion into percentage: divide your 4 hours per day by 8 hours = 50% Full-time equivalent (FTE). This is your base to multiply from the district's medical cap (see example above), dental and vision premiums. Employee's monthly pro-rated contribution is the difference between monthly premiums minus Employer's = Employee's (see example below).
See the following pro-rated sample calculation based on .50%+FTE and Kaiser Single High plan.
- Please be advised that pro-rated contribution will be deducted from your normal pay check. If you do not have normal pay, you MUST remit your monthly contributions during those months to MUSD by the 1st of that month (usually during summer months, June-Aug, July, or July-August).
(A) Insurance Carrier |
(B) No. of Cov |
(C) Monthly Premium Based from 2020 |
(D) Employer Monthly Based from 2020 |
(E) Employee Monthly Based from 2020 (Premium minus Employer's = Employee's) (C-D=E) |
Kaiser High Plan with Chiro (limited visits) Co-payment |
Employee Only |
$710.19 |
$485.50 ($971 x 50%) |
$224.69 ($710.19-$485.50) |
Delta Dental PPO Premium Plan (effective 01/01/2019) Group #07102-11190 give to the Dentist MTA CTA/CSEA/MGMT (Excluding Adult Ed Ayer & Elmwood) |
Employee Only Employee+1 Employee+Family of 3+ |
$64.72 $129.43 $218.81 |
$32.36 ($64.72 x 50%) $64.72 ($129.43 x 50%) $109.41 ($218.81 x 50%) |
$32.36 ($64.72-$32.36) $64.72 ($129.43-$64.72) $109.41 ($218.81-$109.41) |
Vision Service Plan (VSP) High (effective 01/01/2019) Group #2931234A - MTA CTA/CSEA/MGMT Require: .50%+FTE - CTA ADULT ED Req'd: .8166%FTE |
Employee Only Employee+1 Employee+Family of 3+ |
$8.53 $17.05 $32.21 |
$4.27 ($8.53 x 50%) $8.53 ($17.05-$8.53) $16.11 ($32.21-$16.11) |
$4.26 ($8.53-$4.27) $8.52 ($7.05-$8.53) $16.10 ($32.21-$16.11) |
SCCSIG WELLNESS 2019 CHALLENGES
| SCCSIG 2019 Wellness Challenges Overview |
Register and earn points (rewards) for participation in qualifying wellness activities:
https://www.cafewell.com/?code=sccsig
Questions, contact: HealthFitness Customer Service at CustomerService@hfit.com or 1-800-337-8508
https://www.cafewell.com/?code=sccsig
Questions, contact: HealthFitness Customer Service at CustomerService@hfit.com or 1-800-337-8508
Wellness registration "How To" videos
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This is the smallest size, use for internet/website
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720p – This is medium size, use for TV/digital displays
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Affordable Care Act (ACA) Offer (130 hours), Marketplace Insurance:
| 2019 Matrix Rates (Self-pay Premiums ACA) KP Low Plan |
Health Insurance Through Covered California: https://www.coveredca.com/
Questions about Covered California, contact them directly: https://www.coveredca.com/find-help/contact/
Milpitas USD disclaimer: Individual enrollment and coverage, if applied, is directly with the chosen carrier, not with Milpitas USD. We do NOT have insurance plans with the Covered California.
Questions about Covered California, contact them directly: https://www.coveredca.com/find-help/contact/
Milpitas USD disclaimer: Individual enrollment and coverage, if applied, is directly with the chosen carrier, not with Milpitas USD. We do NOT have insurance plans with the Covered California.
New Health Insurance Marketplace Coverage Options and Your Health Coverage
www.dol.gov/sites/default/files/ebsa/laws-and-regulations/laws/affordable-care-act/for-employers-and-advisers/model-notice-for-employers-who-offer-a-health-plan-to-some-or-all-employees.pdf
New Health Insurance Marketplace Coverage Options and Your Health Coverage:
https://www.dol.gov/sites/default/files/ebsa/laws-and-regulations/laws/affordable-care-act/for-employers-and-advisers/model-notice-for-employers-who-do-not-offer-a-health-plan.pdf
www.dol.gov/sites/default/files/ebsa/laws-and-regulations/laws/affordable-care-act/for-employers-and-advisers/model-notice-for-employers-who-offer-a-health-plan-to-some-or-all-employees.pdf
New Health Insurance Marketplace Coverage Options and Your Health Coverage:
https://www.dol.gov/sites/default/files/ebsa/laws-and-regulations/laws/affordable-care-act/for-employers-and-advisers/model-notice-for-employers-who-do-not-offer-a-health-plan.pdf
Forms & Documents
Certificated New Hire Payroll & Benefit (Powerpoint)
Classified New Hire Payroll & Benefit (Powerpoint)
Certificated New Hire Packet
Classified New Hire Packet
COBRA Continuation (Self-Pay premium)
Blue Shield of California Life Insurance (Classified/Management)
Hartford LTD (Disability, Management)
State Disability (SDI), Non-participant Employer, Acknowledgement Form
American Fidelity Assurance (AFA) Contact: Oma.Haidarzada@americanfidelity.com
Classified New Hire Payroll & Benefit (Powerpoint)
Certificated New Hire Packet
Classified New Hire Packet
COBRA Continuation (Self-Pay premium)
Blue Shield of California Life Insurance (Classified/Management)
Hartford LTD (Disability, Management)
State Disability (SDI), Non-participant Employer, Acknowledgement Form
American Fidelity Assurance (AFA) Contact: Oma.Haidarzada@americanfidelity.com
PAYROLL
EMPLOYEE SELF SERVICE (ESS)
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To access your Copies of Milpitas USD Payroll Records, go to Employee Self Service (ESS).
If you need any help, click here to view the Instructions. |
Forms & Documents
| Deferred Pay (Optional) |
| CalSTRS Permissive Electin Form-es0350 |
PARS Beneficiary Designation Form
Employee Benevolent Association
Certificated Acknowledgement of Payroll and Benefits (permanent)
Certificated Adult Ed Acknowledgement of Payroll and Benefits (permanent)
Classified Acknowledgement of Payroll and Benefits (permanent)
Management Acknowledgement of Payroll and Benefits
Extra Work Permanent employee
Pay period from the 16th of previous month to the 15th of the current month is DUE every 15th of the current month (will be paid end of the current month). Must complete and submit a #P-20 time sheet . For all extra work (outside your normal work hours), the Principal/Secretary must submit F-12 prior to allowing employee to work the extra hours. F-12 for extra hours must match the exact hours on time sheet. Failure to complete F-12 for all extra work hours will delay in processing your paycheck. Payroll is unaware of employee's extra work hours. Therefore, it is the employee's responsibility to track all of his/her extra work hours and ensure with the Principal Secretary that all required paperwork has been completed and submitted to Payroll on time for payment.
F-12 permanent FTE employee, extra work (beyond normal position) must be completed prior
P-20 Time sheet for permanent FTE employee, extra work to be paid
Pay period from the 16th of previous month to the 15th of the current month is DUE every 15th of the current month (will be paid end of the current month). Must complete and submit a #P-20 time sheet . For all extra work (outside your normal work hours), the Principal/Secretary must submit F-12 prior to allowing employee to work the extra hours. F-12 for extra hours must match the exact hours on time sheet. Failure to complete F-12 for all extra work hours will delay in processing your paycheck. Payroll is unaware of employee's extra work hours. Therefore, it is the employee's responsibility to track all of his/her extra work hours and ensure with the Principal Secretary that all required paperwork has been completed and submitted to Payroll on time for payment.
F-12 permanent FTE employee, extra work (beyond normal position) must be completed prior
P-20 Time sheet for permanent FTE employee, extra work to be paid
Permanent Employee (Extra Work) Pay Period Time Sheet Deadline (Pay at the end of the Month)
Work Period |
Submit to Payroll |
Payment Will Be Made |
From 10/16/2019 to 11/08/2019 |
11/12/2019 |
11/26/2019 |
From 11/09/2019 to 12/05/2019 |
12/09/2019 |
12/20/2019 |
From 12/06/2019 to 01/15/2020 |
01/17/2020 |
01/31/2020 |
SUBSTITUTE TEACHERS & CLASSIFIED EMPLOYEES
Time sheet deadlines:
Substitutes (on-call) - pay period ( from the 26th of previous month to the 25th of the current month) DUE every 25th of the current month (will be paid the following tenth of the month). Must complete a #P-65 time sheet. The Principal Secretary must submit a P-16 (substitute long term contract) prior to allowing employee to work. P-16 is required for all substitute being contracted to work for certain length of time. Payroll is unaware of who works as a substitute. Therefore, it is the substitute's responsibility to track all of his/her work days/hours and ensure with the Principal/Secretary that all required paperwork has been completed and submitted to Payroll on time for payment.
Time sheet deadlines:
Substitutes (on-call) - pay period ( from the 26th of previous month to the 25th of the current month) DUE every 25th of the current month (will be paid the following tenth of the month). Must complete a #P-65 time sheet. The Principal Secretary must submit a P-16 (substitute long term contract) prior to allowing employee to work. P-16 is required for all substitute being contracted to work for certain length of time. Payroll is unaware of who works as a substitute. Therefore, it is the substitute's responsibility to track all of his/her work days/hours and ensure with the Principal/Secretary that all required paperwork has been completed and submitted to Payroll on time for payment.
P-16 Form - Temporary Employment Service Contract
P-65 Form - Time sheet for Substitute Teaching Service Record & Claim (use if you are a permanent teacher substituting for another teacher or if you are a regular substitute teacher)
P-15 Form - Time Sheet for Substitute/Hourly Employees (Classified substitute and Substitute Teacher with P-16 contract)
P-65 Form - Time sheet for Substitute Teaching Service Record & Claim (use if you are a permanent teacher substituting for another teacher or if you are a regular substitute teacher)
P-15 Form - Time Sheet for Substitute/Hourly Employees (Classified substitute and Substitute Teacher with P-16 contract)
Substitute (non-Permanent) Pay Period Time Sheet Deadline (Pay every 10th of the Month)
Work Period |
Submit to Payroll |
Payment will be made |
From 10/26/2019 to 11/20/2019 |
11/22/2019 |
12/10/2019 |
From 11/21/2019 to 12/15/2019 |
12/16/2019 |
01/20/2020 |
From 12/16/2019 to 01/25/2020 |
01/28/2020 |
02/10/2020 |
Retirement Systems
CalSTRS: Certificated - Employer/Employee Contributions
CalPERS: Classified - .50%+ FTE - Employer/Employee Contributions
Social Security: Classified - .50%+ FTE - Employer/Employee Contributions
PARS: Classified (permanent part time, <.50% FTE) and Substitute employees - Employer/Employee Contributions
Medicare: ALL Employees - Employer/Employee Contributions (employee who are turning 65 years old MUST enroll for Medicare Parts A & B within 90 days of 65th birthday)
CalPERS: Classified - .50%+ FTE - Employer/Employee Contributions
Social Security: Classified - .50%+ FTE - Employer/Employee Contributions
PARS: Classified (permanent part time, <.50% FTE) and Substitute employees - Employer/Employee Contributions
Medicare: ALL Employees - Employer/Employee Contributions (employee who are turning 65 years old MUST enroll for Medicare Parts A & B within 90 days of 65th birthday)
Supplemental Retirement Account (Optional - Employee Only Contribution)
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- MUSD 403(b)/457 Plan ID for brand new account set up: 50618
- Tax Deferred Solutions (TDS) is Milpitas USD's Third Party Administrator (TPA). They are in compliance with the IRS 403(b) and 457 regulations. They handle ALL transactions on behalf of MUSD (reviews, signs, and approves ALL current/previous employee's transaction request regarding rollover, transfer, withdraw or borrowing of funds). Send all requests to them. They will verify your employment period with MUSD. https://www.tdsplans.org/forms_PD.aspx?orgID=5841
- MUSD Federal Identification Number (FIN): 77-0289955
Payroll & Benefits Team: |
Human Relations Team: |
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Tel: 1-408-635-2600 | Fax: 1-408-635-2621
Dept E-mail: Payroll@musd.org Dept general number: x6012 Ria Feldman, x6026, RFeldman@musd.org (Benefits) Sherry Ames, x6027, SAmes@musd.org (Payroll) Uyen Dao, x6021, UDao@musd.org (Time sheets; Mortgage employment verification) Mortgage Loan Application Mortgage employment verification request MUST be sent via fax or e-mail with the employee's authorization page. Such request will be completed within three business days from receipt date. Requests are completed and returned via fax back to the company. Employee's salary information will not be released via phone. |
https://www.musd.org/human-relations.html
Tel. 1-408-635-2600 | Fax: 1-408-635-2617 Employment Status Verification, hire date, status, and job title. Dept. E-mail (District G-mail user only): HumanResources@musd.org Charlotte Torres, x6075, CTorres@musd.org Virginia Coleman, x6079, VColeman@musd.org Kay Dasu, x6074, KDasu@Musd.org Maria Elena Montoya x6076, EMontoya@musd.org Heather Forsyth-Cano, x6073, HForsyth@musd.org Absence Tracking employee access: http://ars.sccoe.org/ |
