Skip To Main Content

Select a School

Madison Metropolitan School District

Employee Handbook 2021-2022

Addendum H: SECTION 8 INSURANCES

8.1 Health Insurance

Eligibility

All substitute teachers are eligible for health insurance coverage provided that they work at least one (1) day per month (September through May), unless off of work due to an approved leave of absence.

Employees will be considered “new employees” for eligibility purposes when they seek to enroll in the District group plan because of loss of their insurance coverage. A “new employee” under this section must submit application for insurance, with evidence of the qualifying event, within thirty (30) days of the loss of other coverage as a result of the following qualifying events: their spouse’s death; (2) their spouse’s termination of employment; (3) divorce; or (4) the reduction of one’s hours of work which results in the loss of eligibility of health insurance for the employee/spouse/dependent(s) via his/her employer, or (5) when the spouse of the employee, who has carried the family health insurance, experiences a significant reduction in benefits. Employees will also be considered “new employees” for eligibility purposes when their hours have been increased allowing them to qualify for health insurance benefits. They must submit application for insurance within thirty (30) days of receipt of the notification of increased hours. The term “employees” when used for health insurance eligibility purposes shall refer only to current and eligible employees who seek to enroll in the District group plan and not to their spouses and/or dependents. Coverage under this section will become effective the first day following the termination date of the other coverage.

Contribution

Extended long-term substitutes who are eligible for health insurance as set forth in Section 2.1 above and who elect such coverage shall receive the same District contribution toward their health insurance as contracted teachers.

Subject to paragraph a below, the District will contribute the full premium cost for the lowest cost individual plan to eligible substitute teachers who elect to participate in HMO coverage available through the District. Eligible substitute teachers will be those who work a minimum of 140 days in the previous school year of those that qualify under the Affordable Care Act.

  1. The District can require employees to make insurance premium contributions not to exceed 10% of the monthly insurance premium for both single and family coverage.

Eligibility for the District contribution is determined annually.

Unless the substitute is eligible for District contribution as set forth above, the full premium payments are the responsibility of the substitute.

Premium payments are made by the substitute via payroll deduction or prepaid by substitute when insufficient money has been earned in the report period to allow premiums to be deducted.