Page 287 - 2021-2022 New Hire Benefits

Right to a Copy of the Notice
You have the right to a paper copy of this Notice upon request by contacting us at the telephone number or
address below.

Complaints
If you believe your privacy rights have been violated, you can file a complaint with us in writing at the address
below. You may also file a complaint in writing with the Secretary of the U.S. Department of Health and
Human Services in Washington, D.C., within 180 days of a violation of your rights. There will be no retaliation
for filing a complaint.

FOR FURTHER INFORMATION
If you have questions or need further assistance regarding this Notice, you may contact:
Kerry Doherty
Chief Financial Officer
Renbrook School
2865 Albany Ave
West Hartford, CT 06117
860-236-1661, ext. 237
kdoherty@renbrook.org

LONG TERM DISABILITY

Long-term disability coverage is available for those benefit eligible employees who experience a medical
disability greater than 180 days. The School currently contracts with SunLife to provide this coverage.
Employees who qualify will receive benefits equal to 60% (reduced by social security benefits) of their cash
salary. Specific details of the plan are available in the Summary Plan Description distributed to each
participating employee. Employees are eligible for this benefit on the first day of the month of employment.

MEDICAL INSURANCE

The school participates in the medical insurance program offered through the Connecticut Independent School
Health Plan (CISHP) consortium. The CISHP group plan operates under the requirements of the insurance
carriers. In order to offer a group insurance plan the carriers require a minimum number of hours
worked (i.e. 660/year) and sponsorship of a portion of the premium by the school.

Members of the CISHP Executive Committee determine premiums and related plan designs annually. The
premium plan year is July 1 through June 30. Summary plan descriptions prepared by the carrier are
distributed annually to each participant during the open enrollment period.

For the plan year beginning July 1, 2018, the School contributes 60% of the premium benchmarked against
ConnectiCare HMO-employee. The employee’s portion, 40% of the premium, is deducted on a pre-tax basis
(both federal and state) from each paycheck. All employees electing coverage receive ID cards for all enrolled
family members and questions can be directed to toll-free customer service representatives or on-line to the
carrier’s website.

For those employees who choose the High Deductible Health Plan (HDHP), the option to open a Health
Savings Account (HSA) is available. These accounts are owned by the employee and maintained at Salisbury
Bank. Contributions to the account, by the employee, may be made on either a pre-tax basis, via payroll
deduction or may be funded with after tax dollars. Annual funding limits are determined by the carrier and
follow IRS guidelines. The School will publish these limits annually as they become available. This account may
be used to pay for eligible medical expenses, dental, vision and over the counter medications with a doctor's
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