Resources & Updates

Each health plan has a list of prescription medicines that are preferred based on an evaluation of effectiveness and cost. Another name for this list is a “formulary.” The plan may charge more for non-preferred drugs or for brand-name drugs that have generic versions. Drugs that are not on the preferred drug list may not be covered.

The most you would pay from your own money for covered healthcare expenses in one calendar year. Once you reach your plan’s out-of-pocket maximum dollar amount (by paying your deductible, coinsurance and copays), the plan pays for all eligible expenses for the rest of the plan year.

A healthcare expense you are responsible for paying with your own money, whether from your bank account, credit card, or from a health account such as an HSA, FSA or HRA.

Network providers (doctors, hospitals, labs, etc.) are contracted with your health plan and have agreed to charge lower fees to plan members, as negotiated in their contract with the health plan. Services from out-of-network providers can cost you more because the providers are under no obligation to limit their maximum fees. With some plans, such as HMOs and EPOs, services from out-of- network providers are not covered at all.

A drug that has the same active ingredients as a brand name drug but is sold under a different name. For example, Atorvastatin is the generic name for medicines with the same formula as Lipitor. You generally pay a lower copay for generic drugs.

Generally include routine cleanings, oral exams, x-rays, and fluoride treatments. Most plans limit preventive exams and cleanings to two times a year.

The amount of healthcare expenses you must pay for with your own money before your health plan will pay. The deductible does not apply to preventive care and certain other services.

A set fee you pay whenever you use a particular healthcare service, for example, when you see your doctor or fill a prescription. After you pay the copay amount, your health plan pays the rest of the bill for that service.

After you meet the deductible amount, you and your health plan share the cost of covered expenses. Coinsurance is always a percentage totaling 100%. For example, if the plan pays 70% coinsurance, you are responsible for paying your coinsurance share, 30% of the cost.

A drug sold under its trademarked name. For example, Lipitor is the brand name of a common cholesterol medicine. You generally pay a higher copay for brand-name drugs.

Dental services such as fillings, routine extractions, and some oral surgery procedures.

A healthcare expense you are responsible for paying with your own money, whether from your bank account, credit card, or from a health account such as an HSA, FSA or HRA.

An individual with qualifying high deductible health plan (HDHP) coverage and no disqualifying non-HDHP coverage can be HSA eligible. An individual who can be claimed by another person as a tax dependent is not HSA eligible.

Classified permanent or probationary employees who work a minimum of 20 hours per week; Certificated employees currently under contract and who work a minimum of 50% of a Certificated job (even though the hours worked may be less than 20 hours per week) are eligible to participate in one of the options offered by the district. 

Variable-hour, temporary, seasonal, and other employees are only eligible to enroll in the Two-Tiered HSA PPO medical plans.

The cost of COBRA is the same premium charged to the district for the plan that the member was enrolled in prior to losing coverage, plus a 2% administration fee for Federal COBRA and 10% administration fee for State Continuation (CalCOBRA). The administrative fee is established according to COBRA Law.

The IRS sets yearly contribution limits. For 2023, you can contribute up to $3,850 annually for yourself and up to $7,750 if you cover yourself and your dependents. For 2024, you can contribute up to $4,150 annually for yourself and up to $8,300 if you cover yourself and your dependents. The maximum dollar limits include any amounts that your employer contributes towards your HSA. If you are over age 55, you are eligible to make “catch-up” contributions of $1,000 annually.

COBRA is temporary group health benefits the member and their family can enroll in after losing coverage through their district. The coverage period is up to 18 months and not to exceed 36 months depending on the qualifying event. Members will be offered the same benefit plan they were enrolled in prior to losing coverage.

An HSA is a tax-favored bank account that certain eligible individuals can use to pay for medical expenses. HSAs can be funded on a pre-tax basis through a cafeteria plan.

The Waiver of Active Benefit Enrollment (WABE) is effectively an opt-out option while upholding the program participation requirements. Employees who prefer to decline medical coverage may elect this option in place of a medical plan. Employees who select this option are not enrolled in a medical/Rx plan but do have access to certain added-value services, including the Employee Assistance Program.

• SISC Blue Shield PPO plans limit the maximum benefit amount at an in-network outpatient hospital facility for the following five procedures: arthroscopy, cataract surgery, colonoscopy, upper GI endoscopy. There is no limit for these procedures at an in-network Ambulatory Service Center (ASC).
• Contact your provider’s office and ask, “Do I need a pre-authorization?” and “Is there a cap or limit for this procedure?” “
• If you use an in-network ASC, you will only be responsible for the regular deductible and coinsurance.
• If you use an in-network outpatient hospital facility, you will be responsible for the regular deductible and coinsurance PLUS any amount by which the hospital charge exceeds the maximum benefit.
• Outpatient procedures can be safely performed at an ASC more quickly for a fraction of the cost.

This is an individual question based on your unique needs and lifestyle. To best answer this question for yourself, determine what health services you are likely to participate in in the coming year. You can look back to the past, your health history, your age-related concerns for screenings you may need, and any current medical care you receive. You will be looking at other factors, too, such as what your budget allows in terms of monthly premiums and out-of-pocket costs.

Enrolled members may elect a different plan option during the designated Open Enrollment period for an October 1st effective date or when there is a qualifying life event. A qualifying life event may include a loss of benefits due to a job change or termination, the birth of death of a dependent, the adoption of a child, a divorce or marriage, and moving to a new state that doesn’t offer your current plan.  

All probationary and permanent employees who work 90% or more of the full-time equivalent for the applicable job classification are required to participate in one of the options offered by the district. An eligible employee who works less than 90% of the full-time equivalent for the applicable job classification or receives less than 90% of the amount that is contributed towards an eight-hour full-time employee may decline coverage.

Retirees are allowed the same Open Enrollment period as active employees. At the time of retirement, a retiree may also elect another plan offered by the district.

Other events which would allow a change outside of Open Enrollment include the following:

• A change to the district contribution resulting in an out of pocket increase to the retiree.
• A retiree requests to move to a PPO Retiree 65+ (EGWP), CompanionCare Medicare Supplement, or Medicare Advantage Plan. Retirees enrolled in Medicare can enroll in these plans without waiting until Open Enrollment.

Yes, retirees must have continuous enrollment in Medicare Parts A and B while enrolled in a RESIG retiree plan.

Retirees and their spouses/domestic partners that are Medicare eligible (65+ years of age, or less than age 65 but Medicare eligible) are required to provide proof of Medicare Parts A and B. A copy of the retiree’s and spouse’s/domestic partner’s Medicare card must be sent to RESIG prior to the first of the month in which they turn 65 (or first of the prior month if their birthday is on the 1st).

Members who do not have A & B assigned at the time they become Medicare eligible may be subject to non-refundable, non-negotiable Medicare surcharge penalties. Additionally, Medicare eligible members who lose A & B due to non-payment of monthly premium(s), non-payment of IRMAA (Income Related Monthly Adjustment Amount) premiums or due to dual Part D (prescription coverage) may also be subject to non-refundable, non-negotiable Medicare surcharge penalties: 

• Missing Part A: $625/month
• Missing Part B: $625/month
• Missing Parts A & B: $1,250/month

• Most individuals will find that deferring Part B is in their best interest. Therefore, they will need to contact Social Security to do so.  It will be important to reach back out to Social Security at least three months prior to the first of the month following your retirement (unless instructed otherwise by RESIG) to enroll with Part B once you’re in retired status. 
• If you’re contributing to or receiving contributions into an HSA, Medicare eligibility may compromise your ability to continue to contribute. Please reach out to your RESIG Benefits Specialist for more details about Medicare and HSAs and consult a tax professional to be sure your HSA is in compliance with Federal laws. 

Retirees or COBRA participants may set up a recurring ACH payment, or they can mail a check or money order to the RESIG office. Cash is not accepted at this time.

Yes, retirees who decline a benefit will not be eligible to enroll in that benefit in the future. COBRA benefits would be offered to retirees and dependents that decline coverage.

Pandemics, fires, food insecurity; these are just some of the traumas that have impacted students in recent years. This has led to injuries to school personnel due to episodes of anxiety or agitation while working with students. Whether triggered by bullying, frustration with school work or stress at home, these situations can escalate to emotional outbursts and even violence when not addressed appropriately. With teachers and school administrators experiencing assaults more frequently, it’s important learn how to deescalate aggressive student behavior. This training will educate attendees on an original, highly effective, universal communication system (The Wolfson Formula) to help
school staff:

• Maintain their own behavior in stressful and critical situations
• Gain compliance in difficult situations
• Achieve cooperation

The 4-hour training, provided by subject matter expert consultants
from Knowledge Saves Lives Inc., will also include employee safety
training to cover valuable topics such as situational awareness for
both work and personal life, recognizing warning behavior, and best
practices to keep you and your staff prepared for an emergency.

Reporting must be done within 8 hours of the incident or knowledge of the incident

Cal/OSHA Enforcement Unit District Office

Phone: (707) 649-3700
Fax: (707) 649-3712

American Canyon District Office
3419 Broadway Street
Suite H8
American Canyon, CA 94503

Cal OSHA Reporting Checklist:

• Time and date of accident
• Employer’s name, address, and telephone number
• Name and job title or badge number of person reporting the accident
• Address of accident or event
• Name of person to contact at the site of accident
• Names & address of injured employee(s)
• Nature of Injury
• Location where injured employee(s) was (were) taken for medical treatment
• List and identity of other law enforcement agencies present at the site of accident/event
• Description of accident/event and whether the accident scene or instrumentality has been altered

RESIG has partnered with Vector Solutions to offer districts an online, on-demand learning management system. Each district can offer, assign, and track training in its portal for documentation purposes. Training includes:

• Bloodborne Pathogens
• Mandated Reporter
• COVID-19
• Hazard Communication
• Lock-Out/Tag-Out and many more

Employees can self-assign and choose their classes, or employers can assign courses based on positions or exposures. Make sure your district meets training requirements by using Vector Solutions as a training resource. For information about Vector Solutions, contact Erin Tarkhanian.

RESIG is partnering with STOPit Solutions to protect our schools by empowering students and employees to speak up about inappropriate behavior such as bullying, violence, substance abuse, and discrimination. A mobile phone application, STOPit allows users to report quickly, anonymously, and comfortably to their school’s administrators. When a report is received, administrators may start a two-way, real-time, anonymous conversation with the reporter. STOPit monitors reports 24/7, giving administrators peace of mind when they are not on duty and ensuring that no messages fall through the cracks.

Primarily designed for secondary schools, the application is more than a reporting tool. RESIG has paid to allow member districts to access several valuable add-ons: a Social-Emotional Learning library and a Crisis Text Line.

The Social Emotional Learning library includes courses for administrators and students based on age. Some available courses for students include:

• Bullying and Cyberbullying: Stop the Cycle
• Dealing with Stress and Anxiety
• Dealing with Your Feelings

New in 2022, STOPit includes a Crisis Text Line.

This resource allows anyone in any type of crisis to access free, high-quality support in the STOPit app and is available anytime, anywhere in the US. A live, trained Crisis Counselor receives the text and responds, all from STOPit’s secure online platform. Communication between an individual and Crisis Counselor is confidential. If you are interested in implementing STOPit at your school site, contact Erin Tarkhanian.

Cumulative microtrauma injuries such as back, neck, shoulder, and knee injuries are expensive for a school district and debilitating for the injured worker. Microtrauma becomes cumulative when a staff member bends over hundreds of times each day or when they enter data for hours each day. To avoid these injuries and their associated costs, it is crucial to teach staff members how to adjust their movements or their workstations to prevent stress and strain. The FIT Back Safe and Sitting Safe programs combine theory and practical hands-on exercises to ensure staff members learn how to use their bodies safely at home and on the job.

Back Safe targets workers that are not sitting at a desk every day; perhaps they drive a bus, clean the school, maintain the grounds, or serve students nutritious meals. Regardless of their position, they are at risk for injury, and Back Safe will help them understand how to protect their body as they go about their day. Each Back Safe class includes a customized obstacle course, where employees can see and practice techniques that they can use immediately.

Sitting Safe targets workers that sit at a desk frequently, and are at risk of carpal tunnel syndrome, tendonitis, and everyday discomfort. Sitting Safe attendees learn how to set up their workspace to fit their body, how to adjust their chair to ensure undue stress is not put on their back and stretches to counteract the effects of remaining in a static position for long periods of time. Both Sitting Safe and Back Safe are 2 hours long and can be offered in person at your school district. The Sitting Safe class can also be done online, on demand. To arrange a Back Safe or Sitting Safe class for your district or for more information, contact Christine Dektor.

Reporting must be done within 8 hours of the incident or knowledge of the incident

Cal/OSHA Enforcement Unit District Office

Phone: (707) 649-3700
Fax: (707) 649-3712

American Canyon District Office
3419 Broadway Street
Suite H8
American Canyon, CA 94503

Cal OSHA Reporting Checklist:

• Time and date of accident
• Employer’s name, address, and telephone number
• Name and job title or badge number of person reporting the accident
• Address of accident or event
• Name of person to contact at the site of accident
• Names & address of injured employee(s)
• Nature of Injury
• Location where injured employee(s) was (were) taken for medical treatment
• List and identity of other law enforcement agencies present at the site of accident/event
• Description of accident/event and whether the accident scene or instrumentality has been altered

If you are injured on the job:

• Report all work-related injuries/illnesses to your supervisor immediately.  If it is an emergency dial 911.
• Call the RESIG Telephonic Triage Nurse at:  836-7457.  The nurse will take the claim information over the phone and assist you in obtaining immediate medical care if needed.
• If you require medical treatment, the RESIG nurse will pre-authorize your visit to the Occupational Health Facility located nearest you.
• Following medical treatment, return the Work Status Report form to Human Resources and your supervisor.
• You play an important role in your recovery.  Make the most of your medical treatment by attending your scheduled appointments and following through with any medical treatment plans.

For travel on or after January 1, 2020:

$0.585 /mile

For travel on or after July 1, 2022:

$0.625 /mile

For additional information, please refer to State of California Department of Industrial Relations- Mileage Rates.

RESIG’s Ergonomic Program        

The purpose of the ergonomics program is to eliminate work-related ergonomic risk factors and prevent or reduce workplace-acquired injuries.

RESIG provides ergonomic assessments to member districts. There is no cost to you or your district for an ergonomic evaluation conducted by RESIG. Anyone can request an ergonomic evaluation.Let your supervisor or manager know that you would like to request this service. They will then contact RESIG.

The evaluation or assessment usually begins with a discussion period between yourself and a RESIG Ergonomic Advisor. A hands-on evaluation of your workstation and job duties will take place. A report will be generated and will provide recommendations to reduce any risk factors.  The report will be provided to your district office.

Adjusting Your Workstation

The design of your workstation is critical. A well designed and properly adjusted workstation that is appropriate for your size and the way you work helps you to be more productive and feel less fatigued. 

Chairs should be adjusted to fit the user. Lower the chair seat until your feet rest on the floor or use a footrest. Adjust the backrest for better lumbar support. Adjust chair armrests, in/out or up/down or remove armrests if they are not used. Use the chair adjustment functions to create a better fit.

Keyboard/mouse adjustments: Use an adjustable keyboard or mouse tray, or adjust your chair height. Retract the keyboard support legs to keep the keyboard flat. Move closer to the equipment or move the equipment closer to you. The proper keyboard/mouse height is reached when you keep your wrists straight and bend the elbow at a 90 degrees or slightly greater.

Computer monitors: Position the monitor in alignment with you, your keyboard and your mouse. Adjust the height so that the top written line is about 1 inch below your horizontal gaze (this can differ depending on single or bifocal lenses). Viewing distance is typically between 16 to 30 inches away from you. Keep your screen clean to help with eye fatigue.

Use specialized equipment to reduce the risk factors.

• Use a headset for your phone.
• Use a document holder.
• Use a wrist rest.
• Use the “buddy system” to help with lifting tasks.

Take extra care to reduce physical strain:

• Take a “micro pause” by standing up and stretching or changing positions frequently.
• Use whole arm movements when keying or mousing. Don’t rest your wrists and move just from your wrists.

Specific Risk Factors

The more risk factors that are present in a job, the greater the danger of incurring an injury.

Awkward postures: These place additional stress on the body and make it more susceptible to injury. Examples include prolonged work over shoulder height, repeated bending or twisting of the wrist, knees, or hips; performing jobs with the back bent or twisted rather than straight.

Forceful exertions: Vigorous exertions place more stress on muscles, tendons, ligaments and joints. Examples of factors that increase force requirements include using only the index finger and thumb for pinch grip and not the whole hand, and also speedy movements.

Repetitive motions: Take micro breaks to reduce the risk of repetitive motion injury.

Duration: The longer a person is exposed to repetitive stress or other risk factors the greater the increase for the risk of fatigue.

Contact Stresses: Constant body contact with hard or sharp objects may cause soft tissue damage, affect nerve function and impede blood flow if objects are not padded or rounded. Examples include resting an arm on the edge of a desk.

Vibration: This includes both localized and whole body vibration. An example would be stress from the vibration and torque of power tools.

Questions… Contact Kelly Cook, Sr. RTW Specialist & Ergonomic Advisor at (707) 836-0779 x 108

Ergonomic evaluation services are FREE to our member districts.

Fees may apply to non-member districts.

A “timely, good faith” Interactive Process is now a stand-alone statutory requirement in the California Code of Regulations (CCR, title2, section 7294.0). California State and Federal laws define the “Interactive Process” as an on-going communication between the employer and the applicant or employee with a known disability in an effort to provide reasonable accommodation.

It is unlawful for employers to fail to engage in a timely, good faith, interactive process whether or not the interactive process would have resulted in an obligation to provide a reasonable accommodation.

Under the Fair Employment and Housing Act (FEHA), if an employer fails to reasonably accommodate an applicant or employee, the Fair Employment and Housing Commission can order the employer to cease and desist the discriminatory practice; to hire or reinstate; and award actual damages including, but not limited to, lost wages; emotional distress damages; and administrative fines not to exceed $150,000.00. If the matter is heard in civil court, the damages would be unlimited.

What is “Good Faith”?

An employer and employee must communicate directly with each other to determine essential information and neither party can delay or interfere with the process. If an employee refuses to respond or participate in the Interactive Process, you should document in writing your efforts to contact the employee and offer the Interactive Process. Contact RESIG’s Sr. RTW/Ergo Advisor for more information.

How does an employer become aware of a need for an accommodation?

An employer may become aware of the need for an accommodation by:

• Request from an employee
• Request made by a third party on behalf of the employee
• Request made by a representative of the employee (such as a spouse)
• Request initiated by a manager who becomes aware of a need for an accommodation either from the employee or through observation

The request may be as direct as a specific oral or written request or may be an unassuming mention of a difficulty due to a medical condition.

Once an employer is aware of the need for an accommodation due to medical work restrictions the employer is obligated to begin this good faith, interactive process in a timely manner.

Another area to be aware of is when placing employees on a 39 month rehire listing. FEHA obligates the employer to look at all vacant jobs. Don’t assume that an employee is not able to perform a job.

Communicate, follow up and document your interactions throughout the Interactive Process.

Getting back to work is an important step in recovering from a work-related injury or illness. It means you are returning to a normal pace in life.   Research shows that returning to work has important health and wellbeing benefits.  An early return to work and activity helps prevent long term disability and improved the likelihood of you continuing to improve and return to full work duties.  RESIG’s Return to Work Program can assist you in returning to work quickly and safety after a work related injury/illness.  Although you may not be able to perform your regular full duties, often you can still perform alternative productive work while recovering fully form your injury.  This process benefits everyone involved.  Workers benefit by a more rapid and complete recovery.  Employers benefit by reduction in the length of time the employee is away from work and Medical Providers benefit by having another tool to utilize in aiding employees with their recovery.

What is the RTW Program All About?

The purpose of the Return to Work Program is to assist you in returning to work quickly and safely. Although you may have temporary work restrictions that might prevent you from preforming regular job tasks, you can often participate in temporary modified duty while recovering.

This is how it works: after an initial appointment with the Occupational Health Clinic the treating doctor may release you back to work with temporary work restrictions.  An Interactive Process meeting should take place with your employer to determine how to accommodate you.  Should you choose to remain off work you will not be paid temporary disability benefits but you may use your own sick time to remain off work.  The progress you make will be monitored while participating in The Program.

Your Responsibilities While Participating in The Return to Work Program

• Perform work safely and follow your work restrictions
• Provide your employer with updated “work status slips” after each doctor appointment
• Attend scheduled doctor and physical therapy appointments
• Communicate with your supervisor if:
  • You experience difficulty or pain while performing your modified duty
  • You miss time due to scheduled medical appointments
  • You are unable to report for work
• Let your supervisor know how you are feeling and how you are progressing

You Play An Important Role

You Make a Difference

You Are Valuable

You Belong To A Team

Be an active participant in your return to work and recovery. No one else can do you recovering for you.

Make the most of your medical treatment by following through with the treatment plan, practice any prescribed stretches/exercises. Attend your medical appointments and comply with your work restrictions.

Ask questions – it’s okay!

Contact Kelly Cook, Sr. RTW/Ergonomic Advisor

707 836 0779 x 108

[email protected]

Accommodation requests don’t need to be daunting. One thing you always want to do is engage in the Interactive Process with your employee, but here are some more tips that might help both you as an employer and your employee while navigating the accommodation process.

• Start by exploring your options.
• Brainstorm with your employee.
• Write down all suggestions and ideas.
• Don’t exclude any ideas even if they are “outside the box”.
• Look at available resources and know what equipment is already available to you.
• Could you use a modified or flexible schedule?

Finally, when considering an accommodation request, make sure it works for both your business needs and the employee. Once the accommodation has been chosen make sure you continue to follow up with the employee.  The Interactive Process is just that: it’s a process which needs to be continually monitored.  Shortly after implementing the accommodation, check back with the employee to ensure the chosen accommodation is effective and working for both the business needs of the employer and the employee needs.  You should also provide the employee with a contact person to report problems should there be an issue with the implemented accommodation.  Lastly, be sure to document what you have done throughout the accommodation process. Accommodation requests can be a win-win for everyone involved.

If you have questions about the Interactive Process or accommodation requests, please contact:

Kelly Cook, RESIG’s Sr. Return to Work/Ergonomic Advisor

(707) 836-0779 x 108.

[email protected]