Business Office

403(b) UNIVERSAL AVAILABILITY NOTICE

Updated 5/12/2021

You have the opportunity to save for retirement by participating in the Mt Blue Regional School District’s 403(b) plan (“Plan”). A 403 (b) plan is a retirement plan for certain employees of public schools, tax-exempt organizations and ministers. Contributions are mad under a Salary Reduction Agreement (SRA) with your employer. This agreement allows your employer to withhold money from your paycheck to be contributed directly into a 403 (b) account for your benefit. Usually, you do not pay income tax on these contributions until you withdraw them from the account. We recommend that all employees view a brief, 3-minute video presentation explaining what a 403(b) plan is, and how to contribute.

If there are any questions, you may contact The OMNI Group at 877-544-6664.

How Can I Participate?

Prior to contributing, you must open an account with an investment provider participating in the Plan, a list of which is available below. You can participate in the Plan with pre-tax contributions by completing and submitting a Salary Reduction Agreement (“SRA”) online at the OMNI 403b website, or by submitting a completed SRA form, which can be found on the same website, to The OMNI Group either by facsimile to (585) 672-6194 or by mail at 1099 Jay St., Bldg F, Rochester, NY, 14611 (“OMNI”).

How Much Can I Contribute Annually?

You may contribute up to $19,500 in 2021; this amount is subject to change annually. If you have at least 15 years of service with your employer or you are at least 50 years old, you may also be able to make additional catch-up contributions. For appropriate limits for your particular circumstances, please contact OMNI’s Customer Care Center at 1-877-544-6664.

What If I Already Have An Account?

If you are already contributing to the Plan, and you want to change your contribution amount or service provider, simply complete and submit a new SRA. See directions above for on-line and paper submission options.

What If I Do Not Want To Contribute?

If you do not want to take advantage of this program, simply submit an SRA with the option “I do not wish to participate at this time” selected. See directions above for on-line and paper submission options.

How can I get more information?

You can access further information at the OMNI 403b website or by viewing the 3-minute video presentation.

The following Vendors are authorized to receive contributions and contract exchanges between vendors under the Mt Blue Regional School District 403(b) Plan:

Name of Vendor	Contact Person	Phone Number
Ameriprise Financial Services	General Number	(800) 862-7919
Franklin Templeton	Aaron Knapp	(207) 778-9779
Franklin Templeton	Jared Ranger	(207) 778-9779
Great American Insurance Group	General Number	(800) 438-3398 ext 17197
Horace Mann Companies	Troy True	(207) 645-4779
Metlife	General Number	(800) 638-5433
Midland National Life Insurance	Bob or Ann Yorks	(207) 779-0505
North American Life Insurance	Bob or Ann Yorks	(207) 779-0505

RATES & COVERAGE FOR UPCOMING, 2024 OPEN ENROLLMENT - More Info to Come

Rates effective 9/1/2024: (No changes in benefits)

$555.96 annually for the employee and one additional family member;
$1,190.28 annually for the employee and two or more additional family members.
There is no cost to the employee for a single subscriber plan. 

Outline of Coverage - Delta Dental PPO plus Premier Network

Current Coverage information

Northeast Delta Dental Change/Enrollment form for open enrollment must be completed and submitted to the business office by July 31, 2023.  The effective date of the change is September 1, 2023. If there is an event such as marriage, divorce, losing another coverage, the change form can be completed at the time of such event. The cost to the employee has not increased. It remains at:

$536.76 annually for the employee and one additional family member;
$1,127.04 annually for the employee and two or more additional family members.
There is no cost to the employee for a single subscriber plan.

Outline of Benefits

RSU #9 dba Mt. Blue Regional School District
Group Number: 0638-5253

Contract Year for Benefits - September 1 through August 31

Eligibility Period - Determined by the Employer

Waiting Period: None

Eligible Persons - Subject to the "Eligibility" provision above, employees and their dependents may be enrolled. Your employer pays the cost for eligible employees.  Employees are responsible for the cost of their enrolled dependents. If enrolling dependents, all dependents must be enrolled for the term of the Agreement.  A newborn child is automatically covered for the first thirty-one (31) days following birth.  Coverage will continue if the child is formally enrolled within the first thirty-one days following birth or the child may be enrolled thereafter at any open enrollment or as of the first day of the month following the month of the child's second birthday.

Benefit Coverages and Percentages Paid by Northeast Delta Dental -

Diagnostic & Preventive: 100%
Basic Restorative: 80%
Major Restorative - including implant services: 50%

Benefit percentages shown are based upon the actual charge submitted up to the Maximum Allowable Charge for participating dentists, or Delta Dental's allowance for Non-Participating dentists.

Maximum Benefit - The maximum amount which your plan will pay is $1000 per person per Contract Year for Diagnostic & Preventive, Basic and Major benefits.

Deductible - There is no deductible

View the Outline of Coverage

Notice of May 2023 Open Enrollment

Open enrollment for health insurance is during the month of May. The effective date of the change is dependent upon your contract renewal date. July 1 is the effective date for administrators, support staff, and school lunch workers. September 1 is the effective date for teachers and any other September 1 contracts. Applications for change for the July or September 2023 contract year must be completed and returned to the business office by May 23, 2023.

The following benefit information was provided by MEA Benefits Trust in a Rate Notice dated April 7, 2023. Please click here for more important MEA Benefits Trust Plan Documents and Open Enrollment Information.

Benefit changes for the 2023-2024 benefit year, effective July 1, 2023:

• MEA Choice Plus Plan and MEA Standard Plan:
  • The annual copayment maximum will increase from $7,350 per individual to $7,500 per individual.
  • The LiveHealth Online network has added dermatology visits and lactation support.
  • Preventive care services have expanded to include certain medical devices, covered in full, for chronic health conditions such as diabetes, asthma, hypertension, liver disease and bleeding disorders.
  • Anthem’s ConditionCare chronic disease management program and the Future Mom’s maternity program will continue with no financial incentives.
    • The Anthem ConditionCare Incentive Program (ACIP) has been discontinued.  This means that financial incentives, which included discounts on condition specific prescription drugs and medical service, will no longer be available for members that participate in the ConditionCare chronic disease management program.
    • Anthem Health Rewards has been discontinued.  This program provided financial incentives in the form of reloadable debit cards to members who participated in ConditionCare & Future Mom’s.
  • Office visit copayments for behavioral health office visits will be waived.
• MEA Standard 500 Plan:
  • The annual copayment maximum will increase from $6,050 per individual to $6,200 per individual.
  • The LiveHealth Online network has added dermatology visits and lactation support.
  • Preventive care services have expanded to include certain medical devices, covered in full, for chronic health conditions such as diabetes, asthma, hypertension, liver disease and bleeding disorders.
  • Anthem’s ConditionCare chronic disease management program and the Future Mom’s maternity program will continue with no financial incentives.
    • The Anthem ConditionCare Incentive Program (ACIP) has been discontinued.  This means that financial incentives, which included discounts on condition specific prescription drugs and medical service, will no longer be available for members that participate in the ConditionCare chronic disease management program.
    • Anthem Health Rewards has been discontinued.  This program provided financial incentives in the form of reloadable debit cards to members who participated in ConditionCare & Future Mom’s.
  • Office visit copayments for behavioral health office visits will be waived.
• MEA Standard 1000 Plan:
  • The annual copayment maximum will increase from $5,550 per individual to $5,700 per individual.
  • The LiveHealth Online network has added dermatology visits and lactation support.
  • Preventive care services have expanded to include certain medical devices, covered in full, for chronic health conditions such as diabetes, asthma, hypertension, liver disease and bleeding disorders.
  • Anthem’s ConditionCare chronic disease management program and the Future Mom’s maternity program will continue with no financial incentives.
    • The Anthem ConditionCare Incentive Program (ACIP) has been discontinued.  This means that financial incentives, which included discounts on condition specific prescription drugs and medical service, will no longer be available for members that participate in the ConditionCare chronic disease management program.
    • Anthem Health Rewards has been discontinued.  This program provided financial incentives in the form of reloadable debit cards to members who participated in ConditionCare & Future Mom’s.
  • Office visit copayments for behavioral health office visits will be waived.

Below is a document with 7/1/23 - 6/30/24 monthly rates. The employer's and employee's percentage of the plan vary depending on the RSU 9 employee group. Please note that these employer's and employee's percentage are subject to completion of contract negotiations for some groups. Additional benefit information and comparative information is available on MEA Benefit Trust's website and on Anthem's MEABT site. 

After reviewing the information on this page, if you would like to make any changes to your coverage, download and save the Anthem Application/change form to your computer, complete the form, re-save and email to Kristi Leavitt at the Business Office.

MONTHLY RATES	7/1/2023	Administrators		Support Staff		Teacher		At Will		School Lunch Updated FY23		School Lunch hired prior to July, 2023
		Employer	Employee	Employer	Employee	Employer	Employee	Employer	Employee	Employer	Employee	Employer	Employee
		79.5%	20.5%	78.5%	21.5%	79.5%	20.5%	79.5%	20.5%	78.5%	20.5%	95% single	5% single
Choice Plus
Employee	814.85	647.81	167.04	639.66	175.19	647.81	167.04	647.81	167.04	639.66	175.19	774.11	40.74
Employee/Spouse	1,836.53	1,460.04	376.49	1,441.68	394.85	1,460.04	376.49	1,460.04	376.49	1,441.68	394.85	774.11	1,062.42
Employee/Family	2,235.30	1,777.06	458.24	1,754.71	480.59	1,777.06	458.24	1,777.06	458.24	1,754.71	480.59	774.11	1,461.19
Employee/Child(ren)	1,442.11	1,146.48	295.63	1,132.06	310.05	1,146.48	295.63	1,146.48	295.63	1,132.06	310.05	774.11	668.00
Employee (Grandfathered 7/1/15)				651.88	162.97
Standard
Employee	879.93	699.54	180.39	639.66	240.27	647.81	232.12	699.54	180.39	639.66	240.27	835.93	44.00
Employee/Spouse	1,983.44	1,576.83	406.61	1,441.68	541.76	1,460.04	523.40	1,576.83	406.61	1,441.68	541.76	835.93	1,147.51
Employee/Family	2414.53	1919.23	494.90	1,754.71	659.42	1,777.06	637.07	1919.23	494.90	1,754.71	659.42	835.93	1578.20
Employee/Child(ren)	1,557.47	1238.19	319.28	1,132.06	425.41	1,146.48	410.99	1238.19	319.28	1,132.06	425.41	835.93	721.54
Employee (Grandfathered 7/1/15)				651.88	228.05
Standard 500
Employee	774.11	615.42	158.69	639.66	134.45	647.81	126.30	615.42	158.69	639.66	134.45	735.40	38.71
Employee/Spouse	1,744.70	1,387.04	357.66	1,441.68	303.02	1,460.04	284.66	1,387.04	357.66	1,441.68	303.02	735.40	1,009.30
Employee/Family	2,123.53	1,688.21	435.32	1,754.71	368.82	1,777.06	346.47	1,688.21	435.32	1,754.71	368.82	735.40	1,388.13
Employee/Child(ren)	1,370.01	1,089.16	280.85	1,132.06	237.95	1,146.48	223.53	1,089.16	280.85	1,132.06	237.95	735.40	634.61
Employee (Grandfathered 7/1/15)				651.88	122.23
Standard 1000
Employee	738.26	586.92	151.34	639.66	98.60	647.81	90.45	586.92	151.34	639.66	98.60	701.35	36.91
Employee/Spouse	1,663.89	1,322.79	341.10	1,441.68	222.21	1,460.04	203.85	1,322.79	341.10	1,441.68	222.21	701.35	962.54
Employee/Family	2,025.18	1,610.02	415.16	1,754.71	270.47	1,777.06	248.12	1,610.02	415.16	1,754.71	270.47	701.35	1,323.83
Employee/Child(ren)	1,306.55	1,038.71	267.84	1,132.06	174.49	1,146.48	160.07	1,038.71	267.84	1,132.06	174.49	701.35	605.20
Employee (Grandfathered 7/1/15)				651.88	86.38

Open Enrollment Dates: May 2, 2023 through May 23, 2023

The enrollment for the Health/Dependent Care Spending Account is administered by Horace Mann. Troy True is the local agent and representatives at his office are available at 645-4779. The reimbursement plans will be processed by Health Equity. This year during the month of May, you must complete forms indicating participation or refusing participation. We must be able to document that everyone is offered this opportunity if audited by the IRS. There are three opportunities with our plan:

• Paying your insurance premiums prior to taxes.
• Flexible Spending Account; this benefit is an opportunity to pay for eligible out-of-pocket expenses with pre-tax dollars, thus reducing your taxable earnings at W-2 time.
• Dependent Care Reimbursement; this benefit is an opportunity to pay for eligible dependent/child care expenses with pre-tax dollars, thus reducing your taxable earnings at W-2 time.

The effective dates are as follows:

July 1 for administrators, psychologists, adult ed staff, support staff, and school lunch workers.
Section 125 Enrollment Form for July 1, 2023 Effective Date 

September 1 for teachers and other professional staff members.
Section 125 Enrollment Form for September 1, 2023 Effective Date

Select the form that is appropriate for your effective date. The completed forms must be returned to Kristi Leavitt in the Business Office by May 23, 2022.

For security reasons, Direct Deposit Forms are not available electronically. They are available in each district building's office or in the superintendent's office.  

• Change of Address/Contact Information Form
• Dental Application and Change Form
• Federal W4 Form
• Maine W-4 Form
• MePERS Member/Benefit Recipient Data Update
• Anthem Application/Change Form
• Course Approval Form - Professional & Support Staff
• Course Approval Form - Administrators
• Conference Request Form Procedure - important instructions
• Conference Request Form - Please see important instructions in the above Conference Request Procedure
• P-Card Summary Card
• Mileage Reimbursement
• Gift Card Sign-off Form

September 2023 Forms

The first payroll of 2023/24 school year is September 8, 2023. 

Administrators	Food Service	Professional Staff	Support Staff
2023/24 Cash In Lieu - Administrator (due 9/1/23) 2023/24 Sick Bank Contribution Form - Administrator (due 9/30/23)	2023/24 Cash in Lieu - Food Service (due 9/1/23)	2023/24 Cash in Lieu - Professional Staff  (Due 9/1/23) 2023/24 Sick Bank Contribution Opt Out Form - Professional Staff  (Due 9/1/23)	2023/24 Cash in Lieu - Support Staff  (Due 9/1/23) 2023/24 Sick Bank Contribution Form - Support Staff Due (9/1/23)

All Staff Payroll Deductions	Other Notices
RSU 9 Employee Scholarship - if you missed the 9/1/23 form deadline, please contact the Business Office (778-5322, option 4) for assistance. UMF Fitness Center Membership (due 9/1/23) United Way of the Tri-Valley Area Impact Brochure Pledge Sheet (due 9/1/23)	2023-2024 Pay Averaging Agreement (due 8/18/23)

 

• MePers Retirement Forms
• Social Security Retirement
• Retiree Checklist
• MEA Benefits Trust - Rate Band