Megan Mills. MCPS Separating Employee. To: Benefits Office. From: Post-Employment Benefits. Subject:

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1 To: From: Subject: MCPS Separating Employee Benefits Office Post-Employment Benefits Attached please find an exit packet that explains benefits post-employment. Please take a moment to read this carefully as it explains important information regarding leave payout, retirement plans, and continuation of healthcare benefits. I will gladly meet with you to discuss any questions or concerns you have regarding the status of benefits upon separation. You may reach me at or via at mmills@mcpsva.org. Regards Megan Mills Megan Mills, Benefits Administrator Human Resource Department, 8700 Centreville Road, Suite 310, Manassas, VA

2 Exit Checklist Employee Considerations: Address Verification: Prior to separation ensure that your current address is on file with the Human Resources Office. Also if you move any time within the following year contact Human Resources so that we may update your address for your W2 tax form. COBRA/Health Insurance: If enrolled in health insurance at time of separation you will be able to continue your benefits under COBRA. If separating at the end of your contract health insurance will end as follows: 10 month employees: September 30th 11 month employees: August 31 st 12 month employees: Month in which separation occurs. For the cost of COBRA coverage, please see the attached rate sheet Disposition of Accumulated Leave: Upon separation an employee may request transfer of sick leave to another employer if such employer allows transfer of leave. This request must be made within 12 months of separation. To receive pay for leave please see the rules in the attached Disposition of Accumulated Leave form. Request for leave pay must be made within 6 months of separation. Final Pay: Your final pay will be deposited to your bank account on file according to the normal bimonthly payroll schedule. Sick and/or annual leave payouts will be paid out, typically within three weeks of separation, but do require that you complete a Disposition of Accumulated Leave Form. Group and Optional Life Insurance: If you covered under the VRS Group Life Insurance Program and leave covered employment before you are eligible to retire, or if you take a refund of your member contributions and interest, your basic group life insurance coverage will end within 31 days of the end of month in which the last premium is paid. Optional Group Life Insurance: You may continue a portion of your optional life insurance at separation if you have 60 months of continous enrollment in the optional group life insurance plan prior to separation. Actions to be taken: Address change forms may be sent to Deborah Shelton at dshelton@mcpsva.org or mailed to her attention at P.O. Box 520, Manassas, VA LD&B the MCPS COBRA vendor, will mail eligible employees a COBRA notice explaining rights to continue coverage under COBRA. For separations you will be eligible to continue benefits for up to 18 months. LD&B will issue you a COBRA notice within 15 days of your benefits end date. You will have 60 days to elect COBRA. Benefits will begin retroactive to the last day of coverage. For questions about COBRA continuation rights, please contact the Benefits Office at Disposition of Accumulated Leave forms are required to be completed and returned to Sara Tanea in person at CO, room 310, or by at stanea@mcpsva.org For questions regarding pay, please contact the Payroll Office at For questions concerning group and optional life insurance, please contact Minnesota Life at If you wish to convert your coverage to a personal plan, you must do so within 31 days of your last day of employment; you will pay the premiums. Proof of good health will not be required. This option is not available after 31 days. Submit a Conversion of Group Life Insurance Enrollment (VRS-35E) to Minnesota 2

3 Exit Checklist Lincoln Financial Services: If you have a loan through your Lincoln Supplemental Retirement Plan you will need to contact Lincoln to discuss payment options via ACH or you may choose to let your loan go into default. Virginia Retirement System (VRS): There are many considerations when taking a refund of your VRS retirement account. MCPS recommends that you speak to a VRS retirement counselor who may be reached at VRS Hybrid Please see the attached document which explains your options with your VRS account. Life at P.O. Box 1193, Richmond, VA The form is available at Please contact Lincoln Financial Services to discuss any questions you may have regarding your Lincoln Supplemental Retirement plan 403b or 457 b and/or to discuss any loans you may have. Lincoln Financial Services may be reached0 at To request a refund, complete a VRS-3 form available at To request a distribution, please contact ICMA- RC at (855)

4 Address and or Name Change Notification Proof of social security card for a name change must be presented to Human Resources and new retirement and payroll forms must be completed as soon as possible. Changes to employment records cannot be made without all appropriate documentation. Please complete this form and return it to the Department of Human Resources. Employee ID Number: Name: Last First MI/Maiden Address: Street City State Zip Code Home Telephone Number: Cell Number: Location of Assignment: Assignment: Please indicate if this is an ( ) address change and/or a ( ) name change Change name from to (A copy of social security card reflecting your name change must be submitted before any changes to employment or school records will be made) Change from to Effective date of change: Employee signature: Date Human Resources will copy to appropriate offices for processing Cc: Human Resources Finance Technology Information Services Principal / Supervisor Support Services Human Resource Department, 8700 Centreville Road, Suite 310, Manassas, VA

5 Manassas City Public Schools Monthly COBRA Rates July 1, June 30, 2017 Medical Plans WITH COMPREHENSIVE DENTAL COBRA Kaiser HMO (with Dominion Dental) Employee only Dual (employee +1) Employee + family Anthem Key Advantage 250 Employee only Dual (employee +1) Employee + family Anthem Key Advantage 1000 Employee only Dual (employee +1) Employee + family Anthem High Deductible Health Plan (HDHP) Employee only Dual (employee +1) Employee + family Medical Plans WITH PREVENTIVE DENTAL COBRA Kaiser HMO (with Dominion Dental) Employee only Dual (employee +1) Employee + family Anthem Key Advantage 250 Employee only Dual (employee +1) Employee + family Anthem Key Advantage 1000 Employee only Dual (employee +1) Employee + family Anthem High Deductible Health Plan (HDHP) Employee only Dual (employee +1) Employee + family Human Resource Department, 8700 Centreville Road, Suite 310, Manassas, VA

6 Disposition of Accumulated Leave Manassas City Public Schools Regulation GCBD-Staff Attendance and Leave Name Employee ID # Assignment / Location Please select from the options below for disbursement of any earned and unused sick leave and/or annual leave, if applicable. Sick leave will be paid out OR transferred. Accumulated personal leave will roll over into sick leave. (Leave balances may be viewed on your employee paystub and are one payroll period behind. Leave is typically accurate on the payroll following your last employment day.) RETIREES Retirees will be paid out at 25% of their daily rate of pay or $40 per day (based on an eight hour day), whichever is greater. Retiree sick leave payout of $1,000 and greater is automatically contributed to the 403(b) as an employer contribution. I request payment for accumulated hours of sick leave. RESIGNATIONS I request payment for accumulated 12-month employees only.) hours of annual leave. (Applicable to I request to contribute hours of sick leave and hours of annual leave to my 403(b) and / or my 457(b). Sick Leave I request the transfer of my sick leave hours to another school division/employer. Note: Request for transfer must be made within 12 months of termination date. I request to contribute hours of sick leave to my 403(b) and hours of sick leave to my 457(b). I request payment for accumulated $20 per day, based on an eight hour work day.) hours of sick leave. (Sick leave payout is Annual Leave I request payment for my accumulated hours of annual leave. (Annual leave will be paid out automatically unless you elect to roll over the payout into your 403(b) or 457. I request to contribute hours of annual leave to my 403(b) and / or my 457(b). Employee Signature / Date Please check one: Resignation Retirement Human Resources Signature / Date Date submitted to payroll 6

7 Supplemental Retirement Plan 403(b) and 457 Employees who separate employment with Manassas City Public Schools and participate in a Supplemental Retirement Plan have the following options regarding the funds in their Supplemental Retirement Account(s): 1. Participants who have an account balance over $5,000 may: Leave the funds in existing account(s). Employees may decide, at a later date, to take a distribution or rollover; Rollover the funds to a similar plan. Cash out the funds (taxes and fees may apply). 2. Participants with an account balance between $1,000 and $5,000 may: Request a cash distribution within 90 days (taxes and fees apply). Rollover funds to a similar plan within 90 days. Those who do not request a distribution/rollover within 90 days will automatically have their funds rolled over into a Lincoln IRA. 3. Participants who have an account balance less than $1,000 may: Request a cash distribution within 90 days (taxes and fees may apply). Rollover the funds to a similar plan within 90 days. Those who do not request a distribution/rollover within 90 days will automatically have their funds dispersed for them. The employee will be responsible for taxes and any applicable fees. Employees are always 100% vested. Employee contributions may be withdrawn or rolled over following the date of separation. You may contact Lincoln Financial at or visit their website at Human Resource Department, 700 Centreville Road, Suite 310, Manassas, VA

8 Virginia Retirement System and Group and Optional Life Benefits Upon Separation: The following documents discuss options you have with your membership in the Virginia Retirement System. You are a member if you were an employee who was regularly scheduled to work 35 hours or more per week. You are in Plan 1 if your membership date is before July 1, 2010 and you are vested as of January 1, You are in Plan 2 if your membership date is on or after July 1, 2010 or your membership date is before July 1, 2010 and you were not vested as of January 1, You are in the VRS Hybrid plan if you are hired on or after January 1, 2014 and are not currently in the VRS Plan 1 or Plan 2. 8

9 VRS Retirement and Life Benefits Upon Separation from MCPS Hybrid Plan Members: Options upon separation from employment Defined Benefit (DB) Component Defined Contribution (DC) Component You can take a refund of your defined benefit member contributions and interest. Taking a refund cancels your VRS membership and eligibility for any future VRS benefits You must be vested (have at least five years of credible service) to be eligible for any member contributions in your account made by your employer after July 1, 2010 and the interest on these contributions, unless you are involuntarily separated from employment for causes other than job performance or misconduct. You have the option of leaving your member contributions and interest with VRS and becoming a deferred member. As a deferred member, you will retain your VRS membership and eligibility for any future benefits. You can withdraw 100 percent of your Hybrid 457 Deferred Compensation Plan account balance. You also are eligible to withdraw your Hybrid 401(a) Cash Match Plan account balance. Withdrawals of your 401(a) employer contributions and net investment earnings on employer contributions are subject to a vesting schedule. You have the option of leaving your money in your hybrid 401(a) plan and/or your hybrid 457 plan and continuing to manager your investments. Taking a refund cancels your VRS membership and eligibility for any future VRS benefits. For questions regarding defined benefit plan contact VRS at For questions regarding defined contribution plan, contact VRS at

10 VRS Retirement and Life Benefits Upon Separation from MCPS VRS Plan I and II: Options upon separation from employment If you leave covered employment and do not retire, you can take a refund of your member contributions and interest or leave your member contribution account balance with VRS and become a deferred member. Taking a Refund If you request a refund and are vested (have at least five years of credible service) or involuntarily separated from employment for causes other than job performance or misconduct, you will be eligible for a full refund of your member contribution balance, excluding any member contributions made by your employer to your account after July 1, 2010 and the interest on these contributions. Requesting a refund. Complete a Request for Refund (VRS-3) and submit this to your human resource office. If you request a refund after six months from leaving your job, submit the form to VRS. Becoming a deferred member If you leave your member contributions with VRS, you will become a deferred member. If you are vested, you may be eligible for a future retirement benefit if you meet the age and service requirements for your plan. Group and Optional Life Benefits Upon Separation from MCPS If you covered under the VRS Group Life Insurance Program and leave covered employment before you are eligible to retire, or if you take a refund of your member contributions and interest, your basic group life insurance coverage will end within 31 days of the end of month in which the last premium is paid. If you die before the end of this period, your beneficiary will receive your natural death benefit. You can convert your coverage to an individual policy if you leave employment before your reach retirement eligibility. If you have optional group life insurance coverage and leave covered employment, you may convert your coverage to an individual policy if you have 60 months of continous service prior to separation. If you do not convert your coverage and you die within 31 days of the end of the month in which the last premium is paid, your beneficiary will receive your optional life insurance natural death benefit. 10

11 VRS Retirement and Life Benefits Upon Separation from MCPS Converting your group life insurance coverage. If you wish to convert your coverage, you must do so within 31 days of your last day of employment; you will pay the premiums. Proof of good health will not be required. This option is not available after 31 days. Submit a Conversion of Group Life Insurance Enrollment (VRS-35E) to Minnesota Life at P.O. Box 1193, Richmond, VA The form is available at 11

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