• Current Insurance Carriers:
     
             Health Insurance:  Independence Blue Cross
     
                   Member website https://www.ibx.com/
                   
                   Preferred Plan Comparison
     
                   Keystone POS
     
                   Personal Choice 20/40/70
     
                   Personal Choice 10/20/70
                                     
                               
             Prescription Drug: Futurescripts
     
                    Futurescripts Mail Order Form
     
                    Certified Staff Prescription Information
     
                    Administrative Staff Prescription Information
     
                    Support Staff Prescripton Information
     
           
             Healthy Lifestyles
     
                    Fitness Program
     
                    Weight Management
     
                   
     
    Dental:    United Concordia
     
    Vision:       
              Certified Staff::     Vision Benefits of America Group 625
                                             
              Support Staff:   Vision Benefits of America Group 626
     
              NSDAA:     Vision Benefits of America Group 626
                               Vision Benefits of America Group 625
                                  
              Confidential Secretary:  Vision Benefits of America Group 626
     
              NASA:  Vision Benefits of America Group 626
                         Vision Benefits of America Group 625
                            
     
    Change in Insurance Coverage:
    It is your responsibility to notify Human Resources if you have a life event that will alter your health insurance coverage.  Examples are:  marriage, divorce, birth or adoption of a child, child reaching age 19, or change in your spouse's employment resulting in the gain or loss or health care coverage.  Our current coverages are:  Single, Husband & Wife, Parent & Child, Parent & Children, Family. 
     
    Voluntary Waiver of Employee Insurance (Opt-Out):
    Employees may waive District paid medical coverage:  hospitalization/medical/surgical coverage and/or prescription drug and/or dental.   Proof of other alternative health insurance is required.  Incentive will be paid on a monthly basis. 
     
    Waiving coverage is effective at the first of the month following the date the waiver is received in the Office of Human Resources.  Revoking a waiver cannot occur until July 1 following the open enrollment period, or some other date if the employee experiences a life event. 
     
         Health, Prescription, and Dental Coverage Waver for 2018 - 2019 School Year:  Opt Out Information
     
    OneAmerica® Employee Benefits:
    Employees are eligible to receive and/or buy short and long term disability coverage.  Please consult your bargaining unit agreement for specific details.
     
    The following forms are available for printing: 
     
                   Short Term Disability:
                        OneAmerica Short Term Disability Claim Statement
                           
                             
                   Life Insurance:
                        OneAmerica® Beneficiary Designation
                        Beneficiary Tips
                        Minor Beneficiary Questionnaire Packet
     
                         
    403B Annuity Information
     
               Annuity Form 403B
               Annuity Providers
     
    Please return completed forms to Karen Morrow in Human Resources.