Benefits

NOTICE: Open Enrollment Begins in May - Watch for upcoming details from your Benefits Officer

Benefit Summary &  Highlight Sheets

• Act 93: PPO (PDF)
• Act 93: Traditional (PDF)
• Administrative Professional: PPO (PDF)
• Administrative Professional: Traditional (PDF)
• Bus Driver: PPO (PDF)
• Custodian: PPO (PDF)
• Custodian: Traditional (PDF)
• Para Professional: PPO (PDF)
• Para Professional: Traditional (PDF)
• Teacher: PPO (PDF)
• Teacher: Traditional (PDF)

Vision Benefits

• Vision Benefits of America Plan (PDF)
• VBA Plan - Spanish​​​​​​ (PDF)

HR Forms

• Health Plan Enrollment Form (PDF)

Harrison Group Flexible Spending Information

• FSA Enrollment Form (PDF)
• FSA Healthcare Calculator (PDF)
• Participant Login Instructions (PDF)
• FSA New User Guide (PDF)
• FSA Plan Summary Carryover (PDF)
• OTC Flyer (PDF)

Capital Blue

• Member Welcome Setup (PDF)
• Loop Member Communication (PDF)
• NEW Capital Blue RX Mail Process (PDF)
• Virtual Care - A Doctor Anywhere, Any Time (PDF)
• Fitness Your Way for Employees (PDF)
• Capital Blue Traveling and Living Abroad (PDF)

Delta Dental

• Delta Dental PPO Coverage Details (PDF)
• Delta Dental Benefit Card Information (PDF)
• Savings to smile about (PDF)

Nomination of Beneficiary Forms

• Public School Employees' Retirement System (PDF)
• Sun Life Group Life (PDF)

Retiree Health Reimbursement Accounts

• Security Benefit Reimbursement Form (PDF)