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Health Forms

 

Health Insurance

 

If you need to update your Health Insurance contact Renee Jones at 992-1013 for the necessary paperwork.

  

Open Enrollment

Open Enrollment Memo


Open Enrollment will begin November 1, 2019 through January 3, 2020. All changes will be effective January 1, 2020.

TO MAKE A CHANGE TO YOUR HEALTH INSURANCE:

If you would like to make any changes to your current insurance please contact Renee Jones at 516-992-1013 or [email protected] for more information.

NO CHANGE TO YOUR HEALTH INSURANCE:

If you do not want to make any changes to your health insurance during Open Enrollment, you DO NOT need to do anything. Your current health insurance will remain unchanged.

BUYOUT/OPT OUT OF HEALTH INSURANCE:

** Even if you are already enrolled in the 2019 buyout, in order to opt out of the health insurance and enroll in the District buyout for the 2020 plan year you MUST complete the following STEPS:

To continue to Opt-out or Opt-out for the first time:

  1. Submit completed 2020 Health Insurance Opt-Out Election Form
  2. Submit completed 2020 Affordable Care Act (ACA) Waiver Form
  3. Submit a copy of your health insurance card for you and all of your dependents


Failure to submit these forms during every open enrollment for the following plan year will result in a forfeit of your buyout for that plan year.

PLEASE BE ADVISED THAT IF YOU MAKE A CHANGE DURING OPEN ENROLLMENT, YOUR INITIAL PAYROLL DEDUCTION MAY BE A LARGER DEDUCTION TO TAKE THE SUMMER MONTHS INTO ACCOUNT.


If you have any question in regards to Open Enrollment please call or email Renee Jones.

Beneficiary

Dental


Flex Benefits


Worker’s Comp

 


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