Insurance Enrollment, Benefits and Coverage

Enrollment Information

Board & Employee Insurance Contributions 2022-23

HSA Enrollment Form (for employees new to the HSA plan)

HRA Enrollment Form (for employees new to the HRA plan) 

Blue Cross Initial Health Insurance Application (for first time health insurance enrollees only)

---

Summaries of Benefits

Blue Cross Health Savings Account Plan (HSA) (through August 31, 2023)

Blue Cross Health Reimbursement Arrangement (HRA) (through August 31, 2023)

BlueCare Dental Insurance (through August 31, 2023)

Blue Cross Blue Shield Vision Insurance (through August 31, 2023)

Blue Cross Blue Shield Life and AD&D Insurance (through August 31, 2023)

Blue Cross Blue Shield Web Access

Blue Cross Blue Shield Virtual Visits

---

HSA and HRA Information

HSA Compliance Overview- Withdrawal and Spending Rules 

HRA Claim Form and Procedures

HRA Employee Direct Deposit Authorization Form

HRA Summary Plan Description

HRA Plan Document

---

Affordable Care Act (ACA) Required Notifications

ACA Health Insurance Marketplace Coverage Options

ACA Health Insurance Marketplace Brochure