The District currently offers a PPO Blue Plan through Highmark Blue Shield.  Please see below for additional information.

Group Number 104165-13, 104165-14, & 104165-15:

• Summary of Benefits and Coverage

• Glossary of Health Coverage and Medical Terms

Group Number 104165-57 & 104165-58:

• Summary of Benefits and Coverage

• Glossary of Health Coverage and Medical Terms

Group Number 25661-78 & 25661-79:

• Summary of Benefits and Coverage

• Glossary of Health Coverage and Medical Terms

Group Number 28972-32 & 104165-85:

• Summary of Benefits and Coverage

• Glossary of Health Coverage and Medical Terms

Group Number 28972-39 & 104165-86:

• Summary of Benefits and Coverage

• Glossary of Health Coverage and Medical Terms

Group Number 28972-30, 28972-83, 28972-84, 28972-85:

• Summary of Benefits and Coverage

• Glossary of Health Coverage and Medical Terms

• Highmark PPO Blue Member Change Form

• 2021 Preventive Schedule - Highmark BS

• 2021 HSA Eligibility & Payroll Election Form

• Medical Insurance Coverage & Certification for Spouse Form

• Medical Insurance Waiver Form

The District annually distributes the Creditable Coverage Notice to participants in the Prescription Drug plan.  If you and/or your covered dependent(s) are not Medicare eligible, then this notice is for informational purposes only.  However, if you and/or your covered dependent(s) are Medicare eligible, then please read the information contained in the Notice carefully, so that you and your dependents can make informed decisions regarding prescription drug coverage.

• Creditable Coverage Notice

The District currently offers dental insurance through Delta Dental of Pennsylvania.  Please see below for additional information.

• Cooks & Custodians (Employee) Delta Dental Benefits Booklet

• Cooks & Custodians (Dependent) Delta Dental Benefits Booklet

• Teachers, Administrators & Clerical (Employee) Delta Dental Benefits Booklet

• Teachers, Administrators & Clerical (Dependent) Delta Dental Benefits Booklet

• Delta Dental of Pennsylvania Claim Form

The District currently offers vision insurance to employees only through Davis Vision.  Please see below for additional information.

• Davis Vision Plan Benefit Description

• Davis Vision Care Enrollment Form

• Davis Vision Direct Reimbursement Claim Form

• IRS Form W-4

• Change of Address Form

• Direct Deposit Form

• FMLA Leave Request Form

• Short-Term Uncompensated Leave Request Form

• 403(b) Tax Sheltered Account Program

• Roth 403(b) Educational Flyer

• 2020 Annual 403(b) Educational Presentation

• Flexible Spending Account (FSA) Summary Plan Description

• Flexible Spending Account (FSA) Forms

• Families First Coronavirus Response Act Employee Poster

  To view the PDF form you must have Adobe Acrobat or an equivalent PDF viewer for the document(s) to be viewed. Adobe Acrobat Reader is a free program that can be downloaded on the Adobe website.