2019-2020 Employee Benefits Open Enrollment

Open Enrollment Period is the one time each year employees can change what health insurance and dental insurance plans they are enrolled in. Open Enrollment period is from 04/15/2019 - 05/15/2019 with an effective date of 07/01/2019.  If changes aren't made during the open enrollment period, an employee must have an "event" in order to make changes such as a birth, wedding, divorce, adoption, or change in employment.





Enrollment forms will be sent to all employees in their April 25th pay stub envelopes. Form here is for reference only.
(Note that Administrators, Married Employees, and Bus Route Drivers have their own form that will be shared individually with them)






 $500 Deductible PSF
(100% Paid by District if Eligible)
 $1,000 Deductible (Grandfathered)$2,500 High Deductible Plan 
Some employees may qualify for district contributions to the HSA with this plan. Check the rate sheets for more information.
 Health Savings Account Information
(with choice of $2,500 HDHP Plan)
$500 Deductible Plan Booklet
Booklet is 2018 version as 2019 version is not yet available.  There are minimal changes to the new policy other than the transition to the Blue Rx Value Plus Drug Benefit Plan.
 $1000 Deductible Plan Booklet
Booklet is 2018 version as 2019 version is not yet available.  There are minimal changes to the new policy other than the transition to the Blue Rx Value Plus Drug Benefit Plan.
 $2500 HDHP Plan Booklet
Booklet is 2018 version as 2019 version is not yet available.  There are minimal changes to the new policy other than the transition to the Blue Rx Value Plus Drug Benefit Plan.
 
What is an Health Savings Account (HSA)
 Partial Self Funding Flow Chart

  Moving to an HDHP Is an HSA right for you?

What are the Qualified Medical Expenditures you can pay from from your HSA?

 Partial Self Funding Arrangement
  
   HSA Direct Deposit Form 
   Titonka Savings Bank (TSB)
HSA Account Information 

TSB HSA FAQ
TSB Customer Application Form
TSB HSA Information
   Manufaturers Bank and Trust (MBT)
HSA Account Information 

MBT Customer Application Form
MBT HSA Information
    

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