Employee Open Enrollment

2012-13

District 95 Open Enrollment for benefits runs from August 1st through August 31st, 2012. There were no information packets sent along with your informational letter.  Rate information, plan summaries, and additional information are listed below.  Please click on the links to view the coverage details for each plan.  There is also a link that provides a cost comparison for last year versus this year's medical and dental program premium charges.


Please remember that if you are making any changes to your current plan coverage choices or are enrolling in the Flexible Spending Plans, you must complete the enrollment forms.

Print out of all forms and packets may also be picked up at the District office at 400 S. Old Rand Road.

If you experience problems with the forms or have any questions, please contact Carol Rams at (847) 540-4956 or email at Carol.Rams@lz95.org.

All files are in either Adobe PDF format or Word.  After you click on a link, use your back button to return to this page.

General Information


Open Enrollment Letter

Medical and Dental 11-12 and 12-13 Premium Comparisons

Dependent Children Age Coverage Change Information

Civil Union Law Information

Medical Loss Ratio (MLR) Notice

 

Medical Plans


PPO Plan Description

PPO Prescription Description

HMO Plan Description

HMO Vision Provider Information

Blue Cross Blue Shield Notice about "Women's Health and Cancer Rights Act of 1998

 BCBSIL Preventative Care Fact Sheet

 

RX Prime Mail Order Forms

New Prescription Form
Refill Prescription Form

 

Dental Plans


Dental Plan Info

PPO Plan Summary

PPO Dental Enhancements

HMO Plan Summary

 

Flexible Spending Accounts (FSA)


Flexible Spending Plan Information Overview

Flexible Spending Summary Plan Description

Flexible Spending Account Enrollment Form

Flexible Spending Account Over the Counter Restrictions

Flexible Spending Account Eligible Expenses

Orthodontic Care Expense Receipt

Flexible Spending Account Direct Deposit Form

Flexible Spending Account Daycare Expenses Receipt

Flexible Spending Account Benny™ Benefits Card

Tax Savings Calculation Worksheet

 

Aflac


Aflac Facts

Why Aflac?

Aflac Presentation

 

Assurant Voluntary Supplemental Life Insurance

Assurant Supplemental Life Insurance Open Enrollment Information

Assurant Benefit Plan Full Packet
Assurant Enrollment/Change Form
Assurant Premium Schedule
Assurant Health Questionnaire

 

Employee Assistance Program (EAP)

EAP Welcome Letter
EAP Brochure

 

403(b)  Tax Sheltered Annuities


Eligibility Notice

Plan Update

Salary Reduction Agreement

Adoption Agreement

403(b) Plan Document

403(b) Authorized Vendor List



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