Annual Benefit Enrollment Period
May 1, 2018 – May 18, 2018
Health Benefits, Opt Out or Flexible Spending Accounts
Health Benefits: New Plan effective 7/1/2018 MVP Health Care PPO Plan
- If you are currently enrolled in the NY44 Health Benefits plan and not making a change you will automatically be enrolled in the new health plan
- If you are currently enrolled in the NY44 Health Benefits plan and want to make a change (add/remove dependents) – you must complete the MVP enrollment form (enrollment form is 3 pages)
- If you are not currently enrolled in the health plan and want to enroll in the new health plan – you must complete the MVP Enrollment form (enrollment form is 3 pages)
Health Plan Opt Out:
- If you elect to opt out of the health plan for the plan year 7/1/2018 – 6/30/2019 an opt out form must be completed
Flexible Spending: Medical or Dependent Care
- To participate for the 7/1/2018 - 6/30/2019 plan year you must complete the BRI FSA Enrollment form
- Please refer to the plan summary for plan information (FSA max contribution $2,650.00/DCA max contribution $5,000.00)
All necessary forms and plan information are available on the health benefits page of the District Website.
Forms will also be available at the front desk of Administration if you do not have access to a computer/printer.
PLEASE DO NOT “PONY” FORMS to ADMINSTRATION. HR staff will collect forms from your building secretary on 5/19/18 afternoon.
NEW Health Plan, effective 7/1/18
Plan Ends June 30, 2018
NY44 Health Benefits Trust Option A | 800-229-5851
Delta Dental | 800-932-0783
Davis Vision | Eligible Employee Benefit | 800-999-5431
Flexible Spending Accounts: Benefit Resource Inc.
Benefit Resource, Inc. | 800-473-9595
For more information, contact MaryJane Carpenter, Employee Benefit Coordinator, at 951 Hoffman Street, Elmira, New York 14905 or at (607) 735-3005.