Highmark has acquired Blue Shield as of July 1, 2022
The month of May is designated as an open enrollment period for health, dental and related dependent care and medical expenses covered under the If you have been thinking of making any changes in your provider or family status, May is the only month in which you are allowed to make these changes without the benefit of a qualifying event.
The open enrollment period is open until May 1-19, 2023.
If you are making changes, please submit the forms to the business office.
If you are making changes and are an active employee, please submit to the forms to Human Resources at HR@sgcsd.net. If you are a retiree, please submit your form to Bobbie DeLong at bdelong@sgcsd.net.
The forms below are provided in PDF format. If you encounter any difficulty attempting to access these files, contact Julia Lilkendey at jlilkendey@sgcsd.net.
Forms and Downloadable Information
- Letter about open enrollment for Scotia-Glenville staff (2023-24)
- Download the Health Insurance Declination Form (2023-24)
- General Notice of COBRA Continuation Coverage Rights
- Fillable Online form for enrollment changes during open enrollment
- Highmark Northeastern NY
- Highmark Point of Service (POS) 200 summary of benefits and coverage (2023-24)
- Highmark POS 200 benefit summary (2023-24)
- Highmark POS 200 booklet (2023-24)
- Highmark Preferred Provider Organization (PPO) 800 summary of benefits and coverage (2023-24)
- Highmark PPO 800 benefit summary (2023-24)
- Highmark PPO 800 booklet (2023-24)
- Highmark Dental Summary
- Express Scripts Prescription Drug Plan Co-Pay amounts (2023-24)
- CDPHP Universal Benefits
- CDPHP EPO summary of benefits (2023-24)
- CDPHP EPO benefits summary (2023-24)
- CDPHP benefit booklet (2023-24)
- CanaRX
- Health and dental insurance rates (2023-24)
- Health insurance contribution rates by bargaining unit (2023-24)
- Online access to your health insurance plans
- Flexible Spending Accounts
4/19/2023 – Please be advised that the IRS has increased the maximum allowable amount for the medical expense annual election. The annual election maximum for medical expense is increasing to $3,050. Scotia- Glenville CSD will be adopting this maximum for the July 1, 2023 – June 30, 2024 year. Dependent care will remain the same at $5000.00.
- Know Your Health Care FSA/HRA Eligible and Ineligible Expenses
- Flexible Spending Employee Election Agreement from Benetech (2023-24)
- Flexible Spending Update Regarding CARES Act and Over the Counter Drugs and Medicine
- Five New Expenses Now Eligible For Your FSA, HRA & HSA Funds
- Flexible Spending Account Dependent Care Expense Recovery Form from Benetech
- Flexible Spending Account Medical Expense Expense Recovery Form from Benetech
- Benny Prepaid Benefits Card – Substantiation Requirements from Benetech
- FSA Benecard brochure
- FSA Direct Deposit Form
- FSA Employee Guide
- FSA Spending Account Worksheet
- Benetech Mobile App
- FSA/HRA Eligible Costs
- Benetech: Save your receipts