Hoosier School Benefit Trust (HSBT) Benefit Guide
Health Plans 2020
Health Plans 2021
- HSBT Plan 1-2
- HSBT Plan 3
- HSBT Plan 4
- HSBT Plan 5
- Side by Side Comparison of Medical Plans
- Enrollment in HSBT Plan 4 or 5 requires an American Fidelity HSA application CONTACT: American Fidelity (Todd Caston, Account representative) (800) 638-4268
Pharmacy 2020
- IngenioRx Claim Form
- IngenioRX Order Form Questions about your Rx prescriptions? Call IngenioRx at: 833-236-6196
Pharmacy 2021
-
HSBT Mail Order Pharmacy Network Questions about your Rx prescriptions? Call True Scripts at: 844-257-1955
Dental Plans 2020 & 2021
Vision Plan 2020 & 2021
Health/Dental/Vision Rates and Enrollment Forms
- Anthem Health/Dental/Vision Enrollment Form
- Required Documents for qualifying spouse or Dependent Enrollment
- Spousal Carve out form
2020 Rates
- 2020 Certified Staff Insurance Rates
- 2020 Support Staff Insurance Rates (12 MONTH STAFF - hired before July 1, 2007)
- 2020 Support Staff Insurance Rates (12 MONTH STAFF- hired after July 1, 2007)
- 2020 Support Staff Insurance Rates (LESS THAN 12 MONTH STAFF- 24 pays, hired before July 1, 2007)
- 2020 Support Staff Insurance Rates (LESS THAN 12 MONTH STAFF- 24 pays, hired after July 1, 2007)
- 2020 Support Staff Insurance Rates (LESS THAN 12 MONTH STAFF- 21 pays, hired before July 1, 2007)
- 2020 Support Staff Insurance Rates (LESS THAN 12 MONTH STAFF- 21 pays, hired after July 1, 2007)
2021 Rates
- 2021 Certified Staff Insurance Rates
- 2021 Support Staff Insurance Rates (12 MONTH STAFF - hired before July 1, 2007)
- 2021 Support Staff Insurance Rates (12 MONTH STAFF- hired after July 1, 2007)
- 2021 Support Staff Insurance Rates (LESS THAN 12 MONTH STAFF- 24 pays, hired before July 1, 2007)
- 2021 Support Staff Insurance Rates (LESS THAN 12 MONTH STAFF- 24 pays, hired after July 1, 2007)
- 2021 Support Staff Insurance Rates (LESS THAN 12 MONTH STAFF- 21 pays, hired before July 1, 2007)
- 2021 Support Staff Insurance Rates (LESS THAN 12 MONTH STAFF- 21 pays, hired after July 1, 2007)
HSBT Health and Wellness Centers
Electronically Scheduling HSBT Appointment
HSBT Hours-Harding Street Location
HSBT Hours-Speedway Location
HSBT - MyWellness Portal
Sun Life Disability and Life Insurance
- Certified Staff-Basic Life Enrollment Form
- Certified Staff Basic Life Certificate
- Support Staff Basic Life Staff Enrollment Form
- Support Staff Basic Life Staff Certificate
- Sun Life Beneficiary Change Form
- Voluntary Life Insurance
- Voluntary Life Insurance Enrollment Form
The district provides Certified Staff with a $50,000 Basic Life Insurance Policy. The district provides Classified Staff with a $25,000 Basic Life Insurance Policy.
American Fidelity
- Benefits Overview
- Disability Claim Form
- Hospital Indemnity Claim Form
- Accident Insurance Claim Form
- Section 125 Flex Benefits Guide
Fifth Third Membership Advantage for MSD of Decatur
Terry Lee Companies Corporate Partner Program
Retirement Programs
- Teachers Retirement Fund (TRF)
- Public Employees Retirement Fund (PERF)
- Retired Teachers Health Insurance/VEBA Guidelines
- Optional 403(b) Plan
- TIAA
- Register for TRF Retirement Education Workshop
Required Notifications
- Health Plan Notification Booklet containing the Special Enrollment Rights, Medicare Part D Notice, WHCRA Notice and Notice of Grandfathered Status and the Health Insurance Portability and Accountability Act (HIPAA) Notice of Privacy Practices.
- Marketplace Notice
- Please contact Jennifer Schuler for an Ineligibile for Coverage Marketplace Notice.
- FMLA Employee Guide
Paper copies of all required notifications are available upon request.
Contact
Jennifer Schuler
Benefits Specialist
317-856-5265 ext 18131