Benefit Information and Forms

 

Amanda Pruitt, Benefits Specialist

Phone: 317-856-5265 ext 18131

Fax: 317-981-3167

apruitt@decaturproud.org

Click on one of the links below to request a meeting:


Health, Dental, Vision Plans 2024

HSBT Benefit Guide 2024   Audio Presentation of the Benefit Guide

HSBT Enrollment Form 

Required Documents for qualifying spouse or Dependent Enrollment

American Fidelity HSA application (HSBT Plan 4 or 5 ONLY)

Benefit Plan Notifications 2023

Spousal Carve-Out Form


2024 RATE SHEET

*Administration will need to reach out to the benefits specialist for their rate sheet*

PLATINUM (Certified Staff Only, Teachers/School Counselor/Psychologist) 
GOLD (Support staff who are year round 260 employees as well as less than 260 but salaried, such as SRO, CIS, OT/PT, Therapist, ETC)
BLUE 24 (Support staff who are less than 260 and hourly but opted for 24 pay) 
BLUE 21 (Support staff who are less than 260 and are on 21 pay)

Pharmacy 2024

NEW!!!  TrueScripts Portal Updated

I-Phone App Instructions

Android App Instructions

Questions about your Rx prescriptions?
Call True Scripts at: 844-257-1955


Employee Assistance Program/Health Coach

EAP

EAP Brochure (english)

EAP Brochure (spanish)

HEALTH COACH (english)

Health Coaching FAQ (english)

HEALTH COASH (spanish)

Health Coaching FAQ (spanish)

HSBT members interested in health coaching click this link to schedule an appointment with one of the Health Coaches

 

Schedule an Appointment

 


OneAmerica Life Insurance

Group Life Beneficiary Form

OneAmerica Voluntary Life Form


Cigna Disability


American Fidelity

Benefits Overview

Disability Claim Form

Hospital Indemnity Claim Form

Accident Insurance Claim Form

Section 125 Flex Benefits Guide

American Fidelity Name Change Form

Manager:  Michael Marshall - michael.marshall@americanfidelity.com - 317-556-1194


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 

FMLA Employee Guide

Paper copies of all required notifications are available upon request.