Benefit Information and Forms

• Cover recommended and CDC adopted COVID-19 vaccine and booster serum and administration in accordance with existing ACA preventive services benefit (zero-dollar cost share).
• No coverage of OTC(over the counter) COVID-19 tests.

Health, Dental, Vision Plans 2023 

• HSBT Benefit Guide 2023 
• 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

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  Pharmacy 2023

• How to Register in the My Drug Benefit Portal
• TrueScripts Prescription Benefits at a Glance
• HSBT Mail Order Pharmacy Network
• NEW!!!  TrueScripts Portal Updated
• I-Phone App Instructions
• Android App Instructions

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)

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OneAmerica Life Insurance

Group Life Beneficiary Form

OneAmerica Voluntary Life Form

Cigna Disability

• Cigna LTD Administrators 
• Cigna LTD Teachers

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

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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

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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.