Benefit Information and Forms
(P): 317-856-5265 ext 18131
The COVID-19 Public Health Emergency (PHE) enacted in February 2020 is set to expire on May 11, 2023. As a result, the following services will revert to standard benefits as of May 12, 2023.
- 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 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*
(Certified Staff Only, Teachers/School Counselor)
(Support staff who are year round 260 employees as well as less than 260 but salaried, such as SRO, CIS, OT/PT, Psychologist, Speach Therapist, ETC)
(Support staff who are less than 260 and hourly but opted for 24 pay)
(Support staff who are less than 260 and are on 21 pay)
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 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
Disability Claim Form
Hospital Indemnity Claim Form
Accident Insurance Claim Form
Section 125 Flex Benefits Guide
American Fidelity Name Change Form
Manager: Michael Marshall - firstname.lastname@example.org - 317-556-1194
Teachers Retirement Fund (TRF)
Public Employees Retirement Fund (PERF)
Retired Teachers Health Insurance/VEBA Guidelines
Optional 403(b) Plan
Register for TRF Retirement Education Workshop
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.
FMLA Employee Guide
Paper copies of all required notifications are available upon request.