Benefits Forms and Information

• 2023-2024 Active Insurance Rates (MHRDEA)
• 2023-2024 Active Insurance Rates (Admin-Non-Unit-Bus)
• PPO - Traditional Plan Schedule of Benefits (MHRDEA)
• PPO - Traditional Plan - Summary of Benefits and Coverage MHRDEA
• PPO - Traditional Plan Schedule of Benefits (Admin, Non Unit, Bus)
• PPO - Traditional Plan - Summary of Benefits and Coverage  (Admin Non-Unit)
• PPO - Traditional Plan - Certificate of Coverage
• POS - Managed Choice - Schedule of Benefits  (MHRDEA)
• POS - Managed Choice - Summary of Benefits and Coverage MHRDEA
• POS - Managed Choice - Schedule of Benefits (Admin/Non-Unit/Bus Drivers)
• POS - Managed Choice - Summary of Benefits and Coverage (Admin Non-Unit Bus Drivers)
• POS - Managed Choice - Certificate of Coverage
• Aetna Open Access Managed Choice - NJEHP - Schedule of Benefits
• Aetna Open Access Managed Choice - NJEHP - Booklet
• Aetna Open Access Managed Choice - NJEHP - Overview
• Aetna Open Access Managed Choice - NJEHP - Summary of Benefits and Coverage
• Find a Medication Link
• GSHP - Aetna Whole Health - Schedule of Benefits
• GSHP - Aetna Whole Health - Certificate of Coverage
• GSHP - Aetna Whole Health-Overview
• GSHP - Aetna Whole Health - Summary of Benefits and Coverage
• GSHP - Savings Plus of NJ - Schedule of Benefits
• GSHP - Savings Plus of NJ - Certificate of Coverage
• GSHP - Savings Plus of NJ-Overview
• GSHP - Savings Plus of NJ - ASP - Summary of Benefits and Coverage
• NJ EHP & NJ GSHP Contribution Schedules
• Dental Benefits Summary
• Dental Benefits Booklet
• Dental Deductions
• NVA Summary of Benefits 
• 23-24 EP Changing Benefits
• 23-24 EP Waiving Benefits
• Delta Enrollment Form 23-24
• NVA Vision Enrollment Form 23-24
• Health Waiver Form 23-24
• Aetna Enrollment Change Request 23-24

• Dependent Care Account (DCA)
• Healthcare Flexible Spending Account (FSA)
• My Ameriflex Participant Portal

• Open enrollment for the district's Flexible Spending account program through Ameriflex for medical & dependent care expenses for the benefit plan year July 1, 2023 to June 30, 2024 will open on Tuesday, May 16, 2023.
• The portal is accessible for eligible employees who are working the full contract year. If you are not working the full contract year please contact me for separate enrollment forms.
• If you are currently enrolled & would like to continue participation for the new plan year, you MUST re-enroll.  
• The maximum amount you may add to a Flexible Spending account for medical expenses is $3,050 for the period July 1, 2023 to June 30, 2024.  At the end of the plan year, up to $610 of unused funds may be carried over for use in the next plan year. The carryover amount can never exceed $610. Any unused funds in excess of $610 at the end of the plan year will be forfeited. 
• The maximum amount you may add to a Dependent Care account is $5,000 per family with no carryover allowed. The grace period for submission of claims is September 15, 2024.
• Enrollment will be processed online through the Ameriflex portal. Instructions for accessing the portal are attached. Please note: When entering your birth date, the slashes must be entered. 
• The portal will close on Friday, June 9, 2023.  No changes will be permitted after June 9, 2023.

• Aetna Medical Plan Claim Form
• Dental Claim Form

• Maternity/Family Leave Overview
• NJ Family Leave Insurance Poster
• NJ Family Leave Website
• NJ Family Leave Application

• Voluntary Benefits - Short/Long Term Disability
• Tax Shelter Providers
• Tax Shelter Application and Changes - OMNI
• Employee Assistance Program
• Benefit Hub (w/ calculator)