Employee Benefits Information and Forms

Benefits Forms and Information

• 2022-2023 Active Insurance Rates (MHRDEA)
• 2022-2023 Active Insurance Rates (Admin-Nonunit-Bus)
• PPO Traditional Plan Schedule of Benefits (MHRDEA)
• POS Plan Schedule of Benefits  (MHRDEA)
• POS Plan Schedule of Benefits (Admin/Non-Unit/Bus Drivers)
• Aetna Open Access Managed Choice - NJEHP - Schedule of Benefits
• Aetna Open Access Managed Choice - NJEHP - Booklet
• Aetna Open Access Managed Choice - NJEHP - Overview
• Find a Medication Link
• GSHP - Aetna Whole Health
• GSHP - Savings Plus of NJ
• Payroll Deductions for Additional Benefits 2021-22 Hired On or After 7-1-2020
• Dental Benefits Summary
• Dental Benefits Booklet
• NVA Summary of Benefits 
• 22-23 EP Changing Benefits
• 22-23 EP Waiving Benefits
• Delta Enrollment Form 22-23
• NVA Vision Enrollment Form 22-23
• Health Waiver Form 2022-23
• Aetna Enrollment Change Request 22-23

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

Information on Open Enrollment 22-23

• Open enrollment for the district's Flexible Spending account program for medical & dependent care expenses for the benefit plan year July 1, 2022 to June 30, 2023 will open on Monday, May 16, 2022.
• 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 $2,850 for the period July 1, 2022 to June 30, 2023.  At the end of each plan year, up to $570 of unused funds may be carried over for use in the next plan year. The carryover amount can never exceed $570. Any unused funds in excess of $570 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, 2023.
• 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 10, 2022.  No changes will be permitted after June 10, 2022.

• 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

Other Useful Benefits

• Voluntary Benefits - Short/Long Term Disability
• Tax Shelter Providers
• Tax Shelter Application and Changes - OMNI
• Brown and Brown Advisors - Online Benefits Center
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• Employee Assistance Program