Printable Claim Forms
- Dental Claim Form
(Please note that some participating providers are now charging a "covid surcharge" above the agreed-upon rate of the Welfare Fund. This fee will not be covered by insurance and will be the responsibility of the member.) - Vision Claim Form
- Hearing Claim Form
- Medical Form Reimbursement 2025
Fee Schedules for 2025-2026
- Benefit Fee Schedule 2025-2026
- 2025-2026 Supplemental Coverage Rates
- 2024-2025 Other Supplemental Coverage
Open Enrollment
September is Open Enrollment Month for members to add eligible spouses and dependents to the Welfare Fund’s Supplemental Dental Coverage
Enrollment for September of 2025 begins Sept 1st and ends on Sept 22nd. All forms and documentation must be received by this date.
- Supplemental Coverage Enrollment Form 2025 – 2026
- Enrollment Documentation Requirements
- Important Information for Dependent Coverage
- Domestic Partner Letter (please call Rose at 636-7999, and she will guide you through the process.)
Benefit and Program Information
Summary Plan Description (SPD) 2022-2023
BENEFITS AT A GLANCE
Statement of Grandfathered Status
UNUM Life Insurance
HIPPA
** EAP Program This program is being provided by the district
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