Employee Insurance Enrollment Information

If employment commences on the first of the month, benefits will be effective on the first day of the same month.

If employment commences after the first day of the month, benefits will be effective the first of the month following employment. 

Employee Insurance and Benefits Enrollment Forms 

2022 -2023 Comprehensive Insurance and Benefits Enrollment Packet – Coming Soon
This comprehensive packet provides an overview of the district-wide benefit and insurance options available to eligible employees. For specific information regarding the benefits in this packet, visit the Employee Insurance and Benefits page.

Insurance and Benefits Enrollment/Change/Cancellation Request Form

Important Information About Insurance 

Following a recommendation by the Insurance Committee, the School Board has approved remaining with United Healthcare (UHC), Delta Dental, and VSP for the new plan year starting on July 1, 2022.  All employees and early retirees will begin paying their new premium amounts on July 1, 2022.  Deductibles and Out-of-Pocket Maximums are calculated on a calendar basis from January 1 – December 31.

Insurance for 2022-2023 Plan Year at a Glance

Insurance Company Changes 
Health  UnitedHealthCare

6% premium increase & no plan design change

Dental Delta Dental 

No premium change & no plan design changes

Vision VSP 

No premium change & no plan design changes



Vendor change to UHC with plan design changes

Long Term Disability (LTD)

Madison National Life (MNL)

No premium change & no plan design changes. 



Plan Year: 7/1/2022 – 6/30/2023
(Must fill out a new form every year)

Health Premium Changes 

    Plan Year 2021-2022 Plan Year 2022-2023
Value Plan ($1,500 Deductable) Employee Only



EE + Spouse



EE + Child(ren)



EE + Family (SP + CH)



High Deductible ($3,500 Deductable) Employee Only



EE + Spouse



EE + Child(ren)



EE + Family (SP + CH)



Health Plan Design Comparison

Single Medical Coverage Value HDHP
Deductible  In-Network $1,500 $3,500
Doctor Office Visit Co-Pay In-Network $25 Deductible
Virtual Visits In-Network $0 Deductible 
Specialist Co-Pay In-Network $40 Deductible
Coinsurance After Deductible  In-Network 80% / 20% Deductible
Out of Pocket Maximum In-Network $3,500 $3,500
Prescription Drug Coverage Value HDHP
Tier One $10 Deductible
Tier Two $30 Deductible
Tier Three $50 Deductible
Plan Year 2021-2022
No premium change
No design change
Employee Only $33.00
+1 Dependent $61.00
+2 Dependents $90.00
+3 or More Dependents $123.00
Plan Year 2021-2022
No premium change
No design change
Employee Only $7.09
+1 Dependent $12.88
+2 Dependents $19.73

SUPPLEMENTAL LIFE (includes matching AD&D)

Plan Year 2022 – 2023

No premium change                                                 New benefit amounts available for election














Plan Year 2022 – 2023

No premium change
No design change

The LTD plan is voluntary (100% paid by the employee).  Rates are based on employees’ age and salary. 

Life Insurance – What’s New Starting July 1, 2022

With our change in life insurance carriers to UHC, the District is now able offer the following basic life insurance to employees:

  • $75,000 for Administrators and Associate Professionals
  • $30,000 for SCEA, SCESPA, Transportation, Food Service, O & M, ESSP, and ESC Admin. Assistants

In addition, starting this July 1st, all employees can elect supplemental life insurance in the following amounts:




Now is a great time to add or increase supplemental life insurance coverage, because no underwriting is required during this open enrollment period only (unless previously declined supplemental life coverage). 

Flex Plan Information

You are required to fill out a new Flex Enrollment Form for the plan year that starts July 1, 2022, and ends June 30, 2023.  If you do not fill out a flex form for the new plan year, you will not be enrolled with the Flexible Spending Account for the 2022 – 2023 plan year. 

Filling out Benefit Enrollment Forms

Please follow these steps to ensure that you are completing your forms correctly.

  1. Review information in Section 1 of the Benefits Information Enrollment Form.
  2. If you do not want to make any changes to health, dental, vision, life, or LTD coverage (including covered dependents), checkmark the box toward the middle of the page, then sign and date in Section 5 and return to Human Resources.
  3. If you do want to make changes (including adding or increasing supplemental life), you will need to turn the form over and complete the other side.
    1. In Section 2, you will need to checkmark all benefits you are electing for 2022-23, and enter information about the dependents you wish to cover.
    2. You will only sign Section 3 if you are electing to waive any of your current coverage.
    3. Sign and date in Section 5.
    4. Return form to Human Resources at the ESC.

If you do not submit your Benefit Information Enrollment Form or Flex Enrollment Form by May 31 Human Resources will assume that you have no change in your medical, dental, vision, life, or LTD coverage for the 2022-23 benefits plan year, and will have no Flex plan benefits.  Please note that this is the only time you can make changes to your insurance coverage, other than through a qualifying event.

Kim Smith, Benefits Manager
712-279-6692 Ext. 6121

Paul Logsdon, Benefits Administrative Assistant
712-279-6692 Ext. 6120