Health & Dental Benefits 

For plan pricing please contact Robin Genetti 851-1172 or see wrap document under benefits description

Evergreen Open Enrollment Notice

Flowchart of how to use your health (including eye exams) and dental insurance.

Insurance card images - which one to use for what

Health (click here for helpful definitions)

• BCBS of VT Benefits Guide
• Premium Grid FY19
• BCBS Enrollment & Change Form
• BCBS Health Insurance Waiver
• BCBS Summary of Benefits and Coverage including HRA Wrap (Printed copies available at no cost from HR)
  • VEHI Platinum
  • VEHI Gold
    • Benefits Description
      • Wrap document for Teachers and Non-Represented employees
      • Wrap document for Represented Support Staff employees
  • VEHI Gold CDHP
  • VEHI Silver CDHP
    • Benefits Description
      • Wrap document for Teachers and Non-Represented employees
      • Wrap document for Represented Support Staff employees
• Telemedicine with Amwell - medical help via computer, tablet or smartphone
  • Link to website and app download instructions
• Medicare, Prescriptions and Creditable Coverage Notice

• Link to VEHI's page and plan details (including video series)

Dental

• Dental Enrollment Form
• Dental Plan Policy Summary
• Dental Plan Policy (complete)
• Dental Waiver of Coverage

FSA, HRA and Dependent Care Claim Forms with DataPath

• FSA Claim Form (you have 45 days to file claims that occured prior to the end of the calendar year OR your date of separation)
• HRA Claim Form
• Dependent Care Claim Form
• Mysource debit card replacement or additional card request form
• Link to DataPath videos that explain these benefits and how they work

Family Medical Leave 

• FMLA - Family Medical Leave Act
• Request for Leave Form
• Return to Work Form

Quick Links

• Open Enrollment
• Health & Dental Benefits
• Employee Assistance
• Retirement Plans
• Life Insurance and Long Term Disability
• Forms
• Discount Programs