Employee Benefits
Employees may choose to enroll in any combination of the benefits listed below.
Health Care
Excellus Blue Cross & Blue Shield - Liverpool offers employees a comprehensive medical and prescription drug plan through Excellus Blue Cross Blue Shield. Open enrollment is December with the effective coverage date of January 1. The health plan consists of four parts:
- Blue Cross covers Hospitalization
- Blue Shield covers Medical/Surgical Benefit
- Major Medical covers Enhanced Medical Benefits
- Prescription Drugs
Please notify Tracy Sheridan of any changes listed below by calling 315-622-7978 or e-mailing her at tsheridan@liverpool.k12.ny.us:
- Change of coverage (for example individual to family or vice versa)
- Name or address changes
- Add a new spouse within 30 days of the date of marriage (a copy of the marriage license is required)
- Add a new baby within 30 days of the baby's birth (a copy of the birth certificate is required)
Excellus forms:
- Excellus Enrollment Form
- Excellus Shared Information Authorization
- Excellus Prescription Claim Form
- Excellus Claim Form
Dental Care
Guardian - Guardian is the dental plan offered to Liverpool employees. Summary Plan documents are available by calling the Human Resources office at 315-622-7978. Claim forms are available in each building, on the Guardian website or below.
Guardian forms:
- Guardian Plan Information Booklet
- Guardian Enrollment Form
- Guardian Claim Form
- Dental Dependent Eligibility Certification Form
Life Insurance
MetLife - All eligible employees can purchase a group term life insurance plan through Metropolitan Life Insurance. Contact the Human Resources Office at 315-622-7978 for more information.
Flexible Spending Account
Preferred Group Plans, Inc. - Use the Preferred Group Plans, Inc. website to find out how you can save 30% to 40% by using pre-tax dollars to pay for out-of-pocket dependent day care, medical, dental and vision expenses and insurance premiums. Enrollment is during the month of December for the next calendar year.
Flex Plan forms:
- Flex Plan Change in Status
- Flex Plan Reimbursement Voucher
- Flex Plan Termination from Service
- Flex Plan Q & A Brochure
- Flex Plan Over the Counter Products Guidelines
- Flex Plan Claim Submission Guidelines
Family and Medical Leave Act
Family and Medical Leave Act - FMLA is designed to help employees balance their work and family responsibilities by allowing them to take reasonable unpaid leave for certain family and medical reasons. It also seeks to accommodate the legitimate interests of employers and promote equal employment opportunity for men and women. FMLA applies to all public agencies, all public and private elementary and secondary schools, and companies with 50 or more employees.
Related Files | |||
Excellus Enrollment Form | 210 KB | ||
Excellus Prescription Claim Form | 75 KB | ||
Excellus Claim Form | 117 KB | ||
Excellus Shared Information Authorization | 383 KB | ||
Flex Plan Change in Status Form | 25 KB | ||
Flex Plan Reimbursement Voucher | 343 KB | ||
Flex Plan Termination of Service Form | 92 KB | ||
Flex Plan Claim Submission Guidelines | 252 KB | ||
Flex Plan Over the Counter Products Guidelines | 70 KB | ||
Flex Plan Q & A Brochure | 2.2 MB | ||
Guardian Enrollment Form | 281 KB | ||
Guardian Plan Information Booklet | 286 KB | ||
Dental Dependent Eligibility Certification Form | 29 KB |