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Medical Insurance and Prescription Drug Benefit Plan Document
Summary of Benefits and Coverage for 2024-2025 Transparency In Coverage Health Savings Account (HSA) Salary Reduction Agreement 2024-2025 Enrollment/Waiver/Change Form | Member Portal Program Overview | Incentives List Teladoc Doctor Visit $55 | Teladoc Mental Health $90-$220 | Teladoc Dermatology $85
Notice of Creditable Prescription Coverage for 2024
COBRA Model Notice for 2024 Health Insurance Marketplace (exchanges)
CHIP - Children's Health Insurance Program Women's Health and Cancer Rights Act HIPAA Notice of Privacy Practices
Dental Insurance Summary Plan Description Your Dental Benefits
Enrollment/Change/Waiver Form | Member Portal
Vision Insurance Summary Plan Description Enrollment Form | Member Portal
Voluntary Life Insurance Coverage and Rates Plan Document Enrollment Form
Aflac Insurance Options: Dental, Accident Advantage, Critical Illness, Hospital Choice, Cancer Protection Assurance
Long Term Disability Plan Document LTD Plan Amendment
Short Term Disability Plan Document STD Plan Amendment
Employee Assistance Program Information Log into EAP online: https://nis.lifeworks.com User Name: NISEAP Password: EAP (password is case sensitive)
403(b) Tax Sheltered Annuity
2025 403(b) Universal Availability Notice and 415 Notice
Authorized Vendors List
Summary Plan Description
403(b) Salary Reduction Agreement
Wisconsin Retirement System (WRS)
WRS Benefit Handbook (et-2119)
Beneficiary Designation (et-2320)
Exposure Control Plan