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Benefits Offering Certification
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2021_01 - 2021 _12 Payroll Deduction for Medical and Dental
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Medical Benefits Waiver
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NYSHIP/ Empire Plan
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Emblem Health Plan
- Website: https://www.emblemhealth.com/
- Group Number: 1102081-002
- 2021 Benefits Highlights
- Enrollment/ Change/ Cancel Form
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Delta Dental Plan
- Website: https://www1.deltadentalins.com/
- 2021 Delta Dental PPO Group Number and Division: 070504-0001
- 2021 Delta Care USA (DHMO) Group Number and Division: 01824 - 00001
- 2021 Delta Dental PPO for Administrators only Group Number and Division: 01824- 00003
- Enrollment/ Change/ Cancel Form
- Delta Dental on the go Flyer
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EAP Plan (Employee Assistance Program)
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Long Term Disability for Administrators, Teachers, and Paraprofessionals
- Company: Reliance Standard
- Policy #: LTD117466
- 2021 LTD Benefits
- Enrollment Form
- LTD Claim Form
- LTD Insurance Booklet: Teacher and Nurse
- LTD Insurance Booklet: Administrator
- LTD Insurance Brooklet: Paraprofessionals
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Life Insurance for Administrator only
- Company: Reliance Standard
- Policy #: GL143598
- LTD and Life Insurance Enrollment Form
- Life Insurance Booklet
TRS (New York State Teachers Retirement System)
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- Civil Service Application (link and attached) https://www.rooseveltufsd.org/site/handlers/filedownload.ashx?moduleinstanceid=321&dataid=1450&FileName=civil%20service%20application.pdf
Additional Retirement Plans
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- NYS Deferred Compensation Plan
- 403 (b) and 457 (b) plans
