BPS Employees:

Have you recently experienced a change in your situation – like getting married, having a baby, or losing health insurance coverage?  If so, this can make you eligible for a special enrollment period, allowing you to enroll in health insurance outside of the yearly Open Enrollment Period.

Please be advised, you CANNOT change your current plan, you can only add/drop dependents. These forms may not be used to change your plan of benefits. 

Open Enrollment is held every November and is the only time you may elect to change your plan. It is also the time when you can add dependents that were not added within 30 days of the event such as marriage or loss of insurance.

The Benefits Office must be notified within 30 days of any life-changing event. Informational packets, complete with the necessary forms, are available by clicking on the hyperlinks below.  

INSTRUCTIONS ON HOW TO COMPLETE AND SUBMIT ELECTRONIC FORMS HERE

Life Qualifying Events include:

Divorce – your former spouse (and stepchildren, if applicable) becomes ineligible for the District health insurance plan on the date of your divorce. It is your responsibility to notify the Benefits Office and complete appropriate paperwork within 30 days of the date of your divorce – even if your divorce decree provides for coverage beyond the date of your divorce. Under no circumstances is the District liable to provide coverage for your former spouse. COBRA will be available as an option for continuing insurance, if necessary. Be sure to update your life insurance beneficiary if needed. Please be advised, you CANNOT change your current plan, you can only drop dependents.

Marriage - your new spouse (and stepchildren, if applicable) becomes eligible for the District health insurance plan on the date of your marriage. It is your responsibility to notify the Benefits Office and complete appropriate paperwork and submit documentation within 30 days of the date of your marriage. Please be advised, you CANNOT change your current plan, you can only add dependents.

Waiver Form - If you are receiving health insurance coverage from another source then you are eligible to participate in the Waiver Program, which entitles you to $100 per month in-lieu of health insurance. This benefit is time-sensitive and not retroactive. There is one annual payment in the month of January for the previous years' participation.

If you are married to a Board of Education Employee you are only eligible for one family policy. The employee not enrolled in health insurance may take advantage of the Waiver Program

Birth/Adoption/Guardianship - your child becomes eligible for the District health insurance plan on the date of its birth.  It is your responsibility to notify the Benefits Office and complete appropriate paperwork within 30 days of your child's birth.  Copies/photos of the child's birth certificate and social security cards must be turned into the Benefits Office as soon as they are received (may exceed the 30-day deadline if the processing is slow). Please be advised, you CANNOT change your current plan, you can only add dependents.

Loss of insurance by eligible dependent - your dependent becomes eligible for the District health insurance plan effective the date of loss by another source.  It is your responsibility to notify the Benefits Office and complete appropriate paperwork and submit documentation within 30 days of the date of loss of insurance.

Employee Turning 26 and Aging off Parent's Insurance - Employees who turn 26 age off of their parent's plan the first day of the month after their birthday.  It is your responsibility to notify the Benefits Office and complete appropriate paperwork and submit documentation within 30 days of the date of loss of insurance. (Please use the new hire packet associated with your union, found at  Benefits , to learn about your health insurance choices and complete and submit enrollment form from your union's packet).

Remove Dependent - Has Their Own Insurance -   For employees whose dependents turn 26, the district will automatically cancel their insurance effective the last day of their birth month, and send COBRA and NYS Marketplace information via US Postal Service.  Please be sure to notify the Benefits Office if your coverage will change from family to single due to a dependent turning 26.

If your dependent obtains health insurance through another source, it is your responsibility to notify the Benefits Office and complete appropriate paperwork and submit documentation within 30 days of the date of obtaining insurance.

Contact Update - Change of Name/Address or Telephone#

Death of a Dependent - While we understand that this is a very difficult time should you experience the unfortunate loss of a covered dependent, there are forms that must be completed to update your records.  

Complete forms using Adobe Sign and submit with your uploaded documentation of dependent eligibility. 

If you are adding a dependent through birth or adoption, enroll the child within 30 days and take photos or scan required documentation once it is received to:

Email: Benefits@buffaloschools.org 

Fax: 716-851-3587

Mail via US Postal Service:

Benefits Office

Room 806 City Hall

Buffalo NY 14202

RELATED FILES

• Loss of Insurance Packet

• Contact Information Change Packet

• Aging Off or Has Own Insurance Packet

• Change Form

• Death of a Dependent Packet