THERE ARE THREE REQUIRED FORMS THAT YOU MUST COMPLETE AND SUBMIT TO THE BENEFITS OFFICE WITHIN 30 DAYS OF HIRE TO ESTABLISH YOUR BENEFITS.  

1. Health Insurance Enrollment Form OR

   1 A. Waiver Form if you decline to enroll in District Health Insurance

2. Group Life Insurance Enrollment Form -Required

3. Employee Notification Acknowledgement - Required

4. Limited Use HRA Form - Required & renewed every fiscal year, you will receive an email from the Benefits Manager at renewal time

Optional Benefits

• Pre-Tax Retirement Savings - 403(b) and/or 457(b) Deferred Compensation

• Health and/or Dependent Care Flexible Spending Account

• Commuter Benefit Account

• Employee Assistance Program

DISCLAIMER

Health insurance and benefits for exempt employees are individually negotiated by contract.  Some or all of the information below may or may not be relevant to a specific employee's negotiated contract.  Any information below does not supersede the language of the employee's individually negotiated contract.  

Health Insurance Eligibility

There are 4 premium Highmark of WNY plans for you to choose from. You may choose to have single or family coverage. View the eligibility guidelines to determine who can be considered a dependent for family coverage.  

The effective date of the insurance coincides with your hire date unless you submit your completed enrollment forms more than 30 days post your hire date.  Then, your effective date is the first of the following month.

Comparison of Health Insurance Plans

We are unable to advise in choosing a health insurance plan.  The Patient Protection and Affordable Care Act requires Group Health Plans to provide a Summary of Benefits and Coverage for each available plan. These comprehensive descriptions are designed to provide standardized information for the purpose of comparison. To access the summaries for the plans available to you please click here: Exempt Summary of Benefits and Coverage or contact the Benefits Office via email to request a paper copy.

You can also view a health insurance comparison chart and the complete plan documents are available here:

• Plan A

• Plan B

• Plan C

• Plan D

Traditional Insurance - There is no network to choose from, so this plan provides the flexibility of going to any medical provider.  (It is imperative that I go to Doctor X, no matter what!)

Plan A may work for an employee/dependent(s) who travels extensively, especially internationally, or for someone/dependent who has a unique medical situation for which they need specialized services and/or equipment.  This plan has a $150 single, $300 family deductible (in addition to bi-weekly payroll contribution), which the employee must meet before insurance kicks in.  Please review the services on pages 3 & 4 of the detailed chart that follows, as those tend to require a 20% co-insurance of the cost of the service/procedure/equipment.  This means the District pays 80% of the bill, and the employee is responsible for 20% of the bill (out of pocket maximum is $500 single and $1000 family). PLAN A does not cover Adult immunizations

Point of Service (POS) Insurance – Enrollees must choose from doctors enrolled in the network, or be required to pay co-insurance for the cost of their service.  (It is not imperative that I go to Doctor X, I can find another highly qualified doctor, in my area, that is enrolled in the Highmark network).

Plans B, C, and D may work for an employee/dependent(s) who generally remains in the Western New York region for the majority of their time, and are not experiencing unique medical situations that need specialized services and/or equipment.  These are generic POS plans, with the majority of services requiring a $15 co-pay, which helps an employee/dependent(s) budget for medical costs for the year (x number of doctor’s visits/year x $15 = out of pocket expenses). 

Differences between these three plans are Durable Medical Equipment, Prosthetic Devices, Diabetic Supplies, Skilled Nursing Facilities, and Out of Network (travel and specialization).  You are greatly encouraged to review these differences in the comparison chart (above) and ask yourself questions about your current and future health insurance needs in an effort to decide among the three.

Please be advised that once a plan is chosen, it cannot be changed until our open enrollment period yearly in November.

To find out if a doctor is in the Highmark of WNY network, visit the WNY Network website.

2025.26 Health Insurance bi-weekly deductions effective 7/1/2025

Eligible employees shall contribute to health insurance at the rate of 20% of the cost of the premium. All contributions will be taken pre-tax. 

Plan A - Traditional

Plan B - POS

Plan C - POS

Plan D - POS

Your application will be processed when your appointment is approved by the Board and all completed paperwork and required documentation is received in the Benefits Office.

If you are receiving health insurance coverage from another source: 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.  

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 by completing the form.

The form is listed as 1 A. at the top of this webpage.

Life Insurance is provided at no cost to you.  You are required to have a form on file to identify your beneficiaries. It is also advisable to update this form periodically as you experience life-changing events.  Life insurance is only provided for the employee and ceases upon separation from the District.

Group Life Insurance Enrollment Form

Learn more about your rights to health insurance and benefits, including detailed information on Employee's Responsibility for Health Insurance, Open Enrollment, Summary of Benefits and Coverage, COBRA, HIPAA, the District's Grandfathered Status of the ACA, the Women's Health and Cancer Rights Act, Newborns' and Mothers' Health Protection Act, and Exchange Notice.  Retain this Employee Notification for your records.

Employee Notification Acknowledgement

The District provides you with a Dental/Vision Health Reimbursement Account (HRA). Each exempt employee is credited annually with $1,375 plus an additional $1,000 for each eligible family member. This amount will be pro-rated for the year, based on your date of hire.

This will also be renewed each fiscal year to confirm dependents. You will receive an email at time of renewal from the Benefits Manager.

Any unused funds will be rolled forward and added to your new annual allotment every July 1st.  Funds can be accessed at the point of service using your P&A Group debit card or by requesting reimbursement with a claim form and receipt.  Once your enrollment form is processed, log into WELCOME FROM AMERIFLEX to create and access your account.  Child dependents over the age of 19 are covered to age 25 only if they are full-time students. If any dependents were newly eligible or lost eligibility mid-year, a pro-rated amount was added or subtracted accordingly. 

Limited Use HRA Form

The Flexible Spending Account (FSA) program is a benefit that enables you to SAVE MONEY by placing pre-tax dollars in an account for unreimbursed healthcare or dependent care expenses. Employees determine the amount to contribute for the year via payroll deductions. 

The plan year runs from January 1st through December 31st

HERE’S HOW IT WORKS 

Employees estimate their expenses for the upcoming year, and complete & submit the FSA enrollment form during Open Enrollment.  Effective January 1st, the employee will have access to a Ameriflex debit card and web portal to submit claims associated with qualified expenses for the calendar year.  The pre-tax contribution lowers your personal taxable income, and subsequently, tax withholdings.  

There are two (2) types of Flexible Spending Accounts offered by the District: 

• Health Care (Medical) FSA’s

• Dependent Care (DCA) FSA’s - (THIS ACCOUNT IS FOR DAYCARE, SUMMER CAMP or ELDER CARE PAYMENTS ONLY)

WELCOME FROM AMERIFLEX

Please be advised Flexible Spending Accounts are regulated by the IRS

IRS substantiation guidelines have tightened up. Participants will be receiving more frequent claim substantiation requests to ensure the plan funds are being utilized appropriately. Although an FSA debit card does a good job weeding out most ineligible items/services, there are times when eligible providers provide ineligible services (for example, teeth whitening at a dentist or Botox at a doctor's office). Please note that documentation should be kept for all claims, even if it is not requested, as it will be needed in the event of an IRS audit.

Enrollment

Initial enrollment MUST occur within 30 days of hire or during the open enrollment period (November 1st – November 30th).  Employees determine the amount to contribute for the year via payroll deductions. It is called your annual election. This amount will be pro-rated over the remaining pay periods in the plan year (January 1 - December 31) for newly hired employees or for those who are enrolling due to life-changing events at a time other than the beginning of the calendar year.

EXAMPLE - If you enroll in in October and choose a max amount of $2500, your deductions are calculated using the paychecks you are receiving for the remainder of the calendar year (October, November and December)

Health Care (Medical) FSA

A Health FSA is so much more than Doctor and Prescription Co-Pays.  It’s also for regular expenses associated with: 

• OTC medicine and drugs such as allergy, sinus, cold, and flu products 

• OTC supplies such as skincare products & sunscreen, bandages, contact lens solution & supplies, feminine care products, first aid supplies, pregnancy tests, and reading glasses 

• Prescriptive glasses and contact lenses (even prescriptive sunglasses) 

• Home medical devices such as blood pressure monitors, glucose tests & monitors breast pumps & accessories, and CPAP accessories 

2026 Limits:
Maximum annual election - $3,400 maximum 
Minimum annual election - $200 minimum

You must incur eligible expenses between January 1st and December 31st to be reimbursed from the amount you contribute to your Health Care FSA during your plan year.  There is a $680 Roll-over feature. Up to $660 in unused funds can roll from one plan year to the next. Any excess funds in excess of $680 will be lost. Rollover funds will become available on your TASC Card in April even if you do not re-enroll for the following year. Separation from service is the only circumstance that would prevent you from utilizing the rollover funds in the future.

For more information on Medical FSA click HERE 

All eligible expenses can be found HERE

Complete and Sign ENROLLMENT FORM HERE. If you are signing up for JUST Medical FSA, then just complete that section ONLY.

If you are enrolling in BOTH FSA for medical AND Dependent Care, complete the section for BOTH.

If you are enrolling in FSA for medical, Dependent Care and Commuter (Commuter is for BCSA, PCTEA, Exempt , and BEST only) then complete the section for each one.

Member Online Account Manager Flyer

Member Portal Registration Instructions

Amerifelx Help Center

SUBMITTING A CLAIM

How to submit reimbursement online

Participants can submit manual claims for reimbursement by e-mailing the attached claim form along with an itemized receipt or EOB for the items purchased to: claims@myameriflex.com

There are two ways an employee can submit a claim:
 1) After logging into their online account, the employee can select the plan they want to submit a claim against via their Personal Dashboard. Then choose the File a Claim button where they will be asked to Pay Myself or Pay my Provider.

• If an employee is reimbursing themselves, they will select Pay Myself, select the Account Type, then upload an itemized receipt or Explanation of Benefits (EOB) with all required information noted on the itemized receipt or EOB.

• If an employee would like us to reimburse their provider directly, they will select Pay my Provider, enter their provider’s information, then upload an itemized receipt or Explanation of Benefits (EOB) with all required information noted on the itemized receipt or EOB.
   

2) Employees can also submit their claims via our MyAmeriflex Mobile App available on the App Store or Google Play.

We highly recommend employees sign up for our direct deposit option for fast turnaround times on receiving their reimbursements. Banking information can be entered by clicking on the More drop down in our online portal, then selecting Reimbursement Settings.

Dependent Care (DCA) FSA

Expenses that are eligible for reimbursement include such items as childcare and eldercare services.  The Dependent Care FSA can help you pay your eligible out-of-pocket dependent care costs. Expenses are limited to household services or the care of one or more qualifying individuals (i.e., a dependent child less than age 13 or a dependent adult), while you are at work.

2026 Limits:
Maximum annual election - $7,500 (if single or if married and filing jointly)
Maximum annual election - $3,750 (if married and filing separately) 
Minimum annual election - $200

The Dependent Care Flexible Spending Account plan has a grace period of 75 days.  This means that any funds from your previous years' account remaining after December 31st can be used for any qualifying purchase for up to 75 days in the following year. 

Reimbursement Claim Forms must be submitted by March 31st.  

For more information on DCA click HERE

Complete and Sign ENROLLMENT FORM HERE. If you are signing up for JUST Dependent Care, then complete that section only.

If you are enrolling in BOTH FSA for medical AND Dependent Care, complete the section for BOTH sections.

If you are enrolling in FSA for medical, Dependent Care and Commuter, (Commuter is for BCSA, PCTEA, Exempt , and BEST only) then complete the section for each one. then complete the section for each one.

LIFE QUALIFYING EVENTS
Qualifying life events can occur that alter your necessary Flexible Spending coverage. The birth of a child, marriage, or a change in employment, will all affect coverage for your FSA plan. When such an FSA qualifying event occurs, you are allowed to make a mid-year election change to your FSA.  Use the enrollment form at the top of the page to create an account or change your annual limit. 

Detailed information can be found by clicking HERE.

RESOURCES TO DETERMINE IF AN FSA IS RIGHT FOR YOU! 
When you enroll in an FSA, you receive the Ameriflex Benefits Card.  This is a convenient debit card that can simplify the process of paying for eligible expenses under your FSA, such as co-payments, prescriptions, glasses, dental expenses, and more. 

For more information and the enrollment form on the Commuter Benefit Plan, please click below.

For more information on Tax-Shelter Annuity Accounts and how to enroll, please click below

The District provides an EAP service that provides free & confidential services to our employees and their family members who may be experiencing personal &/or work-related issues. 

For more information regarding our EAP, please click below

In June 2017, the Buffalo Board of Education approved the District Wellness Policy.  The District recognizes that in order to achieve student wellness, well-being and academic success employee wellness must also be stressed, emphasizing the importance of creating a District-wide workplace culture that supports employee health and wellness.