There are two (2) health insurance plans available.

Please note that the Benefits Department cannot recommend or advise you on which health insurance plan to select. To help determine which plan best meets your needs, you may:

Review plan information on the Cook Manager Benefits Page
Contact Highmark and speak with a dedicated BBOE representative.

Open Enrollment Instructions

There are five (5) Open Enrollment options available. Select the option that best matches your enrollment needs.

IMPORTANT: Complete only one of the five options below. Submitting multiple Open Enrollment forms may delay processing or result in your election not being processed.

Option #1: Change Your Health Insurance Plan

Choose this option if you are changing your current health insurance plan but are not adding or removing dependents and are not changing between single and family coverage.

Complete:
2027 Open Enrollment - Change of Health Insurance Plan

You will need:

Employee ID Number
Highmark Member ID Card

Option #2: Add or Remove a Dependent

Choose this option if you want to add or remove dependent(s) from your current health insurance coverage and are not changing plans.

Complete:
I am adding/removing a dependent to my health insurance BUT keeping the same plan

You will need:

Employee ID Number
Social Security Number (SSN)
Highmark Member ID Card

Required Documentation

Documentation verifying dependent eligibility must be attached.
Examples include:
- Birth certificate
- Marriage certificate
- Other documentation establishing eligibility
SSN of dependents
Date of Birth of dependents

Applications submitted without the required documentation will be declined.

Additional Reminder

Consider reviewing and updating your life insurance beneficiary designation if you are adding or removing dependents. To access the required Life Insurance form, click here -> Group Life Insurance Enrollment Form

Option #3: Change Your Plan and Add or Remove Dependent(s)

Choose this option if you need to change your health insurance plan and add or remove dependent(s) at the same time.

Complete:
I am adding/removing a dependent to my health insurance and changing my insurance plan

You will need:

Employee ID Number
Social Security Number (SSN)
Date of Birth (DOB)

Required Documentation

Documentation verifying dependent eligibility must be attached.
Examples include:
- Birth certificate
- Marriage certificate
- Other documentation establishing eligibility
SSN of dependents
Date of Birth of dependents

Applications submitted without the required documentation will be declined.

Additional Reminder

Consider reviewing and updating your life insurance beneficiary designation if you are adding or removing dependents. To access the required Life Insurance form, click here -> Group Life Insurance Enrollment Form

Option #4: Health Insurance Waiver Program

Choose this option if you have health insurance coverage through another source and wish to waive District health insurance coverage.

Complete:
Health Insurance Waiver Program

Important Information

Waiver payments are issued each January for the prior calendar year.
If you are already enrolled in the Waiver Program, you do not need to re-enroll during Open Enrollment.
You will remain enrolled in the Waiver Program until:
- You elect District group health insurance coverage, or
- You separate employment from Buffalo Public Schools.

Option #5: Enroll in Health Insurance

Choose this option if you are not currently enrolled in District health insurance and would like coverage.

Complete:
I am not currently enrolled in health insurance and would like to enroll

You will need:

Employee ID Number
Social Security Number (SSN)
Date of Birth (DOB)

Required Documentation

Documentation verifying dependent eligibility is required when enrolling in family coverage.
Examples include:
- Birth certificate
- Marriage certificate
- Other documentation establishing eligibility
SSN of dependents
Date of Birth of dependents

Applications submitted without the required documentation will be declined.

Before enrolling, review the health plan options available through the Cook Manager Benefits Page.

Employee Health Insurance Contribution Rates

Employees Hired On or After July 1, 2012

Eligible employees hired on or after July 1, 2012, contribute 20% of the cost of the Base Plan premium.

Employees who elect the Enhanced Plan are responsible for:

Contributing 20% of the Base Plan premium, plus
Paying the difference in premium cost between the Base Plan and the Enhanced Plan.

Payroll Deductions

All health insurance contributions are deducted on a pre-tax basis.
Contributions are spread over the fiscal year's payroll schedule.
Health insurance deductions are taken over 21 paychecks during the school year.

BUFFALO

Local 264 Cook Managers Open Enrollment

HEALTH INSURANCE • FLEXIBLE SPENDING • DENTAL INSURANCE

Health Insurance/ Waiver

Flexible Spending Account

Dental Insurance/ Waiver