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Sussex-Wantage Regional School District

Achieving Excellence

2019-2020 Annual Notice Compliance Guide

Pages 23 (Notice of Unavailability), Pages 24-25 (Notice of Early Termination), and Page 26 Notice of Insufficient Payment, are examples of situations and the notices that would be sent out by OCA Cobra.

2019-2020 SWBOE Annual Notice Compliance Guide.pdf 1.88 MB (Last Modified on May 6, 2019)

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MEDICARE PART D - Creditable Coverage Notice

Page 37 of the Annual Notice Compliance Guide

2019-2020 SWBOE Annual Notice Compliance Guide.pdf 1.88 MB (Last Modified on May 7, 2019)

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Superior Vision Benefit Summary - 2019

Superior Vision Benefit Summary - 2017.pdf 143.17 KB (Last Modified on December 18, 2017)

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Superior Vision Enroll - Change Form - 2019

Superior Vision Enroll - Change Form - 2017.pdf 186.76 KB (Last Modified on December 18, 2017)

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SWBOE-Delta Dental Enrollment form

SWBOE-DeltaDental Enrollment form.pdf 16.8 KB (Last Modified on September 12, 2017)

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SWBOE-2019-2020 Phase 4 MedRxDent Ch 78F Calculator

SWBOE-2019-2020 Phase 4 MedRxDent Ch 78F Calculator.xlsx 24.51 KB (Last Modified on May 2, 2019)

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SWBOE-2019-2020 Open Enrollment Memo 1

SWBOE-2019-2020 Open Enrollment Memo.pdf 370.54 KB (Last Modified on May 2, 2019)

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Sussex Wantage BOE Dental Benefit Summary

SussexWantageBOE Dental Benefit Summary.pdf 14.49 KB (Last Modified on September 12, 2017)

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Sussex Wantage BOE 85107 RX1 $10 $20 $40 RX benefit outline

Sussex Wantage BOE 85107 RX1 10 20 40 RX benefit outline.pdf 18.46 KB (Last Modified on December 1, 2017)

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Sussex Wantage BOE 85107 $15 $25 $40 RX benefit outline

Sussex Wantage BOE 85107 15 25 40 RX benefit outline.pdf 18.48 KB (Last Modified on September 12, 2017)

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SECT125PartWaiverform-SWBOE 2019-2020

SECT125PartWaiverform 2019-2020.pdf 8.6 KB (Last Modified on May 2, 2019)

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Plan Options Presentation 2019-2020

Plan Options Presentation 2019-2020.pdf 4.18 MB (Last Modified on May 2, 2019)

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Horizon PPO Benefit Summary

Horizon PPO Benefit Summary.pdf 26.32 KB (Last Modified on September 12, 2017)

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Horizon EPO Benefit Summary

Horizon EPO Benefit Summary.pdf 25.83 KB (Last Modified on September 12, 2017)

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Horizon enrollment application-fillable 2019-2020

Horizon enrollment application-fillable 2019.pdf 489.86 KB (Last Modified on May 2, 2019)

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Horizon DA Benefit Summary

Horizon DA Benefit Summary.pdf 27.8 KB (Last Modified on September 12, 2017)

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Information for Employees who Marry

Information for Employees who Marry.pdf 271.03 KB (Last Modified on September 8, 2017)

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