Overview

Open enrollment for the 2022-23 school year will begin on May 2, 2022 and will remain open until May 20, 2022 at 4:00 p.m. Please be sure to read the documents in this overview section for more information. 

Benefits Overview

Open Enrollment FAQs and Save the Date

Benefit Enrollment Form/Health Plan Waiver  

Annual and Affordable Care Act Notices

Summary of Benefits and Coverage - Yellow with Choice

Summary of Benefits and Coverage - Yellow

Summary of Benefits and Coverage - Orange

Health Insurance Marketplace Coverage Notice

403(b) Universal Notice

CHIP Notice

Benefit Rate Sheets

SchoolCare/Cigna Medical Plans

HealthTrust/Northeast Delta Dental

Medical Open Enrollment Documents

SchoolCare Annual Open Enrollment Notice

SchoolCare/Cigna Enrollment Guide

SchoolCare/Cigna Open Enrollment Presentation

SchoolCare/Cigna Enrollment/Change Form

Employee Assistance Program

Summary of Medical Benefits

Dental Open Enrollment Documents

HealthTrust Dental Benefits Overview

HealthTrust Enrollment/Change Form

Flexible Spending Accounts (FSAs)

Benefit Strategies Mobile App Directions

JREA/JRAO Exempt Forms

JRSSA Forms

Non-Exempt Forms

Dependent Care Federal Tax Comparison

FSA Eligible Expenses

Flexible Benefit Plan - Summary Plan Description

Adoption Agreement - Cafeteria Plan

JRCSD Formal Record of Action - July 1, 2016

JRCSD Formal Record of Action - May 5, 2021

NH Retirement System

Pre-Retirement Beneficiary Designation Form

Life Insurance, Accidental Death and Dismemberment, and Long Term Disability

Life Insurance and Accidental Death and Dismemberment Enrollment Form

 Mutual of Omaha Beneficiary Designation Change Form

Long Term Disability Enrollment Form

Privacy Notice

Term Life Benefits - Class 1: FT and PT Superintendents

Term Life Benefits - Class 2: FT and PT Administrators

Term Life Benefits - Class 3: FT Exempt Staff

Term Life Benefits - Class 4: PT Exempt Staff

Term Life Benefits - Class 5: Teachers

 Term Life Benefits - Class 6: FT Non-Instructional Staff

 Term Life Benefits - Class 7: FT Non-Exempt Staff

403(b) Plan Documents and Forms

OMNI Group Adoption Agreement - January 1, 2019

403b Plan Hardship and Eligibility Amendments - January 1, 2020

403b Plan Document - January 1, 2019

Change of Address Forms 

SchoolCare Change of Address Form

HealthTrust Change of Address Form

NHRS Change of Address Form

Links to Benefits Websites

Cigna Health Care

SchoolCare

Delta Dental

Benefit Strategies

The OMNI Group 403(b)

New Hampshire Retirement System