Indian Prairie School District 204

• Medicare Part D Creditable Coverage Disclosure Notice 
• Women's Health Act 2007 
• Notice of Privacy Practice 

Medical.
Our medical plan is available to all employees who work 30 or more hours/week. The plan, which includes medical/vision/prescription drugs, is administered by BlueCross BlueShield of Illinois (www.bcbsil.com). The pharmacy portion of the plan is administered by Prime Therapeutics. The following documents and forms are available by clicking on the link above.

• Blue Cross Blue Shield of Illinois 2008 Plan Document
• BCBSIL Claim Form
• Prime Therapeutics Prescription Drug Reimbursement Form
• Prime Therapeutics Pharmacy by Mail Form
• Changes to Medical Plan Enrollment (As of 09/07/07)
• $150 Physical Limit
• Medical and Dental Insurance Change Form

Dental.
Our dental plan is plan is available to all employees who work 30 or more hours/week and is administered by Guardian Life Insurance Company (www.guardianlife.com).

• Guardian Dental Plan Document
• Guardian Dental Claim Form

Flexible Spending Accounts (FSA).
Healthcare and dependent care flexible spending account plans are available to all employees who work 30 or more hours/week. The FSA plans are administered by PayFlex Systems USA (www.mypayflex.com). FSAs give employees a way to reimburse themselves for medical, dental, vision and/or dependent care expenses using money deducted from their checks on a pre-tax basis.

• PayFlex - Year End Grace Period FAQ
• PayFlex - Flex Spending Information Booklet
• PayFlex Reimbursement Claim Form

Life/AD&D Insurance and Long-term Disability Insurance. 
These plans are administered by Lafayette Life Insurance. All employees who work more than 30 hours per week are automatically enrolled in these plans.

• Life Insurance Booklet - Certified Administrators
• Life Insurance Booklet - Non-Certified Administrators
• Life Insurance Booklet - Teachers
• Life Insurance Booklet - Classified Employees
• Long-Term Disability Booklet