WP2017 Active Index

WP-2017 Active Index



The information provided herein is a summary of a portion of our benefits plans.  Should there be a discrepancy between this information and the Medical Summary Plan Description (SPD) or specific contracts for benefits, the SPD or contracts prevail.



 If you cannot find the answers to your enrollment questions after reviewing the items below, please call (321) 633-1000, extension 216


 To review your benefits at any time, click here: www.easybenefits.com



   2017 Benefit Guide Flip-Book    2017 Benefit Guide Book (pdf format)





EAP (Employee Assistance Program)








Life Insurance and AD&D


Short/Long-Term Disability 


Flexible Spending Accounts 








Affidavit - Dependent Age 26-30 (non-disabled)


Affidavit - Spouse Surcharge


 Attestation of Dependent Eligibility to Enroll a Grandchild


Authorization for Release of Health Information


Beneficiary Form


Benefits Change Form (2017)


Proof of Handicapped Disability

1095-C Educational Flyer


Appeal Process


Benefit Changes Due to Qualifying Events


Benefit Specialists Site Listing Num/Alpha


Benefits Guidebook


COBRA Booklet


Cost Per Pay Period


Enrollment Information Document


Flu Vaccination Participating Pharmacies


Frequently Asked Questions


How to Change Your Beneficiaries


Medicare and You as an Active Employee


Preferred Health Centers - When & Where 

To Go 


Preferred Health Centers Listing


Procedures for RETIRING Employees


Vendor Phone Numbers & Websites



Employee Benefit Required Notices











    What is a Combined Household


    How to Complete the  Health Assessment as an Employee


    How to Complete Your Health Assessment If You Are a Spouse in a Combined Household


    Sample LOA Memorandum





    Click here for the Site Biometric Schedule for the 2018 Open Enrollment






    Health Assessment FAQ's 


    Cigna Wellness Screening Form


    Please read the following carefully and select the Biometric Screening Document that applies to YOU:


    -If you are a New Hire, or you are making a Family Status Change, use the following documents: 




     -You can make an appointment with Joni, our Cigna on-site health coach to complete most of the biometric screening, then use the lab voucher for the cholesterol test.  You may reach Joni by phone at (321) 633-100, ext. 219 or via email:  Joni.Deblecourt-Whelen@Cigna.com


    -If you wish to visit your doctor or a BPS Well-Care Center to complete the biometric screening, you will need to print out and take the BPS Wellness Activity/Biometric Form and the Cigna Wellness Screening Form to your appointment. 




    For help finding a Wuesthoff Lab site, click on the following document:



    Each lab voucher is for a specific situation, please understand the employee’s circumstances before printing out the forms.  






      If you have changed your address, you must login to MIC (My Information Center) and change you address there so that you may continue to receive important information sent by our insurance vendors.  To access MIC, go to the District homepage, hover over STAFF from the top menu, then select "My Information Center".  The system will prompt you with further directions to log in to MIC.


            Benefits Homepage      



      The information provided herein is a summary of a portion of our benefits plans.  Should there be a discrepancy between this information and the Summary Plan Description (SPDs) or specific contracts for benefits, the SPDs or contracts prevail.