WP2018 Retiree Index

WP-2018 Retiree 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 questions after reviewing the items below, please contact Lucas.Deborah@brevardschools.org  or call (321)-633-1000, extension 648.   


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


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.











Life Insurance






Authorization for Release of Health


Benefits Enrollment Form 2018


Life Enrollment Form


Affidavit for Spouse


Affidavit Age 26-30 Dependent for OE 2018


Retiree Beneficiary Change Form


Retiree FRS - TASC Deduction Authorization Form



Medical Appeal Process


Retiree Benefits Guidebook


Creditable Coverage Disclosure Notice - Medicare


Flu Vaccination Participating Pharmacies


Preferred Health Centers Listing


Procedures for RETIRING Employees


Retiree Benefit Rates


Vendor Phone Numbers & Websites


Save money in the BPS Health Plan with these Wellness Activities

 Health Assessment Information


How to Complete the Health Assessment as a Retiree


How to Complete the Health Assessment if you

are a SPOUSE








Letter sent to Retirees about the new PCP Biometric Screening Form


Important Notice



 Biometric and Health Assessment


Current Retirees: Deadline to complete both the

biometric and health assessment is 11/15/18 for a savings in the 2019 year.


Please read the following carefully and select the

Biometric Screening document that applies to YOU:


A. If you are a retiree who's making a Family Status Change, use the following documents:



B. If you currently have the BPS Health Plan and will be enrolling again in 2019, be sure to complete a biometric screening at a BPS Well-Care Center, using the following documents:




C.  If you wish to visit your doctor to complete the biometric screening, it must be done during your annual physical, using the BPS biometric Screening Form:




FSRBC - Medicare Enrollments


If you are a retiree or have a dependent with Medicare, please contact FBMC at 1-855-443-7722

Monday-Friday 7 a.m - 7p.m. OR visit  them online at www.myfsrbc.org








Retiree Postcard Mailed

Open Enrollment Password and Instruction Letter

Retiree Enrollment Form

Affidavit - Dependent 26-30 (non-disabled)

Spousal Affidavit





New Requirements for Reduced Calander-Year Deductible in the BPS Health Plan














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