Benefits, Links & Forms

FCPS Wellness Expo

The purpose of this event is to engage and educate our employees while encouraging healthy lifestyle behaviors. We are partnering with United HealthCare and benefits vendors to offer various health screenings as well as fun activities to promote mental, financial, and physical wellness.

Register online and attend the event to be entered into the drawing to win $100 in your paycheck! Three lucky FCPS staff will be selected in the drawing.

Wednesday, April 5, 4-6:30 PM at GTJHS

Health & Wellness Expo Registration


What's New

 

Employee Notice about IRS Tax Form 1095C, December 2016

DPP Brochure
DPP Schedule

FY17 Projected Active Rates
FY17 Projected Retiree Rates

FY17 Benefits Information Packet

ACA Marketplace Exchange Notice

UnitedHealthcare Incentive Program


Forms

403(b) Payroll Authorization
403(b) Roth Payroll Authorization
403(b) Transaction Routing Request
Benefits Enrollment/Change Form
Compensatory Time Record
Coursework Approval
CVS Reimbursement Claim Form
CVS Mail Order Form
Dependent Care Reimbursement Form
Delta Dental Claim Form
Direct Pay
Direct Deposit Authorization
Employee/Supervisor Statement of Illness/Injury
FMLA Certification of Healthcare Provider - Employee
FMLA Certification of Healthcare Provider - Family Member
Life Insurance Beneficiary Form
Leave Request Form
Light Duty Time Record
Online Pay Instructions
Online Pay Advice Activation
Projected Maternity/Parental Leave Form
SRA Application for Estimate of Service Retirement Allowance
SRA Form 4-Designation of Beneficiary Form
SRA Form 26-Request to Purchase Service
SRA Form 46-Qualifying Approved Leave of Absence
Time Sheet
Tuition Reimbursement for Certificated, AMT and A&S
Tuition Reimbursement for Support staff
UHC Claim Form
Vision Out-of-Network Claim Form


Contact Us

Benefits Office Contacts


General Info

FY17 Leave of Absence and COBRA Rates
COBRA Initial Notification
Insurance Company Contacts
HIPAA Privacy Statement
Comprehensive Group Health Plan Benefit Communications
 


United Healthcare

United Healthcare

http://www.uhc.com
http://www.myuhc.com
(877) 702-5116

UnitedHealthCare Benefits-at-a-Glance
How to log onto Virtual Visits
Virtual Visits Frequently Asked Questions (FAQ)
NEW Breast Pump Benefit available as of 7/1/2016
UHC Summary Plan Description
UHC Summary of Benefits
Health Discount Program
Healthy Pregnancy Flyer
Find a UHC Physician or Facility
My United HealthCare
Personalized Health Assessment
UHC Guide to Programs & Services
UHC Medical Claim Form
UHC Sherpa - Your Guide in Difficult Times
UHC Sherpa Frequently Asked Questions
United Healthcare Incentive Program
United Healthcare Virtual Visits
United Healthcare Virtual Visits - How to Access
United Healthcare Virtual Visits - FAQ

UnitedHealthcare offers free NurseLine Services to FCPS health plan participants and covered dependents 24 hours a day, 7 days a week. Get answers about medical conditions and medications plus help choosing appropriate medical care, understanding treatment options and finding a doctor and/or hospital. To speak with a registered nurse: 1-800-846-4678.


United Behavioral Health

www.liveandworkwell.com
(877) 702-5116

Mental Health Parity
UHC Behavioral Health Claim Form
How to Submit a Behavioral Health Claim


United Healthcare Vision

http://www.myuhcvision.com
(800) 638-3120

Vision Plan Summary
Costco: A New Vision Provider
Contact Lens Formulary List
Lasik Plus Information
Out-of-Network Claim Form


CVS Caremark

http://www.caremark.com

(866) 260-4646

http://fcps.silverscript.com
(for retirees only)

(866)785-5711

Caremark Phone App Flyer
CVS Mail Order Form
CVS Reimbursement Claim Form
CVS Mail Order User's Guide
Guide to Generic Drugs
Maintenance Choice
Prescription Drug Program Information
October Formulary Drug List
2017 Formulary Drug List
 


Delta Dental

http://www.deltadentalins.com 
(800) 932-0783

Dental Buy Up Option
Enhanced Delta Dental Online Directory
Enrollee Rights & Privacy Practices
Dental Plan
Delta ID Card Update
Delta Dental Claim Form
Delta Dental Website Info
How to Print an ID Card
Using Your Plan
Diabetes and Oral Health
Enhanced Dental Benefits for Pregnant Women
SmileWay Wellness Newsletter
Taking Care of Your Child's Teeth
The Medical-Dental Connection
Read our latest issue of Grin!


AxisPlus Flexible Spending Account

AxisPlus Benefits
(877) 872-2125

Cafeteria Plan at a Glance
AxisPlus FSA Plan Summary
Flexible Spending Frequently Asked Questions
AxisPlus Benefits Eligible Expenses
AxisPlus Benefits Reimbursement Brochure
AxisPlus Benefits Savings Brochure
 


Life Insurance


(800) 628-8600

Life Insurance Overview
Group Term Life Insurance Certificate
 


Leave Programs,Family Medical Leave, and Regulations

Annual, Personal, Sick
Disability
FY17 Leave of Absence and COBRA Rates
FMLA Certification of Healthcare Provider - Employee
FMLA Certification of Healthcare Provider - Family Member
FMLA-Family and Medical Leave Act
Holidays
Leave Options
Leave Request Form
Other Paid Leave
Regulation 300-42 (FMLA)
Regulation 300-28 (Return to Work)
WC & FMLA Presentation


 Tuition Benefits


NEW Online Course Approval/Direct Pay System Information

Direct Pay Program Information
Direct Pay Program Deadlines
Frequently Asked Questions
FCPS Tuition Benefits A&S AMT FCASA
FCPS Tuition Benefits Certificated FCTA
FCPS Tuition Benefits Support FASSE
Certification Renewal Requirements

Forms:
Direct Pay
Coursework Approval
Tuition Reimbursement for Certificated, AMT and A&S
Tuition Reimbursement for Support staff


Retiree Information

FY17 Projected Retiree Rates
Retiree Dental Buy Up Enrollment Form
Generic Step Therapy & You
Medical Necessity Frequently Asked Questions
Retiree Dental Plan
Retiree Dental Plan Buy-Up Option


Pension Plans

www.sra.state.md.us
(800) 492-5909

Retirement Notification Incentive Q&A
Application for an Estimate of Service Retirement Allowance
SRA Form 4-Designation of Beneficiary Form
SRA Form 26-Request to Purchase Service
SRA Form 46-Qualifying Approved Leave of Absence
Transfer of Sick Leave In-state County
 


403(b) Retirement Plan

www.tsacg.com

Benefit Newsletter, August 2016

Agents/Companies
403(b) Payroll Authorization
403(b) Roth Payroll Authorization
403(b) Transaction Routing Request Form
Product Disclosure
Transaction Info Letter 1/16

457(b) and 403(b) Comparison Chart 2016
457(b) Deferred Compensation Program Meaningful Notice
457(b) Payroll Authorization

Plan(b) Retirement Account Website Login/Registration
Plan(b) Quick Enroll Frequently Asked Questions
 


Employee Assistance Plan

BHS

www.bhsonline.com
(800) 327-2251

EAP Program for FCPS
Childcare Referral Services
Financial Services
BHS Wellness Bulletin, July 2016 Newsletter


FCPS Wellness

Employee Wellness Partnerships
Health and Wellness Tips
Personalized Health Assessment


Awards:
Adventist Health Care Flu Fighter - 2012 - 2015
AHA Gold - Fit Friendly Award 2008-2015
Apex Award - 2010
Business Health Award 2011
Healthy Workplace Certification (Gold) 2014 - 2015
UHC Innnovative Program Design 2011
UHC Well-Deserved, Honorable Mention 2010

UnitedHealthcare offers free NurseLine Services to FCPS health plan participants and covered dependents 24 hours a day, 7 days a week. Get answers about medical conditions and medications plus help choosing appropriate medical care, understanding treatment options and finding a doctor and/or hospital. To speak with a registered nurse: 1-800-846-4678.

Also see Employee Assistance Plan above.


Deals 4U

Deals and discounts for FCPS Employees


Ferko Maryland Federal Credit Union

Ferko Maryland Federal Credit Union


Loan Forgiveness Opportunities

Loan Forgiveness Opportunities


The Board of Education of Frederick County and the recognized employee bargaining groups (FCTA, FASSE, and FCASA) jointly reserve the right to modify or amend, in whole or in part, any or all plan provisions at any time.

Employees can find complete details in the company and plan legal documents, which will always govern in case of a dispute.

Adobe Acrobat Reader is required to view and download some of these documents. Our Human Resources Division welcomes employee comments about FCPS benefits: email.