Insurance and Benefit Information

Welcome to the Insurance & Benefits Information Section of the District Website


The information found here includes the most recent Summary Plan Description with additional links to dental and flexible spending account plan benefits that are listed as attachments in the Summary Plan Description.  This version has been updated from any previous document delivered to you.

You have a right to request and obtain a paper version of the documents at no charge.  Contact the Business Manager at 814-258-5644 X1022 or email to: or to request a copy of the Summary Plan Description or any of the attachments.

Medical and Prescritpion Drug Plan Changes – July 1, 2017

Northern Tioga Summary Description


Medical Insurance Questions

If you have questions regarding your medical insurance coverage or an insurance claim, our representative at the Henry Dunn Agency may be able to assist you.  Click Here for more information.

Notice – Advanced Imaging Services Need Prior Authorization

Flex 125 Information:

Flex 125 Enrollment Form

Flex 125 Enrollment Booklet

Flex 125 Card Information


Professional Staff Health Insurance Information:

Professional Staff Health Insurance Form

Health Insurance Enrollment Form

Professional Staff Insurance Opt Out Form


Support Staff Health Insurance Information:

Support Staff Working 6 or More Hours Enrollment Form – 2017-18

Support Staff Working Less than 6 hours Enrollment Form – 2017-18

Health Insurance Enrollment Form

Act 93 Support Staff Insurance Opt Out Form


Act 93 Staff Health Insurance Information:

Act 93 Support Staff Enrollment Form – 2017-18

Act 93 Admin & School Psychologist Enrollment Form – 2017-18

Health Insurance Enrollment Form

Act 93 Support Staff Insurance Opt Out Form


Dental Benefits Information:

Dental_Benefits – Effective July 1, 2018

Dental Benefits Enrollment form


Life Insurance Benefits Information:

Support Staff (12 mo. Employee) Life Insurance Benefits

Support Staff (9 mo. Employee) Life Insurance Benefits

Professional Staff Life Insurance Benefits

Life Insurance Enrollment or Beneficiary Change Form

Privacy Notice for Life Insurance


Voluntary Vision Insurance Information:

Vision Insurance Benefits Information

Vision Insurance Enrollment Form

Vision Insurance Professional Payroll Deduction Authorization 17-18

Vision Insurance Support Payroll Deduction Authorization 17-18

Contact Lens Information

LASIK Information


Health Care Preventative Health Care Schedule

2016 Medicare Part D Creditable Coverage Notice – Northern Tioga School District

2012 Women’s Health and Cancer Rights Act notice

2012 CHIP Model Notice

Highmark How to Register on Your Member Website Flyer

Highmark Virtual ID Card

Highmark Virtual Care

AMWell – Allows you to talk to a Doctor from Home

Express Scripts – Mobile App

S3 Generic Prescription Drugs

Medical and Prescription Drug Plan