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: kathy.vanschaick@ntiogasd.org or kim.fish@ntiogasd.org to request a copy of the Summary Plan Description or any of the attachments.
Medical and Prescription Drug Plan Changes – July 1, 2019
Plan Document and Summary Plan Description
PPO Bronze Benefit Booklet 2021
The link below is published in accordance with the Consolidated Appropriations Act (CAA) Transparency in Coverage Rule, requiring publication of machine-readable files. The files are being hosted by our medical benefit administrator, and can be accessed at the link included below.
Highmark groups: mrfdata.hmhs.com
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:
Dental Benefits Information:
Dental_Benefits – Effective July 1, 2018
Dental Benefits Enrollment form
Dental Dental Where’s My ID Card
2022 Annual Notices and Disclosures
Life Insurance Benefits Information:
Support Staff 12 months 7-1-19
Support Staff 9 month Employee 7-1-19
Life Insurance Enrollment or Beneficiary Change Form 2018
Privacy Notice for Life Insurance
Voluntary Vision Insurance Information:
Vision Insurance Benefits Summary 7-1-2021
Vision Insurance Benefits Summary 7-1-2020
Vision Insurance Professional Staff Payroll Deduction Form 2021-22
Vision Insurance Support Staff Payroll Deduction Form 2021-22
Annual Notices & Health Care Resources:
Annual Insurance Updates – PPO or Traditional
Annual Notice PPOG Outline of Coverages 7-1-2022
Annual Notice QHDHP Outline of Coverages 7-1-2022
Annual Notice PPOE Outline of Coverages 7-1-2022
Annual Notice PPOC Outline of Coverages 7-1-2022
Annual Notice PPO Bronze Outline of Coverages 7-1-2022
Annual Notice QHDHP Outline of Coverages 7-1-21
PPO Plan G Summary of Benefits-Coverage 7-1-2022
PPO Plan E Summary of Benefits-Coverage 7-1-2022
PPO Plan C Summary of Benefits-Coverage 7-1-2022
PPO Plan QHDHP Summary of Benefits-Coverage 7-1-2022
PPO Plan Bronze Summary of Benefits-Coverage 7-1-2022
Annual Notice PPO Bronze Outline of Coverages 1-1-22
Annual Notice PPO E Option Outline of Coverages 1-1-22
Health Care Preventative Health Care Schedule
Medicare Creditable Coverage Notice 2021
2022 Annual Notices and Disclosures
Highmark How to Register on Your Member Website Flyer
AMWell – Allows you to talk to a Doctor from Home
Medical and Prescription Drug Plan
Notice Regarding Wellness Program 2019-20
Wellness Program
NTIC Wellness Incentive Program 21-22
NTIC Annual Physical Examination Verification Form
NTIC Annual Vision Examination Verification Form
NTIC Cervical Cancer Screening Verification Form
NTIC Colonoscopy Examination Verification Form
NTIC Dental Examination Verification Form
NTIC Dermatology Examination Verification Form
NTIC Health Screening Consult Verification Form
NTIC Mammogram Screening Verification Form
NTIC Primary Care Provider Verification Form
NTIC Prostate Screening Verification Form
Employee Assistance Program (EAP)