UHC Forms & Resources
UHC
Phone: (800) 340-9716
USD 495 Ft. Larned offers employees medical coverage through UHC in which employees can choose the plan that best suits their needs.
USEFUL LINKS
- UHC Online Portal Instructions
- Mail Order Information
- Healthy Pregnancy Flyer
- Virtual Visit Information
- Real Appeal Information
- 2024 SBC 1500
- 2024 SBC 2500
- 2024 SBC 3500
- 2024 SBC 5000
- 2024 SBC 3500 HDHP
- 2024 Benefit Summary 1500
- 2024 Benefit Summary 2500
- 2024 Benefit Summary 3500
- 2024 Benefit Summary 5000
- 2024 Benefit Summary 3500 HDHP
Delta Dental of Kansas
Delta Dental of Kansas
Phone: (800) 234-3375
A Delta Dental ID card can be printed from the Delta Dental National Portal website (click on the link below). If you are a new website user, select the "Need to Register?" link and follow the directions to register. Once registered, type in your user name and password at the prompts and then select the "Sign In" button. Click "ID Cards." The card will have the primary subscriber's information, but should be used as identification for all eligible dependents.
Surency Vision
Surency Life and Health, Inc.
Phone: (866) 818-8805
USD 495 will offer employees two options for voluntary vision through Surency Life & Health.
Reliance Standard
Reliance Standard
Customer Service: 1-800-351-7500
Website: www.reliancestandard.com
- 3 in 1 Enrollment Form Application
- EF-1008 Portability Form
- EF-2543 - VCI Wellness Claim Form
- EF-2544 - VCI Claim Form
- EF-2554 - VAI Claim Form
- EF-3497 - VHI Claim Form
- Life/AD&D Claim Form
- Voluntary STD Claim Form
- Life/AD&D Plan Summary
- Voluntary Life/AD&D Plan Summary
- Voluntary STD Plan Summary
- Accident Plan Summary
- Critical Illness Plan Summary
- Hospital Indemnity Plan Summary
Cafeteria Plan (Flexible Spending and Dependent Daycare Accounts)
Surency FLEX
Phone: 1 (866) 818-8805
Website: www.myflexaccount.com
USD 495 Ft. Larned offers employees a Section 125 plan which allows you to pay your portion of the insurance premiums before taxes are calculated on your earnings. Your take home pay may increase because you do not pay federal and state income tax, FICA and Medicare tax on these expenses. Since deductions are before taxes are calculated, the employee’s taxable income is reduced. The employee’s take-home pay may increase because federal and state income tax, FICA and Medicare tax are not paid on the amount deducted.Since you pay your share of the group health and dental insurance premiums before taxes are calculated, you have limitations. You may not stop your insurance deductions or change how you are enrolled in the insurance plans, unless you have one of the following status changes:
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Termination of employment
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Child no longer eligible
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Spouse changes jobs
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Death of a dependent
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Change of marital status
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Birth or adoption of a child
Other reasons may be within the provisions of the plan. The plan administrator must approve all changes. If you do not want your premiums deducted before taxes are calculated, contact Human Resources.
