Embedded Files
See benefit forms and resources below. Contact the District Office with questions.
Health Insurance
Health Insurance
Forms
Health Plan Change Request (Current Subscriber)
Healthy Living Reimbursement Request - submit directly to Security Health Plan
Out of Area Dependent Coverage Verification Form (required annually) - submit directly to Security Health Plan
HIPAA Authorization Form (Security Health Plan) - submit directly to Security Health Plan
Resources
Register for My Security Health Plan (track claims history, explanation of benefits, spending and responsibility)
Over the Counter Medication Program ($30 available quarterly) - available through My Security Health Plan login
MedImpact Pharmacy Benefit Resources - available through My Security Health Plan login
I-S Health Plan Refresher Video- 2-2025 (Corresponding Handout/Slides)
HSA (Health Savings Account)
HSA (Health Savings Account)
Contact the Participant Services Team at Associated Bank with questions regarding your HSA at 800-270-7719 or ParticipantServices@AssociatedBank.com.
Forms
HSA Election Form - use this for changes to your payroll contribution amounts (submit changes to the district office)
Resources
Dental Insurance
Dental Insurance
Forms
Resources
Delta Dental Member Portal - online account access to find providers, estimate costs and more
Vision Insurance
Vision Insurance
Forms
Resources
DeltaVision Member Portal - online account access to find providers, estimate costs and more
Tax Sheltered Annuity (TSA) / 403(b)
Tax Sheltered Annuity (TSA) / 403(b)
Wisconsin Retirement System
Wisconsin Retirement System
Page updated
Report abuse