Medical Insurance
Summary of Benefits & Coverage
$1700 Single/$3400 Family deductible
$3250 Single/$6500 Family deductible
$6350 Single/$12700 Family deductible
Dental Insurance
Life Insurance
Long Term Disability Insurance
Pre-tax Accounts: HSA/FSA/DCAP/VEBA
Health Savings Account (HSA) Introduction
HSA Employee Contribution Election form
Flexible Spending Account (FSA) Introduction
Dependent Care Assistance Program DCAP Introduction
Voluntary Employee Beneficiary Association (VEBA)
Retirement (403B)
Contracts
If injured at work, please complete the following steps:
1. Notify your supervisor
2. Call the SFM Nurse Line immediately at 855-675-3501
Employer Name: ISD #578 Pine City
Policy Number: 035287.214
3. If you seek medical treatment, submit a note from the doctor to Jill Nolan in the District Office.
Worker's Compensation Employee Information
District Office Junior/Senior High School ECFE/Community Education Elementary School Pine Area Learning Center VISION
1400 Main St. S. 1400 Main St. S. 700 6th Ave. SW 700 6th Ave. SW 1225 Main St. S. 870 Main St. S.
Pine City, MN 55063 Pine City, MN 55063 Pine City, MN 55063 Pine City, MN 55063 Pine City, MN 55063 Pine City, MN 55063
320-629-4010 320-629-4100 320-629-4030 320-629-4200 320-629-4040 320-322-2203
Independent School District No. 578, Pine City Public Schools, 1400 Main St. S., Pine City, MN 55063, does not discriminate on the basis of race, color, national origin, sex or disability.