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Insurance Information and Forms

 Summaries of Benefits and Coverages:
   PPO Plan
 

Chautauqua County School District's Medical Health Plan: Summary Plan Description

SPD Amendment 8 - Effective January 1, 2011 (NYS Approved April 16, 2012)
SPD Second Amendment - Approved October 1st, 2014  
 
 
Medical Benefits Plan:
 

 

Vision Plan:

Davis Vision
 
You will need this vision insurance out of network claim form in order to submit your
out of network claim for payment.
 
  
 

Dental Plan:

 
 
 

Medical Expense & Dependent Care Reimbursement Account:

P&A Group Form

 

 

 

New Health Insurance Marketplace Coverage

Options and Your Health Coverage
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