Benefits and Coverage Summaries

As an employee, the health benefits available to you represent a significant component of your compensation package. They also provide important protection for you and your family in the case of illness or injury.

Depending on your district, you may be offered a series of health coverage options. Choosing a health coverage option is an important decision. To help you make an informed choice, SWSCHP makes available a Summary of Benefit Coverage (see the two links below), which summarizes important information about any health coverage option in a standard format to help you compare options.

A paper copy is available to you upon request to your District’s Health Benefit Representative.

Forms and Documents

Please note: SWSCHP is updating the following documents, but you can still link to the existing versions:

    •    Medicare Part D Reimbursement Form
    •    Medicare Part D Reimbursement Instructions
    •    Young Adult Option Booklet
    •    HIPAA Authorization to Release Information Form
    •    Out-of-Network Claim Form
    •    International Claim Form
    •    UCR Form
    •    Manual Accident Letter
    •    Notice of Privacy Practices