2024-2025 Employer-Sponsored Health Care Plans
Professional and Administrative Employees
PDF File
Admin 24-25 Blank Enrollment Form
April 19, 2024
PDF File
LBT Enrollment Form
April 19, 2024
PDF File
Professional 24-25 Blank Enrollment Form
April 19, 2024
PDF File
Professional AND Admin Spouse Eligibility Certification 2024-25 outside of OE Time
April 19, 2024
PDF File
Spouse ER Verification Form outside of OE
April 19, 2024
Support and Confidential Employees
PDF File
10 Mth 24-25 Blank Enrollment form
April 19, 2024
PDF File
12 Mth 24-25 Blank Enrollment form
April 19, 2024
PDF File
LBT Enrollment Form
April 19, 2024
PDF File
OE form 24-25 Confidential Blank Form
April 19, 2024
PDF File
Spouse ER Verification Form outside of OE
April 19, 2024
Additional Forms
PDF File
Dependent Care- Quick Start Guide
May 5, 2022
Dental Coverage
PDF File
Delta Dental (Rev. 04.2024)
April 23, 2024
PDF File
Delta Dental glb-financial-privacy
December 22, 2023
PDF File
Delta Dental HIPAA Notice
December 22, 2023
PDF File
Delta Dental language-assistance-notice
December 22, 2023
PDF File
Delta Dental non-discrimination-notice
December 22, 2023
Mandatory Postings
PDF File
2024 Universal Availability Notification Dover Area School District includes 457
November 14, 2023
PDF File
Medicare Part D Cover Letter and Attestation 2023
September 7, 2023
Flexible Spending Account (FSA)
PDF File
Flexible Spending Account FAQ 4 2023
March 27, 2023
PDF File
FSA Election Form Existing July 2024
April 19, 2024
PDF File
FSA Election Form NEW July 2024
April 19, 2024
PDF File
FSA- Quick Start Guide
May 5, 2022
Vision Coverage
PDF File
Davis Vision (May 2022)
May 19, 2022
Wellness Highlights
PDF File
Baby BluePrints
May 4, 2022
PDF File
Cancer Screening
May 4, 2022
PDF File
Care- Female
May 4, 2022
PDF File
Diabetes- Highmark Prevention Program
May 4, 2022
PDF File
Diabetes- Retrofit Program
May 4, 2022
PDF File
Diabetes- YMCA Prevention Program
May 4, 2022
PDF File
Hydration
May 4, 2022
