2022-23 Benefit Information and Documents

2022-23 Insurance Rates

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Employee Assistance Program (EAP)

EAP.pdf 1.18 MB (Last Modified on July 13, 2021)

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Blue Cross of Idaho Enrollment Form

ISBT enrollment app.pdf 423.12 KB (Last Modified on July 14, 2020)

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PPO Medical $1000 Deductible Benefit Summary

Minidoka SD 1000 Ded PPO Highlights - 09-22.pdf 1.1 MB (Last Modified on October 3, 2022)

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PPO Medical Summary of Benefits

Summary of Benefits Description for _Minidoka SD - 1000 PPO 09-22.pdf 398.66 KB (Last Modified on October 3, 2022)

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HSA Medical $5000 Deductible Benefit Summary

Minidoka SD 5000 Ded HSA - Highlight Sheet 09-22.pdf 661.69 KB (Last Modified on October 3, 2022)

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HSA Medical Summary of Benefits

Summary of Benefits Description for _Minidoka SD - 5000 HSA - 09-22.pdf 396.44 KB (Last Modified on October 3, 2022)

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Prescription Benefit Summary

Highlight Sheet PPO Pharmacy Minidoka County School District 92021.pdf 465.6 KB (Last Modified on July 13, 2021)

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Preventive Care Highlights

Preventive Care Flyer.pdf 59.64 KB (Last Modified on July 13, 2020)

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HSA Preventive Drug Lists

HSA Preventive Drug List.pdf 97.85 KB (Last Modified on July 13, 2021)

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$0 Pediatric Copay

Zero Pediatric Copay.pdf 598.91 KB (Last Modified on July 13, 2020)

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Delta Dental Enrollment/Change Form

DELTA DENTAL Enrollment-Change-Form.pdf 131.3 KB (Last Modified on July 14, 2020)

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Delta Dental Benefit Summary

Delta Summary.pdf 38.19 KB (Last Modified on July 13, 2020)

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Willamette Dental Enrollment Application

Willamette Application.pdf 285.75 KB (Last Modified on July 14, 2020)

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Willamette Benefit Summary

Minidoka SD Dental Blue Connect Highlight Sheet - 09-22.pdf 370.31 KB (Last Modified on October 3, 2022)

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Member Registration

Delta Member Registration.pdf 526.62 KB (Last Modified on July 13, 2020)

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Orthodontic Discount Flyer

Orthodontic-Discount-Flyer.pdf 329.02 KB (Last Modified on July 13, 2020)

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Delta Discounts

Delta Discounts.pdf 1.39 MB (Last Modified on July 13, 2020)

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Health Oral Wellness Program

HOW Program.pdf 229.59 KB (Last Modified on July 13, 2020)

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Life Smile Wellness

Life Smile Wellness.pdf 7.94 MB (Last Modified on July 13, 2020)

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5 Reason to Choose Willamette Flyer

Five Reasons to Choose Dental Blue Connect.pdf 264.39 KB (Last Modified on July 13, 2020)

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Vision Enrollment Application

Minidoka School District - Vision Enrollment Form.pdf 111.49 KB (Last Modified on July 14, 2020)

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Vision Summary

Minidoka School District - Vision Summary.pdf 104.5 KB (Last Modified on July 13, 2020)

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VSP Flyer

Vision-EE_06808-lm.pdf 1.31 MB (Last Modified on July 13, 2020)

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How to Use Vision Benefits

Vision-How to Use Your Benefits_EE.pdf 228.93 KB (Last Modified on July 13, 2020)

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Find an Eye Doctor

Vision_Find-an-eye-doc_Flyer.pdf 185.93 KB (Last Modified on July 13, 2020)

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Life Enrollment Application

Life enrollment fillable.pdf 110.24 KB (Last Modified on July 14, 2020)

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Life Insurance Summary

Minidoka School District - Basic Life summary.pdf 81.75 KB (Last Modified on July 13, 2020)

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Life Beneficiary Change

Beneficiary change.pdf 57.93 KB (Last Modified on July 14, 2020)

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