- Plainview-Old Bethpage Central School District
- Employee Benefits Information
Human Resources & Safety
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Benefit Information
Health Insurance
Form Name Form/Flyer Information - Health Insurance Empire Plan “Summary of Benefits and Coverage”
(What our Plan covers and what you pay for covered services)
Download - Health Insurance Empire Plan “At A Glance”
(Health insurance benefits information for active employees, retirees, vestees and dependent survivors)
Download - Health Insurance Empire Plan “Preferred Drug List”
Download - Health Insurance Empire Plan “On The Road”
Download - Required Exchange Marketplace Notification to Employees
Download Disability
The information below references disability benefits for our POB employees.
Form Name Form/Flyer Information - Understanding what disability is –
Frequently Asked Questions and Answers Flyer
(This flyer will give a summary to everyone of what disability is, when to file and what to expect).
Download - Form DB-120 Notice of Compliance is posted in a visible location in each building.
Download - Form DB-271 – Statement of Rights for disability insurance.
Download - Form DB-450 – the actual claim form that the employee is responsible for completing. As an employer, you will need to complete part C of this form.
Download - Health Insurance Empire Plan “Summary of Benefits and Coverage”
