Welcome

Annual Open Enrollment

Annual enrollment is your opportunity to learn about your health care benefits, review your current coverage and choose the best options for you and your family.

Your plan year runs from August 1, 2022 through July 31, 2023


Benefits Overview

Benefit Grids and Summary of Benefits and Coverage (SBC)

Please review the August 1, 2022 - July 31, 2023 Benefits by clicking the appropriate arrow


  • UPMC PPO $2,500 30/40 15/40/75 RX Benefit Summary
  • UPMC Basic Dental with Discount Benefit Summary
  • UPMC Vision Care Exam Only with Copay Benefit Summary
  • Nationwide Gilsbar Medical Supplement: (You will present your UPMC medical card and your Nationwide Gilsbar card for service's subject to your medical deductible)
  • Deductible $1,000 for employee only and $2,000 for employee plus one or more
  • Benefit - plan pays $1,500 for employee only and $3,000 for employee plus one or more
  • Physician Office Visits - Not Included
  • UPMC PPO $2,500 30/40 15/40/75 RX SBC
Medical Benefit

Medical Benefit Summary

Medical Benefit

Medical Benefit Summary

Dental Benefit

Dental Benefit Summary

Dental Benefit

Dental Benefit Summary

Vision Benefit

Vision Benefit Summary

Vision Benefit

Vision Benefit Summary

Summary of Benefits and Coverage

SBC Benefit Summary

Summary of Benefits and Coverage

SBC Benefit Summary

How To Enroll

Enrollment Forms

No Changes:

Your current benefits will carry forward for the 2022 -2023 plan year and you do not need to do anything.


Changes:

If you need to change an address, add or delete a dependent, or you wish to add or delete benefits:

You must complete the attached application and return it to:

Tonya Greenwalt

tonyag@bollmancharter.com

on or before July 31, 2022


New Hires:

You will need to complete the attached application and return it to:

Tonya Greenwalt

tonyag@bollmancharter.com

on or before July 31, 2022.



UPMC Application

UPMC Application/Change/Termination Form

UPMC Application

UPMC Application/Change/Termin ...

NFP Contacts

You have dedicated Agents ready to handle any situation in a discreet and confidential manner.

For Service questions and needs such as:

  •        Understanding what your medical, dental or vision benefits cover
  •        Help finding in network providers
  •        Assistance with prescription or pharmacy issues
  •        Questions regarding bills you receive from your doctor, hospital, dentist, optometrist or lab
  •        Claims you believe haven’t been paid properly


Your Agent is:

Casey Maschue, Senior Advisor • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •   814-289-4228

Email address:   casey.maschue@nfp.com



If your Agent is not available, please contact:

Joni Thomas, Senior Account Manager • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •    814-289-4226

Email Address:  joni.thomas@nfp.com