Business Office

Health Care Benefits

MEBCO Health Benefit Summary Plan Description
IMPORTANT Updates to Health Plan Effective July 1, 2023
TELEDOC Mobile App offers virtual doctor visits, please click here for detailed information
UMR: Provider Finder
UMR Complex Condition CARE
ProAct (Pharmacy Benefit Management):
- Video link for: Mail Order
- Pharmacy Mail Order Services Prescriptions for controlled substances are excluded from the Automatic Refill Program & Automatic Renewal Requests made to physicians
- Your Prescription Drug Benefit
- MEBCOHealth-Rx is a voluntary international prescription drug program administered by CanaRx that is available to MUFSD eligible members, retirees and their dependents:
  - CanaRx: Video & Program Offering and How it Works
  - Click here for Enrollment Form
  - Eligible medications can be found by scanning the QR Code below or online at: CANARX Plan | Simple. Safe. Smart .
  - For more information, please contact: CanaRx 1-866-893-MEDS (6337) or info@canarx.com

Click here for a helpful list of Benefits contacts:

Please expand the tabs below to access forms and information.

Benefits

WHAT YOU NEED TO KNOW

Open Enrollment - Health Insurance Information

MEBCO/UMR Health Insurance Enrollment Form

EMBLEM Health Plan for MUFSD Teacher Aides

Emblem Health Plan Detail

Emblem Health Plan Enrollment / Change Form

HEALTH PROTECTION BENEFITS

Medical Insurance Benefits

Benefits Quick Reference Guide

Prescription Drugs:

Your Prescription Drug Benefit
Mail Order Program Prescriptions for controlled substances are excluded from the Automatic Refill Program & Automatic Renewal Requests made to physicians

Calculate Your Health Insurance Rates

Health Insurance Rates for Active Employees

Dental and Vision

Flexible Spending Accounts Information

Flexible Spending Accounts - Education Guide

Flexible Spending Accounts Enrollment/Change Form

WEALTH PROTECTION BENEFITS

Life Insurance

Voluntary Life Insurance Enrollment Forms:

For Teachers, Nurses, Monitors & Custodians

For Administrators, Unaffiliated Personnel & Clerical

Basic Long-Term Disability

403 (b) Retirement Savings Plan

403(b) How to Contribute and Plan Limits

403(b) Frequently Asked Questions & Answers

403(b) OMNI Plan Detail for Mamaroneck UFSD

TRS Membership Registration Form

ERS Membership Registration Form

WORK/LIFE BENEFITS

Total Care EAP Employee Brochure

Employee EAP Benefits

ESI Employee Assistance Program: Video Orientation

Life Assistance Program

Gym Membership Reimbursement Claim Submission Form

CUSTOMER SERVICE CONTACTS

Complete Customer Contact Directory

Patient Advocate Contact for MUFSD Retired Employees:

Rebecca Stroud

Employee Benefits Client Service Specialist

(914) 345-7098

rstroud@lawleyinsurance.com

Financial Reports

Financial Audit (Year End June 30, 2025):

Financial Audit (Year End June 30, 2024):

Financial Audit (Year End June 30, 2023):

Financial Audit (Year End June 30, 2022):

Financial Audit (Year End June 30, 2021):

NY State School Funding Transparency Reports:

Learn about Medicare - How & When to Apply, Basic Costs, & Understanding the Diffferent Parts

Please click here for information regarding the process for resolving complaints submitted to the New York State Education Department’s (NYSED) Office of ESSA-Funded Programs alleging that a local educational agency (LEA), grantee or NYSED has violated a law, rule, or regulation in the administration of any “covered Federal program” under the Elementary and Secondary Education Act (ESEA), as amended by the Every Student Succeeds Act (ESSA).

Medicare Part B Reimbursement Information for MUFSD Retirees

The Mamaroneck Union Free School District (the District) provides Medicare Part B premium reimbursement to retirees and their spouses, provided the spouse is enrolled in the current Mamaroneck health insurance plan and is not receiving Medicare reimbursement from another agency.

If either you or your spouse is 65 years of age or older, currently on the Mamaroneck health insurance plan, and receives Medicare Part B benefits, please submit the following documents to the Mamaroneck School District Business Office on or before February 27, 2026, so that your Medicare Part B reimbursement can be processed.

1. 2025 Social Security Administration Benefit notice of Medicare Part B Premium – also known as 2025 Social Security Benefit Verification Letter. This form is mailed directly from the Social Security Administration usually in November 2024

Sample SSA Benefit Statement Letter from Social Security Administration

To obtain a replacement SSA Benefit Verification Letter: https://www.ssa.gov/myaccount/proof-of-benefits.html

2. SSA 1099 Tax Form – also known as 2025 Social Security Benefit Statement, for both you and your spouse if your spouse is eligible. This form is mailed out directly from Social Security in January 2026. If you do not collect Social Security and pay for Medicare Part B on your own, please provide proof of your payments (premium statements and/or cancelled checks).

To obtain a replacement SSA 1099 Tax Form: https://www.ssa.gov/myaccount/replacement-SSA-1099.html

3. Notarized Certificate of Eligibility Form signed by both retiree and retiree's spouse:

Notarized Certificate of Eligibility Form

4. Retiree Payment Form for both you and your spouse.

PLEASE SUBMIT THE RETIREE PAYMENT FORM ONLY IF YOUR BANKING INFORMATION HAS CHANGED SINCE LAST YEAR’S PAYMENT:

Retiree Payment Form (ACH Direct Deposit Form)

Upon receipt and review of the above documents, if appropriate, the District will issue a payment to you and your spouse for the standard Medicare Part B Premium. Payments will be issued on or before April 30, 2026, for the 2025 calendar year. Reimbursements for 2025 will only be paid for documentation received by February 27, 2026.

Please e-mail the required documents to benefits@mamkschools.org

or send by mail by February 27, 2026, to:

Business Office-Medicare Department

Mamaroneck UFSD

1000 West Boston Post Road

Mamaroneck, NY 10543