Health Insurance Plan Documents, Forms and Information:

The Distrist's Health insurance plan is administered by:

Meritain Health
400 Highway 169 South, Suite 800

Minneapolis, MN 55426

www.mymeritain.com

*** Please Note: After enrolling, each employee will have their own login sent to them. ***

Health Insurance Plan Books:

RBMS Plan 1 Booklet Ketchikan School District (PDF)

RBMS Plan 2 (PDF)

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FORMS:

Meritain Insurance Application Form  (PDF) Use for all groups.

Meritain Health Other Insurance Coverage (PDF)

Meritain Health Insurance Claim Form (PDF)

Meritain Dental Insurance Claim Form (PDF)

Meritain Travel Authorization Form (PDF)

Full Time Student Certification Form (PDF)

Flexible Benefit Plan Expense Reimbursement Voucher (PDF)

 

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Retirement Plan Information (PERS and TRS):

The State of Alaska's Division of Retirement & Benefits administers the district's retirement plan.

Click here for forms and similar information.
Address:
Division of Retirement Benefits	P: (907) 465-3086
PO Box 110203	F: (907) 465-3086
Juneau, AK 99881-0203

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Pretaxed benefits and medical expense plans:

The Ketchikan School District offers it's employees a dependent care and unreimbursed medical plan for its employees through American Fidelity Assurance Company.

Expense Reimbursement Voucher
Address:
American Fidelity Assurance Company	P: (800) 325-0654
Flex Account Administration	F: (800) 543-3539
PO Box 25510
Oklahoma City, OK 73125

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403b Deferred Compensation Plans:

The District uses Citizens Bank and Trust as a "gate keeper" for deferred compensation (deferred compensation) services.

List of Approved Investment/403b Provider Firms

Contact the payroll department for more information.

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Other Payroll Forms:

IRS Form W-4 (2009) (PDF)

Change of Address Form (PDF)

Direct Deposit Form (PDF)

 

 

 

 

Last Updated 8/17/09

@ Melanie Villa 2008