About This Page

Additional Services

Use of Facilities

Link to Facilities webpage to find information that must be completed and sent in to Facilities:

Community Use of School Facilities

When outside organizers request to use or rent a PCSB facility for their events and they do not have liability coverage they can simply visit to the PCSB TULIP site.

Event coverage for dances and festivals etc. can also be purchased on the same site:


TULIP Brochure

Special Event Coverage

Acceptable Classes Special Events

Highlights- Special Events

Special Events -Not Sports - Supplemental Application

Special Events - Amateur Sports - Supplemental Application

Keyword for this page: Insurance

Benefits Information

Section 125 of the IRS code allows employees to use pretax dollars to pay the premiums on certain group insurance products. These deductions are taken prior to Social Security and Federal Income Taxes being deducted from your paycheck, which can lead to significant savings. Benefits elections must remain in effect until the next Open Enrollment Period unless you experience a qualifying event. A qualifying event is a change in status to your life that meets IRS approved definitions.

If you need to make a change to your coverage due to a Qualifying Event, you must submit the Change of Status Form along with required documentation no more than 31 days after the qualifying event has taken place.

Change of Status Form


2018 Open Enrollment Guides

2018 Open Enrollment Guide

2018 Spanish Open Enrollment Guide

2018 Retiree Open Enrollment Guide


Benefit Notices

Market Place Notice

Model Exchange Notice

2018 Summar of Benefits and Coverage

2017 Summary of Benefits and Coverage


2016 Blue Medicare Formulary

2016 Summary of Benefits and Coverage

2016 SPD


Benefits, Coverage Details, and Contact Information:

As always, please feel free to contact the Risk Management & Employee Benefits Department for any assistance you may need.

Risk Management Hours: Monday thru Friday 8:00-5:00

By phone: 1-863-519-3858

By email: RiskManagement-AllStaff@polk-fl.net

Attention employees wishing to visit Risk Managemet regarding insurance benefits. The RIsk Management benefits team is temporaily located in the 1st gray portable located next across from Building A. Employees visiting our Retirement Specialist Kayla Rodriguez or with questions regarding a leave of absence will still want to visit Facilities Building C.


The Standard

Customer Service 1-800-325-5757 ext. 0286

The Standard Website

Disability Coverage Video

Claim Forms

In order to file a disability claim with The Standard you will need to download both Step 1 and Step 2 below:

Standard STD Claim Form

Standard STD Claim Form - Spanish

Standard LTD Claim Form

Standard LTD Claim Form - Spanish

If you have any questions or need assisance completing this claim form, please contact Employee Benefits at 863-519-3858 or by email at RiskManagement-AllStaff@polk-fl.net


Certificates & Guidelines

There is a Guarantee Issue for life insurance up to the amount of $150,000 for new hires.  If you did not elect additional life insurance, short term disability or long term disability the first time it was available to you, or during a true open enrollment year for these products and you choose to enroll at a later date you will be considered a late entrant and be subject to medical underwriting.  Medical underwriting is also required for life insurance amounts in excess of $150,000. If you are required to undergo medical underwriting, please follow the link below to the Medical History Statement.

Group number: 625950

Maternity FAQ

MedEx Flyer

For all forms for AIG, Allstate/American Heritage & American Fidelity products please contact Sunbelt Worksite Marketing at 863-967-8045.


Customer Service 1-855-748-2661



Preferred Medication List

  Generic Preferred Brand Non-Preferred Brand
Retail 30 $8 $30 + 10% (max $60) $50 + 10% (max $100)
Retail 90 $8 $90 + 10% (max $180) $150 + 10% (max $300)
Mail 90 $8 $75 $125


Remember: There are a number of generic drugs available through Wal-Mart pharmacies for $4. A list can be obtained at your Wal-Mart pharmacy or on their website.

Publix pharmacies also offer certain generic antibiotics for free. This list can be obtained at your Publix pharmacy or on their website.

VERY IMPORTANT: If you receive one of these free or reduced prescriptions remind the pharmacy NOT to use your prescription coverage.

FAQ: I noticed I did not receive my $25 pharmacy incentive with WellDyne for participating in a disease management program, can you tell me why?

In order to be eligible for the above incentive, you must be identified as having one of the five chronic health conditions (CAD, CHF, COPD, Diabetes or Asthma) AND make contact with one of the Florida Blue health coaches (either inbound call to, or an outbound call from a health coach) on a quarterly basis. Contact must be made each quarter in order to continue to qualify.

If you have been contacted by a health coach either via mail or phone and would like to contact them, please call them at 1-877-789-2583.

Risk Management Department Directory