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Benefits & Wellness Information

Staywell Health Dental Vision
Prescription Life COBRA
Staywell Wellness Aflac/WageWorks Affordable Care Act


S T A Y W E L L  H E A L T H   /  W E L L N E S S

Visit the MCOE Staywell webpage for plan summaries and coverage booklets.

**Blue Shield Claim Form (Download)**

Staywell Advocate: Angie Daniels

Staywell Newsletters


Staywell Fall Challenge Materials: 

Fall Activity Challenge Flier

Biometric Screening Form


Classified/CSEA Representative:  Linda Stephens

Certificated/BDTA Representative:  Holli Williamson

Administrative/Confidential Rep:  Wendy Boise


D E N T A L   I N S U R A N C E

Delta Dental Plan Summary

Delta Dental Evidence of Coverage (Plan Book)
For an in-depth review of the plan coverage please click on the link above. ** The evidence of coverage books are not updated unless a change is made to the plan. Since no changes have been made, the attached is current as of October 2014.** 

For questions or clarifications of plan coverage please contact:

Delta Dental of California 
(888) 335-8227    www.deltadental.org


V I S I O N   I N S U R A N C E

Coverage begins on the first of the month following 30 days of employment. If you elect not to enroll at the time of initial employment you may enroll during the open enrollment period.  Benefits of this plan are limited to the following:  

Eye Exams: A complete analysis of the eyes and related structures to determine the presence of vision problems, or other abnormalities (one per fiscal year). Maximum allowable amount $65 per year, per insured member.

Lenses and Frames: The plan provides for prescription lenses if needed for vision correction (once every 24 months per insured member, or within a 12 month period if a .5 or greater diopter change occurs).  

Allowable Amounts: Single vision Prescription Frames & Lenses $80.00, Bifocal $115.00, Trifocal/Lenticular $135.00. Prescription contact lenses, cosmetic or convenience, hard or soft $90.00.  

You may use the services of ANY licensed ophthalmologist, optometrist or dispensing optician. The allowable charges will be reimbursed and any balance due will be the patient’s responsibility.    

All claims should be submitted to Arrow Benefits Group, P.O. Box 750578 Petaluma, CA 94975 and copies of receipts must be attached to the Foundation’s CLAIM FORM.


P R E S C R I P T I O N   P L A N

Visit the MCOE Staywell webpage for plan summaries and coverage booklets.

PrimeMail Mail Order Instructions

New Prescriptions

  1. Obtain a written prescription from your doctor for a 90 day supply as allowed by your plan.
  2. Obtain and complete the Prime Mail form:
    1. Online: Go online and download the form at www.myprimemail.com
    2. Phone: Call (866) 346-7200 and request a PrimeMail form by phone.  Representatives are available 24 hours a day, 7 days a week (including holidays).
  3. Mail your completed form and prescription to:

PrimeMail Pharmacy
P.O. Box 27836
Albuquerque, NM 87125-7836

Refill Mail Service

Use one of the following methods to order your refill prescriptions:

  1. Online: Sign in to your MyPrimeMail account.
  2. Phone: Call (866) 346-7200 and follow the telephone prompts to use the automated reorder system. PrimeMail representatives are available 24 hours a day, 7 days a week (including holidays).
  3. Mail:Complete the PrimeMail Refill Order form included in your last medication shipment and mail it to PrimeMail at the address listed on the form:

    PrimeMail Pharmacy
    P.O. Box 27836
    Albuquerque, NM 87125-7836


A F L A C  /  W A G E W O R K S

Aflac / WageWorks

Fort Bragg Unified School District offers its employees the opportunity to purchase supplemental benefits through AFLAC.  Supplemental benefits are specialized insurance policies that employees may purchase voluntarily.  These optional insurance policies do not take away from your regular medical, dental, life, and AD&D coverage through the district.  Instead they are simply other insurances you may purchase at your option that go above and beyond the coverage already provided under your regular district insurance.

If you choose to sign up for any supplemental coverage through AFLAC, your premiums may be paid through payroll deduction for convenience.  If you leave the district, you may keep your coverage with AFLAC, and the premiums will remain at the original rate.  (When you leave the district, you must make payments directly to AFLAC as payroll deduction would no longer be available to you.)

Open Enrollment:  May

WageWorks Healthcare Flexible Spending Account (FSA)

Helpful Links / Documents / Forms:

What is an FSA & how does it work? - WageWorks FSA Information Sheet   

or browse the WageWorks website at: WageWorks Flexible Spending Account
WageWorks FSA Claim Form

TakeCare by WageWorks instruction sheet.

TakeCare by WageWorks online FSA Claims Link:  myflexonline.com

Aflac website:  www.aflac.com

Supplimental Aflac Policies Offered:

  • disability
  • accident
  • cancer
  • hospital
  • critial care
  • dental
  • vision
  • life

Aflac Representative:  BarabaraLee Lilker, barbaralee_lilker@us.aflac.com


L I F E  I N S U R A N C E

All eligible faculty and staff members are offered life insurance as follows. 

certificated faculty (those working 50% or more) are insured for $20,000 (base). Your insurer is Standard Insurance Company and coverage begins on on the first of the month following enrollment/employment. Contact information: P.O. Box 4664, Portland, OR  97204-1282, customer service (800) 522-0406. 

classified employees (those working 50% or more) are entitled to $10,000 of insurance coverage. Your insurer is TransAmerica Life Companies and coverage begins on the first of the month following enrollment/employment. Contact information: Box 8063, Little Rock, AR  77203-8063, customer service (800) 763-7474.

Fort Bragg Unified School District312 S. Lincoln St.Fort Bragg, CA  95437


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