Waiver Incentive
Buy Back Option
Mansfield Township School District
If eligible, you have the option to waive your District medical/prescription and/or dental benefits. This waiver option offers flexibility in creating your own personalized package of benefits. If you have health benefits elsewhere, you may be eligible. Note: your waiver payment is considered taxable income.
(Note: while you may choose to waive medical or prescription separately, the waiver incentive applies only when waiving both coverages together.)
To enroll, you must complete the below form and must re-enroll each year during our Open Enrollment if you wish to remain in the program. If you lose coverage from the alternative source, you can immediately enroll in our District plans by completing an enrollment form and providing required documentation.
Waiver amounts are pro-rated according to when you elect the waiver option. Please refer to the form and memo below for details on waiver amounts. If you have questions about this option, please email the Business Office (lmccoy@mansfieldschool.com).
Waiver of Health Benefits Form
Waiver Incentive (Benefit Buy Back) Memo
If eligible, you have the option to waive your District medical/prescription and/or dental benefits. This waiver option offers flexibility in creating your own personalized package of benefits. If you have health benefits elsewhere, you may be eligible. Note: your waiver payment is considered taxable income.
(Note: while you may choose to waive medical or prescription separately, the waiver incentive applies only when waiving both coverages together.)
To enroll, you must complete the below form and must re-enroll each year during our Open Enrollment if you wish to remain in the program. If you lose coverage from the alternative source, you can immediately enroll in our District plans by completing an enrollment form and providing required documentation.
Waiver amounts are pro-rated according to when you elect the waiver option. Please refer to the form and memo below for details on waiver amounts. If you have questions about this option, please email the Business Office (lmccoy@mansfieldschool.com).
Waiver of Health Benefits Form
Waiver Incentive (Benefit Buy Back) Memo