Skip to Main Content

Search Our Site

Arlington Central School District

Empire Blue Cross/Blue Shield (PPO-Alternate)

Empire Blue Cross/Blue Shield (PPO-Alternate) Website

For Teaching Assistants Only

Summary of Benefits and Coverage (Effective 7/1/2025)

DEHIC ALT PPO - 7.1.2025.pdf 278.14 KB (Last Modified on March 21, 2025)

Comments (-1)
Summary of Benefits and Coverage (2025-2026)

SBC - DEHIC ALT PPO - 7.1.25.pdf 645.61 KB (Last Modified on March 31, 2025)

Comments (-1)
Summary of Benefits and Coverage (2024-2025)

SBC SBC - ALT PPO.pdf 658.02 KB (Last Modified on March 20, 2024)

Comments (-1)
Enrollment Form

Empire-BC-BS-Enrollment-Form.pdf 361.28 KB (Last Modified on July 26, 2021)

Comments (-1)
PPO-Alternate & Blue View Vision Booklet 2023

DEHICALT PPO Blue View Vision booklet July 1 2023.pdf 2.4 MB (Last Modified on April 10, 2023)

Comments (-1)
Certificate of Coverage

Certificate - PPO-Alternate.pdf 1.97 MB (Last Modified on July 26, 2021)

Comments (-1)
Certificate of Coverage with Domestic Partnership

Certificatewith Domestic PartnershipPPO-Alternate.pdf 1.99 MB (Last Modified on July 26, 2021)

Comments (-1)
Young Adult Children coverage forms - under 26 years

empirebluecrossunder26.pdf 367.53 KB (Last Modified on July 26, 2021)

Comments (-1)
Young Adult Children coverage forms - 26 - 30 years

empirebluecross26-30.pdf 85.65 KB (Last Modified on July 26, 2021)

Comments (-1)
Find a Doctor Tutorial

DEHIC-Find-a-doctor-tutorial.pdf 605.07 KB (Last Modified on July 26, 2021)

Comments (-1)

CLOSE

CLOSE