Employee Benefits

UMR Health Insurance Coverage - 1.1.2024

2024 UMR High Deductible (HDHP) Summary of Benefits

2024 UMR Preferred Provider (PPO) Summary of Benefits
No new enrollees, plan closed as of 7/1/2017

UMR Pre Authorization
Call UMR at 800-207-3172 for plan required pre-authorization. Failure to do so may reduce benefits.

Prescription Drug Coverage

ARORx Welcome Pack
Drexi Mobile App
Drexi Pill Pack Mail Order

Features easy registration, simple navigation, and an innovative, user-friendly design to help you navigate your prescription benefits. Plus, you'll gain access to all of the helpful information you need to make informed decisions about your prescriptions and continue in the path to improved health.
If you use a prescription medication that has a high out of pocket cost, please contact ARORx via phone (833-306-4092) or email: rx@arorx.com and ask if the medication is covered through one of their mail order pharmacies. When you contact ARORx, please have the following information available:

  • Employer name (School District of Cudahy)

  • Your full name & birth date

  • Your Member Rx ID & the RXGroup ID (both are located in your ARORx card)

  • The name of the medication and the dose

Accident and Critical Illness Policies
Employees enrolled in the HDHP and their dependents are automatically enrolled in the Voya Insurance Plans below. Employees enrolled in the PPO have the option to purchase one or both of the Voya Insurance Plans below for themselves and their dependents.

Voya Accident Insurance
Voya Critical Illness
Voya Insurance - How to File a Claim
Voya Insurance - Wellness Benefit Claim

Health Savings Accounts
Employees enrolling in the HDHP must set up a BMO Harris HSA account by Lively to receive the district's HSA deposits.

BMO Harris HSA presented by Lively
Use this link to enroll.

IRS Qualified Expenses

2024 HSA Additional Payroll Deduction Form

Health Risk Assessments
Each Spring, employees can choose to participate in the Health Risk Assessment Program.  This is a voluntary process, but if you are enrolled in the district insurance and do not choose to participate, you will pay an extra monthly charge.

HNI Account Manager
Margarita Lewison is our Account Manager at HNI Risk Services of Wisconsin.  Margarita is available to help with healthcare coverage questions on your behalf while maintaining HIPAA compliance.  Contact Margarita at mlewison@hni.com.

Dental Insurance Coverage

Delta Dental Summary of Benefits

Vision Insurance Coverage

NVA Vision Benefit Summary

Veterinary Pet Insurance

Nationwide Pet Insurance

Employee Trust Funds

Wisconsin Retirement System (WRS)
If you are expected to be employed for at least one year and expected to work at least two-thirds of full-time, you will be enrolled in the Wisconsin Retirement System.  If you previously worked in a WRS-covered position and did not take a separation benefit, you retain your earlier rights under the previous eligibility criteria.

Wisconsin Public Employers Group Life Insurance Program
If you are WRS eligible and under the age of 70, you may enroll in the Wisconsin Public Employers Group Life Insurance Program.

Beneficiary Designation Form
A beneficiary is a person(s) or entity named to receive benefits upon your death. The beneficiary designation on file at the time of death is binding in the payment of your benefits.  If a beneficiary is not designated, benefits will be paid according to 
Wisconsin law and standard sequence.  If you wish to designate a beneficiary(ies), complete the Beneficiary Designation Form (ET-2320) above and mail to WI ETF at the address in the upper left hand corner of the form.

ETF Evidence of Insurability
Employees who did not enroll for group life insurance coverage during their initial enrollment period, or insured employees who wish to apply for more insurance for themselves or their spouse or dependents, may apply using this form. See your human resource department for an enrollment form.

Payroll Forms

2024 Federal W-4 Employee's Withholding Certificate
If you would like to make changes to the tax deductions, complete this form and return it to payroll.

2024 Wisconsin WT-4 Exemption Certificate
If you would like to make changes to your WI tax deductions, complete this form and return it to payroll.