Southwest Allen County Schools

• Click Plan Document Summary for the Plan Document and Summary Plan for SACS prior to 2025.
• Click Plan Amendment for Plan Document Schedule of Benefits Amendment Effective 1/1/22-12/31/2024.

- MEDICAL -                  

Benefit Guide 

2024 SACS Benefit Guide 
Three Rivers Preferred Plus  

• In-Network Hospitals

Three Rivers Preferred Plus Traditional Plan A EPO 2024

• Schedule of Benefits

Three Rivers Preferred Plus Traditional Plan B PPO 2024

• Schedule of Benefits

Three Rivers Preferred Plus High Deductible HSA Plan A EPO 2024

• Schedule of Benefits

Three Rivers Preferred Plus High Deductible HSA Plan B PPO 2024

• Schedule of Benefits

Health Savings Account

• HSA Information                                                               
• UMB – How to use your HSA

Flexible Spending Account                                                                                           

• Flex Spending Account

Pharmacy / Caremark prior to 2025

• Pharmacy / Caremark

- VISION -

• Schedule of Benefits
• Limited Summary

- DENTAL -

• Schedule of Benefits
• Limited Summary

-MEDICAL PROVIDERS-

• View in-network medical providers

- Allie Benefit CLAIM FORMS – Effective 1/1/25

• Allied Medical Claim Form
• Allied Dental Claim Form
• Allied Vision Claim Form
• Allied/Caremark Prescription Claim Form

- Employee Plans CLAIM FORMS – Claims Through 12/31/24

• Medical
• Vision
• Dental

RETIREMENT

• INPRS (IN Public Retirement System)
• TRF Information (Teachers Retirement Fund) 
• PERF Information (Public Employees Retirement Fund)
• 403-B
• 403-B Salary Reduction form (Please return this form to Diane Wilson in the Business Office)
• CONTACT INFORMATION FOR BENEFIT VENDORS
• EMPLOYEE PLANS
• EMPLOYEE ASSISTANCE PROGRAM
• SACS ONSITE CLINIC
• TICKETS AT WORK