Board policy 407.6, Licensed Employee Early Retirement, allows the employee to continue to participate in the school district's group health insurance plan until age 65 by meeting the requirements of the insurer.
The licensed employee is responsible for the cost of the health insurance premium. The licensed employee must pay the employee's share of the premium by paying the monthly premium amount in full to the board secretary prior to the due date of the school district's premium payment to the insurance carrier.
The undersigned licensed employee __________________ (does, does not) wish to continue to participate in the school district's group health insurance plan.
______________________________________ ________________
Licensed Employee Date
Approved: 02/13/2023 Reviewed: __________ Revised: ___________