Southern York County School District P.O. Box 128, Glen Rock, Pennsylvania 17327-0128 www.sycsd.org
Telephone (717) 235-4811
Fax (717) 235-0863
2015 - 2016 School Year STUDENT ACCIDENT INSURANCE Dear Parents & Guardians: The School District does not carry medical insurance on students but has arranged to offer student accident insurance at parent/guardian expense. A brochure describing the benefits and limits of the program as well as an enrollment form may be accessed at www.sycsd.org, click on Student Insurance under Quick Links on the left side of the District’s website. Two plans are available:
$28 premium - School Time Coverage $124 premium - 24Hour Coverage
The 24Hour Coverage provides continuous around the clock accident coverage for your child from the effective date to the opening of next school term. Questions may be directed to A-G Administrators at (610) 933-0800. Additional dental accident coverage is not available, however the medical insurance coverage does provide the following dental benefit: For treatment, repair, or replacement of each injured tooth, which was sound and natural at the time of injury, $300 per tooth. To purchase Student Accident Insurance, download the form from the website. Complete a separate application for each child you wish to enroll. Return the application, with your check or money order made payable to United States Fire Insurance Company ℅ AG Administrators, Inc. Mail to: A-G Administrators P.O. Box 979 Valley Forge, PA 19482
If unable to access the application, please call the District’s Administrative Services at 235-4811, extension 7278 and we will be happy to mail an application form to you. If you should have a claim under this policy, claim forms can be downloaded at www.agadministrators.com Claim forms are also available in each school office. Sincerely,
Debra Baker Koller Administrative Services