EMPLOYEE BENEFITS INFORMATION 

***2020 OPEN ENROLLMENT MATERIALS  WILL BE POSTED  MONDAY,  OCTOBER 21, 2019 (1st Day of Open Enrollment)*****                                                                                                                                                                                                                                    Employee Health & Benefits Guide and Forms -                                                          Health, Life and Flexible Spending Account                                                     

  1. 2019 Open Enrollment Guide with Rates - Employees & Retirees
  2. Benefit Enrollment Form
  3. Basic Life Insurance Enrollment and Beneficiary Designation Form (PDF)
  4. Supplemental Life and Evidence of Insurability Form (PDF)
  5. Flexible Spending Account (FSA) Enrollment Form (2019)
  6. Employee Benefit Handbook
  7. Dependent Life Insurance Enrollment Form (PDF)
  8. Sick Leave Bank Enrollment Form

457 Deferred Compensation Plan

  1. ICMA-RC 457 Enrollment Form (Employer Plan Number - 303368)
  2. ICMA Traditional and Roth IRA Authorization Form (PDF)
  3. ICMA-RC IRA or ROTH Application Form
  4. ICMA Emergency Withdrawal Form 457
  5. ICMA Employee Information Change Form (PDF)
  6. 2019 Deferred Compensation Change Form
  7. 2019 457 ANNUAL LEAVE ELECTION FORM

Occupational Health

  1. Authorization for Evaluation and Treatment at Secure Medical Care (PDF)
  2. Directions to Cardiovascular Consultants (PDF)
  3. Directions to Hiland and Associates Office in La Plata (PDF)
  4. Directions to Secure Medical Care Both Locations (PDF)

Tuition Assistance Program

  1. TAP Practice and TAP Application (PDF) ( Amended 9-17-2018)
  2. TAP Procedure (PDF) (Amended 9-17-2018)

Domestic Partner Documents 

  1. Domestic Partner Recertification
  2. Domestic Partnership Agreement and Affidavit

Prepaid Legal Plans 

  1. Legal Resources
  2. U.S. Legal Services