File Library

HRA Direct Deposit

HRA Direct deposit.pdf 50.84 KB (Last Modified on June 18, 2019)

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BT HRA Expense Recovery Form

BT HRA -- Expense Recovery Form.pdf 183.54 KB (Last Modified on June 18, 2019)

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FSA HRS Eligible

FSA_HRA_Eligible.pdf 98.46 KB (Last Modified on June 18, 2019)

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Voorheesville CSD Health Reimbursement Arrangement Enrollment Form

Voorheesville CSD HRA Enrollment Form - 05 15 0219.pdf 124.23 KB (Last Modified on June 18, 2019)

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HRA Overview - Benetech

Voorheesville CSD HRA Overview.pdf 493.63 KB (Last Modified on June 18, 2019)

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2019 - 2020 CDPHP Model Plan SBC

19 20 CDPHP Model Plan SBC.pdf 656.68 KB (Last Modified on May 31, 2019)

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2019 - 2020 SBC CDPHP

19 20 CDPHP SBC.pdf 694.57 KB (Last Modified on May 31, 2019)

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2019 - 2020 Blueshield ASO RX

19 20 Blueshield ASO RX SBC.pdf 238.65 KB (Last Modified on May 29, 2019)

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2019- 2020 SBC Empire EPO

19 20 SBC Empire EPO.pdf 646.5 KB (Last Modified on May 29, 2019)

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2019- 2020 SBC Empire PPO

19 20 SBC Empire PPO9.pdf 652.93 KB (Last Modified on May 29, 2019)

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2019-20 Pay Date Schedule

19-20 pay schedule.pdf 7.29 KB (Last Modified on May 30, 2019)

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2019-2020 CanRx Voorheesville Meds

18 19 VoorheesvilleMeds Enrollment Package 4.18.pdf 574.01 KB (Last Modified on April 23, 2018)

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2019-2020 HEALTH COMPARISON

2019 20 HEALTH COMPARISON ACTIVE EMPLOYEES.pdf 296.59 KB (Last Modified on May 30, 2019)

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2019-2020 Health/Dental Election Form

All employees must fill this out and return to Lori Saba by June 1, 2019 If there are any changes or questions please call me at ext. 106. The three months of health/dental deductions will be taken out of your June 8, 2019 payroll check.

ELECTION FORM.pdf 71.48 KB (Last Modified on May 29, 2019)

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2019-2020 RETIREE HIPAA AUTHORIZATION

HIPAA AUTHORIZATION.pdf 11.84 KB (Last Modified on May 29, 2019)

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2019-2020 RETIREE RATE SHEET - UEV

19 20 UEV RETIREE HEALTH RATES.pdf 189.01 KB (Last Modified on May 29, 2019)

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2019-2020 RETIREE RATE SHEET - VTA/VAA

19 20 VTA HEALTH DENTAL RATES.pdf 99.01 KB (Last Modified on May 29, 2019)

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2019-2020 School Calendar

School 2019-2020.pdf 279.42 KB (Last Modified on May 29, 2019)

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2019-2020 UEV Rate Sheet

19 20 UEV HEALTH DENTAL RATES - revised to only CASHIC MODEL PLAN.pdf 182.02 KB (Last Modified on June 10, 2019)

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2019-2020 VTA/VAA Rate Sheet

19 20 VTA HEALTH DENTAL RATES.pdf 99.01 KB (Last Modified on May 29, 2019)

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2019 W4

2019 W4.pdf 2.69 MB (Last Modified on December 20, 2018)

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403B Eligibility Notification

Benetech is our third party administrators for our 403b plan. The following are the plans we participate in:

American Funds/Capital Guardian

Ameriprise Financial

ASP - ASPire

AXA Equitable Life Insurance Company

Fidelity Group

First Investors Corporation

VOYA National Trust

Lincoln Investment Planning

Mass Mutual

Metropolitan Life Insurance Company

MetLife of CT

NYS Deferred Compensation

Vanguard

Waddell & Reed Inc.

BENETECH403B.PDF 167.29 KB (Last Modified on May 4, 2015)

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CanaRX: VoorheesvilleMeds Enrollment Package

VorrheesvilleMeds Enrollment Package 02.14.pdf 116.12 KB (Last Modified on September 25, 2014)

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Cancer Screening Form

cancerscreeningform.PDF 34.13 KB (Last Modified on November 17, 2014)

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CASHIC Formulary

CASHIC Formulary .pdf 62.84 KB (Last Modified on September 25, 2014)

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Employee Forms