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Voorheesville Central School District
Employee Forms
2020-2021 Blueshield Benefit Summary
PPO 815 Class 0003.0004 BS - 2020.pdf
555.08 KB
(Last Modified on May 21, 2020)
Comments (-1)
HIPPA Authorization
HIPAA AUTHORIZATION.doc
32 KB
(Last Modified on May 21, 2020)
Comments (-1)
2021-2020 CAPITAL AREA SCHOOLS HEALTH INSURANCE CONSORTIUM (CASHIC)
CASHIC Enrollment Form with group.pdf
201.33 KB
(Last Modified on May 21, 2020)
Comments (-1)
2020 - 2021 Blueshield SBC ASO RX
ASO RX class 0001.0002 SBC.pdf
177.03 KB
(Last Modified on May 21, 2020)
Comments (-1)
2021-2020 Voorheesville CSD CDPHP EPO Plan Benefit Summary
2020 Voorheesville CSD Benefit Summary.pdf
196.96 KB
(Last Modified on May 21, 2020)
Comments (-1)
Sexual Harassment Policy & Form
Policy 0110. Sexual Harassment Policy 8.26.19.pdf
363.21 KB
(Last Modified on August 29, 2019)
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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)
Comments (-1)
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)
Comments (-1)
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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2020 - 2021 SBC Blueshield
PPO 815 Class 0003.0004 SBC - 2020.pdf
972.76 KB
(Last Modified on May 21, 2020)
Comments (-1)
2020 - 2021 Blueshield ASO RX
ASO RX class 0001.0002 BS.pdf
112.67 KB
(Last Modified on May 21, 2020)
Comments (-1)
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
7 19 CanaRX.pdf
361.05 KB
(Last Modified on September 3, 2019)
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2020-2021 HEALTH COMPARISON
20 21 HEALTH COMPARISON.xlsx
16.99 KB
(Last Modified on May 21, 2020)
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2020-2021 Health/Dental Election Form
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ELECTION FORM20-21.doc
29.5 KB
(Last Modified on May 21, 2020)
Comments (-1)
2019-2020 RETIREE HIPAA AUTHORIZATION
HIPAA AUTHORIZATION.pdf
11.84 KB
(Last Modified on May 29, 2019)
Comments (-1)
2020-2021 RETIREE RATE SHEET - UEV
20-21 UEV RETIREE HEALTH RATES.xlsx
12.77 KB
(Last Modified on May 21, 2020)
Comments (-1)
2020-2021 RETIREE RATE SHEET - VTA/VAA
2020-21 RETIREE VTA VAA RATES.xlsx
12.66 KB
(Last Modified on May 21, 2020)
Comments (-1)
2019-2020 School Calendar
School 2019-2020.pdf
279.42 KB
(Last Modified on May 29, 2019)
Comments (-1)
2020-2021 UEV Rate Sheet
20-21 UEV HEALTH DENTAL RATES.xlsx
10.73 KB
(Last Modified on May 21, 2020)
Comments (-1)
2020-2021 VTA/VAA Rate Sheet
20-21 VTA-VAA HEALTH DENTAL RATES.xlsx
10.55 KB
(Last Modified on May 21, 2020)
Comments (-1)
2019 W4
2019 W4.pdf
2.69 MB
(Last Modified on December 20, 2018)
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