File Library

2018 - 2019 SBC CDPHP

2018 2019 CDPHP SBC.pdf 758.08 KB (Last Modified on April 17, 2018)

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2018 - 2019 SBC Express Scripts

18 19 RX SBC.pdf 495.47 KB (Last Modified on April 27, 2018)

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2018- 2019 VCSD Empire EPO

18 19 VCSD EMPIRE EPO SBC.pdf 990.6 KB (Last Modified on April 19, 2018)

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2018- 2019 VCSD Empire PPO

18 19 VCSD - EMPIRE PPO SBC .pdf 1.02 MB (Last Modified on April 19, 2018)

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2018-19 Pay Date Schedule

18-19payschedule .pdf 7.41 KB (Last Modified on April 17, 2018)

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2018-2019 CanRx Voorheesville Meds

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

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2018-2019 HEALTH COMPARISON

18 19 HEALTH COMPARISON ACTIVE EMPLOYEES.pdf 320.99 KB (Last Modified on April 18, 2018)

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2018-2019 Health/Dental Election Form

All employees must fill this out and return to Lori Saba by June 1, 2018 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, 2018 payroll check.

ELECTION FORM.pdf 70.79 KB (Last Modified on April 17, 2018)

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2018-2019 RETIREE HIPAA AUTHORIZATION

RETIREE HIPAA AUTHORIZATION .pdf 24.51 KB (Last Modified on April 17, 2018)

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2018-2019 RETIREE RATE SHEET - UEV

18 19 UEV RETIREE HEALTH RATES .pdf 187.47 KB (Last Modified on April 17, 2018)

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2018-2019 RETIREE RATE SHEET - VTA/VAA

2018-2019RETIREE VTA VAA RATES.pdf 180.83 KB (Last Modified on April 17, 2018)

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2018-2019 School Calendar

School 2018-2019.pdf 312.02 KB (Last Modified on April 17, 2018)

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2018-2019 UEV Rate Sheet

18 19 UEV HEALTH DENTAL RATES.pdf 100.62 KB (Last Modified on April 17, 2018)

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2018-2019 VTA/VAA Rate Sheet

18 19 VTA HEALTH DENTAL RATES.pdf 97.77 KB (Last Modified on April 17, 2018)

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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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Certification of Medical Necessity

Certification_of_Medical_Necessity.pdf 92.62 KB (Last Modified on August 21, 2017)

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Claim Form

Claim Form.pdf 11.12 KB (Last Modified on May 13, 2019)

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Delta Dental Benefits

DELTABENEFITS.PDF 1.06 MB (Last Modified on September 25, 2014)

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Delta Dental Enrollment Form

deltadentalenrollmentfrm.pdf 144.26 KB (Last Modified on September 25, 2014)

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Dependent Care Expense Claim

BT FSA -- Dependent Care Expense Claim Form February 2011.pdf 115.70 KB (Last Modified on September 25, 2014)

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Doctor Fax Form

Doctor Fax Form 02.14.pdf 90.39 KB (Last Modified on September 25, 2014)

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Employee Forms