EMPLOYEE BENEFITS INFORMATION 

                                                                                                                                                                                Employee Health & Benefits Guide and Forms -                                                          Health, Life, LTD, Sick Leave Bank and Flexible Spending Account                                                     

  1. Health Plan Price Transparency in Coverage
  2. Employee and Retiree 2023 Benefits Guide
  3. 2023 Healthcare Plan Rates
  4. Employee Benefits Handbook
  5. Benefit Enrollment/Change Form
  6. Flexible Spending Account Election Form 2023
  7. Life Insurance Beneficiary Designation Form (Basic/AD&D/Supplemental/PDF)
  8. FOP ADDITIONAL LIFE $50k Designation of Beneficiary Form
  9. Supplemental Life and Evidence of Insurability Form (PDF)
  10. Dependent Life Insurance Enrollment Form (PDF)
  11. Life Insurance Brochure/Rate Worksheet
  12. Sick Leave Bank Enrollment Form
  13. Supplemental Long Term Disability (Salary Must Be Greater Than or Equal to $108,000)
  14. Guide to VIewing Current Benefits and Designating Your Group Life Beneficiaries Using ESS
  15. M-NCPPC Behavioral Health Resources Snapshot 2020

457 Deferred Compensation Plan

  1. EASY ONLINE ENROLLMENT - MissionSquare 457/Roth & Traditional IRAs
  2. Maximize Your MissionSquare 457 Plan Retirement Benefits
  3. MissionSquare (formerly ICMA-RC) 457 Enrollment Form (Employer Plan Number - 303368)
  4. ICMA Traditional and Roth IRA Authorization Form (PDF)
  5. ICMA-RC IRA or ROTH Application Form
  6. 5 Reasons to Choose an ICMA-RC Payroll Roth IRA
  7. MISSIONSQUARE (formerly ICMA-RC) Emergency Withdrawal Form 457
  8. ICMA Employee Information Change Form (PDF)
  9. MissionSquare 2023 457 Deferred Compensation Change 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