Benefits

Cancer Financial Protection Insurance

• AFLAC Brochure
• AFLAC Wellness Claim Form
• AFLAC Cancer Claim Form
  

Dental Insurance

• Dental Claim Form

Domestic Partner 

• Affidavit of Domestic Partnership
• Eligibility Certification for Dependent Children
• Notice of Termination of Domestic Partnership

Education Benefits

• Tuition Waiver Request

Flexible Spending Account (FSA)

• FSA Medical Reimbursement Form
• FSA Dependent Care Reimbursement Form

Life Insurance

• Life Insurance Beneficiary
• Evidence of Insurability Form

Long Term Disability Insurance

• LTD Medical History Statement

Medical Insurance

• Blue Healthy Choices Life Style Benefits Reimbursement

Retirement

• TIAA-CREF Designation of Beneficiary Notice

Vision Insurance

• Vision Claim Form

Job Reevaluation (Support Staff)

• Support Staff Position Description Questionnaire

Job Description

• Administrative Staff Position Description
• Support Staff Position Description

Payroll

• Direct Deposit
• NYS IT-2104
• W-4

Performance Appraisal

• Support and Administrative Staff Performance Appraisal Form Instructions
• Administrative Staff Performance Appraisal
• Support Staff Performance Appraisal
• Support Staff Standards/Goals Worksheet

Staffing/Employment

• Additional Work Request Form
• Applicant Appraisal
• Exit Questionnaire
• I9 Form and Instructions
• New Employee Welcome Checklist
• Notice of Personnel Action (NPA)
• RBA Staffing Solutions Reference Checking Authorization
• Telephone Reference Check
• Recruitment Satisfaction Survey

Other Forms

• Accident Report Form
• Application for Staff Leave of Absence 
• Change of Address/Name/Telephone Number
• Emergency Contact
• Recreation Card