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Personnel - Forms and Important Links
Medical & Dental Options
Open Enrollment for Medical/Dental Benefits
Notification for change in coverage must be submitted to the Central Office between June 1st and June 15th to be effective for July 1st.
Medical and Dental Benefits
Type
Name
125 Medical Plan Description
BCBS Enroll Form
Dental Enroll Form
HIPPA Employee Notification
School Medicare Part D Notice 2011-12
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Annuity/Retirement Information
Type
Name
2012 403b Annual Elect Notice
403(b) Eligibility Notification Form
Annuity Comp Contact Info 12-1-10
CPI Elective Deferral and Vendor Election Form 8-10
IRS Publ 571 - Tax Annuity 12-2010
Policy 403b - GBB rsvd
Social Security - Windfall Elimination Provision
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General Forms and Information
Type
Name
BCB Conflict of Interest
Dir Dep Form
Life Insurance Enrollment Form
Name-AddressChangeForm
W-4 Form 2012
Whistleblower Policy
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Important Links
Delta Dental of RI - Link to Online Benefits
Employees Retirement System of RI
AESOP Online
The TRUST - Preferred Physician Network
RI Certification Log-in Screen
IRS Bulletin - Add'l Tax when Deferring Income
Social Security - Windfall Provision
CPI - 403b Plan - Third Party Administrator
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