Payroll

Forms
I-9    I-9 Form & Instructions
W-4
Direct Deposit Form
Drug Testing Policy - 300.20a
Drug Testing Policy Acknowledgement

Blue Cross  - Health Insurance
Website

Employee Health Coverage Application

Employee Waiver of Coverage

Preferred Blue PPO for Statewide Schools - $1,000 Deductible

Persons Covered Total
Cost		 Employee
Cost
Employee $638.43 $-0-
Employee/Spouse 1,368.78 730.35
Employee/1 Child 967.08 328.65
Employee/2+Children 1,119.23 480.80
Family 1,581.78 943.35







HSA Blue PPO for Statewide Schools - Economy Option - $3,000 Deductible

Persons Covered Total Cost Employee Cost
Employee $503.13               $   -0-
Employee/Spouse 1,071.03 567.90
Employee/1 Child 758.68 255.55
Employee/2+Children 876.98 373.85
Family 1,236.68 733.55
District Contribution
to HSA		 135.30 $-0-

Delta Dental
Website
Area PPO Providers
Area Premier Providers
General Benefit Plan Summary
Enrollment Form

Lifemap Vision
VSP Info
Vision Summary
Vision Enrollment
Vision Waiver
 Persons Covered
Employee
Employee/Spouse
Employee/Child
Employee/Children
Family


Employee
Employee/Spouse
Employee/Children
Family
 Total Cost
$32.66
  65.31
  64.90
  95.07
125.81


  6.63
13.25
14.19
22.66 		Employee Cost
$ -0-
  32.65
  32.24
  62.41
  93.15


  -0-
   6.62
   7.56
  16.03

Public Employees Retirement System of Idaho (PERSI)
Website
Beneficiary Designation
Choice 401k Forms and Information