Insurance Forms

• Blue Cross Blue Shield Enrollment/Change Form
• Northeast Delta Dental Enrollment/Change Form
• FSA & DCA Enrollment Form
• HSA Enrollment Form

Payroll

• W-4
• Automatic Deposit Enrollment/Change Form
• 403(b) ROTH Agreement
• 403(b) Salary Reduction Agreement
• 403(b) Participating Providers
• Pay Schedule for 2023-2024

Workers Comp

• Accident Report Form

Health Insurance

• Benefits Guide
• VEHI Health Plan Comparison
• Health Rates - 7/23-12/23
• HRA Summary of Benefits
  • Gold
  • Gold CDHP
  • Platinum
  • Silver CDHP
• Prescription Information
• 2023 HEA VEHI Benefit Wrap
• 2023 HAA VEHI Benefit Wrap
• 2023 ESP - FY VEHI Benefit Wrap
• 2023 ESP - SY VEHI Benefit Wrap

Dental Insurance

• Outline of Coverage

Vision

• EyeMed

HRA

• HRA Fact Sheet
• HRA Essential Guide ER Pay HPC

HSA

• BCBSVT Further Partnership
• HSA Fact Sheet
• HSA Essential Guide
• HSA Worksheet

FSA

• FSA Fact Sheet
• FSA Medical Care - Essential Guide
• FSA Medical - Worksheet
• FSA Dependent Care - Essential Guide
• FSA Dependent Care - Worksheet

403b

• Plan Summary Info. 2023
• 403(b) ROTH Agreement
• 403(b) Salary Reduction Agreement
• 403(b) Participating Providers

Alisha St George
Human Resources
802-295-8600
stgeorgea@hartfordschools.net

Who Does What at the Superintendent's Office

• What is the Employee Assistance Program?
• Online portal for stress tools for VT school employees

• Request a Personal/Emergency Day
• Request a Professional Day

• HSD Response Page

(Click the image for details)

(Click the image for details)