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HaddonáTownship School District will be holding á
OPEN ENROLLMENT
for the 2017-2018 school year
MAY 2017

This is the only time you can make changes or enroll into the HT benefit plan. áIf you are enrolling or making changes, please see information (and fill out the enrollment forms) below. áIf you are waiving benefits, information about our waiver and enrollment also follows. áPlease note that you can still take Dental and Prescription coverage without affecting your waiver. If you have questions or concerns please contact Dorothy Miller at extension 1105.

Please be sure to return the PURPLE form that you will be receiving at the end of April to the BOE office. á
According to ACA regulations we need a response from every eligible employee.
á
Benefit Information and Enrollment Forms
Click hereáfor Amerihealthá
Click here for NVAávisoná
Click here for Delta Dentalá
Click here for Benecard Rx
Click hereáfor Premium Sharing Chart.

Waiver Information and Enrollment Form
Click here for 2017-2018 School YearáWaiverá

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FSA - Open Enrollment for 2018 is in Nov/ Dec 2017
Click hereáfor FSA 2017 Information Booklet

Click hereáfor 2017 FSA Enrollment forms

Pension
Click hereáforáMBOSáregistration instructions (Access to info regarding your PENSION).

Other Benefits
Click here for information on 403B Universal Availability Notice and Providers.
Click here for Direct Deposit EnrollmentáForm.
Click here áfor Summer SavingsáEnrollment Form (Teachers Only)
Click hereáforáSUMMER SAVINGS Address ChangeáForm.

Leave of Absence Information and Forms
Click here for FMLA Fact Sheet
Click hereáforáFMLAáapplication.
Click here for FMLA Physician Certification forms for yourself.
Click here for FMLA Physician Certification forms for a family member.

Click hereáforáNJFLAáapplication.
Click hereáforáNJFLAáfact sheet.

Other Forms

Click here for Change of Address Form.á
Click here for 2017 FEDERAL W-4 to change marital status/ deductions
Click here for 2017 STATE W-4 to make any changes such as increasing deductions.

á
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