EMPLOYEE BENEFITS INFORMATION 

                                                                                                                                                                                Employee Health & Benefits Guide and Forms -                                                          Health, Life, LTD, Sick Leave Bank and Flexible Spending Account                                                     

  1. Health Plan Price Transparency in Coverage
  2. 2023 BENEFITS GUIDE FOR EMPLOYEES AND RETIREES
  3. 2023 PREMIUM RATES FOR EMPLOYEES AND RETIREES
  4. OE 2023 INFOR ESS USER GUIDE 10-17-2022
  5. 2023 FSA MNCPPC ELECTION-CHANGE FORM
  6. 2023 MissionSquare 457 Deferral Election/Change Form
  7. Employee and Retiree 2022 Benefits Guide
  8. 2022 Healthcare Plan Rates
  9. Employee Benefits Handbook
  10. Benefit Enrollment/Change Form
  11. 2022 FSA ELECTION-CHANGE FORM
  12. Life Insurance Beneficiary Designation Form (Basic/AD&D/Supplemental/PDF)
  13. FOP ADDITIONAL LIFE $50k Designation of Beneficiary Form
  14. Supplemental Life and Evidence of Insurability Form (PDF)
  15. Dependent Life Insurance Enrollment Form (PDF)
  16. Life Insurance Brochure/Rate Worksheet
  17. Sick Leave Bank Enrollment Form
  18. Supplemental Long Term Disability (Salary Must Be Greater Than or Equal to $108,000)
  19. Guide to VIewing Current Benefits and Designating Your Group Life Beneficiaries Using ESS
  20. M-NCPPC Behavioral Health Resources Snapshot 2020

457 Deferred Compensation Plan

  1. EASY Enrollment NOW-MissionSquare 457 Retirement Plan-Computer, Tablet or Mobile Device
  2. Maximize Your MissionSquare 457 Plan Retirement Benefits
  3. MissionSquare (formerly ICMA-RC) 457 Enrollment Form (Employer Plan Number - 303368)
  4. ICMA Traditional and Roth IRA Authorization Form (PDF)
  5. ICMA-RC IRA or ROTH Application Form
  6. 5 Reasons to Choose an ICMA-RC Payroll Roth IRA
  7. MISSIONSQUARE (formerly ICMA-RC) Emergency Withdrawal Form 457
  8. ICMA Employee Information Change Form (PDF)
  9. 457 Deferred Compensation Change Form (2021)
  10. 2022 MissionSquare (formerly ICMA) 457 Deferral Election/Change of Contribution Form

Occupational Health

  1. Authorization for Evaluation and Treatment at Secure Medical Care (PDF)
  2. Directions to Cardiovascular Consultants (PDF)
  3. Directions to Hiland and Associates Office in La Plata (PDF)
  4. Directions to Secure Medical Care Both Locations (PDF)

Tuition Assistance Program

  1. TAP Practice and TAP Application (PDF) ( Amended 9-17-2018)
  2. TAP Procedure (PDF) (Amended 9-17-2018)

Domestic Partner Documents 

  1. Domestic Partner Recertification
  2. Domestic Partnership Agreement and Affidavit

Prepaid Legal Plans 

  1. Legal Resources