The Human Resources and Payroll Department handles many issues. You may use the information below to access forms or websites that you may need to make changes to your benefits or to learn more about them. If you have questions or comments please use the form at the bottom of the page.
Forms and Resources
2017-2018 Work Calendars: Classified and Certified work calendars
Blue Cross Application: Use this form to make changes to your Blue Cross Health Insurance Plan
CHIPRA Notice: Federal form regarding potential state assistance with healthcare premiums
Direct Deposit: Use this form to authorize payroll payments directly to your bank accounts
Education Foundation Deduction: Use this form to donate part of your paycheck to the Jefferson Education Foundation
EOBs for Buy Down: Information for submitting Explanation of Benefits forms for the Buy Down Program
Flex Reimbursement: Use this form if you have a Section 125 Flex account
Healthcare Exchange Notice: Federal form notice regarding the district’s health plan
Healthy Measures Application: Use this form to apply to participate in the Healthy Measures Buy Down Program
Life Map Beneficiary: Use this form to change those designated as beneficiaries for Life Map insurance.
PERSI 401k: Use this form for PERSI Choice 401k Plan changes
PERSI Beneficiary: Use this form to change those designated as beneficiaries for PERSI
Payroll Deduction Authorization: Use this form to make changes to an authorized payroll deduction
W-4 Changes: Login to iVisions to change your number of deductions on your W-4
Additional Links for More Information
For additional questions or comments you may contact the Human Resources and Payroll Department using the form below.