FY16 Benefit Information

Health Plan Benefits and Enrollment Forms

Harvard Pilgrim Subscriber Benefits and Enrollment Forms

HMO Summary of Benefits and Coverage
POS Summary of Benefits and Coverage
PPO Summary of Benefits and Coverage
Harvard Pilgrim HMO enrollment/change form
Harvard Pilgrim POS enrollment/change form
Walgreen's Prescription Mail-In service form
Wellness Reimbursement Form (including list of reimbursable activities) 

SaveOn Program, begun December 2013
SAU 70 is taking part in this program, which rewards Harvard Pilgrim members for finding lower-cost tests and procedures.
Link to an informative flyer;  Link to a short video with further information.

Vermont BlueCross BlueShield Subscriber Benefits and Enrollment Form

JY Summary of Benefits and Coverage
VHP Summary of Benefits and Coverage
$300 Comp Summary of Benefits and Coverage
BlueCross BlueShield of Vermont enrollment form

Life Insurance/Longterm Disability Form

Lincoln Life and Longterm Disability Insurance enrollment form

Investment Enrollment Information

General Employment Forms for SAU 70 Employees

Direct Deposit Form
Direct Deposit Form - School Year
403b Salary Reduction Form
W-4 Form (You can type in this form online before printing)
Vermont W-4 Form
I-9 Employment Eligibility Verification (Read online, then type in your information on Page 7 while online, then print Page 7 and sign.)
Notice of Accidental Injury or Occupational Disease
Employee Address and Name Change Form
Important Phone Numbers
2015-2016 SAU office holidays

Ċ
Bridget Peters,
May 23, 2014, 12:58 PM
Ċ
Bridget Peters,
May 16, 2016, 6:29 AM
Ċ
Bridget Peters,
Aug 5, 2013, 8:44 AM
Ċ
Bridget Peters,
Aug 2, 2013, 12:29 PM
Ċ
Bridget Peters,
Aug 2, 2013, 12:51 PM
Ċ
Bridget Peters,
Nov 12, 2013, 12:09 PM
Ċ
Bridget Peters,
Nov 12, 2013, 12:09 PM
Ċ
Bridget Peters,
May 23, 2014, 12:58 PM
Ċ
Bridget Peters,
Aug 2, 2013, 12:25 PM
Ċ
Bridget Peters,
Aug 2, 2013, 1:11 PM
Ċ
Bridget Peters,
Aug 2, 2013, 12:29 PM
Ċ
Bridget Peters,
May 23, 2014, 12:58 PM
Ċ
Bridget Peters,
Aug 2, 2013, 12:25 PM
Ċ
Bridget Peters,
May 23, 2014, 1:03 PM
Ċ
Bridget Peters,
Aug 2, 2013, 12:25 PM
Ċ
Bridget Peters,
Sep 25, 2015, 5:47 AM
Ċ
Bridget Peters,
Aug 2, 2013, 1:11 PM
Ċ
Bridget Peters,
Dec 20, 2013, 5:45 AM
Ċ
Bridget Peters,
Nov 12, 2014, 12:58 PM
Ċ
Bridget Peters,
Nov 12, 2014, 12:54 PM
Ċ
Bridget Peters,
Aug 2, 2013, 12:29 PM
Ċ
Bridget Peters,
Jan 5, 2016, 5:57 AM
Ċ
Bridget Peters,
Aug 2, 2013, 1:11 PM
Ċ
Bridget Peters,
Aug 2, 2013, 12:25 PM
Ċ
Bridget Peters,
Nov 6, 2013, 6:44 AM