Go to Benefit Forms
New Employee Benefits Info Session Recordings
The following info sessions cover the new employee benefits available to county employees effective 07/01/2024. The last day of Open Enrollment is 05/31/2024 and the last day to make any last corrections/adjustments is 06/07/2024. If you only have time to watch ONE recording, watch the All New Benefits Overview.
Whole Life Insurance: What it is and how to apply (without talking to anyone)
The Hartford Benefits Overview
MassMutual Whole Life Overview
Benefit Forms
- Bereavement Form
- Bereavement Policy
- EAP (Employee Assistance Program) Information
- Excused Leave
- Fitness Program and Weight Management Reimbursement Form
- Flexible Spending Account/Health Reimbursement Account (VEBA)
- Health Insurance Waiver
- IT2104 Form (NYS Tax withholding form) - Please send completed form to Payroll
- Medical Leave
- Medical/Prescription Insurance
- Military Leave Policy
- Military Leave of Absence Form
- NYS Deferred Compensation Plan
- NYS Retirement
- Retiree Health Insurance Information
- Reasonable Accomodation Policy
- Reasonable Accommodation Request Form - ADA Accommodation
- Reasonable Accommodation Request Form - Religious Accommodation
- Reasonable Accommodation Request Form - Domestic Violence Accommodation
- Student Loan Forgiveness
- W-4 Form (Federal Tax withholding form) - Please send completed form to Payroll
FLEXIBLE WORK SCHEDULE INFORMATION
Appendix A - Request for Flexible Work Schedule Form
Appendix B - Flexible Work Schedule Agreement
TELEWORK AGREEMENT INFORMATION
Appendix A - Request for Telework Arrangements
Appendix B - Telework Agreement
Appendix C - Telework Weekly Log