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Information for Employees

Employee Reference Section

Commonly Requested Forms Notes
21/22 Payroll Calendar Updated 7/21/21
2021 Expense Form Updated 7/21/21
Approved 403b Providers  

 

Family Medical Leave Act (FMLA) 

Requests for FMLA should be completed and returned to the Office of Fiscal & Personnel Services with as much notice as possible. In response to your request, you will receive a letter that outlines your leave dates and the number of accrued days that will be available for use. Please direct questions to cpeer@griswoldpublicschools.org. 

Request for Leave Under FMLA - General request form to be completed by the employee. 

Request for Employee Health Condition - Health care provider input required. 

Request for Family Member Health Condition - Health care provider input required.

Griswold Education Association - Frequently Asked Questions

 

Health Insurance 

Anthem Life Form

Anthem Life Beneficiary Change Form

Anthem Drug Formulary List

Century Preferred (PPO) Benefit Summary

Anthem Lumenos HSA Plan Summary

Anthem Lumenos HRA Plan Summary

Dental Benefit Summary

Vision Benefit Summary

Enrollment / Change form

 

Health Savings Account Direct Deposit Form

(Please note, a deposit into your health savings account cannot be made until you are active on a High Deductible Health Plan, for GPS that is after July 1st.)

You can find more information on Health Savings Accounts and High Deductible Health Plans here:

http://www.hsacenter.com/

www.irs.gov

IRS Publication 969 (Guidelines to HSA)

 

Helpful Videos

HSA Saving for Retirement & Healthcare

What is the difference between an HMO, PPO, and HDHP Plan?

High Deductible Health Plan (HDHP) & Health Savings Account (HSA) Basics

HDHP vs PPO