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Active Employee


BENEFIT DECLINATION FORM 


HEALTH - GROUP INSURANCE COMMISSION
(New employee coverage begins on the 1st of the month following 60 calendars days from the  first date of employment)

DENTAL - DELTA DENTAL
(Coverage begins 1st of the month following first date of employment)
FLEXIBLE SPENDING - CAFETERIA PLAN ADVISORS (CPA)
LIFE INSURANCE - BOSTON MUTUAL  (New Hire Enrollment Only)
AFLAC
LONG TERM DISABILITY - SUN LIFE FINANCIAL (SCHOOL ONLY - New Hire Enrollment Only)
403B  - TSA CONSULTING GROUP  (SCHOOL ONLY)
457 DEFERRED COMPENSATION - MASS SMART PLAN