Look below for Health, Dental, Vision, Flexible Spending, Workers Comp, FMLA and other leave forms. Please contact Laura Corley at 706-865-2315 x 1701 or email laura.corley@white.k12.ga.us with any questions. See SHBP Legal Notices in the SHBP folder below. |
Departments > Benefits >
Benefit Forms
| Selection | File type icon | File name | Description | Size | Revision | Time | User |
|---|
ACA - Affordable Care Act| Selection | File type icon | File name | Description | Size | Revision | Time | User |
|---|---|---|---|---|---|---|---|
| Ċ | View Download |
Affordable Care Act Notice 10/1/2013 | 1062k | v. 2 | Dec 6, 2016, 8:05 AM | Laura Corley |
| Selection | File type icon | File name | Description | Size | Revision | Time | User |
|---|---|---|---|---|---|---|---|
| Ċ | View Download |
Dental Plan Documents | 204k | v. 2 | Dec 6, 2016, 7:56 AM | Laura Corley | |
| Ċ | View Download |
Dental Plan Documents | 189k | v. 2 | Dec 6, 2016, 7:56 AM | Laura Corley |
| Selection | File type icon | File name | Description | Size | Revision | Time | User |
|---|---|---|---|---|---|---|---|
| Ċ | View Download |
FMLA - Employee Request Form for Self, Spouse, Parent or Child | 139k | v. 2 | Dec 6, 2016, 7:51 AM | Laura Corley | |
| Ċ | View Download |
Long Term Leave Request Form | 292k | v. 2 | Dec 6, 2016, 8:05 AM | Laura Corley | |
| Ċ | View Download |
FMLA - Physician Statement | 190k | v. 2 | Dec 6, 2016, 7:45 AM | Laura Corley |
| Selection | File type icon | File name | Description | Size | Revision | Time | User |
|---|---|---|---|---|---|---|---|
| Ċ | View Download |
Flexible Spending Account Forms and Documents | 179k | v. 2 | Dec 6, 2016, 8:06 AM | Laura Corley | |
| Ċ | View Download |
Flexible Spending Account Forms and Documents | 1957k | v. 2 | Dec 6, 2016, 8:06 AM | Laura Corley | |
| Ċ | View Download |
Flexible Spending Account Forms and Documents | 141k | v. 2 | Dec 6, 2016, 8:06 AM | Laura Corley |
| Selection | File type icon | File name | Description | Size | Revision | Time | User |
|---|---|---|---|---|---|---|---|
| Ċ | View Download |
3074k | v. 2 | Dec 6, 2016, 8:14 AM | Laura Corley | ||
| Ċ | View Download |
69k | v. 2 | Dec 6, 2016, 8:14 AM | Laura Corley | ||
| Ċ | View Download |
106k | v. 2 | Dec 6, 2016, 8:14 AM | Laura Corley | ||
| ĉ | View Download |
17k | v. 2 | Dec 6, 2016, 8:14 AM | Laura Corley | ||
| Ċ | View Download |
Create online Social Security Account | 620k | v. 2 | Dec 6, 2016, 8:07 AM | Laura Corley |
| Selection | File type icon | File name | Description | Size | Revision | Time | User |
|---|---|---|---|---|---|---|---|
| Ċ | View Download |
1333k | v. 3 | Dec 6, 2016, 8:26 AM | Laura Corley | ||
| ć | View Download |
2017 Active Employee Benefits Presentation | 328k | v. 2 | Dec 6, 2016, 7:56 AM | Laura Corley | |
| Ċ | View Download |
2017 SHBP Enrollment Form | 352k | v. 2 | Dec 6, 2016, 7:56 AM | Laura Corley | |
| Ċ | View Download |
2017 ACTIVE EMPLOYEE DECISION GUIDE | 2105k | v. 2 | Dec 6, 2016, 7:56 AM | Laura Corley | |
| Ċ | View Download |
2017 ACTIVE EMPLOYEE SHBP RATES | 12k | v. 2 | Dec 6, 2016, 7:56 AM | Laura Corley |
| Selection | File type icon | File name | Description | Size | Revision | Time | User |
|---|---|---|---|---|---|---|---|
| Ċ | View Download |
Sick Leave Bank Form | 122k | v. 2 | Dec 6, 2016, 8:07 AM | Laura Corley |
| Selection | File type icon | File name | Description | Size | Revision | Time | User |
|---|---|---|---|---|---|---|---|
| Ċ | View Download |
VSP Vision Plan Info | 63k | v. 2 | Dec 6, 2016, 7:56 AM | Laura Corley | |
| Ċ | View Download |
VSP Vision Plan Claim Form | 157k | v. 2 | Dec 6, 2016, 8:17 AM | Laura Corley |
