Benefit Forms

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.

Selection	File type icon	File name	Description	Size	Revision	Time	User

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

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

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

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

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

Selection	File type icon	File name	Description	Size	Revision	Time	User
	Ċ	View Download	Worker's Compensation Forms	219k	v. 2	Dec 6, 2016, 8:19 AM	Laura Corley
	Ċ	View Download	FY17 WCSS Work Comp Panel of Physicians	97k	v. 2	Dec 6, 2016, 8:19 AM	Laura Corley

White County is a State Charter School District and is located in the foothills of the Appalachian Mountains in North Georgia.

There are two main towns located in White County, Cleveland our county seat, and Helen.

Cleveland is the home of the famous Cabbage Patch Kids and Truett McConnell College.

Helen is Georgia's Alpine Village nestled in the mountains and is a favorite vacation site for many visitors.

The School System serves about 3,900 K-12 students with two of our schools

having achieved Georgia Schools of Excellence. We are committed to providing

the best possible education to all the students of White County.

White County School System

136 Warriors Path, Cleveland, GA 30528

Phone: 706-865-2315