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BCSD #61
118. W. Bullion St.
Hailey, ID 83333
208-578-5000
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New Staff Benefit Information and Forms
(for New Hires)
 Please Read:
The following is a preview of your benefit package with
Blaine County School District. We will be distributing a paper packet
and discussing your benefits in detail with you at your
orientation. Therefore, do not worry about printing or completing forms,
unless you desire to do so. Your benefits are scheduled to take
effect the first day of the month following your hire date, as long as you have submitted all of the required forms.
If you have any questions, please contact Human
Resources at (208) 578-5000.
Summary & Checklist of All Benefits
- forms in blue are required and
may be printed, completed, and returned at orientation.
Medical Insurance
- form in blue is required and may be printed, completed,
and returned at orientation (choose between PPO or HD PPO) .
Prescriptions
(optional
forms)
- Express Scripts RX Mail Form
(optional - for use with
Traditional BlueCross Plan; get a 90-day supply of brand-name
medication for $20 or generic medication for $10)
- BlueCross Prescription Reimbursement Form
(optional - only
necessary to use if you need reimbursement for a prescription filled at a
local pharmacy before you receive your BlueCross Enrollee ID card)
Dental Insurance
- form
in blue is required and may be printed, completed, and returned at orientation.
Vision Insurance
(employee automatically
enrolled)
Life Insurance
- form in
blue is required and may be printed,
completed, and returned at orientation.
Flexible Benefit Plan
(optional
enrollment)
Employee Assistance Plan
(employee
automatically enrolled)
Retirement Plans
- form in
blue is required and may be printed,
completed, and returned at orientation.
Other Forms for ALL NEW STAFF
- forms in
blue are required and may be printed, completed, and
returned at orientation.
-
W-4 Form (Taxes)
- required
form - may print, complete, and return at orientation
- I-9 Employment Eligibility Verification Form
- required form - will complete at orientation. Please
bring your choice of identification with you to orientation
- Emergency Records Form
- required form - may print, complete, and return at orientation
- Policy Acceptance Form
- required form - may print, complete, and return at orientation
- Safe Workplace Form
- required form - may print, complete, and return at orientation
- Network Acceptable Use Agreement
- required form - may print, complete, and return at orientation
- Professional Liability Insurance Carrier List
- required form - may print, complete, and return at orientation
- Professional Liability Insurance Disclosure Form
- required form - may print, complete, and return at orientation
- Privacy Notice for BCSD
- required form - may print, complete, and return at orientation
- Privacy Notice Signature Page
- required form - may print, complete, and return at orientation
- Payroll Direct Deposit Form (optional, but highly recommended)
- Voluntary Payroll Deduction Vendor List (for
your review)
-
OMNI Group 403 (b) Salary Reduction Agreement
- required form - must accept or decline participating
- Bloodborne Pathogen Informational Handout (for your review; we will also show a film on this subject at orientation)
- COBRA Informational Handout (for your information, in case you leave employment with us)
Other Forms for CERTIFIED PROFESSIONAL Staff
- forms in
blue
is required and may be printed, completed, and returned at
orientation.
Other Forms for NON-CERTIFIED (CLASSIFIED) Staff
- forms in
blue
are required and may be printed, completed, and returned at
orientation.
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