Payroll & Benefits Forms and Information
PAYROLL INFORMATION
Deferred Compensation Policy (School Employees)
Exempt Employees Qualifications
Payroll Call-in Deadlines – 2023/2024
Payroll Forms
New Hire Onboarding Instructions
Change/Transfer/Re-Hire Employee Information
Paycor Online Paystub Registration Instructions
Teacher Salary Scale – 2023/2024
Tax Forms
IRS Form I-9 (Employment Eligibility)
IRS Form W-4 (Federal Withholding)
KY Form K-4 (Kentucky Withholding)
OH Form IT-4 (Ohio Withholding)
IN Form WH-4 (Indiana Withholding)
DIOCESAN PROVIDED BENEFITS
Lay Employee Benefits Summary – 2023/2024
Medical
Open Enrollment Memo to Employees – 2023/2024
Anthem Medical and Vision Summary of Benefits – 2023/2024
Required Disclosure – PPACA Summary of Benefits and Coverage – 2023/2024
Required Disclosure of Your Rights and Protedtions Against Surprise Medical Bills
US Government Annual Health Plan Notices
Medical Insurance Rates – 2023/2024
Anthem Application Form
Anthem Application Form – Excel Fill-In
Anthem Application Form – Paper Form
Anthem Live Health Online Program
Anthem Certificate Request Form
Medicare Creditable Coverage Notice
Lay Employees Pension Plan (Defined Benefit)
Open Enrollment Packet 2023 – Lay Employees’ Pension Plan
Pension Plan – Web Portal User Guide
Pension Plan Participation Waiver Form
OPEN ENROLLMENT FORMS – The following three forms are ONLY applicable during the open enrollment period (month of October) for employees that have previously opted out of participation and wish to re-join the plan. All new hires are automatically enrolled in the Pension Plan and complete all applicable forms during the hiring process.
Pension Plan Beneficiary Designation
Pension Plan Employment Record Form
Tax sheltered Retirement Plan (403b Account)
VOLUNTARY EMPLOYEE BENEFITS
Voluntary Insurance Summary of Benefits – 2023/2024
Voluntary Insurance & Flexible Spending Enrollment Form – 2023/2024
Flexible Spending Accounts
Flexible Spending Enrollment Brochure
Flexible Spending Summary Plan Description
Flexible Spending – Carryover Provisions
Dental Plan
NEW PLAN for 2023/2024:
Delta Dental Summary & Information
Insurance Plans
Group Term Life and AD&D Insurance Rates
Long Term Disability Insurance Rates
Universal Life Insurance
Universal Life Insurance Brochure
Accelerated Death Benefit Information for KY
Premiums
Universal Life Premiums – Weekly ($4/$6/$8)
Universal Life Premiums – Weekly ($10/$12/$14)
Universal Life Premiums – Policy Value ($25k/$50k/$100k)
Auto-Home Insurance
Auto-Home Insurance Discount Program
Request for Auto/Homeowners Quote
Click Here to See a Video with More Information
Identity Theft Protection & Legal Services
Legal Shield~ID Shield Brochure
Legal Shield~ID Shield Application