Payroll & Benefits Forms and Information
PAYROLL INFORMATION
Deferred Compensation Policy (School Employees)
Exempt Employees Qualifications
Payroll Call-in Deadlines – 2022/2023
Payroll Forms
New Hire Onboarding Instructions
Change/Transfer/Re-Hire Employee Information
Paycor Online Paystub Registration Instructions
Substitute Teacher Pay Form – 2022/2023
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 – 2022-2023
Medical
Open Enrollment Employee Memo – 2022/2023
Anthem Medical and Vision Summary of Benefits – 2022/2023
PPACA Summary of Benefits and Coverage Required Disclosure – 2022/2023
Required Disclosure of your Rights and Protections Against Surprise Medical Bills
US Government Annual Health Plan Notices
Medical Insurance Rates – 2022/2023
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)
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 – 2022/2023
Voluntary Insurance & Flexible Spending Enrollment Form – 2022/2023
Dental Plans
Dental Care Plus
Dental Care Plus Brochure – 2022/2023
Dental Care Plus Total Vision Service Plan
Dental Care Plus Hearing Service Plan
Dental Care Plus Portal Instructions
Insurance Plans
Group Term Life Insurance Rates – 2022-2023
Long Term Disability Insurance Rates – 2022-2023
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)
Long Term Care Insurance
Long Term Care Insurance Program
Long Term Care Insurance Information
Long Term Care Insurance Brochure
Auto-Home Insurance
Auto-Home Insurance Discount Program
Request for Auto/Homeowners Quote
Click Here to See a Video with More Information
Flexible Spending Accounts
Flexible Spending Enrollment Brochure
Flexible Spending Summary Plan Description
Flexible Spending – Carryover Provisions
Identity Theft Protection & Legal Services
Legal Shield~ID Shield Brochure – 2022-2023
Legal Shield~ID Shield Application – 2022-2023