Human Resources/ Open Enrollment Forms
 
 
Online W2 Enrollment
2019 Payroll Calendar
2019 Holiday Calendar
 
Health Insurance    
NYSHIP
 
2019 NYSHIP Choices
2019 Empire Plan Supplement
2019 Empire Plan Flexible Formulary
PS 404 Health Insurance Enrollment & Change Form
Voluntary Salary Deduction Agreement for Retiree Health
 
Dental Insurance    
Metlife
Enrollment and Change Form
Metlife Dental Plan Booklet
 
Vision and Legal    
Metlife Vision Benefits Overview
Metlife Vision Enrollment Form
Vision Claim Form
Eye Exam - What is Covered?
MetLaw Summary of Benefits
MetLaw Enrollment Form
Hyatt Legal Fee Schedule
Hyatt Legal Fact Sheet
Legal Certificate of Coverage
Family Matters Brochure
LifeStages Identity Management Services Brochure
Vision and Legal Presentation
Frequently Asked Questions
 
Flexible Benefit Programs    
DAC online
Employee User Guide for the Wealthcare Admin Portal
FAQ's for Flexible Spending Accounts
Mobile App Information
W-10 for Dependent Care Enrollment
2019 Transportation & Parking Enrollment Form
2019 Health Flex & Dependent Care Enrollment Form
2019 Healthflex Reimbursement Form
2019 Dependent Care Reimbursement Form
2018 Parking Reimbursement Form
2019 Health & Dependent Care Qualifying Event Change Form
 
Health Buy Out    
2019 Health Buy Out Enrollment Form
Health Buy Out Summary of Provisions
 
Life Insurance    
Life Insurance Beneficiary Form
Optional Life Enrollment Form
Statement of Health
Optional Life Rate Chart
 
TIAA    
Roth Contribution Option
Contact your RFMH Human Resources/Payroll Team    
 


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