Human Resources

Employee Forms & Benefits

Policy Manual

  1. Fayette County Policy Manual 10-25-22

Benefits Materials

  1. 2022 VSP Overview (PDF)
  2. 2023 H S A Summary of Benefits (PDF)
  3. 2023 PPO Summary of Benefits (PDF)
  4. American Fidelity Benefit Overview (PDF)
  5. CCAO 457 Deferred Compensation (PDF)
  6. CEBCO - Anthem 2023 booklet (PDF)
  7. CompPsych Guidance Resources (PDF)
  8. Hartford Overview 2022 (PDF)
  1. HSA Summary Plan Description (PDF)
  2. JFS Delta Dental Summary of Benefits (PDF)
  3. JFS VSP 2022 overview (PDF)
  4. Ohio Deferred Compensation Program Highlights (PDF)
  5. PPO Summary Plan Description (PDF)
  6. Superior Dental Plan Description (PDF)
  7. HSA 2022 Overview (PDF)

Forms

  1. CEBCO - Anthem Change Request Form (PDF)
  2. CEBCO Enrollment Form (PDF)
  3. Delta Dental Enrollment Form (PDF)
  4. Direct Deposit Form (PDF)
  5. Hartford Beneficiary Designation Form (PDF)
  1. Hartford Enrollment Form 2022 (PDF)
  2. IT 4 State Tax Form (PDF)
  3. Superior Dental Enrollment Form (PDF)
  4. VSP Enrollment Form (PDF)
  5. W-4 2023

Legal Notices

  1. 2022-23 CEBCO Wellness Program (PDF)
  2. 2022-23 HIPAA Notice of Privacy Practices (PDF)
  3. 2022-23 WHCRA Notice (PDF)
  1. Auditor of States Fraud Reporting (PDF)
  2. CEBCO Drug Coverage and Medicare (PDF)
  3. Market Place Health Coverage (PDF)