Payroll and Insurance Forms for All Staff
Payroll and Insurance Forms and Information:
State of Ohio IT-4 Withholding Form
Municipal Income Tax Withholding Authorization Form
Employee Withholding Exemption Certificate
ACH Direct Deposit for Reimbursements
STRS Ohio Member Resources
Member Services Center toll-free number: 1-888-227-7877
Member website: www.strsoh.org
Member email: ContactUs@strsoh.org
SERS Ohio Member Resources
Website: www.ohsers.org
Members toll-free: (866) 280-7377
Retirees toll-free: (800) 878-5853
Insurance Information and Forms:
HIPPA Privacy Rights Notice 2012
Summary of Benefits and Coverage Medical Plan 1
Glossary of Health Coverage and Medical Terms
Medical Mutual Health Information
Flexible Benefit Summary Plan Document (Medical and Dependent Care)
Census Change Form - to update name, address, add/drop dependents, etc.
Dependent Forms Coverage - Understanding your dependents coverage.
Job Calendars 2012-2013:
Counselor extended day calendar
12 month classified staff and supervisors
224 day lead administrative assistant
217 day Administrative Assistant
210 day Administrative Assistant
202 day Administrative Assistant
Bus Drivers and Monitors (bus, cafeteria and playground)
