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Division of Human Resources
Human Resources Recruitment and Staffing
Staffing
Teaching Positions
Teacher Recruitment Events
Lead Positions
Support Positions
Contact Us
Temporary Services
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Hiring Groups & Processes
Maryland Healthy Working Families Act
Certification
Teacher Certification
Tuition and License Reimbursement
Professional Development
Certification Cohorts
Salary Guidelines
Employment Verification
Contact Certification
Office of Position Management and Classification
Contact Us
Upcoming Events
Human Resources Operations
Benefits, Leaves, and Retirement
Families First Coronavirus Response Act (FFCRA)
Leaves of Absence
HR Approved Leaves of Absence
Adoption
Conversion of Personal Illness to Family Illness
Maternity
Paternity
Short Term Unpaid
FMLA
Board Approved Leaves of Absence
Academic/Educational
Child Rearing
Military
Personal
Personal Illness
Sabbatical
Unusual and Imperative
Forms
Benefits
Costs
Benefits Enrollment
New Hires
Open Enrollment
Health Improvement Tour
Qualifying Life Events
COBRA
Retiree Benefits
Plan Documents
Forms
Retirement Resources
Maryland State Retirement
Baltimore County Employees Retirement
403(b) and 457(b) Supplemental Retirement
Forms
Employee Assistance Program
Work / Life Support Resources including child care, eldercare and pet care
Legal & Financial Resources
Alcohol & Drug Education Resources
Mental Health & Well-Being Resources
Working from Home Tips & Tools
Transitioning Back to School Tips & Tools
Self-Care Information including Mindfulness
Intimate Partner Violence Resources
COVID-19 Information
Resources & Readings on Race
Employee Wellness
General Health and Well-Being
Nutrition
Activity Programs
Weight Loss Programs
Other Offerings
Site Based Activities
5k Series
Forms Repository
Active Employee Benefits Guide
Retiree Benefits Guide
Contact Us
Employee Absence and Risk Management
Absence Management
IDM
EAMP
Risk & Insurance
Environmental Issues
Property Damage or Loss
School-Sponsored Activities
Student Accident
Visitor Accident
Workers' Compensation
COVID-19 Returning to Work
Contact Us
Employment Dispute Resolution
Contact Us
Equal Employment Opportunity
Contact Us
EEO Investigations
ADA Accommodations
EEO Complaints and Procedures
Fingerprinting
Contact Us
Investigations and Records Management
Contact Us
Staff Relations and Employee Performance Management
Contact Us
Extra Dutiy Activities (EDA)
Calendar
Staff Directory
Home
Division of Human Resources
Human Resources Recruitment and Staffing
Staffing
Teaching Positions
Teacher Recruitment Events
Lead Positions
Support Positions
Contact Us
Temporary Services
Contact Us
Hiring Groups & Processes
Maryland Healthy Working Families Act
Certification
Teacher Certification
Tuition and License Reimbursement
Professional Development
Certification Cohorts
Salary Guidelines
Employment Verification
Contact Certification
Office of Position Management and Classification
Contact Us
Upcoming Events
Human Resources Operations
Benefits, Leaves, and Retirement
Families First Coronavirus Response Act (FFCRA)
Leaves of Absence
HR Approved Leaves of Absence
Adoption
Conversion of Personal Illness to Family Illness
Maternity
Paternity
Short Term Unpaid
FMLA
Board Approved Leaves of Absence
Academic/Educational
Child Rearing
Military
Personal
Personal Illness
Sabbatical
Unusual and Imperative
Forms
Benefits
Costs
Benefits Enrollment
New Hires
Open Enrollment
Health Improvement Tour
Qualifying Life Events
COBRA
Retiree Benefits
Plan Documents
Forms
Retirement Resources
Maryland State Retirement
Baltimore County Employees Retirement
403(b) and 457(b) Supplemental Retirement
Forms
Employee Assistance Program
Work / Life Support Resources including child care, eldercare and pet care
Legal & Financial Resources
Alcohol & Drug Education Resources
Mental Health & Well-Being Resources
Working from Home Tips & Tools
Transitioning Back to School Tips & Tools
Self-Care Information including Mindfulness
Intimate Partner Violence Resources
COVID-19 Information
Resources & Readings on Race
Employee Wellness
General Health and Well-Being
Nutrition
Activity Programs
Weight Loss Programs
Other Offerings
Site Based Activities
5k Series
Forms Repository
Active Employee Benefits Guide
Retiree Benefits Guide
Contact Us
Employee Absence and Risk Management
Absence Management
IDM
EAMP
Risk & Insurance
Environmental Issues
Property Damage or Loss
School-Sponsored Activities
Student Accident
Visitor Accident
Workers' Compensation
COVID-19 Returning to Work
Contact Us
Employment Dispute Resolution
Contact Us
Equal Employment Opportunity
Contact Us
EEO Investigations
ADA Accommodations
EEO Complaints and Procedures
Fingerprinting
Contact Us
Investigations and Records Management
Contact Us
Staff Relations and Employee Performance Management
Contact Us
Extra Dutiy Activities (EDA)
Calendar
Staff Directory
Division of Human Resources
»
Division of Human Resources
»
Human Resources Operations
»
Benefits, Leaves, and Retirement
»
Benefits
»
Forms
Forms
Costs
Benefits Enrollment
Retiree Benefits
Plan Documents
Forms
Forms
BENEFITS FORMS
Benefits Enrollment/Change Form:
Benefits Enrollment/Change Form
Medical:
Cigna Medical Claim Form
Cigna Transition of Care/Continuity of Care with Mental Health Form
Prescription:
Cigna Prescription Drug Claim Guide Sheet (under 65)
(Instructions for completing the drug claim form)
Cigna Prescription Drug Claim Form (under 65)
Dental:
CareFirst Dental Claim Form
Vision:
Car
eFirst Davis Vision Reimbursement Claim Form
Flexible Spending Account:
Benefit Strategies FSA Enrollment
(new enrollments only)
To enroll in a FSA plan during Open Enrollment (either health care or dependent care) please visit
the
Benefit Strategies Portal
. Employees must use their Employee ID found on the home screen of ESS, under General Information. Social security numbers may not be used for enrollment in a FSA health care or dependent care account. For troubleshooting assistance, please
call 1-888-401-3539.
FSA Overview
FSA Health Care Eligible Expenses
FSA Dependent Care Eligible Expenses
FSA Tax Savings Calculator
Life Insurance and PAI (Personal Accident Insurance)
MetLife Employee Enrollment/Change Form
M
etLife Statement of Health
M
etLife Beneficiary Designation
Division of Human Resources
6901 N Charles Street, Towson, MD 21204
Phone
443-809-4191
Fax
Division of Human Resources