GreenwichCentral School District

1. My WinCapWeb
2. IRS form W-4
3. IT-2104 form
4. Substitute Packet Teaching
5. Substitute Packet Non-Teaching

Health Insurance

Summary of Benefits:

• PPO Benefit Summary
• ALT PPO Benefit Summary
• HRA Benefit Summary
• Summary of all Plans
• Summary of Benefit Glossary
• Health Insurance Change Form
• Letter from Empire on Billing Procedure for HRA Members

• Video - How to access your HRA Spending Account

• Presentation on ALT PPO & HRA Plans

Medicare:

• Medicare & You 2022
• CDPHP Medicare Advantage Information Packet

OTHER FORMS

• Expense Report Form (Excel)
• Claim Form
• Payroll Claim Form
• Damaged-Lost-Stolen Equipment Form

Unemployment Fraud...
You can report UI benefits fraud three ways:

Report UI Fraud (Online Form)
Click the button to use our Online Form

Call our hotline toll-free at (1-888) 598-2077

Report by mail to:

NYS Department of Labor
Office of Special Investigations
Bldg 12 - Room 200
W. Averell Harriman Campus
Albany, NY 12240

Customer should review information on identity theft on IRS and Federal Trade Commission websites

https://www.identitytheft.gov/

https://www.irs.gov/newsroom/taxpayer-guide-to-identity-theft

Flex Forms

• FSA Enrollment Form
• Flex Brochure
• Election Change Form
• Eligible Items
• Flexible Spending Plan Reimbursement Voucher

Reference Documents

1. CHIP (Children Health Insurance Program)
2. Pupil Benefits Medical Claim Form
3. Pupil Benefits Parent Information Brochure

Washington County Civil Service

• Open Jobs and Exam Announcements
• Blank Civil Service Application for Washington County Employment/Exams