Go to Benefit Forms
***Retiree Health Insurance Info Session with GTCMHIC - 11/21/2024 @ 11:00am*** CLICK HERE
Open Enrollment 2025 - Benefits Info Session Recordings
- WATCH THIS - It Impacts EVERYONE on Health Insurance in 2025
- ONLY AVAILABLE THIS OPEN ENROLLMENT
- Tompkins County Core Benefits Overview
- Excellus BCBS Health Insurance
- CanaRx Prescription Insurance
- CSEA EBF Dental and Vision Plans
- The Hartford Supplemental Benefits
- MassMutual Whole Life Insurance
- Employee Assistance Program
- GTCMHIC Preparing for Retirement
Benefit Forms
- Bereavement Form
- Bereavement Policy
- EAP (Employee Assistance Program) Information
- Excused Leave
- Fitness Program and Weight Management Reimbursement Form
- Flexible Spending Account/Health Reimbursement Account (VEBA)
- Health Insurance Waiver
- IT2104 Form (NYS Tax withholding form) - Please send completed form to Payroll
- Medical Leave
- Medical/Prescription Insurance
- Military Leave Policy
- Military Leave of Absence Form
- NYS Deferred Compensation Plan
- NYS Retirement
- Retiree Health Insurance Information
- Reasonable Accomodation Policy
- Reasonable Accommodation Request Form - ADA Accommodation
- Reasonable Accommodation Request Form - Religious Accommodation
- Reasonable Accommodation Request Form - Domestic Violence Accommodation
- Student Loan Forgiveness
- W-4 Form (Federal Tax withholding form) - Please send completed form to Payroll
FLEXIBLE WORK SCHEDULE INFORMATION
Appendix A - Request for Flexible Work Schedule Form
Appendix B - Flexible Work Schedule Agreement
TELEWORK AGREEMENT INFORMATION
Appendix A - Request for Telework Arrangements
Appendix B - Telework Agreement
Appendix C - Telework Weekly Log