Employee Benefits Forms & Brochures

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5 E. South Street, Hernando, MS 38632
PH: (662) 429-5271 | FX: (662) 429-4198

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Employee Benefits Forms & Brochures

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662.449.7112

BENEFITS FORMS

Change in Status Form
Benefits Contact Information
COBRA
HIPPA Privacy Notice
Notice of Enrollment Rights

DENTAL & VISION

Dental ID Card
Dental & Vision Application
Dentist Nomination Form
Guardian Anytime Website
New Dental & Vision Rates Effective 01/19/19
Vision ID Card
2019 - 2020 Dental & Vision Benefit Summary

HEALTH

2019 Summary of Benefits for Base & Select Coverage
2020 HEALTH RATES.pdf
Amwell Online Doctor Visits
Glossary of Medical Terms
Health Insurance Reference Guide
State of MS Application
Wellness Exam Guidelines

LIFE

State of Mississippi Life Insurance Application
Evidence of Insurability - Late Enrollee
Portability Packet for Life Insurance
Beneficiary Designation Online Instructions
State Life Ins Beneficiary Designation Form
Conversion Brochure
State Life Insurance Plan Certificate
State Life Insurance Rates

MISCELLANEOUS

Employee Assistance Program Support Services
Affordable Care Act Information Marketplace
American Fidelity-Beneficiary Change Form
American Fidelity-Gap Claim Form
American Fidelity Disability Claim Form
American Fidelity Reimbursement Form

OTHER CARRIERS

2019 Wellness Webinars
Active Health Guide
July Handout
LegalShield - IDShield Application
LegalShield - IDShield Information
MACS & MPACT Payroll Deposit Information
Mississippi College Savings MACS & Impact Program
Mississippi Deferred Compensation
TELAMED

DCS is committed to providing a work environment that is free of discrimination. It is the policy of DCS that all applicants and employees are entitled to equal employment opportunity regardless of race, color, religion or creed, gender (includes pregnancy or related medical conditions), national origin, age, disability, veteran status or other protected characteristics as required by local, state and federal law.

The DeSoto County School District is also committed to providing a website that is accessible to the widest possible audience, regardless of technology or ability. This website endeavors to comply with best practices and standards defined by Section 508 of the U.S. Rehabilitation Act. If you would like additional assistance or have accessibility concerns, please contact the webmaster at (662) 449.7183. We are always striving to improve the accessibility standards of our website. For more information, please visit our Website Accessibility page.

PRIVACY POLICY

TERMS OF USE

ACCESSIBILITY POLICY

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