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**NEW** Employee Health Care Benefits Forms
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Effective January 1, 2016, all benefit eligible employees will have health care benefits with the Stark County Schools Council of Governments Consortium.
All benefit eligible employees are required to submit the
Application (Medical, Prescription, Dental, and Vision) and
Enrollment Form (Life Insurance) to:
Department of Human Resources / Attn: Benefits * (330-744-6964 p /330-744-5295 f)
474 Bennington Ave., Youngstown, OH 44505
Information about a change in the Medical Mutual Network, effective, Jan. 1, 2019
Flexible Spending Account form
Benefit eligible employees hired after July 1, 2015, are also required to submit theSpouse Eligibility CertificationForm.
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Link to: Application (Medical, Rx, Dental, and Vision)
-For Benefit Eligible Employees
Link to: Enrollment Form (Life Insurance)
-For Benefit Eligible Employees
Link to: Spouse Eligibility Certification
-Applies to Benefit Eligible Employees hired after JULY 1, 2015.