Treasurer’s Office Forms and Resources
Treasurer’s Office Forms and Resources
2026 Wellness Screening Sign Up Website
Current Business Mileage Rate is $0.725 effective 01/01/2026
Insurance
- Medical Claim Form
- Dental Claim Form
- Vision Claim Form
- Express Care Online Member Flyer
- Cleveland Clinic Express Care Online Step-by-Step Instructions Document
- Express Scripts Mail Order Form
- Flexible Spending Medical Claim Form
- Flexible Spending Dependent Care Form
- MHS-MMO Enrollment Form
- Spousal Coordination of Benefits Form
- Affordable Care Act Employee Information Document
- All Model Notice Document
- Medicare Part D 2025 Creditable Coverage Notice
- Medical Mutual Supermed Network Website
- Notice of Privacy Practices Document
- Test Definitions from the Wellness Screening Document
- 2015 Questions and Answers Internal Revenue Service Form 1095-C
- Marketplace Exchange Notice Document
- Non-Discrimination Notice Document
- Employee Health
Payroll
- Pay Date Schedule 2025-2026
- Tax-Sheltered Annuity Providers Document updated as of December 1, 2024
- Section 403(b) Plan Salary Reduction Agreement Form
- Federal Tax Withholding Form
- State Tax Withholding Form
Other Resources