Benefits & Payroll Services
Ms. Leyshla M. Patel - Employee Benefits Coordinator
Phone: (732) 376-6200 ext. 30-124Ms. Maria M. Hernandez - Payroll
Phone: (732) 376-6200 ext. 30-127Ms. Rosemarie Gragnano - Payroll
Phone: (732) 376-6200 ext. 30-123178 Barracks Street
Perth Amboy, NJ 08861
For information & questions, please contact Member Services at 1-866-658-2455 or visit their website for a list of providers: http://www.aetna.com/
- Aetna Complaint & Appeal Form
- Aetna Dependent Continuation Ages 26 - 31
- POS II monthly rate plan = $559.14
- POS monthly rate plan = $595.46
- PPO monthly rate plan = $676.24
- Aetna Request for Disabled Dependent
- Aetna EAP (Employee Assistance Program)
- Aetna Medical Claim Form
- Aetna POS II: Plan Summary
- Aetna POS: Plan Summary
- Aetna PPO: Plan Summary
- Aetna Specialty Care Rx Program
- Health Insurance Premium Form 2017-2018
- Health Insurance Premium Form 2017-2018 (Administrators and Supervisors)
For information & questions, please contact Member Services at 1-877-723-6005 or visit their website for participating pharmacies: http://www.benecardpbf.com/
- Benecard Dependent Continuation 26 - 31
- Monthly rate plan = $149.83
- Benecard Mail Order Form
- Benecard Plan Summary
- Benecard Summary of Benefits Coverage
- Benecard Reimbursement Form
DELTA DENTAL (Dental)
For information & questions, please contact Member Services at 1-800-452-9310 or visit their website for participating dentists: http://www.deltadentalnj.com/
VISION SERVICE PLAN (Vision)
For information & questions, please contact Member Services at 1-800-877-7195 or visit their website for a list of providers: http://www.vsp.com
HARTFORD (Voluntary Disability & Life Insurance)
The Perth Amboy Board of Education offers Voluntary Long-Term Disability & Voluntary Life Insurance through The Hartford Insurance Company. If you are interested in either insurance, please complete an enrollment form & return it to the Benefits Department in the Business Office. Upon leaving your employment with the Board of Education, you may continue your Life Insurance by completing the portability form &submitting it directly to The Hartford.
LIFE 1-888-563-1124 LTD 1-800-741-4306
FAX 1-866-344-9747 FAX 1-888-393-2106
- Enrollment Form (New employees must submit this form within 31 days of their hire date.)
- Change of Beneficiary
- Insurability Questionnaire (Employees who did not enroll within 31 days of their hire date.)
- LTD & Life Insurance Highlights
- Long Term Disability Claim Packet
- Portability vs Conversion Summary
- Portability/Conversion Form (Retirees must complete form within 31 days of retirement in order to continue life insurance.)
The district uses the Qual-Lynx call center for all worker's compensation accidents. An incident form MUST be completed & forwarded to the Nurse & Benefit Coordinator within 24 hours of the accident's occurrence. The incident form can be obtained from the school nurse &/or Building Administrator.
IF YOU GET HURT ON THE JOB, TELL YOUR SCHOOL NURSE/BUILDING ADMINISTRATOR IMMEDIATELY AND CALL QUAL-LYNX AT 1-800-425-3222. IN CASE OF AN EMERGENCY, GO TO THE NEAREST HOSPITAL OR MEDICAL FACILITY AND TELL YOUR SCHOOL NURSE/BUILDING ADMINISTRATOR WITHIN 24 HOURS.
PLEASE NOTE THAT ALL MEDICAL APPOINTMENTS RELATED TO A WORKER'S COMPENSATION CLAIM MUST BE MADE BEFORE OR AFTER SCHOOL HOURS!
BOLLINGER INSURANCE (Student Accidents)
The Perth Amboy Board of Education offers Student Accident Insurance through Bollinger. This insurance covers students for accidents that occur on our premises. Please note that the parent's insurance MUST be utilized prior to this insurance. Bollinger can be reached at:
PO Box 1346
Morristown, New Jersey 07962
VERIFICATION OF EMPLOYMENT:
All forms MUST be received by the payroll department Monday - Thursday to be processed by Friday. Once completed, verified & signed by the Business Administrator, the forms will then be faxed to the Mortgage/Bank Companies. THERE WILL BE NO EXCEPTIONS.
All forms pertaining to your payroll/personal information MUST be received one (1) week prior to the pay date. Updates/New Direct Deposits will take into effect after two (2) pay periods.
- Direct Deposit Form
- Change of Address / Change of Name Form
- Paycheck Definitions
- Payroll Schedule 2016-2017
- Withholding Allowance Taxation Form (NJ-W-4-WT)
NEW JERSEY DIVISIONS OF PENSIONS & BENEFITS
All Perth Amboy Board of Education employees MUST be enrolled in one of the following NJ State Pension plans depending on their position:
- TPAF (Teachers’ Pension & Annuity Fund) is for certified staff. Employees who qualify are: Teachers, Guidance Counselors, Social Workers, Nurses, Principals, Vice-Principals & Administrators.
- PERS (Public Employees’ Retirement System) is for non-certified staff. Employees who qualify are: Secretaries, Law Enforcement Officers, Custodial Staff, Food Service Staff & Transportation Staff.
- DCRP (Defined Contribution Retirement Program) is for part-time enrollees that work less than 32 hours per week.
All employees MUST enroll in the MBOS (Member Benefit Online System). Please visit the pension website at http://www.state.nj.us/treasury/pensions/ to enroll.
- Account of Statement
- Beneficiary Changes
- Pension - Address Change (For retired members only.)
- Pension - Name Change (Must be notarized.)
- Pension Loans
- Pension Retirement Checklist
- Purchase Application (Employees may be eligible to buy back time absent from work, i.e. leave of absence.)
RETIREMENT CHECKLIST: PABOE Retirement Procedure
- Retirement Letter to the following: Superintendent, Director of Personnel & Evaluations & Your building Principal.
- Retirement Application via MBOShttp://www.state.nj.us/treasury/pensions/
- Advise Social Security. (If age appropriate.)
- Complete the Pension's Health Insurance Form. Please visit this link for a video presentation on health benefits.
- Pension's Direct Deposit Form
- PABOE's Continuation of Health Benefits for retired members.
Pension inquiries can be directed to Maria Hernandez at ext. 30.127 or the Pension Help Desk at 1-609-777-0534 / 1-609-292-7524. You can also email them via the contact us link at the bottom of their website.
TAX SHELTER COMPANIES (403b)
The Perth Amboy Board of Education has partnered with several Tax Shelter (403b) companies to provide employees with a tax-deferred way to save for their future. Enrollment in these plans are voluntary. Employees should make sure to research all companies & tax-shelter plans prior to completing the “Salary Modification Form.” The following companies are Board approved:
- Met Life
- Lincoln Investment Planning
Any questions regarding 403B investments should be directed to your Tax-Shelter representative.
CENTRAL JERSEY FEDERAL CREDIT UNION
The Perth Amboy Board of Education offers employees the opportunity to enroll in the Central Jersey Federal Credit Union for all banking needs: savings & checking accounts, summer savings, loans, mortgages, etc. Please visit the Credit Union’s website for more information or visit a local office:
380 Berry Street 130Maple Avenue
Woodbridge, NJ 07095 South Plainfield, NJ 07080