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Benefits Forms

This section provides information and forms regarding the benefits available to WCC employees.

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A. FMLA
  File Name File Size Last Updated
FMLA Request Form (REV 2009) 10.85 KB 06/04/2009

B. Health Care Coverage
  File Name File Size Last Updated
Coordination of Benefits 16.59 KB 09/08/2008
Declaration of Intent for 2010 30.43 KB 10/16/2009
Opt Out of Coverage 8.49 KB 09/08/2008

C. Health Expense Reimbursement
  File Name File Size Last Updated
College Provided Reimbursement Request IG, Temp Fac & NOPT 12.04 KB 01/03/2012
Flexible Spending Reimbursement Request 190.61 KB 10/24/2011
Flex Spending Direct Deposit Authorization 74.7 KB 06/15/2009
Health Savings Account 2012 Payroll Deduction Authorization 35.21 KB 01/05/2012
WCC Medical Reimbursement (Faculty) 56.62 KB 08/17/2010
WCC Medical Reimbursement 2012 ( CM and OPTA) 56.39 KB 07/13/2011

D. Retirement
  File Name File Size Last Updated
403b Salary Reduction Agreement 2012 28.5 KB 10/24/2011
457 Salary Reduction Agreement 2012 28 KB 10/24/2011

E. Tuition Reimbursement
  File Name File Size Last Updated
Independent Staff - Outside WCC Tuition Reimbursement 95.02 KB 11/06/2008
OPTA - Outside WCC Tuition Reimbursement 95.87 KB 11/06/2008
PT WCC Tuition Grant Request Form 10.98 KB 06/30/2010



Health Insurance | Dental Insurance | Vision Insurance | Life Insurance | Long Term Disability | Flexible Spending Accounts | Employee Assistance Program | Retirement | Tuition Grants | WCC Flexible Benefits Plan Policy | Compliance Notification




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