Skip to Main Content
District Home
Select a School...
Select a School
Somerville High School
Somerville Middle School
Van Derveer
Somerville Highlights
Sign In
Search Our Site
Translate
Select a School
Sign In
Register
User Options
Site Manager
Account Settings
Sign Out
Click to Open Search
Home
Our District
"
Somerville School District
Donations
Collective Bargaining Agreement
Awards
District Dashboard
Superintendent of Schools
Harassment, Intimidation & Bullying
Title IX/Affirmative Action
Highly Qualified Teachers
Inclement Weather/Early Closing Information
Administrative Headquarters Directory
Chain of Command
#Vision2020
Registration
BOE
"
Agendas & Minutes
Board Meeting Videos & Presentations
Board of Education
Policy Explanation Video
Policies
Budget Information
Public Notices
Archived District Policies
21st Cent. Ed.
"
Professional Development
Recent Graduate Survey
Lesson Plan Survey
Technology Integration Lesson Plan Report
Summer Reading Surveys 2014
CID
SBOEAPP
1:1 Chromebook Program
Resources: Grades PS-2
Resources: Grades 3-5
Resources: Grades 6-12
Resources: SBOE Staff
WiFi Hot Spots
21st Century Ed.
Curriculum
"
Curriculum & Instruction
Graduate Course Application Procedure
Curriculum Maps
Achieve NJ
Somerville Academy
Somerville Leadership Institute
Gifted & Talented
Special Services
"
Special Services
Help for Families
Resources
Project Child Find
Athletics
"
Athletics
Employment
"
Employment Opportunities
Employee Forms
Community
"
Latino Advisory Board
Mentoring
Somerville Alumni
Ville Volunteers
Departments
"
Student Info
"
Student Info
Calendar
Open Global Icons
Somerville Public School District
Benefit Forms
Employee Forms
Benefit Forms
Summary of Benefits and Coverage
Payroll Forms
Chapter 78 Calculator
Sub Service
Aetna Enrollment/Change Request Form
Aetna Enrollment Form.pdf
643.33 KB
(Last Modified on May 15, 2020)
Comments (-1)
Aetna Enrollment/Change Request Form - Dependents to Age 31 (26-31)
Aetna DU31 enrollment form.pdf
583.12 KB
(Last Modified on May 29, 2019)
Comments (-1)
Benecard (Rx) Enrollment/Change Request Form
Benecard_Form_2020.pdf
126.77 KB
(Last Modified on June 10, 2020)
Comments (-1)
Benecard (Rx) Enrollment/Change Request Form - Dependents to Age 31 (26-31)
NJ Overage Dep Enrollment Form to 31 Rev 2.2015.pdf
25.51 KB
(Last Modified on August 14, 2018)
Comments (-1)
Benecard Mail Service
Benecard Mail Service.pdf
183.94 KB
(Last Modified on May 30, 2014)
Comments (-1)
Children's Health Insurance Program (CHIP)
CHIPRA Notice_2020.pdf
176.02 KB
(Last Modified on May 15, 2020)
Comments (-1)
Credible Coverage Notice - Prescription (Rx) Drug Coverage and Medicare
Credible Coverage Notice - Prescription Drug Coverage and Medicare.pdf
79.86 KB
(Last Modified on September 27, 2016)
Comments (-1)
Delta Dental Enrollment/Change Request Form
Delta_Dental_NJ_Enrollment-Change-Form_Fill.pdf
90.02 KB
(Last Modified on June 30, 2020)
Comments (-1)
Delta Student Verification Form
Delta_Student_Verification.pdf
175.12 KB
(Last Modified on June 17, 2020)
Comments (-1)
Employer Exchange Notice
Employer Exchange Notice .pdf
251.97 KB
(Last Modified on May 11, 2016)
Comments (-1)
FMLA
FMLA.pdf
93.56 KB
(Last Modified on January 9, 2020)
Comments (-1)
Health Benefits Dependent Age Limits (2020)
Dependent Age Limits Flyer Somerville BOE 2.pdf
131.86 KB
(Last Modified on May 15, 2020)
Comments (-1)
Health FSA Guide
FSA Employee Guide.pdf
1.93 MB
(Last Modified on May 15, 2020)
Comments (-1)
Horizon Copayment Reimbursement Form
Px Copay Process.pdf
337.23 KB
(Last Modified on May 22, 2019)
Comments (-1)
Horizon Enrollment/Change Request Form
Horizon-BCBSNJ-6859-EnrollmentChangeRequest.pdf
151.39 KB
(Last Modified on May 15, 2020)
Comments (-1)
Notice of Change to 403(b) and 457(b) Retirement Plans
Notice to Participants 09262016 - Somerville.pdf
316.98 KB
(Last Modified on September 27, 2016)
Comments (-1)
Universal Availability Notice-2019 (403b & 457b Tax Shelter Providers)
2019 Universal Availability Notification Somerville Public School District including 457.pdf
140.04 KB
(Last Modified on January 25, 2019)
Comments (-1)
Waiver Form-Group Health Benefits 2020-2021
Health Benefits Waiver Form_fill.pdf
209.2 KB
(Last Modified on May 27, 2020)
Comments (-1)
Womens Health and Cancer Rights Notice
Horizon_ WHCRA flyer.pdf
2.91 MB
(Last Modified on May 15, 2020)
Comments (-1)
CLOSE
CLOSE
