We are pleased that you are joining us and hope that you will enjoy your time of service here. Below you will find information and forms regarding benefits offered.  Some of the links below are for your information and some are forms which we require you to return.
Lexington Public Schools
Attn: Human Resources
Central Administration Building
146 Maple Street
Lexington, MA 02420

If you have any questions relating to any of these materials, please call us at (781) 861-2580


Forms and Information concerning your Employee Benefits

GIC Health Information and Enrollment Forms 

(if you are enrolling in health and/or dental insurance, you will need to produce a government-issued marriage certificate for your spouse and birth certificates for any dependents to be covered)

GIC – Decision Guide

GIC – Rate Sheet

GIC – 1MUN Enrollment/Change Form

GIC – Dependent Age 19-26 Enrollment/Change Form

For changes to your current health insurance plan, you now have the convenience
of submitting documents electronically through MyGICLink. The GIC website can be accessed at: MyGICLink

If you are eligible for GIC Health Insurance and you enroll in our health insurance, please read the information regarding the Hiatus Period Stipend and your Health Reimbursement Account (HRA) as well as the details regarding the agreement with the Town of Lexington and the Lexington Public Employee Committee. Existing employees may have the opportunity to Opt-Out. Please read the information below.

MOA between the Town of Lexington and the Lexington Public Employee Committee

Hiatus Period Information
HRA – PART 1
HRA – PART 2

Opt-Out Program & Form

Other Benefit Forms/Information 

  1. Delta Dental Plan Descriptions
  2. Dental Rate Sheet
  3. Delta Dental Enrollment/Change Form
  4. EyeMed Info
  5. EyeMed Rate Sheet
  6. EyeMed Enrollment Form
  7. FSA Enrollment Form
  8. Life Insurance Basic & Optional Rates
  9. Life Insurance Basic and Optional Enrollment Form
  10. Life Insurance Beneficiary Change Form
  11. Evidence of Insurability Form To be completed only if making change after original eligibility
  12. 403b Plan
  13. 457 Plan – Massachusetts Deferred Compensation SMART Plan
  14. MA Health Connector Information (for review by non-benefit’s eligible staff)

General Information and Forms:

  1. School Calendar 2021 – 2022
  2. Tuition Reimbursement – Lane Change Procedure
  3. Sample Individual Professional Development Plan
  4. Sample HOUSSE Log
  5. Immunization Recommendation
  6. Pregnancy Workers Fairness Act Q & A