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 x68048

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

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

 Opt-Out Program & Form

Other Benefit Forms/Information 

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

General Information and Forms:

  1. School Calendar 2020 – 2021
  2. Tuition Reimbursement – Lane Change Procedure
  3. Electronic Tuition Reimbursement/Grad Credit Approval Form
  4. Sample Individual Professional Development Plan
  5. Sample HOUSSE Log
  6. Immunization Recommendation
  7. Pregnancy Workers Fairness Act Q & A