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 FY21

(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)

  1. GIC Decision Guide
  2. GIC – Rate Sheet
  3. GIC – 1MUN Enrollment/Change Form
  4. GIC – Dependent Age 19-26 Enrollment/Change Form

If you are eligible for GIC Health Insurance, please fill out and return the below acknowledgment form and if you enroll in our health insurance, please read the information regarding the Hiatus Period Stipend and your Health Reimbursement Account (HRA). Existing employees may have the opportunity to Opt-Out. Please read the information below.

Hiatus Period Information
HRA – PART 1
HRA – PART 2

New Enrollee Opt-Out Program & Form

Current Enrollee Opt-Out Program & Form

Other Benefit Forms/Information for FY20

  1. Delta Care Description
  2. Delta Premier Description
  3. Dental Rate Sheet
  4. Delta Dental Enrollment and Change Form
  5. FSA Enrollment Form
  6. Life Insurance Basic & Optional Rates FY20
  7. Life Insurance Basic and Optional Enrollment Form
  8. Life Insurance Beneficiary Change Form
  9. Evidence of Insurability Form To be completed only if making change after original eligibility
  10. 403b Plan
  11. 457 Plan – Massachusetts Deferred Compensation SMART Plan
  12. MA Health Connector Information (for review by non-benefit’s eligible staff)

General Information and Forms:

  1. School Year Calendar 2019-2020
  2. Tuition Reimbursement – Lane Change Procedure and Form
  3. Electronic Tuition Reimbursement/Grad Credit Approval Form
  4. Non-Represented & Non-Certified Staff Tuition Reimbursement Policy
  5. Sample Individual Professional Development Plan
  6. Sample HOUSSE Log
  7. Immunization Recommendation
  8. Pregnancy Workers Fairness Act Q & A