Danville Public Schools

Benefits Enrollment/Change Forms (Current Employees Only)

• The Local Choice (TLC) Enrollment Form
• TLC Personal Data Change Form
• TLC Express Scripts Home Delivery Pharmacy Form
• Delta Dental Voluntary Plan Enrollment Form
• Allstate Benefit Plans Enrollment Form (For employees within their first 30 days of employment)
• Allstate Benefit Plans Enrollment Form (For employees after their first 30 days of employment)
  
• Allstate Name/Address Change Form
• Allstate Cancellation Request
• Optional Group Life Insurance Enrollment Form
• Optional Group Life Insurance Evidence of Insurability Form
• Designation of Beneficiary (VRS Plan1, Plan 2, Hybrid Plan Defined Benefit Account) - To designate more than three beneficiaries, a continuation form is also required.
• Designation of Beneficiary – Continuation (To designate more than three beneficiaries)
• VRS Hybrid Designation of Beneficiary Instructions (VRS Hybrid Plan Defined Contribution Account)
• Sick Leave Bank Enrollment Form (For Part-time and Full-time employees in VRS Plan 1 and Plan 2 only)
• 403b Salary Reduction Agreement Form

Benefits Information

• Affordable Care Act Marketplace Coverage Information
• The Local Choice (TLC) Anthem Health Plan Website
• TLC Key Advantage 500 Benefits Summary - 2018
• TLC Key Advantage 1000 Benefits Summary - 2018
• TLC Key Advantage 500 and 1000 Member Handbook
• TLC Key Advantage Prescription Drug Plan
• TLC Prescription Listing by Tiers
• The Local Choice (TLC) Delta Dental Website
• Blue View Vision Key Advantage 500 Benefits Summary
• Blue View Vision Key Advantage 1000 Benefits Summary
• Delta Dental of Virginia Voluntary Plan Website
• Delta Dental Voluntary Plan Online Account Access Brochure
• Delta Dental Oral Health Guide
• Delta Dental Voluntary Plan Healthy Smile, Healthy You Program Brochure
• Delta Dental Voluntary Plan MaxOver Rewards Brochure
• Delta Dental Voluntary Plan Mobile App Flyer (Voluntary Plan)
• Anthem Employee Assistance Program (Click on Member Login - Company Code is "Commonwealth of Virginia," then select "The Local Choice")
• Group Term Life Certificate of Insurance
• Hybrid Disability Plan Handbook (VACORP)
• Hybrid Disability Plan Employee FAQs
• 403b Information and Vendor List