CHECKLIST FOR BENEFIT ORIENTATION
CONDUCTED BY THE OFFICE OF HUMAN RESOURCES
EMPLOYEE NAME
POSITION TITLE
DEPARTMENT
EFFECTIVE DATE OF APPOINTMENT
AGENCY 295
PROCEDURES FOR COMPLETION OF FORM
This form is designed to act as a guide to orientation of the College and Commonwealth’s
policies, procedures, and benefits. It is not meant to limit the information presented, but rather to
act as an outline of the minimum information to be explained and as a check of the paperwork to
be completed by the new employee. The completed checklist will be retained in the employee’s
personnel file and a copy forwarded to the employee.
1.
The checklist should be completed by all new classified and faculty employees in the
status of full-time employment or restricted positions; and employees within the
appointment status of original appointment, re-employment, or state transfer.
2.
The space by each item should be checked as that item is discussed. Any additional
items covered should be added as an addendum and attached to the checklist.
3.
After all items have been checked, the checklist must be signed by a representative
from the Office of Human Resources and the new employee.
For further information, contact the Office of Human Resources.
FORMS TO ACTIVATE PAYROLL STATUS
COPY OF SOCIAL SECURITY CARD
EMPLOYMENT ELIGIBILITY VERIFICATION (I-9)
Copies of identification used to verify eligibility
FORM W-4
FORM VA-4
CHILD SUPPORT ENFORCEMENT FORM
EMPLOYEE DIRECT DEPOSIT AUTHORIZATION
Four (4) accounts available
SUMMARY OF COMMONWEALTH OF VIRGINIA’S
POLICY ON ALCOHOL AND OTHER DRUGS
EMPLOYEE ACKNOWLEDGEMENT OF
RESPONSIBILITIES FOR SAFEGUARDING PERSONAL
NON-PUBLIC INFORMATION
PERSONAL INFORMATION & EMERGENCY CONTACT
FORM
POLICIES & PROCEDURES
EMPLOYEE HANDBOOK
(located on TCC website at www.tcc.edu)
Full-time Faculty Handbook
Classified Staff Handbook
PARKING PASS/DECAL
(contact your campus Business Office)
PROX CARD ID ACCESS
(District Administration – Joseph Green Bldg., Virginia Beach Science
Bldg., Regional Automotive Center & Tri–Cities Chesapeake and
Portsmouth Campus)
___________
REPORTING CHILD ABUSE
______________
VIOLENCE AGAINIST WOMEN ACT
Page 2 of 5
8/2014
EQUAL EMPLOYMENT OPPORTUNITY
HOLIDAY/PAY SCHEDULE
Payline
MANDATORY DEDUCTIONS FROM PAY
Federal and state withholding tax
Social Security or FICA equals 7.65% - listed as OASDI & HI on pay stub
OPTIONAL DEDUCTIONS FROM PAY (PRE- AND POST-TAX)
Health Insurance
Flexible Reimbursement Accounts
Optional Group Life Insurance
Deferred Compensation
Tax Sheltered Annuities
Supplemental Insurances
Credit Unions
529 Plan
Charitable contributions
TCC Education Foundation
Commonwealth of Virginia Campaign (CVC)
INCLEMENT WEATHER
EMPLOYEE SUGGESTION PROGRAM
OUTSIDE EMPLOYMENT
PROFESSIONAL DEVELOPMENT
Training
Educational Assistance
STANDARDS OF CONDUCT (refer to handbook on TCC website)
Attendance
Harassment
Workplace Violence
Alcohol and Other Drugs
WORKERS COMPENSATION
RESIGNATION & EXIT INTERVIEWS
BENEFITS PROGRAM
HEALTH INSURANCE
Membership eligibility
Enrollment periods (newly eligible, QME’s, Open Enrollment)
Effective Dates of Coverage
Health Plan Options
CommonHealth
Employee Direct
Premium Conversion
Monthly Premiums
Page 3 of 5
8/2014
FLEXIBLE REIMBURSEMENT ACCOUNTS
Medical Reimbursement Account
Dependent Care Reimbursement Account
VIRGINIA RETIREMENT SYSTEM (VRS)
Full-time Classified Staff automatically enrolled
Full-time Faculty automatically enrolled if no retirement election is made
within 60 days of eligibility
Purchase of Prior Service
OPTIONAL RETIREMENT PLAN (ORP)
Available to Full-time Faculty only
Requires completion of Election to Participate (form VRS-65)
Two investment providers available
Open Enrollment
BASIC LIFE INSURANCE
OPTIONAL GROUP LIFE INSURANCE
DESIGNATION OF BENEFICIARY
For VRS, Basic Life, Optional Group Life
FAMILY AND MEDICAL LEAVE ACT
VIRGINIA SICKNESS AND DISABILITY PROGRAM (VSDP)
Sick Leave
Family and Personal Leave
Short-Term Disability
Long-Term Disability
Long-Term Care
TRADITIONAL SICK LEAVE PLAN
For Faculty who elect ORP only
PERSONAL LEAVE
For 9 month Faculty who elect ORP only
ANNUAL LEAVE
SCHOOL ASSISTANCE AND VOLUNTEER SERVICE
LEAVE
CIVIL AND WORK-RELATED LEAVE
MILITARY LEAVE
LEAVE SHARING PROGRAM
LONG-TERM CARE
DEFERRED COMPENSATION (457 PLAN)
Page 4 of 5
8/2014
CASH MATCH PROGRAM
COMMONWEALTH OF VIRGINIA PROVIDER LISTING
Miscellaneous Insurances – life insurance, pre-paid legal services, etc.
Tax-Sheltered Annuities – 403(b) Plans
Administrative Fees
529 PLAN
I, as the employee, agree that the above checked items have been explained to
me and that I have had an opportunity to ask questions for clarification.
Date
Signature
I, as the representative of the Office of Human Resources, certify that this
employee has attended a Benefit Orientation in which the above checked items
were explained.
Date
Signature
Title