Center Woods Upper Elementary School


School employees have the right to make elective deferrals to the School Administrative Unit #24 403(b) Plan. Contributing to a 403(b) plan helps to ensure that they will have funds to provide themselves with an income during retirement. A 403(b) plan allows them to contribute a portion of their compensation on a pre-tax basis in order to save for their retirement. Contributions are made to the plan by payroll deduction. If school employees are already contributing to the 403(b) Plan, they may want to increase their deduction.

Details on available 403(b) programs can be found on the below attachment.

General information about the 403(b) program can be found in the below attachment. 

CHIP Model 2016 Notice

On February 4, 2009, the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA) was signed into law by President Obama.  The law provides two specific provisions that you should be aware of.
CHIPRA provides a special enrollment period for employees and/or their eligible dependents for loss of coverage, or becoming eligible for premium assistance, under Medicaid or a State’s Children’s Health Insurance Program.  If a non-enrolled employee (or dependent) is covered under Medicaid or a State child health plan, and that coverage is terminated based on loss of eligibility, the employee (or dependent) can enroll in an employer’s group health plan due to the loss of coverage.  Loss of coverage has always been a qualifying event for HealthTrust enrollees so the impact of this legislation is negligible.  Enrollment for this specific situation, however, must be requested within 60 days of the loss of coverage, rather than the 30 day notification requirement for other eligible qualifying events. 
An additional provision of the law requires employers to provide an annual written notice to all active employees (even if they are not eligible for or enrolled in the employer’s health plan) informing them of potential opportunities to obtain premium assistance from their state of residence.  Annual notice requirements began July 1, 2010 for members with plan years beginning July 1, and January 1, 2011 for members with plan years beginning January 1.  Please note that there are considerable civil penalties for employers who do not comply with this annual notice requirement.
Attached is the most recent Department of Labor model notice; you can access this document at  This document can be provided electronically, in printed format or with open enrollment materials but must be provided prior to your plan year of July 1, 2015 in order to fulfill your annual notice obligations.  
If you have any questions, or need additional information, please contact HealthTrust Enrollee Services at 800.527.5001 or This email address is being protected from spambots. You need JavaScript enabled to view it..
Download this file (CHIP Model Notice 2016.pdf)CHIP Model Notice 2016.pdf[ ]40 kB2016-05-03 08:11

W-9 Form

W-9 Form is an IRS form, also known as "Request for Taxpayer Identification Number and Certification", which is used by an individual defined as a "U.S. person" or a resident alien to verify his or her taxpayer identification number (TIN).

Go to

Summary of Benefits and Coverage (SBC)

Health insurance issuers and group health plans are required to provide employees with a summary about a health plan’s benefits & coverage (SBC). The new regulation is designed to help potential employee(s) better understand & evaluate their health insurance choices.

The new rules are a joint effort among the Department of Health and Human Services, the Department of Labor, and the Department of the Treasury.

The use of standardized SBC’s makes it easier to understand information about the differences between health plan benefits & coverages. Another way to explain is it provides “apples to apples” comparisons among the insurance plans that are offered.

Please Note: Only certain health plans are available per School District. If you have questions or concerns, please contact Human Resources at (603) 428-3269.

Download this file (AB20(07)-RX10_20_45-July.pdf)AB20(07)-RX10_20_45-July.pdf[ ]348 kB2017-06-22 16:23
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Download this file (OPTION 1J-July.pdf)OPTION 1J-July.pdf[ ]194 kB2017-06-22 16:22

Section 125 Flexible Enrollment

The district has established a voluntary Flexible spending account plan under IRS Section 125. This plan allows employees to enroll in payroll deductions for certain health/dental and dependent care spending including your payroll deductions for health insurance. These deductions are used to reimburse the employee after actual expenditures and have the privilege of being tax sheltered under the IRS code.  During the contract renewal time the employee will have the opportunity to enroll for the next school year. HR will have the enrollment form included in the employee’s packet. In order to get reimbursed for expenses incurred the employee must submit a reimbursement form and submit to Local Government Center.

Important Flexible Spending Account Update

Change to Over-the-Counter Medications Reimbursement

Effective January 1, 2011 and as part of recently enacted healthcare reform legislation, a medicine, drug or insulin must be prescribed by a physician in order for incurred related expenses to be reimbursable.

At that time, Flexible Spending Account (FSA) funds can no longer be used for over-the-counter (OTC) drugs and medicines (e.g., Advil, cough medicine, antihistamine and Benadryl). You
will, however, be able to continue using your FSA funds and Benny™ Prepaid Visa® Card for purchasing prescribed medications as well as OTC supplies and equipment like bandages and reading glasses.

New Hampshire Local Government Center (LGC) anticipates further guidance from the IRS regarding this legislation. Based on current interpretation, a revised Healthcare FSA List of
Eligible/Ineligible Expenses is now available at To download a copy, click on FSA Program Individual > Healthcare FSA List of Eligible/Ineligible Expenses. Please contact LGC at 800.527.5001 or This email address is being protected from spambots. You need JavaScript enabled to view it. with related questions or for further assistance.

Download this file (Important_Flexible_Spending_Account_Update.pdf)Important_Flexible_Spending_Account_Update.pdf[ ]78 kB2015-03-20 17:05

Request for Family Medical Leave

If you know ahead of time that you will be away from your position for more than 3 consecutive days this form must be completed to start the FMLA process. Please review the form and check the reason that best fits your situation.(i.e birth of a child). Please contact HR Department if you have questions regarding this form.

Substitute New Hire Packet

Congratulations on completing the interview process and receiving an appointment for a new hire orientation with Human Resources.

The forms listed below that require personal information and a signature MUST be completed and brought to orientation.

For the I-9, only original documents from the “Lists of Acceptable Documents” must be presented at orientation. “Lists of Acceptable Documents” can be found on the fourth page of the I-9.pdf found below. Copies will NOT be accepted.

The “Sub Employment Log” is only to be completed when subbing for a Teacher or a Para-Educator. The log is an employee’s responsibility to complete and bring to the secretary of the school to initial each and every day the employee substitutes.

For informational purposes, the Substitute Handbook is also located below.

Download this file (01. W4 2016.pdf)01. W4 2016.pdf[ ]117 kB2017-01-10 13:52
Download this file (02. I-9 2017 Version 1.pdf)02. I-9 2017 Version 1.pdf[ ]992 kB2017-01-30 10:36
Download this file (03. Direct Deposit Form and Email.pdf)03. Direct Deposit Form and Email.pdf[ ]1384 kB2017-01-10 13:53
Download this file (04. NHRS Attestation Form.V1.pdf)04. NHRS Attestation Form.V1.pdf[ ]2661 kB2017-01-10 13:54
Download this file (05. SAU 24 Employee Handbook.pdf)05. SAU 24 Employee Handbook.pdf[ ]169 kB2017-01-10 13:54
Download this file (06. Employee Handbook Acknowlegement.V2.pdf)06. Employee Handbook Acknowlegement.V2.pdf[ ]2293 kB2017-03-06 11:00
Download this file (07. Substitute Handbook .pdf)07. Substitute Handbook .pdf[ ]964 kB2017-01-10 13:54
Download this file (08a. Pupil Safety, etc...  V1.pdf)08a. Pupil Safety, etc... V1.pdf[ ]680 kB2017-01-10 13:55
Download this file (08b. SAU 24 Procedures and Reporting Bullying V1.pdf)08b. SAU 24 Procedures and Reporting Bullying V1.pdf[ ]790 kB2017-01-10 13:55
Download this file (08c. Understanding Bullying Law, etc... V1.pdf)08c. Understanding Bullying Law, etc... V1.pdf[ ]295 kB2017-01-10 13:55
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Download this file (Sub Handbook .pdf)Sub Handbook .pdf[ ]964 kB2017-01-10 13:57

Lumenos High Deductible Health Plan-District HSA Contributions

On July 1, 2014, one-half of your deductible funds will be available for your use through a debit card or paper check. If you deplete these funds within the first six months, you must submit a Claim Recap to the SAU office in order to replenish your HSA account. Your Claim Recap is available to you in your Anthem Member account.

To register for an Anthem Member account:


·         Select Register Now and follow the prompts.

·         You can also access the step by step instructions in printable form from the SAU Staff Portal

Once registered you will be able to log in to view and print ‘Your Claim Recap’ (a sample is available on the SAU 24 Staff Portal) and ‘Your Quarterly Health Plan Status’.


To access your deductible, log in to your account, click on “Claims” then “Deductibles and Out-of-Pocket Amounts” to access an up-to-date deductible balance report (Your Claim Recap.) Print this report and send a copy to SAU 24, in care of the Business Administrator, to request an additional deposit to your HSA prior to January 1, 2015.

After January 1, 2015 and upon receipt of a current ‘Your Claim Recap ’ your HSA account will be replenished to the full annual deductible.


Express Scripts – How to Access Your Prescription Benefits

Once you have created your Anthem Member account, you will be able to link directly to the Express Scripts secure site and may access the following features to help you manage your prescription benefit needs:

                Order refills by mail (Home Delivery)

                Check the status of recent orders

                Price medications and access plan information

                Print and download forms

                View opportunities to save money

To get started with Home Delivery (mail order), ask your doctor to fax your prescriptions directly to Express Scripts at 1-866-8856 on or after July 1, 2014. 

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