Passaic City Public Schools Employee Benefit Information Systems web site

• myNewJersey! The official New Jersey web “portal”, which gives you direct access to online information that’s specific to you
• myNewJersey! Help Site – frequently asked questions, etc.
• The Member Benefits Online System (MBOS): Provides pension and health benefit account information and online applications

Memos

• MEMO regarding Member Benefits Online System (MBOS) the Employer Pensions and Benefits Information Connection (EPIC) Logon ID Retrieval (.pdf)

Medical Forms – Open Enrollment Forms

• Health Benefits Application
• Prescription Enrollment Form
• VSP Enrollment Form
• City of Passaic Board of Education MBS 7-14 (VSP)
• Health Benefits Waiver Form
• Health Capsule (Fall 2015)
• Prescription Waiver Form

Flexible Spending Account Forms

• FSA Eligible Expense Information List
• PBOE FSA Claim Form
• PBOE FSA Enrollment Application
• PBOE FSA Open Enrollment Information

Dental Open Enrollment Forms

• Dental Enrollment Form – Revised 10/2/15
• Dental Open Enrollment Form – Revised 9/30/15
• Dental Open Enrollment Form – Revised 9/30/15
• Non-Reps (Delta Dental)
• PAEOP, PADCAM & PASA (Delta Dental)
• PSA Delta Dental Buy-Up

Delta Dental Booklets

• PASA Employee Booklet
• PAES, PADCAM, Non Rep Employees Booklet
• EAP Employees Booklet
• PMCCA Employees Booklet
• All Other Employees Booklet