Pre-retirement seminar information
Due to COVID-19 and adherence to strict CDC safety guidelines, there will be no in-person preretirement seminars. Information provided in previous meetings is available below.
For more information about the ACA, including the full text of the law, visit www.healthcare.gov.
If you have questions about how Henrico County’s ACA compliance will affect you, please contact: HCPS Benefits via email at firstname.lastname@example.org or by phone at 804-652-3624.
Eligible employees may elect to enroll in the Catastrophic Leave Pool (CLP) during the open enrollment window. Employees enrolling during Open Enrollment will have an eligibility date of Jan. 1, 2022.
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This program is intended to cover only those health conditions that are catastrophic and/or potentially terminal in nature and can be of great benefit when unexpected illnesses occur. This program does not apply to short-term illnesses, injuries or disabilities (including short-term conditions related to childbirth and pregnancy) or chronic conditions that are not life-threatening and do not require lengthy hospitalization or home care. This program may not be used for absences to care for a sick family member. Please refer to Policies and Regulations (http://webapps.henrico.k12.va.us/policy/) for more details.
Participating employees are eligible to receive up to 30 days of paid leave in a 12-month period. The 12-month period is measured on a rolling forward basis from the first day the employee used leave under the policy. An employee is not required to reimburse HCPS for any days used under this program.
An employee must exhaust any accrued sick leave, annual leave and personal leave before using Catastrophic Leave Pool benefits.
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Employees already enrolled do not need to submit a form or contribute more days. Your participation will continue in the program. If you elect to discontinue participation in the CLP or separate from employment with HCPS you forfeit your contribution.
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The school division may require additional donated days in subsequent years should the pool become depleted and/or inadequate to support beneficiaries. Employees are not required to continue participation in the CLP if they decide not to contribute additional days.
If the Catastrophic Leave Pool should become inoperative for any reason, the Catastrophic Leave balance shall be first distributed to those employees approved to receive benefits. Any remaining days will be distributed equally among those enrolled in the Catastrophic Leave Pool.
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Each employee who elects to enroll will be required to contribute one day of accrued sick leave to the CLP. If you wish to enroll, complete the Catastrophic Leave Pool Form and submit to the HCPS Payroll Office by close of business on Oct. 29, 2021.
If no sick leave is available to contribute, your enrollment request will be denied. Revisit at the next Open Enrollment.
Submit your completed CLP enrollment form to the HCPS Payroll Office by 4:30 p.m. on Oct. 29.
EDA enrollment is not available for this benefit.
When You Leave
When you leave employment it is important to understand when benefits end and how you can continue them. Health and dental benefits cease at the end of the month in which you separate from employment. If you are eligible for COBRA — Consolidated Omnibus Budget Reconciliation Act — coverage, you will receive information and an election form by mail to the address on file with Henrico County Public Schools. This brochure provides important details about your benefits after you leave HCPS.
How COBRA Works
Under the Consolidated Omnibus Budget Reconciliation Act of 1985, you may purchase (at your expense) extended coverage for health care, dental and flexible spending accounts for you and/or your qualified beneficiaries if you lose coverage under a group plan due to termination of employment or a reduction of work hours. This coverage is available for up to 18 months, except if a beneficiary is disabled according to Social Security guidelines, in which case the coverage for that beneficiary may be extended to 29 months. If any family member enrolled in the plan loses coverage due to one of the following events, he/she may purchase continued coverage at his/her own expense, without proof of insurability, under the group plan for up to 36 months: Death of employee, entitlement of the employee to Medicare benefits; divorce; or a dependent child reaches the maximum age of coverage or loses dependent status.
The right to continue purchasing group coverage may terminate before 18 or 36 months (whichever applies) if:
- You fail to pay the required premium on time.
- The plan terminates.
- The person continuing coverage becomes a covered employee under another group health plan which does not have a preexisting condition clause.
- In the case of a spouse beneficiary, the spouse remarries and is covered under another group health plan which does not have a preexisting condition clause.
If you become divorced or your dependent child reaches the maximum age for coverage, or loses dependent status, you must notify the Health Benefits Office within 60 days of the qualifying event. Please see the General Notice for important details. In other qualifying circumstances, you will be notified that continuation coverage is available and you must then make an election. If you do not receive notice of your opportunity to elect continuation coverage, immediately contact the Health Benefits Office for an election form. You must decide whether or not you want to purchase continued coverage within 60 days from the later of: the date coverage ends, or the date you are notified of your eligibility. Failure to meet the plan’s requirements makes you ineligible.
You may be entitled to purchase an individual conversion policy when you are no longer covered under the employer’s group plan. If you elect coverage under COBRA, the effective date is the day after coverage stops under the regular group plan.
Other Important Details
If COBRA coverage is elected, it will begin as soon as your group coverage ends. COBRA premiums are paid on a monthly basis and are due at the first of the month. Payments should be mailed to the attention of the Health Benefits Office at HCPS, P.O. Box 23120, Henrico, VA 23223. Checks or money orders should be made payable to “HCPS.” If you wish to no longer continue with COBRA coverage, contact the Health Benefits Office. COBRA coverage will automatically terminate if payment is not received in our office in a timely manner.
Henrico County offers three coverage options through Delta Dental:
Delta Dental PPO – High and Low Options
Both options offer diagnostic and preventive care, basic and major dental care, but differ in their levels of coverage for these services. Both the High and Low Option plans provide savings if you use a provider from the Delta Dental PPO network or the Premier network. Out-of-pocket expenses will vary depending on which network your provider participates in. To enroll in either of these options, you do not have to select a dentist. The link to the provider search is below.
- Delta Dental PPO High Option Plan
Offers diagnostic and preventive care services, which covers in-network oral exams and cleanings twice a year at 100%. Basic dental care (fillings, periodontic care) is covered at 50-80% depending on which network is used. Major dental care (crowns and bridges) is covered at 50%. This plan also covers orthodontics at 50% with a lifetime maximum of $1,500. The annual calendar year maximum is $1,500 per patient, which does not include the cost of preventive care.
- Delta Dental PPO Low Option Plan
Offers diagnostic and preventive care services, which covers in-network oral exams and cleanings at 75%. Basic dental care (fillings, periodontic care) and major dental care (crowns and bridges) are covered at 50%. This plan does not include orthodontics. The annual calendar year maximum is $1,500 per patient, which does not include the cost of preventive care.
With the Delta Dental PPO- EPO Plan Design Plan you will know prior to treatment what you will have to pay for covered benefits. The plan offers diagnostic and preventative services as well as basic and restorative dental care. Orthodontic care is provided when utilizing a PPO dentist. The lifetime Orthodontic Maximum and calendar year maximum benefit is slightly higher than the High Option. To locate a network PPO dentist, log onto the Delta Dental website at www.deltadentalva.com.
Dental Information & Forms
- Dental Information:
- Delta Dental Enrollment Guide
- Delta Dental Rates
- Provider Search for High and Low Option Plans
- Low Option Plan—Evidence of Coverage
- High Option Plan—Evidence of Coverage
- Delta Dental Plan—Evidence of Coverage
Delta Dental’s “Healthy Smile, Healthy You” program provides an additional cleaning for members with certain medical conditions. View the brochure below for details.
- Healthy Smile, Healthy You Brochure
- Healthy Smile, Healthy You Enrollment Form
- Children’s Dental Health – Sealants
- Smart Smiles –now online!!
Dental Contact Information:
Delta Dental of Virginia
4818 Starkey Rd, SW
Roanoke, VA 24018-8542
Delta Dental Plans Benefits Services
High and Low Option Plans
Henrico County Public Schools—Benefits Office
Benefits Office Line: 804-652-3624
Send us an email
Dental Plan FAQs
How do I choose a network dentist?
Visit the Delta Dental of Virginia website at www.deltadentalva.com to view a list of Delta Dental participating dentists. You can also call 800-862-0838.
Can I change my dentist?
You can change your Delta Dental provider by calling the Delta Dental program at 800-862-0838 by the 15th of the month. Your change will then be effective on the first day of the following month.
If I choose the Delta Dental program, will I have coverage if I visit a dentist other than my selected Delta Dental provider?
No, services must be rendered by your Delta Dental provider. You may be referred to a specialist with written authorization.
What services and procedures are covered by the Delta Dental program?
Basic and restorative dental services are provided by the Delta Dental program for set copayments. The list of covered services can be viewed in the Delta Dental booklet.
Are braces covered under the Delta Dental program?
Yes, orthodontic (braces) services are covered with participating Delta Dental providers in the High Option and the EPO-PPO.
Delta PPO – High and Low Option Plan FAQs
What is the difference between the High and Low Option plans?
The difference is the percentage of your dentist’s charges that Delta Dental will pay. Under the High Option, services are covered at a higher level than the Low Option. Also, the Low Option does not cover orthodontics.
Do I have to go to a dentist in the PPO or Premier networks?
No, you may go to any dentist you wish but you will probably pay more for services with a dentist who is not part of the Delta PPO or Premier networks.
How can I find a dentist who participates in the Delta Dental PPO or Premier networks?
Visit the Delta Dental Web site www.deltadentalva.com to find lists of PPO and Premier dentists. You may also call Delta Dental Benefit Services at 800-237-6060.
Do both the High and Low Option plans provide coverage for orthodontics (braces)?
No, only the High Option plan covers braces up to a lifetime maximum of $1,500 per patient. There is no orthodontics coverage with the Low Option plan.
- Delta Dental PPO High Option Plan
The Employee Assistance Program (EAP) is a helpful resource that can be used to address life’s challenges, solve personal problems or tackle work-related issues. These may include marital, financial, drug or alcohol, vocational and stress-related difficulties. This service is available to full-time and part-time eligible employees and their household members free of charge to you, as a benefit paid by HCPS.
The Employee Assistance Program is contracted to Optima EAP. Services are provided by the skilled, professional counselors of Optima EAP. They will help you sort through your problems and explore possible solutions. Help is as simple as a phone call away. You or a family member can call and speak with one of the counselors, who will schedule an appointment.
The EAP is confidential and your right to privacy is strictly protected. No information about the nature of your personal situation is shared with your employer.
For your convenience, there are several office locations throughout the Richmond area. A member of the Optima EAP staff is available to help you 24 hours a day, seven days a week, 365 days of the year. You may contact Optima EAP at 757-363-6777 or 800-899-8174 to schedule an appointment.
Henrico County Public Schools
Human Resources Department
Flexible Spending Accounts allow you to contribute pretax dollars that you expect to spend on qualified expenses into the account and therefore lower your taxable income. There are two types of FSAs offered:
- Health Care (for out-of-pocket health care expenses).
- Day Care (for costs of adult or child care that enable you — and your spouse — to work).
When considering the Health Care account, estimate costs for copayments of prescription drugs and doctor visits for yourself and your family members. You don’t have to participate in Henrico County health care or dental coverage to participate in a FSA and your family members do not have to be covered by Henrico County’s plans for you to be reimbursed for their eligible expenses. Click here for Health Care FSA FAQs.
When considering the Day Care account, review costs for child care services for dependent children under the age of 13. This account may also be used if you have expenses for adult-care services. Eligible child or adult-care expenses are those that you incur when you are working and that enable you (and your spouse) to work. Click here for Day Care FSA FAQs.
Henrico County Flexible Spending Accounts are administered by TASC (Total Administration Services Corporation).
Enrolled participants may register online with TASC at www.tasconline.com.
Annual maximum of:
- $2,750 for Health Care FSA.
- $5,000 for Day Care FSA.
- Participant Benefits
- Eligible Expenses
- Beneshop provides low cost options on thousands of eligible Flexible Spending Account (FSA) and Health Savings Account (HSA) products. Visit Beneshop at https://beneshop.benfinityonline.com/.
- Mobile App Guide
- MyCash Account
- Dependent Care Qualifications
Total Administration Services Corporation: 1-800-422-4661 (8 a.m. to 5 p.m., Monday through Friday).
Email: Log in to your online account and click on Contact Us.
Henrico County Health Plan
- Anthem COVID – 19 OTC HSA
- Anthem website
- Special Offers and Discounts at Anthem
- Anthem HealthKeepers Enrollment Guide
(POS and Healthkeepers HDHP HSA plans)
- Anthem KeyCare Enrollment Guide (out-of-area PPO plan)
- Qualifying Events
- Find a Doctor Flyer
- Find a Doctor Video
- LiveHealth Online
- MyLive Health Video
- Dispatch Health
Healthkeepers HDHP HSA – Information Resources
- Healthkeepers HDHP with Health Savings Account (HSA) – Plan Summary
- Healthkeepers HDHP with Health Savings Account (HSA) – Fee and Rate Schedule
- Healthkeepers HDHP with Health Savings Account (HSA) – Questions & Answers
- Note: You may make Health Savings Account (HSA) contribution changes at any time during the year by logging into Employee Direct Access. Changes become effective with the next pay period. Monthly and biweekly pay calendars are available at https://henricoschools.us/employee-information/.
- Benefit Plan Comparison
- Benefit Plan Summary – KeyCare PP0
- Summary of Benefits and Coverage (SBCs) (required by health care reform to help you compare plan benefits):
Pharmacy Benefits High Deductible Health Plan with HSA
- Prescription Drug List – Healthkeepers HDHP with HSA
- Prescription Drug Cost Finder
- Specialty Pharmacy
- Anthem Pharmacy Immunization Program
- Home Delivery Pharmacy FAQ
- Participating Pharmacy Vaccine List
- Prescription Benefit Smartphone App
Pharmacy Benefits POS and PPO
- Prescription Drug List – Express Scripts
- 2021 National Preferred Formulary with Exclusions
- 2021 National Preferred Formulary Exclusions List Changes 7-1-2021
- 2022 National Preferred Formulary Updates
- Prescription Drug Deductible FAQs
- Prescription Drug Cost Finder
- Express Scripts FAQs
Health Care Forms
- Anthem Enrollment/Change Form
- Status Change Form
- Prescription Mail Order Form
- Transition of Care Form
Health Plan Documents
- County of Henrico Health Plan Document
- Compliance Notices
- Amendment One to the County of Henrico Health Plan – Effective Jan. 1, 2016
- Amendment Two to the County of Henrico Health Plan – Effective Jan. 1, 2017
- Notice of Privacy Practices
Anthem Wellness Programs:
- Healthy Lifestyles Tutorial
- Healthy Lifestyles Online Video
- Healthy Lifestyles Rewards Highlights
- Healthy Lifestyles Member Experience
- Wellness Newsletter
Nurseline and MyHealth Advantage
Condition Care (Disease Management)
Future Moms (Maternity Management)
Health Care FAQs
- What qualifying events allow me to make changes to my present coverage?
- Marriage or divorce of the employee.
- Birth or adoption of a child by the employee.
- Obtaining custody of a child (court documents must be provided).
- Death of employee’s spouse or dependent.
- Change in the employment status of the employee, spouse or dependent.
- Unpaid leave of absence of the employee, spouse or dependent.
- Significant change in the spouse’s or dependent’s employer-provided health care coverage.
- Dependent child no longer eligible for coverage.
Changes to your health coverage must be consistent with your qualifying event.
- When can I make changes to my health coverage if I have a qualifying event?
- You may make a change to your coverage within sixty (60) days after the date of an approved qualifying event. The effective date of the change in coverage is determined by the qualifying event and the date the request is received in the HCPS Benefits Office. If you have questions, please click Qualifying Events or contact the HCPS Benefits Office at 804-652-3624 or email email@example.com.
- When can I expect to receive my ID card?
- If you are a new employee, you should receive an ID card within 10 days. If you have made a change to your coverage, please allow seven to 10 days.
- Who should I call if I have a problem with a claim?
- For all plans, call Anthem Member Services at 800-421-1527. You may also review your claims by visiting the Anthem website.
For general information about benefits offered to eligible employees of Henrico County Public Schools, click on the link for the specific benefit. For additional information or questions, please call the Health Benefits Office at 804-652-3624 or email us at firstname.lastname@example.org.
Income protection programs offer employees the opportunity to replace their income during periods of disability.
Short-Term Income Protection
Henrico County Public Schools’ Short-Term Income Protection (STIP) program for VRS Plan 1 and VRS Plan 2 full-time employees and eligible part-time employees is administered by MetLife and coordinates with HCPS leave-balances. These employees can elect to purchase coverage when initially hired or during the annual open enrollment period. These employees may choose from three options: waiting periods of 42 days, 28 days or 14 days. Participating employees may use either their HCPS leave or MetLife STIP benefits during an absence of 90 days or less. STIP benefits provide 60% of an employee’s salary.
View the MetLife Short Term Income Protection brochure for more details.
VRS Hybrid Plan employees may choose to enroll with MetLife for the first 12 months of employment. After 12 months of employment, VRS Hybrid Plan employees are automatically covered with a short-term disability benefit administered by the Standard at no cost to the VRS Hybrid Plan employee. View The Standard Hybrid Disability Program brochure for details.
Long-Term Income Protection
Henrico County Public Schools’ Long-Term Income Protection (LTIP) program is administered by MetLife for employee absences beyond 90 days. VRS Plan 1 and VRS Plan 2 full-time employees who have completed six months of employment are automatically members in the LTIP program. For these employees, MetLife provides coverage for up to a $50,000 annual salary at no charge. If your salary is above $50,000 and you have been employed at least six months, you may be eligible to purchase additional coverage for the remainder of your salary. Long-term income protection benefits provide 60% of an employee’s salary.
View the MetLife Long-Term Income Protection brochure for additional details.
VRS Hybrid Plan employees have employer-paid long term disability benefits through the Standard. (VRS Hybrid Plan employees are not eligible for the MetLife Long-Term Income Protection program.) View The Standard Hybrid Disability Program brochure.
Short-Term Income Protection
- MetLife Rates
- STIP Enrollment Form
- Metlife STIP Brochure
- Instructions for Filing an MetLife STIP Claim
- Online Access to Your MetLife Disability Claim
- Income Protection Fact Sheet
- MetLife Short-Term Disability — Certificate of Insurance (VRS Plan 1 and Plan 2 members and part-time permanent employees)
Long-Term Income Protection
- MetLife LTIP Brochure
- MetLife Statement of Health Form
- Income Protection Fact Sheet
- MetLife Long Term Disability — Certificate of Insurance
Short Term Disability and Long Term Disability (only for VRS Hybrid Plan employees)
- The Standard Hybrid Disability Program brochure
- The Standard Hybrid Disability Coverage
- Short-Term Disability (STD) – FAQs about filing a STD claim
- Long-Term Disability (LTD) – FAQs about filing a LTD claim
- MetLife Short-Term Disability — Certificate of Insurance (VRS Hybrid Plan members for first year of employment before eligibility for Hybrid Disability)
Employees are offered two types of life insurance coverage: basic (paid in full by Henrico County) and optional (paid by the employee):
All full-time eligible employees participate in a group term life insurance and accidental death and dismemberment insurance program through the Virginia Retirement System. Life insurance coverage is two times, or in the case of accidental death, four times the next highest thousand dollars above annual salary. Example: If annual salary is $13,455, coverage is for $28,000 life insurance in the case of regular death, or $56,000 for accidental death. Henrico County assumed the cost of this coverage effective July 1, 1977. Federal law requires that the employer report the value of this coverage (exceeding $50,000) as income received by the employee for tax purposes.
Optional Life Insurance
Employees covered for basic group life insurance may purchase optional group life insurance coverage in an amount equal to one, two, three or four times their salary. Optional group life insurance also is available to the member’s spouse and dependent children. This life insurance is offered through the Virginia Retirement System and is underwritten by Minnesota Life.
If you have a question about life insurance, you may email the HCPS Payroll Office at email@example.com or call 804-652-3623.
- Virginia Retirement System — Group Life Program
- Optional Group Life – Virginia Retirement System/Securian Financial – log in to your myVRS account, select Life Insurance under the My History tab and select the Visit Securian button.
P.O. Box 1193
Richmond, Va. 23218-1193
Phone (toll free) 800-441-2258
Henrico County Public Schools – Payroll Office
Send an email
- All HCPS employees are eligible to participate in the program to enhance their future VRS retirement benefits or for part time and temporary employees to investment for their future.
- The program’s sole provider is VALIC.
- Participation can be into the 403(b) program, into the 457 program or in both:
- Deductions to these two programs are done through payroll deduction on a pretax basis.
- Deductions can also be made on an after-tax basis into a Roth 403(b).
- Deductions can be set up as a fixed dollar amount for each pay period or on a percentage basis for each pay period.
- Semi-monthly employees can choose to have their VALIC deductions set up for either 24 or 26 pay periods.
- 2022 calendar year maximum for the 403(b) is $20,500 with a catch-up provision for employees age 50 or older of an additional $6,500.
- 2022 calendar year maximum for the 457 is $20,500 with a catch up provision for employees age 50 or older of an additional $6,500.
The Virginia Retirement System, or VRS, administers retirement plans, life insurance plans and related services for its active members. Eligible members include full-time salaried, permanent employees of the Commonwealth of Virginia, participating local cities, towns, political subdivisions and all Virginia school boards. Henrico County participates in the Virginia Retirement System and pays the employer contribution of an eligible employee’s salary. Eligible employees contribute 5% of their salary to their member accounts. VRS members are “vested” when they have five years of VRS service credit.
There are three VRS Plans:
Plan 1: Members with service credit before July 1, 2010, and vested as of Jan. 1, 2013, are eligible to retire with unreduced benefits at age 65, with at least five years of service, or at age 50 with at least 30 years of service. An employee’s highest consecutive 36 months of creditable compensation is used as the average final compensation.
Plan 2: Members hired or rehired on or after July 1, 2010, with no pre-July 1 service credit are eligible to retire with an unreduced benefit at their normal social security retirement age with at least five years of service credit or when age and service equal 90. An employee’s highest consecutive 60 months of creditable compensation is used as the average final compensation.
For Plan 1 and Plan 2, service retirement is a defined benefit based on a member’s average final compensation, years of service, and age at retirement. VRS Plan 1 and Plan 2 members may apply for disability retirement benefits if they become unable to perform their job because of a physical or mental disability and the disability is most likely to be permanent.
Hybrid Plan: This plan applies to most members hired on or after Jan. 1, 2014 with no prior VRS service credit. This plan offers a defined benefit component and defined contribution component (similar to 401k). The Hybrid Plan does not offer disability retirement benefits; instead, Hybrid Plan members have a separate program of short and long term disability benefits and a separate County sick leave accrual plan for biweekly employees.
- Hybrid Retirement Plan Information Resources:
- VRS Hybrid Plan Road Map for Members
- Special Issue of VRS Member News – for an overview of the new Hybrid Retirement Plan and list of VRS information resources.
- VRS Plan Comparison Guide for details on significant benefit differences.
- Hybrid Disability – an employer-paid program of short and long term disability benefits for Hybrid Plan members.
Hybrid Sick Leave Accrual Program – a separate County sick leave accrual plan for Hybrid Plan members that corresponds to the employer paid disability program.
Contact the Hybrid Retirement Plan Support Team at 855-291-2285 or email firstname.lastname@example.org.
Thinking about retiring from Henrico County? You can visit the HCPS Benefits’ Retirees page to learn about retiree health and dental coverage, and other tools to help you plan for retirement.
Purchase of Prior Service
You may be able to increase your VRS benefit by purchasing prior service credit. Prior service is a period of service that has not been credited to your VRS service record because it was not covered by VRS or it was covered service for which you previously took a refund. Because the amount of your benefit is based on your years of service credit, purchasing prior service credit can increase your monthly retirement benefit. VRS allows eligible members to purchase time for: certain leaves of absence, noncovered service with a participating employer, public service, active duty military service and VRS-refunded service. Although the VRS online tools provide cost estimates, you must request an official cost letter through the HCPS Payroll office to start purchasing service. For more information on purchasing prior service, visit the VRS purchase of prior service Web page. In order to initiate a purchase of prior service, a member needs to complete the Application to Purchase Prior Service Credit (Form VRS-26). When a completed form is submitted to VRS, a cost letter is generated for the member. The letter provides cost information and payment options, which may include payroll deduction, lump-sum payment, or trustee-to-trustee transfer.
Links and Resources
- Hybrid Retirement Plan Information Resources:
Henrico County now offers voluntary benefits to full-time and part-time benefited employees. If you are interested in enrolling or want more information, please contact Pierce Insurance at 800-421-3142 or www.pierceins.com/henrico.
Per HCPS Regulation 4-06-002, all “Accidents resulting in injury regardless of the necessity for medical treatment, including First Aid, must be reported”.
The following list of Worker’s Compensation forms can be found on the HCPS intranet and are required if an employee is injured in the course of working for HCPS:
- Employee Report of Injury Form
- Supervisor Investigation Form
- Physical Capabilities Form
- Panel Of Physicians
- PMA MS First Fill Form
- Workers Compensation Reporting Flowchart
An injured employee who requires medical attention must choose a physician from a panel of physicians pursuant to 65.1-88 of the Code of Virginia. The names, addresses and phone numbers of those comprising the panel are provided to employees on the “Panel of Physicians” form at their employment site. “Panel of Physicians” forms are also available in the Payroll Office.