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St. Helena Unified School District
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Welcome to Payroll and Benefits
To use these forms please click a link to download. Print the form and fill out all appropriate fields and send to:
Jamie Norton
You may also bring the completed forms directly to the Finance Office, Room 201, Vintage Hall
Forms and Information
Payroll Forms
DE 4 Tax Form - State Withholdings
W-4 Tax Form Federal Withholdings
Automatic Payroll Deposit Authorization
Deferred Net Pay Authorization
Benefit Coverage
CalPERS Medical Insurance
Met Life Insurance
VSP (Vision Services Provider)
Delta Dental of California
Low Option - $1,000/$1,200 per calendar year
High Option - $2,000/$2,200 per calendar year
Benefit Enrollment Forms
CalPERS Enrollment Form
Delta Dental Enrollment Form
VSP Enrollment Form
Met Life Insurance Enrollment Form
TSA Forms
403 (b) Salary Reduction Authorization and Amendment
457 Salary Reduction Authorization and Amendment
Health Insurance Company Links
CalPERS Medical
Delta Dental
VSP Vision Plan
Retirement System Links
Public Employees Retirement System (PERS)
State Teachers Retirement System (STRS)
Links and Resources
403(b) Compare Website
North Bay Schools Insurance Authority (NBSIA)
Escape Employee Portal - Click HERE To View and Access Payroll and Leave Information
Comments (-1)
2024 - Health Benefit Rates for 11 Month Employees
11 Month Employee rates.pdf
172.14 KB
(Last Modified on April 15, 2024)
Comments (-1)
2024 - Health Benefit Rates for 12 Month Employees
12 Month Employee rates.pdf
172.35 KB
(Last Modified on April 15, 2024)
Comments (-1)
Timesheet Schedule 2024-25
Timesheet Schedule 24-25.pdf
52.85 KB
(Last Modified on July 10, 2024)
Comments (-1)
CSEA Holiday Schedule 2024-25
2024-25 CSEA Holidays and Vacation Days.pdf
61.13 KB
(Last Modified on July 10, 2024)
Comments (-1)
Contact Us
Questions? Contact:
Jamie Norton
Payroll/Benefits Technician
St. Helena Unified School District
465 Main Street
St. Helena, CA 94574
Phone: (707) 967-2702
Business Fax: (707) 968-9310
jnorton@sthelenaunified.org
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