About This Page

This page contains information regarding Benefits, Insurance, Workers' Compensation, Forms and more. Looking for contact names and phone numbers? Visit the Risk Management department page.

Click here for HIPAA Information

Additional Services

Use of Facilities

Link to Facilities webpage to find informatin that must be completed and sent in to Facilities:

Community Use of School Facilities

When outside organizers request to use or rent a PCSB facility for their events and they do not have liability coverage they can simply visit to the PCSB TULIP site.

Event coverage for dances and festivals etc. can also be purchased by schools on the same site:

TULIP

Tenant User's Liability Insurance Program

Special Event Coverage

AcceptableClassesSpecialEvents

Highlights- Special Events

Special Events - Not Sports - Supplemental Application

Special Events - Amateur Sports - Supplemental Application

Keyword for this page: Risk

Frequently Used Numbers

Click here to view or print this list of important numbers.

Notices & Forms

  • New Beneficiary Statute
  • BlueCross BlueShield Saturday Service Hours

    Service team members are available to accept PCSB employee calls from 10:00-8:00

     

Leave of Absence Forms

**Completed forms may be returned to Risk Management via fax (863)534-5085 or courier Rte E. DO NOT SCAN AND EMAIL FORMS**

If you any questions regarding leave of absence (FMLA, Medical or Parental) contact Connie Bias 863-519-3858 ext. 2223 or Charlina Wikner 863-519-3858 ext. 2230.

Leave of Absence Request Form

Leave of Absence Request Form - Spanish

Employee Application for Leave

Parental Leave Request

Parental Leave Request - Spanish

 

Retirement Office

For comprehensive information from the retirement office, or to access your FL Retirement System Online Services Account, visit our main retirement page.

Social Security Number Collection Policy

Risk Management & Employee Benefits Department Social Security Number Collection Policy

Know Your Rights

Health Insurance Portability and Accountability Act (HIPAA)

Section 125 Information

INFORMATION ABOUT IRS PERMITTED Election Changes

COBRA

Women's Health & Cancer Rights and Newborn & Mothers Health Protection

Early Retiree Reinsurance Program (ERRP)

Newborn and Mothers Health Protection Act

Newborn MothersEspañol

Workers' Compensation

Effective 01/01/2015 the third-party administrator for Workers Compensation is Johns Eastern. Reporting of a workers compensation injury is done electronically via the Johns Eastern's website. Instructions for reporting the first notice of injury via the internet can be found below. If you need assistance for a workers' compensation injury or assistance with a claim please contact Johns Eastern at 1-800-749-3044.

First Notice of Injury Reporting Instructions

PCSB-Workplace-Incident-Investigation-Form

 

Student Accidents

Student Accident Form

Student Accident Guide

 

Citizen Accident Form

(for use in reporting incidents not involving a student or employee)

Citizen Accident Form

Incident Form-Missing Items

For items that are reported missing that have been confiscated/collected from a student by a staff member.

Incident Form-Missing Items

For items involving non-students

Incident Form- non student

BENCOR

Interesting and Useful Websites

Still Have Questions?

Please browse all of the Risk Management and Employee Benefits pages and if you still have questions, feel free to contact us.

View the Risk Management and Insurance District Info page for a list of staff and their phone numbers.