Employee Forms
2021 Payroll Schedule
Federal Form W4 (Personal Allowances)
Federal I-9 Form
Virginia VA 4 Form (Personal Exemptions)
Change of Address
Direct Deposit Form
Time sheet - full time
Time sheet - part time
Company Nurse Workplace Injury Hotline
Designation of Beneficiary Form (Virginia Retirement System)
Designation of Beneficiary Instructions
Personnel Policy Manual This covers everything from new hire orientation to sick leave.
Northampton County Employee Benefits
Anthem Health
555 Middle Creek Parkway
Colorado Springs, CO. 80921
Flexible Benefit Administrators
Cobra Administrator
PO Drawer 8188
Virginia Beach, Va. 23450
800-437-3539
Virginia Retirement System
1200 East Main St.
PO BOX 2500
Richmond, Va. 23218
888-827-3847
Minnesota Life (group life insurance)
PO BOX 1193
Richmond, Va. 23218-1193
800-441-2258
Voluntary benefits through:
Commonwealth of Virginia's Voluntary Group Long Term Care Insurance
Genworth Life Insurance Company
Minnesota Life (optional life insurance)
PO BOX 1193
Richmond, Va. 23218-1193
800-441-2258
Flexible Benefit Administrators
PO Drawer 8188
Virginia Beach, Va. 23450
800-437-3539
Nationwide Retirement Solutions
PO BOX 182787
Columbus, OH 43218
877-677-3678
Aflac
Chad T. Knapp - Group Critical Illness
Charles Bono - Representative
PO BOX 496
Nassawadox, Va. 23413
Express Scripts
Home Delivery Service
PO BOX 66785
Saint Louis MO 63166
Payroll deductions that are available:
United Way of Virginia's Eastern Shore
PO BOX 605
Onley, Va. 23418
757-787-5622
Virginia Credit Union
PO BOX 90010
Richmond, Va. 23225
800-285-6609
Northampton County Treasurer's Office
PO BOX 598
Eastville, Va. 23347
757-678-0450