New Hire Forms
MIIA/BCBS has a website devoted to the Town of Berlin, if you need any additional information regarding health care benefits, click below:
https://planinfo.bluecrossma.com/customblue/2023/miiatownofberlin
Applicant Forms
- Employee Application
- Personnel Action Form (To be completed by hiring authority)
- Employee Physicals: If required, please contact the Selectmen's Office for details
- CORI Policy
- CORI Form
- Personnel Document Checkoff Form
- I9
- I9 Instructions
Taxes and Retirement
- W4
- M4
- OBRA (Completed by all employees working less than 20 hours/week)
- Worcester Regional Retirement System (WRRS) completed by all employees working 20 hours/week or more)
- Social Security Form
Legal Requirements
- Sexual Harassment Form
- Ethics Form
- Non-smoking Form (For police and fire employees only)
Benefits and Direct Deposit
- 2021 Employee Rates
- 2020 BC Medical and Dental Enrollment site
- 2020 Basic Medical and Dental Information
- Medical/Dental enrollment form (for employees working 20 hours/week or more)
Miscellaneous
Note: To prevent fraud, all changes to direct deposit must be done in person with either your supervisor or the Treasurer's Office. Do not fax changes to your supervisor or the Treasurer.
If you have been a member of Worcester County Regional Retirement in a past or current position, or were a member of another government retirement system, or are a member of OBRA at the Town of Berlin but start a second job that requires you to be a member of WRRS, contact the Treasurer.