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Welcome to the official site for the town of Brimfield, MA
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On Our Site

 
Town Employee Information
General Employee Forms
 
 
W-4 2016
MA-4
 
Waiver of Group Coverage
 
Health, Life and Dental Insurance
July 1, 2019 to June 30, 2020
Deductable 500-Summary of benefits
Deductable 500-Summary of benefits
Deductable 500-Summary of benefits
No deductable-Summary of benefits
Basic and Voluntary
Group Benefits Form
Life and Accidental Death & Dismemberment
2017 Summary of Benefits
2017 Summary of Benefits
Summary of Benefits
Dental Rollover Information
Fact Sheet for Dental Plan
Accident, Cancer, Disability Insurance
Reimbursement Form
New Full Time Employee
 
Form I-9
Form W-4
Form MA-4
 
New Member Enrollment Form
Statement Concerning Your Employment in a Job Not Covered by Social Security
 
New Part Time Employee
 
Form I-9
Form W-4
Form MA-4
OBRA/PST Acknowledgement Card
 
Statement Concerning Your Employment in a Job Not Covered by Social Security
Part Time Employee

 
Virtual Towns & Schools Website