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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, 2018 to June 30, 2019
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
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