Treasurer | Southeast Local Schools

Mark Dickerhoof, Treasurer

Welcome to the home page of Southeast Local Schools Treasurer’s office. As Treasurer, I serve as the Chief Financial Officer of the Southeast Local School District and am responsible for the receipt, investment, accounting and disbursement of all types of public funds as required by law and in accordance with Board policies. I hope you find this site useful and informative.

Southeast Local Schools' employees will find information regarding Payroll Policies & Procedures, a summary of the District's 403B Plan, as well as general financial statements. Should you desire further information, please contact me at 330-698-3001.

TREASURER'S OFFICE CONTACT INFORMATION:

Mark Dickerhoof / roc_mardick@tccsa.net / cell 330.265.8187

PAYROLL: contact number: 330-683-9620
Chris Cvanciger / ritt_cvancig@tccsa.net
Lisa Hahn / orvl_lhahn@tccsa.net

PURCHASE ORDERS - ACCOUNTS PAYABLE / RECEIPTING / INSURANCE / AMERICAN FIDELITY
contact number 330-683-9615

Estefany Silva / soea_esilva@tccsa.net

	►PIPELINE FUNDING AND OFCC INFORMATION Public's Right to Know FORMS Item Disposal Form (for buildings) CAFETERIA ♦Cafeteria Prices for 2022 - 2023		FINANCIAL STATISTICS ♦Southeast Local Schools Five Year Forecast - 2021 ESSER - USE OF FUNDS ♦ESSER ARP Use of Funds Part 1 ♦ESSER ARP Use of Funds Part 2

	PAYROLL INFORMATION ♦Pay Period Schedule for 22-23 ♦Classified Sub Timesheet ♦Supplemental Duty Request Form MISCELLANEOUS FORMS/INFO ♦2021 Ohio Minimum Wage ♦2022 Mileage Rate Reimbursement Form ♦Medicare Part D Notice Distribution - 2020 ♦HIPAA Notice of Privacy Practices - 2021		EMPLOYEE 403B BENEFIT PLAN ♦Summary of 403B Benefit Plan ♦Employee Salary Reduction Agreement ♦TSA Approved Provider List

EMPLOYEE MEDICAL INFORMATION

♦Prescription Fax Form (must be faxed from physician's office
♦Prescription Mail Form
♦Prescription Drug Claim Form
Reimbursement of prescription costs paid out-of pocket

SCHEDULE OF BENEFITS / MEDICAL MUTUAL

♦ EyeMed benefit website:

♦ American Fidelity Reimbursement Flex Claim Form

♦Medical Enrollment Form
New employee insurance form or adding a dependent

♦Trustmark Dental Enrollment Form (effective Jan. 2020)
♦Coresource Dental Claim Form

♦Medicare Part D Prescription Drug Coverage

♦Medical Mutual Claim Reimbursement Form
Send to: PO Box 6018, Cleveland OH 44101

♦EyeMed Enrollment/Change Form
♦EyeMed Out of Network Claim Form

The Transparency in Coverage mandate in the No Surprises Act/Transparency in Coverage Rule Under the Consolidated Appropriations Act, 2021, requires that insurers and group health plans make rate information publicly accessible starting July 2022. For information regarding this Act, including rate information, click on:

https://www.medmutual.com/For-Employers/Employer-Resources/No-Surprises-Act-Legislation.aspx Under the Consolidated Appropriations Act, 2021, can be found under the Employer Resources tab on the https://www.medmutual.com/For-Employers.aspx .

Insurance / Medical Contact Info
CONTACT INFORMATION BELOW FOR INSURANCE QUESTIONS:

Medical Mutual questions/problems:

Customer Care 800-585-2583

To find providers:
MedMutual.com

CVS questions/problems:

Customer Care 888-865-6584
www.caremark.com

Trustmark Dental questions/problems:

800-282-3920

www.mycoresourse.com

Eyemed questions/problems:

800-521-3605

Or Eyemed.com

If your issue is not resolved by first using the numbers/websites above, please call Mark Dickerhoof

♦PPO Network Comprehensive Major Medical Health Care Benefits
♦FMLA Employee Rights and Responsibilities
♦Affordable Care Act Notification

STUDENT ACTIVITY GUIDELINES
♦Student Activity Guidelines