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Thursday, July 02, 2009
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Human Resources Toolbox
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Benefits
Forms
Center for Government Excellence
Classification
Disability Access Office
Employee Assistance Services (EAS)
Employee Relations
Employee Services
Recruitment & Selection
Return-To-Work Program
Risk Management
Safety
Workers' Compensation
Affidavits/Declarations
Affidavit of Marriage (County)
Affidavit of Marriage (CalPERS)
Affidavit of Eligibility for Economically Dependent Childern (CalPERS)
Declaration of Tax Dependent Status
Deferred Compensation
Nationwide Beneficiary Change Form
Nationwide Distribution Request Form
Deferred Compensation Change Form
AIG Distribution Request Form
AIG Beneficiary Designation Form
AIG Transfer In/Rollover Form
AIG Intra Plan Transfer Out
Disability Insurance
Standard Long Term Disability Claim Form
Standard Life Long Term Disability (LTD) Certificate
Sedgewick/VPA Disability Forms
Flexible Spending Accounts
Dependent Care FSA Claim Form
Health Care FSA Claim Form
Health Care Letter of Medical Necessity
Health Care Capital Expense Worksheet
General Forms
Employee Status Change Form
Password Security
Beneficiary Designation to Receive Warrant
Health (Medical) Benefits
Benefit Election Form 2009
(County Plans)
Benefit Election Form 2009
(CalPERS Plans)
Current Plan Rates
Health Plan Enrollment Form HBD-12
(CalPERS)
Statement of Financial Liability for Domestic Partner Health Benefits
(County Pl
Statement of Financial Liability for Domestic Partner Health Benefits
(CalPERS)
Medical report for Disabled Dependent Benefits
(County Plans)
Member Questionnaire for Disabled Dependent Benefits
(County Plans)
Medical report for Disabled Dependent Benefits
(CalPERS)
Member Questionniare for Disabled Dependent Benefits
(CalPERS)
Zip Code Election (HBD109)
(CalPERS)
After-Tax Benefit Plan Election Form 2009
Retirement
401(a) Election Form
CalPERS Beneficiary Designation Form
Retiree Address Change Form
VEBA Claim Form
VEBA Systematic Payment Form
Retirement Plan Options
Blue Shield Medicare Enrollment Form
Post Employment Program Election Form (Mgmt, Conf, Unrep, DDAA & LEMU only)
Post Employment Program Election Form (LIUNA & SEIU Only)
2009 Retiree Benefit Election Form
2009 Retiree Benefits Enrollment Guide
Leave Forms
Click here for Leave Forms.
Life Insurance
Lincoln Financial Basic Life Insurance Certificate
(All SEIU & LIUNA employees have this coverage, paid for by the County.)
Lincoln Financial Beneficiary Designation Form
Lincoln Financial Enrollment Form for Group Insurance
Lincoln Financial Evidence of Insurability
Lincoln Financial Life Insurance Claim Form
Lincoln Financial Supplemental Life Insurance Certificate
Lincoln Financial Portability/Conversion Summary
Lincoln Financial Conversion Form
Lincoln Financial Portability Form
Standard Life Insurance Beneficiary Form
Standard Life Insurance Certificate
Standard Life Insurance Claim Form
Standard Life Insurance Evidence of Insurability
Standard/Supplemental Life Benefits Summary
Standard/Supplemental Life Enrollment Form
Standard Life Portability Application
Standard Life Conversion Application
Standard Life Request for Conversion Material
Standard Frequently Asked Questions About Basic Life Benefits
Standard Frequently Asked Questions About Long Term Disability (LTD) Benefits
Transportation Expense Program
Rideshare Registration
Enrollment/Change Form
Reimbursement Claim Form
Vision
Medical Eye Services Claim Form
Health & Wellness Links
Healthy Lifestyle Rewards
Wellness Programs
Leave Balance Cash-Outs
Annual Leave Buy-Down Request (Management, Confidential, & Unrepresented)
Leave Balance Cash-Out (LIUNA & SEIU only)
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