New Employee Benefits Orientation Forms

New Employee Benefits Orientation Forms

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• Annual Leave – Sick Leave/Vacation – Election Form
• Authorization to Use a Privately Owned Vehicle on State Business
• Beneficiary Designation (Locate and print from CalPERS )
• COBRA Election Form – FlexElect
• COBRA Election Form – Health, Dental, and Vision
• Consolidated Benefits Cash Enrollment Election Form
• Dental Benefits
• Designation of Person to Receive Warrants
• Employee Action Request (EAR)
• Employment Eligibility Verification Form I-9
• FlexElect: Cash Option
• FlexElect: Premium-Only Plan (Request for Disenrollment)
• FlexElect: Reimbursement Account Enrollment
• FlexElect: Reimbursement Claims
• Health Benefits (Locate and print from CalPERS)
• Home Address – Request for Non-Disclosure
• Long-Term Disability Insurance
• Military Service Information
• Oath of Allegiance
• Paychecks: Direct Deposit
• Paychecks: Time Sheet
• Pre-Tax Parking Claim Form
• Pre-Tax Parking Enrollment Form
• Race/Ethnicity Questionnaire
• Vision Benefits

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