Expense Reimbursement Policy – Forms
Insurance
AFLAC (SUPPLEMENTAL INS)
ANNUAL COMPLIANCE DOCUMENTS
LIFEMAP (DENTAL-LIFE-AD&D-LTD-STD)
» LifeMap Advantages Summary
» LifeMap Beneficiary Desination
» LifeMap Claim Form LTD
» LifeMap Claim Form STD
» LifeMap Dental Enrollment
» LifeMap Dental Find A Dentist
» LifeMap Dental Member Registration
» LifeMap Dental Summary
» LifeMap Dental Waiver
» LifeMap EAP Summary
» LifeMap Life Insurance Summary
» LifeMap LTD Summary
» LifeMap STD Summary
» LifeMap Travel Assistance Summary
PACIFICSOURCE (HRA-FSA-COBRA)
» PacificSource FSA Eligible Expenses
» PacificSource FSA Enrollment Form
» PacificSource FSA HRA Portal User Guide
» PacificSource FSA Ortho Guide
» PacificSource FSA Overview
» PacificSource HRA – SBC 2023
» PacificSource HRA Enrollment Form
» PacificSource HRA Overview
» PacificSource HRA SPD 1.1.23
» PacificSource Mobile App Flier
» PacificSource Reimbursement Request FSA-HRA Form – 2020
PROVIDENCE (MEDICAL-VISION-RX-CHIROPRACTOR)
» Reimbursement Claim Form (medical)
» Reimbursement Claim Form (vision)
» Out of Area-Cigna ID Card Flyer_Provider Tool
» Providence Benefit Summary – Medical
» Providence Benefit Summary – RX
» Providence Benefit Summary – Vision
» Providence Domestic Partner Plus
» Providence Enrollment Form
» Providence Resource Guide
» Providence SBC
Job Descriptions
Performance
ADMIN STAFF PERFORMANCE EVAL DOCS
FIELD STAFF PERFORMANCE EVAL DOCS
Employment – MT
Employment – OR
BREAKS & OT (SPANISH)
BREAKS & OT
EEOC - Know Your Rights
EQUAL PAY (SPANISH)
EQUAL PAY
EVerify Participation Poster
Family & Medical Leave (Federal)
Family & Medical Leave Spanish (Federal)
FAMILY LEAVE ACT (SPANISH)
FAMILY LEAVE ACT
INJURED ON THE JOB
Minimum Wage (Federal)
Minimum Wage (State)
Minimum Wage Spanish (Federal)
Employment – TX
ARE YOU OWED WAGES
ARE YOU OWED WAGES (SPANISH)
CHILD LABOR LAW
CHILD LABOR LAW (SPANISH)
EIC NOTICE - ANNUAL DISTRIBUTION
Employee Polygraph Protection Act
Employee Polygraph Protection Act (SPANISH)
Employee Rights & Responsibilities FMLA
Employee Rights
Employers First Report of Injury
Employers Supplemental Report of Injury
Employers Wage Statement
EVerify Participation Poster
Family & Medical Leave (Federal)
Job Safety - It’s the Law
Job Safety - It’s the Law (Spanish)
Know Your Rights
Know Your Rights (Spanish)
Minimum Wage (Federal)
Minimum Wage (Federal) (Spanish)
Ombudsman Program
Ombudsman Program (Spanish)
Pay Transparency
Payday Law (Spanish)
Payday Law
RTW Reimbursement Program for Employers
The Law - Employee Rights
Unemployment Notice (Spanish)
Unemployment Notice
Your Rights Under USERRA
Employment – WA
Domestic Violence Resources
EEOC - Know Your Rights
EVerify Participation Poster
Family & Medical Leave (Federal)
Family & Medical Leave - Spanish (Federal)
Job Safety & Health Law
Job Safety & Health Law (Spanish)
Minimum Wage (Federal)
Minimum Wage (State) (English)
Minimum Wage (State) (Spanish)
Minimum Wage (Federal) (Spanish)
Notice to Employees If an Injury Occurs (Spanish)
Paid Family Medical Leave
Paid Family Medical Leave (Spanish)
Polygraph Protection (Federal)
Polygraph Protection SPANISH (Federal)
Pregnant Workers’ Accommodation Right
Pregnant Workers’ Accommodation Right (Spanish)
Right To Work
Right To Work (Spanish)
Unemployment Benefits
USERRA
Your Rights As A Worker
Your Rights As A Worker (Spanish)
WA CARES FUND POSTER

