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