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Human Resources

Chapter 6 BENEFITS ADMINISTRATION

Sections in this Chapter:

6.10 Types of Leave
6.15 Education Financial Assistance
6.17 Sick Leave Insurance Program
6.20 Workers' Compensation
6.25 Health Insurance
6.30 Dental Insurance
6.35 Life Insurance
6.40 Long-term Disability Insurance
6.45 Reserved
6.50 Deferred Compensation and Tax-Sheltered Annuities
6.70 Pretax Premium Conversion Program
6.80 Flexible Spending Accounts
6.85 Donated Leave for Employees
6.87 Donated Leave for Immediate Family Members
6.90 Family and Medical Leave Act Policy

Guidance

Military Leave and Military Pay Differential

 

Related Administrative Rules:

None


Related Performance & Development Solutions Training Available:

None


Workers' Compensation Provider List:

Workers' Compensation Provider List

 

Forms Referenced in This Chapter:

Agreement for Recouping Education Payments 552-0707 PDF
Application for Education Leave and/or Education Financial Assistance 552-0304 PDF
Word Document
Donated Leave  
Donated Leave for Catastrophic Illness Application 552-0611 PDF
Donated Leave for Catastrophic Illness Contribution 552-0612 PDF
Donated Leave for Catastrophic Illness Request 552-0620 PDF
Word Template
Donated Leave for Catastrophic Illness Tracking 552-0628 PDF
Donated Leave for Catastrophic Illness Immediate Family Member Application 552-0639 PDF
Donated Leave for Catastrophic Illness Immediate Family Member Contribution 552-0640 PDF
Donated Leave for Catastrophic Illness Immediate Family Member Request 552-0641 PDF
Word Template
Donated Leave for Catastrophic Illness Immediate Family Member Tracking 552-0642 PDF
Family and Medical Leave Act (FMLA) Forms  
FMLA Application & Intent to Return to Work (552-0599) PDF
Employee Rights and Responsibilities under the Family and Medical Leave Act (WHD Publication 1420) PDF
Leave Retention (552-0649) PDF
Notice of Eligibility and Rights & Responsibilities (552-0730) PDF
FMLA Return to Work Certification (552-0731) Word
FMLA Designation Notice (552-0762) PDF
Certification of Health Care Provider for Employee's Serious Health Condition (552-0755) PDF
Certification of Health Care Provider for Family Member's Serious Health Condition (WH-380-F) PDF
Certification of Qualifying Exigency for Military Family Leave (WH-384) PDF
Certification for Serious Injury or Illness of Covered Servicemember for Military Family Leave (WH-385) PDF
Certification for Serious Injury or Illness of a Veteran for Military Caregiver Leave (WH-385-V) PDF
Servicemember Family Leave Tracking (552-0725) PDF
Excel Spreadsheet
Sick Leave Insurance Program (SLIP)  
Sick Leave Insurance Program Enrollment Form 552-0713 PDF
SLIP Calculation Estimate Form Excel
Group Insurance Direct Pay Continuation Form 552-0442 Word Document
SLIP Checklist for PAs Word Document
Workers' Compensation  
Workers' Compensation Benefit Election 552-0568 PDF
Workers' Compensation Wage Statement 552-0679 PDF
Word Document
Workers' Compensation Status Report 552-0678 PDF
Word Document
Workers' Compensation Travel Reimbursement Request 552-0680 PDF
Word Document
Workers' Compensation First Report of Injury or Illness PDF


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Updated 02/05/2013