Personnel Forms

THE BELOW LISTED FORMS ARE AVAILABLE FOR YOUR CONVENIENCE.  

 

 

 

MEDICAL INSURANCE

Health Insurance Change Form

Health Insurance Enrollment Form

LIFE INSURANCE

Life Insurance Enrollment Form

FLEXIBLE SPENDING ACCOUNT

FSA Enrollment Form

 DEFERRED COMPENSATION

Cal-PERS 457 Enrollment Form

Nationwide Enrollment Form

Nationwide Deduction Change Form

RETIREMENT

Cal-PERS Beneficiary Designation Form

WORKER'S COMPENSATION

Physician's Pre-designation

CATASTROPHIC LEAVE

Catastrophic Leave Application

OUTSIDE EMPLOYMENT

Request for Outside Employment

DISASTER RELIEF

Disaster Relief Form

Resources

 

 This page is under construction, please check back soon for updates.                                                                                                        

 

 

Benefits

 

Health benefits are very important.  Tehama County provides a comprehensive and competitive benefit program for our employees.  Below are a list of resources and services for our medical, dental, and vision providers, as well as information regarding additional programs available to eligible employees.  One of the most important factors regarding getting the most value for your benefits is understanding your plans and how to use them.  Please feel free to view and print the attached documents as references.

 

HEALTH

Annual Notice 2019

Summary of EPO Plan 2020

Summary of PPO Plan 2020

Registered Domestic Partners

Self-Service Enrollment

 DENTAL

Delta Dental Summary 2019

VISION

VSP Coupon

Tru-Hearing

Vision Summary 2019

EMPLOYEE ASSISTANCE PROGRAM

Employee Assistance Program - ACI

Employee Assistance Program - Compsych

EXPRESS SCRIPTS

2019 Exclusion List

Express Scripts Home Delivery

2019 Preferred Formulary

Express Scripts EPO 2019 Summary

Express Scripts PPO 2019 Summary

FLEXIBLE SPENDING ACCOUNT

Claim Form

Frequently Asked Questions

Online Participant User Guide

Summary Plan Description

LEAVE OF ABSENCE GUIDELINES

CFRA Guide

FMLA Fact Sheet

Department of Labor FMLA Employee Guide

PFL Guide

SDI Guide

LIFE INSURANCE

Life Insurance Summary - This flyer includes information on the supplemental life insurance option.

Group Life Insurance Plan

WORKER’S COMPENSATION

Pre-Designation of Personal Physician  

York Brochure