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Workers' Comp Quick Guide |
Human Resources |
 wcprocessforsupvrev04-15.pdf |
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Workers Compensation Pre-Designation of Physician Form |
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 noticetonewemployeeswebsiteonly.doc |
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Work-Related Injury Reporting Procedure |
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work_related_injury_reporting_procedures_2024.pdf |
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W-4 |
W-4 - Employee's Witholding Allowance Certificate |
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http://www.irs.gov/pub/irs-pdf/fw4.pdf |
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VSP Vision Insurance Claim - No form required for vision services |
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VSP Video Display Terminal (VDT) Claim Form |
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vsp_video_display_terminal_claim_form.pdf |
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VSP Out-of-Network Reimbursement Form |
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vsp_out_of_network_reimbursement_form-2.pdf |
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Universal Availability Notice 2014 |
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universal_availability_notice_-2014_plan_year.pdf |
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Universal Availability Notice - 403(b) Plan Information |
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universal_availability_notice-_final_20121218.pdf |
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TSA Information |
Human Resources |
saving_made_easy_brochure_2016_final.pdf |
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Supervisor's Report of Injury |
Human Resources |
supervisors_report.pdf |
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SPF Workers' Comp Guide |
Sponsored Programs Foundation |
spf-wc_process_for_supv_rev_03-13.pdf |
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SPF TIAA-Cref Summary of Plan Services and Costs |
Sponsored Programs Foundation |
plan_related_info.pdf |
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SPF Out of Area WC Procedures |
Sponsored Programs Foundation |
spf_out-of-area_w-c.pdf |
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Social Security & Your Retirement |
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seminarhsu.pdf |
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Self Service Guide: My Benefit Enrollments |
Human Resources |
self-service_guide.pdf |
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Savings Plus Benefits Payment Booklet |
Human Resources |
https://nationwidefinancial.com/media/pdf/NRM-4204CA.pdf?_ga=2.218510169.1738... |
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Saving Made Easy - 403(b) Information |
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saving_made_easy_brochure_2014.pdf |
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Retirement Information |
|
retirement.pdf |
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Request for Service Credit - Service Prior to Membership |
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request_for_service_credit_cost_information-_service_prior_to_membership.pdf |
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Quick Guide to Logging Your Steps |
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quick_guide_to_logging_your_steps.pdf |
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Privacy Notice - Employee Assistance Program |
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october_2014_eap_notice.pdf |
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Pregnancy Disability Certification |
|
pregnancy_disability_certification.pdf |
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Pre-Designation of Physician |
Human Resources |
noticetoemployeespre-des.pdf |
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PERS Declaration of Health Benefits |
|
pers_declaration_of_health_hbd12a.pdf |
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Letter/Options for Sanders Voluntary Insurances |
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final_letter_to_covered_employees.pdf |
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How Service Credit is Earned |
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service_credit_breakdown.pdf |
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Highlights of New Voluntary Plans |
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pages_from_tl-ben2011-02.pdf |
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Health Care/Dependent/Care Reimbursement Account Claim Form |
|
claim_form.pdf |
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HCRA/DCRA 2016 Open Enrollment Form |
Human Resources |
drca_hcra_oe_form.pdf |
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Fee Waiver Application-Self |
Human Resources |
https://apex.humboldt.edu/ords/f?p=245:11 |
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Fee Waiver Application-Dependent |
Human Resources |
https://apex.humboldt.edu/ords/f?p=245:10 |
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Employee's Claim Form For Worker's Compensation Benefits |
|
dwc_1.pdf |
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Employee Assistance Program (EAP) |
|
eap_0.pdf |
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e-Benefits Self-Service Electronic Signature Authorization Form |
Human Resources |
e-benefits_electronic_sig_auth_form.pdf |
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Domestic Partner Information |
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taxationofdomesticpartnershipbenefits-after11-08_0.pdf |
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Domestic Partner Forms |
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formsdomesticpartnerbenefits_0.pdf |
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Direct Deposit for Accounts Payable Reimbursements |
Financial Services |
https://link.humboldt.edu/ZG6 |
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Dental Plan Enrollment Authorization |
|
csu_dental_form.pdf |
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Defense of Marriage Act Updates |
|
defense_of_marriage_act_0.pdf |
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DCRA-HRCA Enrollment Form |
Human Resources |
dcra-hcra-2018-enrollment-form.pdf |
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CSU Fee Waiver Program Information |
|
http://www.humboldt.edu/hsuhr/employee/waiver/index.html |
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CSU 403(b) form |
Human Resources |
csu_403b_srp_enrollment_form_new_number.pdf |
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COBRA Rates for 2015 |
|
cobra_rates_for_2015.doc |
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Career Development Plan |
|
https://apex.humboldt.edu/ords/f?p=244:3 |
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CalPERS Member Reciprocal Self-Certification Form |
|
https://www.calpers.ca.gov/docs/forms-publications/self-certification.pdf |
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CalPERS Health Plan Benefit Comparison |
Human Resources |
calpers_health_plan_benefit_comparison_1_sheet_0.pdf |
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CalPERS Beneficiary Designation Form |
|
http://www.humboldt.edu/hsuhr/docs/benedesignee.pdf |
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CAL-ORE Life Flight Membership Form |
Human Resources |
cal_ore_application_2024.pdf |
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Biometric Screening Quick Guide |
|
maximwellness_registration_calpers_2014_2.pdf |
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Benefits Fair Flyer |
Human Resources |
oe_and_benefit_fair_flyer2.pdf |
|
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Benefit Enrollment Worksheet |
|
benefits_enrollment_worksheet_052024_final.pdf |
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Authorization to Transport Form |
Human Resources |
authorization_to_transport_form_2024.pdf |
|
|
2017 CalPERS Health Benefit Premiums |
Human Resources |
2017_calpers_health_benefit_premiums.pdf |
|
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2016 Open Enrollment Notice to Campus |
Human Resources |
oe_for_2016_notice_to_campus.pdf |
|
|
2016 Open Enrollment Benefits Communication |
Human Resources |
open-enrollment-cummunication_2016.pdf |
|
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2016 Open Enrollment - Health Plan Change Only Form |
Human Resources |
calpers_hbe_form_2016_oe_editable.pdf |
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2016 Monthly Premiums for Health |
Human Resources |
2016_calpers_health_benefit_premiums_use.pdf |
