Forms
(Please click the link to download each form as a pdf )
Newsletter
- ERISA Reporting and Disclosure Requirements for Welfare Plans
- How to Communicate Consumer-Driven Health Plans
- Total Rewards Statement
- Health Care Expenses Per FTE
- 2009 Stimulus Package
Payroll
- Direct Deposit Authorization
- Direct Deposit Cancellation - NEW
- Employee Application
- Employee Update
- L4
- Mississippi Withholding Certificate
- Payment Authorization
- W-4 2009
- W-9
Cobra
Cafeteria Plans
HRA
Benefits - Blue Cross Blue Shield of Louisiana
- BCBS PPO Prior Carrier form
- BCBSLA enrollment - PPO and Blue Saver 2005
- Blue Cross Cancellation Form
- Prior Coverage BCBS LA and HMO LA 2
HSA
Benefits - Coventry Health Care
Benefits - Humana
- Humana LA Change Form
- Humana LA COBRA Continuation
- Humana LA Dependent Form
- Humana LA Enrollment Form 2-9 Employees
- Humana LA Enrollment Form.10-25 Employees
Benefits - United Health Care
Benefits - Starmount
- Starmount Change Request Form
- Starmount Dental Enrollment Form
- Starmount Life Insurance Enrollment Form
- Starmount Life Insurance Evidence of Insurability Form
Benefits - Dental Select
Benefits - Fortis
Benefits - Allstate
- Allstate Accident Claim Form Instructions
- Allstate Accident Claim Form
- Allstate Disability Claim Form Instructions
- Allstate Disability Claim Form
- Allstate Proof of Good Health
Benefits - Unum
Benefits - ESS 401(k) Plan
- Blackrock Beneficiary Designation
- Blackrock Distribution Request
- Blackrock Enrollment Form
- Blackrock Rollover Form
Human Resources
- COBRA Event Notification
- I9 Form - 2009
- Medical Quest for the Second Injury Fund
- Social Security Application
- Performance Evaluation
- FMLA Request Form - NEW
- Unprotected Leave of Absence Request Form - NEW
- HR/B Form - NEW
Workman's Comp
Training