Employee Resources

Documents

Policies

  1. 2023 Handbook FINAL
  2. 2023 Changes

Tax Forms

  1. W4
  2. Local Tax (PDF)
  3. State Tax (PDF)

Direct Deposit Forms

  1. Authorization for Email (PDF)
  2. Set-Up or Cancel Form (PDF)

Insurance Forms

  1. Member Guide FAQs
  2. Blood Screening Consent Form (PDF)
  3. 2023 Registration - Physical, Blood Screening
  4. Flexible Spending Account Enrollment (PDF)
  5. Health Insurance Enrollment Form (PDF)
  6. Health Savings Account Authorization Form (PDF)
  7. 2023 Health Savings Account Procedure
  8. Insurance Termination Notice (PDF)
  9. Wellness Physical Checklist
  10. Registration Form - Blood Screening and Physical (PDF)
  11. Spouse Coverage Form (PDF)
  12. Life Insurance beneficiary form (Mutual of Omaha)
  13. Contact Information
  14. Wellness Exam verfication
  15. Vaccine Administration form
  16. HSA Deduction Form
  17. Dental Exam verfication
  18. 2024 Registration - Physical, Blood Screening
  19. Wellness Incentive Info Sheet

Benefit SBCs for Insurance Plans

  1. PPO
  2. HSA Single
  3. HSA Family

Requests for FMLA

  1. Family and Medical Leave Act (FMLA) - Employee Rights Notice (PDF)
  2. Family and Medical Leave Act (FMLA) - Self (PDF)
  3. Family and Medical Leave Act (FMLA) - Family Member (PDF)

Informational Sheets on Ancillary Benefits

  1. Deferred Compensation - Ohio Deferred Compensation (PDF)
  2. Deferred Compensation - Empower (PDF)
  3. CCAO Deferred Comp Plan-Highlights
  4. Deferred Comp Open Enrollment Instructions - Empower
  5. EAP Poster

CORSA

  1. 2019 CORSA University Access Instructions (PDF)
  2. Accidents and Traffic Citations (PDF)
  3. Report of Accident (PDF)

Other Employee Forms

  1. Employee Injury and Incident Report (PDF)
  2. Leave Request Form (PDF)
  3. Travel Expense Reimbursement Form (PDF)
  4. Hourly Employee Time Sheets (XLSX)
  5. Internal Employment Application
  6. ID Form
  7. 2023 IRS Mileage Rate memo

Wellness

  1. Wellness Committee Cookbook