Employee Information Documents

Below are downloadable forms and information that are commonly requested by employees. Please refer to the Employee Opportunities Page for an Employment Application and IRS Form 8850 - Request for Work Opportunity Credit.

Cafeteria Plan Information

• Cafeteria Reimbursement Form (2013) (DOC)
• Dependent Verification Form (PDF)
• Medical Home Designation Form 261 (PDF)
• Medical Provider Preventative Prescription Form 26 (PDF)
• Preferred Providers in California (N/A)
• Preferred Providers in Oregon (N/A)
• Preventative Drug List - Express Scripts 2012 (PDF)
• WebMD Coverage Advisor (N/A)
• Western Benefits Insurance Application Form 302 (PDF)
• Western Benefits Major Medical Drug Report Form 32 (PDF)

Other Human Resource Documents

• I-9 Employee Eligibility Verification Form (PDF)
• Request for Leave Form #304 (PDF)
• Training Incentive Program (PDF)
• W4 (2012) Employee Withholding Allowance Certificate (PDF)

Please help us conserve resources. Copies of these documents are available at your work location for review. If you must print copies, these documents are formatted to print double sided. Thank you!