Benefits Claims | Employee | FMLA | Health and Flex Benefits | How To Guides | Pharmacy |
Payroll | Classification | Seasonal/Temporary | Supervisor | Workers' Comp

 

 

Benefits Claim Forms	Adobe	Word
HRA & FSA Claim Form	Click Here
Accident Insurance Claims Process	Click Here
Dependent Spending Account Recurring Claim Form	Click Here
Hospital Indemnity Insurance Claims Process	Click Here
Health Claim Form	Click Here
Short Term Disability	Click Here
Vision Out of Network Claim Form	Click Here
Deductible Verification Form	Click Here
Dependent Care Reimbursement Form	Click Here

 

 

Employee Forms	Adobe	Word
Reduced Tuition Form
Paid Family Leave Form	Click Here	Click Here
Reasonable Accommodation Request Form	Click Here	Click Here
Outside Employment	Click Here
Request for an Alternative Work Schedule	Click Here	Click Here
State of SD Release and Waiver - Employment Reference Release	Click Here
Conflict of Interest Waiver Instructions and Form	Click Here
Conflict of Interest Matrix	Click Here

 

Family and Medical Leave Act Forms	Adobe	Word
FMLA Certification of Health Care Provider for Employee's Serious Health Condition	Click Here
FMLA Medical Certification of Health Care Provider for Family Member's Serious Health Condition	Click Here
FMLA Certification of Qualifying Exigency for Military Family Leave	Click Here
FMLA Certification for Serious Injury or Illness of Covered Service Member for Military Family Leave	Click Here
FMLA Certification for Serious Injury or Illness of a Veteran for Military Caregiver Leave	Click Here

 

Health and Flexible Benefits	Adobe	Word
Biometric Screening Form	Click Here
Tobacco Use Election Form	Click Here
Wellmark Appeal/Review Form	Click Here
External Review Experimental Review Form	Click Here
External Review Expedited Review Form	Click Here
New Health Insurance Marketplace Coverage Options and Your Health Coverage	Click Here

 

How To Guides	Adobe	Word
Employee Space Quick Reference Guide	Click Here
Manager Space Documents
Manager Space Disposition Quick Reference Guide	Click Here
Proxy Management Quick Reference Guide	Click Here
Tobacco Free Q&A	Click Here

 

Pharmacy	Adobe	Word
Wellmark Drug Formulary Search	Click Here

 

Payroll	Adobe	Word
Direct Deposit Form	Click Here
Request to Receive Donated Leave	Click Here
Request for an Alternative Work Schedule	Click Here	Click Here

 

Classification Forms	Adobe	Word
Reclass a Vacant Position	Click Here
Create a New Position	Click Here
Position Description Questionnaire (PDQ) Employees Section	Click Here
Position Description Questionnaire (PDQ) Supervisor's Section	Click Here
Reclassification for Certification Promotional	Click Here
Career Band Questionnaires (CBQs) (List by Career Families)
Accounting – Supervisor | Employee Level 2 or Above | Employee Level 1
Attorney – Supervisor | Employee Level 2 or Above | Employee Level 1
Engineering – Supervisor | Employee Level 2 or Above | Employee Level 1
Environmental Science – Supervisor | Employee Level 2 or Above | Employee Level 1
Information Technology – Supervisor | Employee Level 2 or Above | Employee Level 1
Nurse – Supervisor | Employee

 

Seasonal/Temporary	Adobe	Word
Seasonal/Temporary Job Application	Click Here
Seasonal/Temporary Requisition Request		Click Here

 

Supervisor Forms	Adobe	Word
Selection Process Guidelines	Click Here
Competency-Based Selection
Initial Interview Form I		Click Here
Final Interview: Form F1		Click Here
Final Interview: Form F2		Click Here
Reference Check: Form R		Click Here
Verification of Education & Experience: Form V		Click Here
Decision Justification: Form D		Click Here
Pay Increase Request Form	Click Here
Reference Check Forms
Option 1: Employer Reference Check Form	Click Here
Option 2: General Reference Check Form	Click Here
Requisition Request		Click Here
Requisition Request Instructions	Click Here
Hiring Manager Create Requisition Guide	Click Here
Seasonal/Temporary Requisition Request		Click Here
Intern Request Form		Click Here
Risk Management Training Form	Click Here
Volunteer Agreement	Click Here

 

Workers' Comp	Adobe	Word
To file your First Report of Injury, please call 888.585.5075
First Fill Instructions for RAS	Click Here
Workers' Compensation FAQ	Click Here
Workers' Compensation Program Sick and Vacation Leave Form	Click Here