Forms

Note: Address, name, W-4, direct deposit, insurance, and HSA contribution changes must be completed through ESS.

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General

Benefits – Medical

Benefits – Vision

Employment

Flexible Spending Accounts

Leave of Absence

MERS

457/Empower

Life Insurance

MetLife Enrollment/Change FormMetLife Supplemental Insurance Enrollment/Change/Cancellation Form

Payroll

Supplemental Benefits

Talent Development

Workers’ Compensation

  • Supervisor’s Report of Injury Form (Workers’ Comp): Used specifically when an employee suffers an injury or illness due to employment. This form documents how the injury happened, the nature of the injury, and any medical treatment if necessary. It is used to initiate and support a workers’ compensation claim.
  • Incident Report Form: Used for non‑injury events or injuries sustained by a third-party, such as property damage, auto accidents, or equipment issues. This form focuses on what occurred, what was affected, and any corrective actions needed, without initiating a workers compensation claim. It is used to initiate an Auto, Property, Legal, or Other claim.