HR Forms and Checklists

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Updated Forms

  • Certification of Health Care Provider for Pregnancy Disability Leave, Transfer And/Or Reasonable Accommodation

    Updated  |  Personalize

    Have the employee's health care provider complete this medical certification as needed. This form is used for employee's seeking reasonable accommodation, transfer or Pregnancy Disability Leave for pregnancy, childbirth or a related medical condition.​​

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  • CHIP-Childrens Health Insurance Program-Model Notice for Employers

    Free  |  Updated

    If you are eligible for health coverage from your employer, but are unable to afford the premiums, some states have premium assistance programs that can help pay for coverage. These states use funds from their Medicaid or CHIP programs to help people who are eligible for employer-sponsored health coverage, but need assistance in paying their health premiums.  ​​​​​

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  • CHIP-Childrens Health Insurance Program-Model Notice for Employers - Spanish

    Free  |  Updated

    If you are eligible for health coverage from your employer, but are unable to afford the premiums, some states have premium assistance programs that can help pay for coverage. These states use funds from their Medicaid or CHIP programs to help people who are eligible for employer-sponsored health coverage, but need assistance in paying their health premiums.  ​​​​

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  • COBRA Continuation Coverage Rights General Notice - California Employees

    Updated

    Provide this form to an employee or spouse within 90 days of the commencement of coverage or the first date at which the plan administrator is required to advise a qualified beneficiary of the right to elect coverage.

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  • COBRA Continuation Coverage Rights General Notice - Outside California

    Updated

    Provide this form to an employee or spouse within 90 days of the commencement of coverage or the first date at which the plan administrator is required to advise a qualified beneficiary of the right to elect coverage. Use this form for employees outside California. ​

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  • Employment Application - Long Form - Instructions

    Updated

    Download and read these Instructions prior to using Employment Application - Long Form and Employment Application - Long Form - Spanish​.​​​

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  • Employment Application - Short Form - Instructions

    Updated

    Download and read these instructions prior to using Employment Application - Short Form and Employment Application - Short Form - Spanish​.​​

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  • Features of Mass Layoff and Plant Closing Laws

    Updated

    Review this chart any time you are considering a layoff of a large number of employees or the temporary or permanent close or relocation of a facility or department. This chart identifies covered employers, notification requirements, penalites, trigger events, exceptions and notice content.​

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  • I-9 Retention

    Updated

    Use this form to determine how long the employer needs to retain the employee's completed Form I-9.​

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  • Local Minimum Wage and Paid Sick Leave Ordinances

    Updated

    This chart provides information on local ordinances that contain minimum wage and paid sick leave laws. The minimum wage rates in these cities may change at any time; employers should closely monitor them. Some localities also have industry specific rates, such as specific rates for hotel workers. ​Check with your local city government as to whether any local minimum wage ordinance might apply to your workforce/industry.

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  • New Health Insurance Marketplace Coverage Options and Your Health Coverage - for Employers That Do Not Offer a Health Plan

    Free  |  Updated

    Under the Affordable Care Act, employers must provide a notice of coverage options to employees. The U.S. Department of Labor has provided this model notice for use by employers who do not offer a health plan. ​

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  • New Health Insurance Marketplace Coverage Options and Your Health Coverage - for Employers That Offer a Health Plan

    Free  |  Updated

    Under the Affordable Care Act, employers must provide a notice of coverage options to employees. The U.S. Department of Labor has provided this model notice for use by employers who offer a health plan to some or all employees. ​

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  • New Health Insurance Marketplace Coverage Options and Your Health Coverage (for Employers That Do Not Offer a Health Plan) - Spanish

    Free  |  Updated

    Under the Affordable Care Act, employers must provide a notice of coverage options to employees. The U.S. Department of Labor has provided this model notice for use by employers who do not offer a health plan. ​​

    Preview  |  Download

  • New Health Insurance Marketplace Coverage Options and Your Health Coverage (for Employers That Offer a Health Plan) - Spanish

    Free  |  Updated

    Under the Affordable Care Act, employers must provide a notice of coverage options to employees. The U.S. Department of Labor has provided this model notice for use by employers who offer a health plan to some or all employees.  ​

    Preview  |  Download

  • Termination Decision Checklist

    Updated

    Use this checklist to help evaluate whether termination of an employee is likely to lead to litigation. This checklist helps to avoid potential legal problems by suggesting issues to review with counsel before terminating the employee. ​

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