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Forms & Resources
Employee Evaluation Forms
o Executive & Middle Management
o Maintenance Related Personnel
o Police
General Forms
o Alternate Work Schedule Agreement
o Direct Deposit of Paycheck Form
o Drug Testing (Consent for Collection for Minors)
o Employee Information Change Form
o Family Medical Leave Act - Employee Kit
o Family Medical Leave Act - Family Member Kit
o Request for Public Records Form
o Telework Agreement - Fillable
Health Insurance Forms
o Healthy IS Wellness Incentive Flier
o 2020 City of Billings Employees Benefit Plan Document and Summary of Benefits & Coverages
o 2020 Overview of Medical, Dental, Vision, Flex and HSA Benefits - ACTIVES
o 2020 Annual Wellness Exam Incentive Program Form
o 2020 Health Insurance Announcement Benefit Guide
EBMS Forms
o EBMS Forms
o City of Billings Network Provider - Rocky Mountain Health Network (RMHN)
o miRX Patient Profile Prescription Order Form
o miRX Vaccine Administration Record-Consent Form
Standard Insurance
o City of Billings Marketing Booklet
Workplace
Safety & Well-Being
o
Accident/Injury Form
(Fillable)
o
Discrimination
Harassment Complaint Form
Miscellaneous Benefits
o Identity Guard Election Form
o Identity Guard Value Total Premier Brochure
o MassMutual - 457 EZ Enrollment Form
o MassMutual - Retiresmart Online Access Guide
o NCPERS Voluntary Life Insurance - annual open enrollment
o PerksConnect How To Register Flyer
o PsychHub
o SVH Employee Assistance Program
COVID-19 Documents
o Administrative Order No. 142
o Administrative Order No. 143
o EMERGENCY Family Medical Leave Act (EFMLA) Request Form
o Emergency Paid Sick Leave (EPSL) Request Form
o Families First Coronavirus Response Act (FFCRA) Flyer
o Health Insurance Plan Document Amendment 1-2020