North Carolina State Seal

DOC Personnel

DOC Human Resources logo

Insurance Forms and Job Aids

                                                           Level A conformance icon, W3C-WAI Web Content Accessibility Guidelines 1.0

Insurance Forms and Job Aids Description
PDF icon  DOC Payroll Cancellation Form The form used to submit a cancellation for any of the agency specific insurance plans.
PDF icon  NC Flex Change Form (12/09) The form used to submit cancellation or changes to an NC Flex election due to a qualifying life status change.
PDF icon  SHP Change Form The form used to submit cancellation or changes to the State Health Plan due to a qualifying life status change.
PDF icon  SHP Warehouse Requisition Form The form used to order enrollment kits for the State Health Plan.
PDF icon  401k Address & Contribution Rate Change Form (4/06) The form used to submit a change of address or contribution rate change to Prudential for the 401k Savings Plan.
PDF icon  Deferred Comp Address & Contribution Rate Change Form (12/08) The form used to submit a change of address or contribution rate change to Prudential for the Deferred Comp Savings Plan.
PDF icon  Beacon Adjustment Reason Job Aid (7/14/09) A job aid that lists all applicable adjustment reasons used in the Beacon/SAP systems.
PDF icon  BEST LOA Process Job Aid (3/3/09) A job aid that explains how an employee's insurance benefits are administered in the Beacon/SAP system during a Leave of Absence (LOA).
PDF icon  Enrolling in Benefits Online Job Aid (4/30/09) A job aid that gives step by step instructions on ESS online enrollment in the Beacon/SAP system.
PDF icon  Employee Benefits LOA Letter
MS Word icon   Employee Benefits LOA Letter
The letter that outlines an employee's options to continue or discontinue their insurance elections while on LOA status.
PDF icon  Reinstatement from LOA - Insurance Guide A job aid that provides re-enrollment procedures and information onh how to identify the insurance elections an employee is eligible or required to re-enroll in upon reinstatement from LOA.
PDF icon  2010 DOC Insurance Reference Guide - HBRs (1/7/10) Insurance Vendor reference guide for facility HBRs that contains contact information, enrollment & cancellation procedures, where to send forms, how to obtain enrollment kits as well as the impact to insurance products when employees go out on LOA or terminate.
PDF icon  2010 DOC Insurance Reference Guide - Employees (1/7/10) Insurance Vendor contact guide that can be given to employees with their New Hire insurance packets.
PDF icon  Insurance Benefits Process Overview & Quick Reference Guide (1/7/10) Reference guide outlining the Insurance benefits responsibilities shared between OSP, DOC Central Personnel, BEST Shared Services, DOC Payroll, Facility HBRs & Employees.
PDF icon  Insurance Benefits Guideline (1/5/10) Step by step procedures for HBRs on how to perform the following Insurance benefits functions in SAP: Print Benefit Confirmation Forms, Create an Adjustment Reason, Print Health Plan Not Enrolled Letters, Print LOA Notice Letters, Print Benefit Termination Letters.
MS Word icon  Employee Insurance Benefits Coverage Form (09/23/11) *NEW* - This form can be used by Facility HBRs to list the employee's current insurance elections & monthly premium amount to accompany the 'Continuation of Benefits During Leave of Absence (LOA) Notice' Letter that is printed from Beacon/SAP.
MS Word icon  Employee Insurance Benefits Termination Guide (09/08/11)
*NEW* - A job aid that outlines an employee's insurance continuation options upon termination of employment for all DOC insurance products.  HBRs can provide this guide to employees upon separation or attach and mail along with the 'Benefits Termination Letter' that is printed from Beacon/SAP.
PDF icon  IT0019- Estimated Leave Run Out Guide (09/16/11) *NEW* Step by step procedures for HBRs on how to update the 'estimated leave run out date' in the Monitoring of Tasks Infotype 0019 for employees on LOA status when they exhaust all leave.
   

THE NORTH CAROLINA DEPARTMENT OF CORRECTION DOES NOT DISCRIMINATE ON THE BASIS 
OF RACE, COLOR, SEX, RELIGION, NATIONAL ORIGIN, AGE, OR DISABILITY.

DOC Personnel Home | DOC Home | NC General Assembly | State Personnel | State Personnel Manual
1995-2009 North Carolina Department of Correction. All rights reserved.