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Other Links

Clatsop Community Action

SAFE

CARE of Tillamook County

 

 

Employee Forms

If you have questions about benefits please contact the fiscal office.

Administrative Services Directory Link

Below you will find many commonly requested forms in pdf.

(CIGNA) Health Coverage Information and Forms

Life & AD&D Insurance Information and Forms

Standard Disability Insurance and EAP Forms

Fiscal Forms

Payroll Forms

Personnel Committee Referral

Program Guides and Manuals

Retirement Program Information

(CIGNA) Health Coverage and Forms

Minimum Hours for Benefits (2017)

CIGNA Vision Booklet (2017)

CIGNA OAP Booklet (2017)

CIGNA Dental Booklet (2017)

CIGNA Dental Summary of Benefits (2016)

CIGNA Summary of Benefits and Coverage Health and Life (2016)

CIGNA Summary of Benefits and Coverage OAP Individual/Individual + Family (2016)

CIGNA Summary of Benefits - OAP (2016)

CIGNA Summary of Benefits and Coverage and Costs (2016)

POP CAF 125 Plan Document

POP CAF 125 Summary Plan Description

Dental Claim Form
Vision Claim Form
Medical Claim Form
Pharmacy Claim Form
Mail Order Form for Pharmacy

Life and AD&D Insurance and Forms

Life Insurance (AD&D) Summary of Benefits (2016)

Standard Disability Insurance and EAP Forms

Certificate and Summary Plan Description: Group Short Term Disability Insurance

Certificate and Summary Plan Description: Group Long Term Disability Insurance

Disability Insurance Claim Packet

Benefits At A Glance: Group Short Term Disability Insurance

Enrollment and Change Form

Certificate and Summary Plan Description: Group Life Insurance

Employee Assistance Program

Fiscal Forms

Print and Fill PO

Fillable PO

Print and Fill Disbursement Voucher

Fillable Disbursement Voucher

Payroll Forms

2017 W-4
Payroll Advance Form
Payroll Direct Deposit Form
2017 Time Sheet Due Dates
2017 Draw Request Due Dates

Personnel Committee Information

Personnel Policy Handbook

Personnel Committee Referral Form

Personnel Committee Referrals can be given to any member of the Personnel Committee.

Updated 2/1/2017
Standing Committee Members:

Liz Visser; P:503-791-6145

Sherry Kluge; P:503-366-6570

Amy Watts P:503-429-9243

Cheryl Nicholson P: 503-366-6591

Carmen Kulp P:503-366-6587

Darlene Smith P:503-366-6541

Program Guides and Manuals

Emergency Solutions Grant
Homeless State Funds (EHA/SHAP/LIRHF)
Housing Stabilization Program

Retirement Program Information

2016 401K Plan Summary
2015 401k Summary Annual Report
2016 Special Notice And Plan Overview - Standard
2016 Aviso Especial y Resumen del Plan - Estándar


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