New Hire Forms & Resources
- I-9 FORM: Please bring the I-9 and your valid US Passport or Driver's License and Social Security Card to your New Hire Orientation. Original ID are required; facsimiles cannot be accepted. Please see form for full list of alternative documents.
BENEFITS-RELATED FORMS (For all benefits-eligible positions)
Note: You may waive medical benefits, but not dental. You must do so via the enrollment forms below. Eligible employees must submit completed enrollment forms within 31 days of hire. Coverage will be effective for all eligible employees on the 1st of the month following eligibility date (typically 1st day of hire).
- PEBB Enrollment Guide: Includes Benefits Summaries and Premiums. San Juan County employees may choose from three plans under Uniform Medical Plan (UMP): UMP CDHP (High Deductible plan*), UMP Classic or UMP Select.
- PEBB Long-Term Disability Form: Accept default enrollment to 60% plan, change to 50% plan or decline. Plan details are available at this web link. IMPORTANT: If you do nothing, you will automatically be enrolled in the 60% LTD plan.
Please complete and sign all applicable forms below. Eligible employees must submit completed enrollment form within 90 days of hire or be defaulted to Plan 2, permanently. Eligibility is based on position details; Must be anticipated to work at least 70 hours/month for 5 months during a 12-month period, for at least 2 consecutive years.
- DRS Plan Information for New (Eligible) Employees: Includes summaries of Plan 2 and Plan 3.
- DRS Retirement Status Verification Form: Complete Employee Information section, only.
- DRS Beneficiary Designation Form: Eligible employees, only.
- DRS Plan Enrollment Form: Eligible employees, only.