Orientation Checklist 

Completed forms must be returned within 30 days of hire.

Standard Forms Which Must be Filled Out:
• Life Insurance/AD&D Enrollment Form  (Full Time and Part Time Employees)
• Full Time Employees Only:  Money Purchase Plan Enrollment Form - General Employees- Plan Information
• Full Time Employees Only:  Money Purchase Plan Enrollment Form - Sworn Police Employees - Plan Information
• Voluntary Group Term Life Insurance - Optional Insurance Paid for by Employee - form must be completed to either enroll in or waive coverage (Full Time and Part Time Employees)

Health Insurance (Full Time Employees - Choose One of Two Options) and Dental Insurance (Full Time and Part Time)

Plan - Full Time Only	Plan - Full Time Only	Plan - Full Time and Part Time
Medical Care Expense Plan - Administered by Anthem BC/BS Wellness Program Information	Kaiser Permanente	Delta Dental To access your account go to: www.deltadental.com/Public/index.jsp  Please note that to register and set up your user name and password, you will need the Subscriber ID number which is the number on the ID card that Delta mailed to you.  If you do not have the subscriber ID number, please call Delta's customer service at 303.741.9305 or contact HR.
Enrollment Form (use for both health and dental enrollment)

Section 125 - Flexible Spending Plan - Full  Time and Part Time Employees

Flex Plan	Forms Required	Plan Information
Medical Spending Plan Dependent Care Account Qualified Transportation	Enrollment Form Direct Deposit Form	Plan Information

Optional Forms (To be returned only if/when you wish to participate)

Vision Service Plan (Optional insurance paid for by the employee - Plan Information)

ICMA-RC Pension Plan Form - (457 Deferred Compensation Plan Information)-(Optional pension plan paid for by the employee)

Part Time Employee's Medical Insurance Premium Reimbursement Program  & Reimbursement Request Form