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Benefits

Forms

Main Sources of State Benefits Forms

• Access to all NC Flex Benefits Forms
• Access to State Health Plan Important Forms
• DHHS "Day 1" Orientation Forms (Forms that require an employee's signature, such as I-9, W-4, Computer Usage Policy, Direct Deposit, etc.)
• State Health Plan Enrollment for BEACON Agencies

Direct Links to Benefits Forms

• Certificate of Health Care Provider
• Electronic Pay for Travel Reimbursement (DOC, 35 KB)
• Employee Work Schedule (DOC, 25 KB)
• Family Medical Leave Request Form
• ID/Card Building Access Badge Request (DPH Six Forks Campus) (PDF, 17 KB)
• Retirement System Forms
• State Tax Withholding Form NC-4
• Training Acknowledgement (PDF, 20 KB)
• Travel Reimbursement Direct Deposit
• Voluntary Shared Leave Application
• Voluntary Shared Leave Donation

Policies

• OSP: Leave Policy
• OSP: Employee Benefits and Awards
• DHHS: Alcohol and Drug Free Workplace Policy
• DHHS: Smoking Policy
• DPH: Fire and Life Safety Training
• DPH Basic Privacy and Security Awareness Training (Presentations and Training Records / Acknowledgement Forms)

Benefits Unit

A variety of benefits programs and services are provided for state employees, retirees and long-term disability recipients.

Benefits options for DPH employees are comprehensive and include health insurance for employees and families, flexible spending accounts, family income security programs, work and leave options, academic assistance, and more. DPH provides information regarding benefits during new employee orientation, upon request based on changing needs of the individual, or as modifications are made to benefits offerings.

Information regarding the DHHS community, resources regarding your job, and departmental policies for new and/or current employees may be accessed from the DHHS New Employee Orientation Program.

For more information regarding DPH Benefits, please contact:

Benefits Summary

State Health Plan

The State Health Plan offers a wide range of health benefits to all eligible state employees, teachers, retirees and other individuals identified in the North Carolina General Statutes.

The State Health Plan offers four health plan designs for its members -- please see the State Health Plan plan comparisons (PDF) page for more information.

Optional Insurance Coverage

In addition to the State Health Plan, you have 30 days to decide on optional insurance coverage available to you. If you choose not to enroll within 30 days, you will not have another opportunity to get the coverage until the next “Open Enrollment Period” for all employees which usually runs from October through November each year (specific dates may vary).

Your HR representative will give you some information to look over on each optional insurance program that will include:

• the cost of each type of insurance
• detailed information on what is covered and
• forms you’ll need to complete for any insurance you choose.

If you decide to enroll in any of these programs, the premium amount will be deducted each month from your paycheck. Some of the programs are covered under the NC Flex program that allows your premiums to be taken from your gross salary that is not taxed (saving you money). (See the NC Flex section for more information.)

If you are covered by insurance from a previous state job, talk to your HR representative about options for keeping this insurance or switching coverage.