ON-BOARDING AND BENEFITS INFORMATION AND FORMS TitleFile SizeFile TypeDateLinkDownloadsCriminal History Record Check & Fingerprinting Instructiona65 KBpdfJanuary 12, 2024DownloadElectronic Funds Transfer Enrollment Authorization48 KBpdfJanuary 12, 2024Download4Employee Emergency Information Form41 KBpdfJanuary 12, 2024DownloadEmployment Eligibility Verification62 KBpdfJanuary 12, 2024DownloadHealth Insurance Employee Contribution Rates31 KBpdfJanuary 12, 2024DownloadHealth Insurance Employee Contribution Tables31 KBpdfJanuary 12, 2024Download1Horizon BCBC Enrollment or Change Request Form661 KBpdfJanuary 12, 2024Download1Horizon BCBSNJ Coverage Waiver233 KBpdfJanuary 12, 2024DownloadHorizon BCBSNJ Dental and Vision Details. 2023-24858 KBpdfJanuary 12, 2024DownloadHorizon BCBSNJ Health Costs by Plan, 2023-2421 KBpdfJanuary 12, 2024DownloadHorizon BCBSNJ Omnia Blue Card Plan Summary 20242 MBpdfJanuary 12, 2024DownloadHorizon BCBSNJ Omnia Gold Plan Summary 20242 MBpdfJanuary 12, 2024Download8Horizon BCBSNJ Omnia Silver Plan Summary 20242 MBpdfJanuary 12, 2024Download11Horizon Direct Access 100/80/60 Blue Card Health Benefits Amendments, January 2024April 16, 2024DownloadHorizon Vision Panorama IVA527 KBpdfJanuary 12, 2024DownloadLCCS I-9 Form583 KBpdfJanuary 12, 2024DownloadMantoux Test46 KBpdfJanuary 12, 2024DownloadPension Information and Form87 KBpdfJanuary 12, 2024DownloadUnited Concordia Dental Plan Enrollment Form71 KBpdfJanuary 12, 2024Download
