Gunnison County Human Resources

Gunnison County Human Resources

High Profile

Photo Courtesy of Bev Alexander

• CCOERA Retirement
• Flex Comp
• Medical / Dental / Vision
• Life Insurance
• Health Club Memberships
• Payroll
• Workers' Compensation
• Family & Medical Leave
• Sick Leave transfer
• Performance Evaluation Forms

CCOERA Retirement

Click on any of the following to retrieve the form.

401(a) 3% Mandatory Contribution Plan

• 401(a) Enrollment Form (Must be obtained at the HR Office)
• 401(a) Salary Deferral Agreement - to add or change voluntary contributions after-tax up to 10% of gross salary
• 401(a) Beneficiary Change Form - Beneficiary can also be changed online @ ccoera.org
• Personal Information Change Request Form
• Electronic Funds transfer Form
• Incoming Transfer/Direct Rollover Form
• Distribution/Direct Rollover Request Form

457 Optional Contribution Plan - Before Tax (County will match up to an additional 2% contribution)

• 457 Enrollment Form
• 457 Salary Deferral Change Request Form - to add or change before-tax optional contributions
• 457 Beneficiary Change Form - Beneficiary can also be changed online @ ccoera.org
• New Roth 457 Provision - Available 1/1/2011
• Personal Information Change Request Form
• Electronic Funds Transfer Form
• Incoming Transfer/Direct Rollover Form
• Catch-Up Form
• Distribution/Direct Rollover Request Form

Flex Comp

Click on any of the following to retrieve the form. NEW: As of 1/1/2012, reimbursement forms may be scanned and emailed to ngsflex@coresource.com.

• Flexible Benefits Enrollment Form
• Request for Reimbursement Form
• Grace Period Rule
• Auto Submission Authorization Form
• How Flex Accounts Work
• Eligible Expenses in an Flexible Spending Account - Flexible Spending Reimburseable Items
• Over-the-Counter Drug Guidelines - Healthcare Reform
• Flex Benny Card
• Debit Card Substantiation Requirements
• Flexible Benefits Planning Worksheet
• HIPAA Notice of Privacy Practices

Medical / Dental / Vision

Click on any of the following to retrieve the form.

• Medical Insurance Enrollment Form
• Medical Insurance Change Form
• Dental Insurance Enrollment Form
• Dental Insurance Change Form
• Vision Insurance Enrollment Form
• Vision Insurance Change Form
• Gunnison County Employee Benefit Plans Privacy Notice
• CVS Caremark Mail Service Order Form

NGS CoreSource

PO Box 2310

Mt. Clemens, MI 48046

or fax: (586) 416-3001

NGS CoreSource

Flex Department

PO Box 2312

Mt. Clemens, MI  48046

or Fax: (586) 416-2378

Life Insurance

• Voluntary Supplemental life Insurance Program Specifications
• Life Insurance Enrollment Form
• Evidence of Insurability Form
• AD&D Insurance Enrollment Form
• Life Insurance Change Request Form
• Beneficiary Change Form

Health Club Memberships

• Colorado Fitness
• Main Street Gym

Payroll

• W-4 Form
• Direct Deposit Authorization Form
• Employee Information Change Form
• Personnel Action Form - merit increase
• Personnel Action Form - other
• Personnel Action Form - grant

Workers' Compensation

• Employee's 1st Report of Injury - Page 1 / Page 2
• Instructions for Employee's 1st Report of Injury
• Employee's Authorization for Release of Medical Information
• Supervisor's Report
• Employer's 1st Report of Injury
• Statement of Safety - Must be completed before Modified Duty can be accepted.
• Designated Medical Provider list

Family & Medical Leave

• FMLA Leave Application

Sick Leave Transfer

• Sick Leave Transfer Request Form

Performance Evaluation Forms

• Employee Input Form
• Supervisor Evaluation Form

Office Hours

8:00 a.m. - 12:00; 1:00 – 5:00 p.m.

Monday through Friday (except holidays)

Contact Information