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Current Employees:

Below are a variety of commonly requested documents from Human Resources. Any documents that are available for download please forward the completed forms via interoffice mail, email or fax back to the attention of Kristi Carey or Michelle Thrasher.

If you have questions please contact us, Kristi Carey or Michelle Thrasher

Misc. Forms Information

Employment Policies

Benefit Forms/Information

Commonly Requested Benefits Information

Section 125 Plan Pre-Tax Deductions of Premiums -Health, dental and vision insurance premiums are all deducted (if you have elected deductions) from your pay on a pre-tax basis (exempt from FICA, Federal and State tax) which in turn provides significant cost savings. This will continue and does not require any action on your part unless you desire to make changes. You will be able to make changes on any of your elections during the open enrollment period. You selections cannot be changed until next year unless the revocation and new elections are due to and consistent with a valid status change (e.g. marriage, divorce, death of a spouse or child, birth or adoption of a child or change of employment of your spouse and detailed in the Section 125 Regulations) If you have a status change during the year you must notify Human Resources within 30 days. Any request to make changes after 30 days will not be allowed until the next annual open enrollment. Please contact Michelle Thrasher or anyone in the Human Resources Department.

The following change form must be accompanied with proof of qualifying event;
Insurance Change Form

Example of Proof of qualifying event documents:
Birth-Certificate of Live Birth (given by the Hospital and sent home with baby)
Marriage-Marriage Certificate
Divorce-Finalized Divorce Decree
Death of Spouse or Child-Death Certificate
Change of Employment of Spouse Loss of Coverage or Obtaining Coverage-Paperwork from Spouses HR Department showing effective date of loss or coverage.

Benefits
FY17 Barrow Handbook
Wellness Participation Form

Medical

BlueCross_BlueShield Dental Directory
Domestic Partner Affidavit

Blue Cross Blue Shield Contact
Medical Group #GA7756 Dental Group # 319945
Member Services 1-855-397-9267 Member Services 1-877-604-2158

To order Blue Cross Blue Shield Cards and/or view Explanation of Benefits please click here.

Vision
Eyemed Claim Form

Eyemed Contact
Group # 9680604
1-866-939-3633

AFLAC
Accident-Hospital Indemnity Claim Form
Aflac Accidental Claim Form
Critical Illness Claim Form
Group Accident-Hospital Indemnity Claim Form

Aflac Contact
Gloria Camp
Main Source and Associates, LLC
Sr Executive Account Manager
2420 Old Flowery Branch Rd
Ste. 105
Gainesville, Ga. 30504
Ofc: 770-535-8920
Fax:770-531-4405

Greater Georgia Life
LTD Claim Form
STD Claim Form

Greater Georgia Life Contact
STD/LTD Supplemental Life
Group # GA2072 Group # GA2072
1-800-232-0113 1-800-851-8544

MSI Benefits Group, Inc.
Administrative Contact
770-425-1231

Retirement Forms/Information

Defined Benefit Plan

Barrow County's Pension Plan is designed to provide a monthly retirement income in addition to other retirement savings plans and Social Security which an employee may be eligible to receive. An employee is vested in the plan after completing 5consecutive years of credited service. Credit towards the 5consecutive years of service begins with the first day of employment with Barrow County. Normal retirement age is 65 with at least 5 years of employment. Plan Summary

Deferred Compensation

Deferred compensation, under IRS Code 457, is a tax deferred supplemental retirement program that allows public employees to contribute a portion of their salary, before federal and state taxes, to a retirement account. The government's aim in establishing these tax-favored plans is to encourage workers to build their own financial security in anticipation of retirement. Barrow County employees are eligible to enroll in the deferred compensation plans on the first day of their employment. Barrow County also offers a deferred compensation package with a 1% (401a) match on the first 1% of salary contributed to a 457 plan up to a 3% match. Plan Summary

Plans are administered by GebCorp. (Click link to login to your account; username social security number, password: last 4 of social)

GebCorp
400 Galleria Parkway
Suite 1250
Atlanta, GA 30339
1-800-736-7166

GebCorp Forms
Employee Information Change Form
457b Distribution Package
401a Distribution Package
Form W-4P Form
GebCorp Deferral Amt. Change Form
GebCorp Direct Deposit Form

For employees who are vested and eligible for Barrow County Retirement if you would like a calculation of benefits please click here.

FMLA Forms/Information

Family and Medical Leave Act

Overview

The Family and Medical Leave Act (FMLA) provides certain employees with up to 12 weeks of unpaid, job-protected leave per year. It also requires that their group health benefits be maintained during the leave.

FMLA is designed to help employees balance their work and family responsibilities by allowing them to take reasonable unpaid leave for certain family and medical reasons. It also seeks to accommodate the legitimate interests of employers and promote equal employment opportunity for men and women.

Eligible employees are entitled to:

  • Twelve workweeks of leave in a 12-month period for:
    • the birth of a child and to care for the newborn child within one year of birth;
    • the placement with the employee of a child for adoption or foster care and to care for the newly placed child within one year of placement;
    • to care for the employee's spouse, child, or parent who has a serious health condition;
    • a serious health condition that makes the employee unable to perform the essential functions of his or her job;
    • any qualifying exigency arising out of the fact that the employee's spouse, son, daughter, or parent is a covered military member on "covered active duty;" or
  • Twenty-six workweeks of leave during a single 12-month period to care for a covered servicemember with a serious injury or illness if the eligible employee is the servicemember's spouse, son, daughter, parent, or next of kin (military caregiver leave).

Employees are eligible for leave if they have worked for their employer at least 12 months, at least 1,250 hours over the past 12 months, and work at a location where the company employs 50 or more employees within 75 miles. Whether an employee has worked the minimum 1,250 hours of service is determined according to FLSA principles for determining compensable hours or work.

Time taken off work due to pregnancy complications can be counted against the 12 weeks of family and medical leave.

Employee's Paid Time Off and FMLA run concurrently.

Employee's seeking to utilize FMLA must complete the forms below: (Please read the Information Sheet and direct any questions to Michelle Thrasher)

Employee Application for Family Medical Leave
Employee Family Medical Leave Information Sheet

In addition to the Employee Application above you will need to complete one of the following certification documents:

  • the birth of a child and to care for the newborn child within one year of birth;
  • the placement with the employee of a child for adoption or foster care and to care for the newly placed child within one year of placement;
  • to care for the employee's spouse, child, or parent who has a serious health condition;
  • a serious health condition that makes the employee unable to perform the essential functions of his or her job;
  • any qualifying exigency arising out of the fact that the employee's spouse, son, daughter, or parent is a covered military member on "covered active duty;"
  • Twenty-six workweeks of leave during a single 12-month period to care for a covered service member with a serious injury or illness if the eligible employee is the service member's spouse, son, daughter, parent, or next of kin (military caregiver leave).

Payroll Forms/Information

Paydays
Barrow County paydays for most of its employees are biweekly on Wednesday. When a holiday falls on Monday of payroll week paydays will be moved to Thursday of the payroll week.

Direct Deposit
Direct Deposit of your pay is a safe and secure way to make sure you receive your net pay in a timely manner. The county sends your pay through Electronic Funds Transfer to your personal checking or savings account which ensures that your money is available to you without you having to make a deposit to your account in person. Direct deposit of your pay protects you against loss or theft of your pay check.

Direct Deposit Form

Acceptable documentation for deposit to a checking or money market account:

  • a PHOTOCOPY of a CHECK with preprinted name and current address
  • a CHECK marked "VOID" with preprinted name and current address
  • an official BANK FORM, certified and stamped by a banking official, which provides the account number and the bank routing number

Acceptable documentation for deposit to a savings account:

  • an official BANK FORM, certified and stamped by a banking official, which provides the account number and the bank routing number
  • a DEPOSIT SLIP with preprinted bank routing and savings account number

Federal and State Withholding

Tax Forms
Tax form can be completed at any time and retuned to Misty Landers in Payroll or to Human Resources. They must be turned in before Monday of payroll week.

Georgia Tax Form
Federal Tax Form

Deductions not subject to Federal and State Withholding
Certain deductions are not subject to Federal and State Withholding taxes. Medical insurance deductions and supplemental retirement deductions ( 457 Plans) are tax deferred (not subject to federal or state withholding).

FICA and Medicare Tax

The Federal Insurance Contributions Act (FICA) provides for a system of old-age, survivors, disability, and hospital insurance. The 2014 FICA tax rate is 6.2% for the employee and 6.2% for the employer up to the wage base limit of $117,000. The current Medicare tax rate is 1.45% for both the employee and employer. There is no wage base limit for Medicare tax.

Special Tax Forms (Accounts Payable Recipients ONLY)

Managers Forms/Information

Posting a Job

When the time comes for you to post a position please completed the below required documents. Make sure that you indicate where you want the job posted. Once these forms are complete, forward them to the Human Resources Department.

Determination of Need
Request for Advertisement

Once all required signatures are gathered the position will be posted until filled.

HR Actions
Below is the HR Action Request form that needs to be completed for any personnel changes, new hires, change in status and terminations.

HR Action Request

Evaluations

Evaluation Supervisor's Guide

Performance Management Process Training Video

Disciplinary Action Forms (Prior to disciplining an employee it is recommended that you consult with Human Resources)

Worker Compensation

If an employee is injured on the job please complete to following documents and submit to HR immediately:

Worker's Compensation Injury Packet