Welcome to the EXCEL 2011 Intranet Forms Page.    

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Employment Forms

Employment Application I-9 Form Direct Deposit Consumer Authorization Form Emergency Contact Form 2010 Benefits Overview

Healthcare

UHC HSA/HRA Plan Description UHC Performance Plan Description UHC Enrollment Form HSA Payroll Contribution Form Fifth Third Bank HSA Enrollment Form HRA Enrollment Form HRA Reimbursement Claim Form FSA Enrollment form FlexBank Direct Deposit form

Dental

Delta Dental Plan Description & Enrollment Form

Vision Insurance

EyeMed Plan Description EyeMed Enrollment Form

Tax Forms

W4 Federal Form State of Ohio Tax Form State of NC Tax Form

Life Insurance

Company paid Life Plan Description Company paid Short Term Plan Description Company paid Long Term Plan Description Company paid Life, Short Term & Long Term Enrollment Form Voluntary (employee paid) Plan Description & Rates Voluntary Life Enrollment Form

Additional Forms

Training/Education Authorization Form Vacation Buy Back Family Medical leave of Absence (FMLA) Form Worker’ compensation First Report of Injury call 1-888-627-7586