Employee Policies & Forms

Continuation Letter COBRA Acknowledgement of COBRA for new hires
Employee Safety Policy Form Acknowledgement of Safety Policy for new hires
Grievance Form
Whistleblower Policy Adopted 9-14-2015
I9 Form Employment Eligibility Verification
2018-2019 MEDCOST Enrollment Form Medical, Dental, and Vision Enrollment Form for City Employees
USABLE Group EnrollmentForm Life Insurance Enrollment form for City Employees
Personnel Policy Manual Statement Personnel Policy Manual Statement sign off for new hire
Code of Ethics Code of Ethics for new hires
Employee Check List List of required documents and information for new hires
Form2C NCRetirement North Carolina Retirement Designated Beneficiary(ies)
401(k) Enrollment Form 401K Retirement Enrollment Form
Flex Spending Account Enrollment Form FSA Enrollment and waiver form
2018-2019 MedCost Insurance Rates July 1, 2018 - June 30, 2019
2018-2019 MedCost Benefits Plan Overview Summary of current benefit plan
Flex Spending Account Flyer Information on FSA
Teladoc Flyer Information on Teladoc services
MedCost Flyer Information on activating your MedCost account
Medical Benefits for Med 2500 Information on Medical benefits
Dental Plan II Information on Dental benefits
Vision Plan (Basic) Information on Vision benefits
Dental Plan III (Buy-Up Option) Information on Dental benefits for Buy-Up
Vision Plan (Plus) Information on Vision benefits for Buy-Up
NC4 StateTax Form NC State Withholdings
W4 Federal Tax Form Federal Withholdings
FMLA-WH-381 (Exp. 2026) FMLA for Notice of Eligibility & Rights & Responsibilities
FMLA-WH-382 (Exp. 2026) FMLA for Designation Notice
FMLA-WH-384 (Exp. 2026) FMLA for Military Leave for Qualifying Exigency
FMLA-WH-385-V (Exp. 2026) FMLA for Serious Injury or Illness of a Veteran for Military Caregiver Leave
FMLA-WH-385-2023 (Exp. 2026) FMLA for Serious Injury or Illness of a Current Servicemember for Military Caregiver Leave