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Madison County HR

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FORMS

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RETIREMENT & DEFERRED COMP

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LIFE

& OTHER

Virtual Outprocessing

Complete all out processing forms, exit survey, and find more information here

Virtual Outprocessing

Health / Dental & Vision

Dependent Cancellation

Vision Add / Drop

Declination of Coverage

OptumRX Reimbursement

Vision Cancellation

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Payroll

Pre-Tax Authorization

Flex (FSA) Enrollment

Flex (FSA) Reimbursement

Flex (FSA) Direct Deposit

Life & Other Forms

Lincoln Life Enroll

Lincoln Life Cancel

Request for Outside Employment

Transitional Light Duty Request

Lincoln Life Change

Colonial Life Cancel

COVID Leave Request

Request for Appeal

Lincoln Beneficiary Update

Colonial Cancer Cancel

Accomodation Request

Termination Form

Name Change Request

FMLA & Leave

FML / Parental Leave Request

Sick Leave Bank Application

Medical Emergency Certification

Certification for Employee

Certification for Family Member

Sick Leave Bank Enroll

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Retirement & Deferred Comp

Beneficiary Change

Other ERS Forms

ERS Address Change

RSA-1

Enrollment Packet

Beneficiary Designation

Investing Elections

Authorization to Defer Comp

Nationwide

Enrollment / Change

Beneficiary Change

Divorce Proceedings

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