1671. COBRA Form 11 IB11 - Alabama

INSTRUCTIONS: ALABAMA COBRA EMPLOYER NOTICE MEMO (Form IB11) When an Alabama state employee enrolled in the state's SEHIP retirement plan is terminated, dies, has a reduction in hours or becomes eligible for Medicare ...

1672. Wellness Discount Certification Form IB07 - Alabama

INSTRUCTIONS: ALABAMA WELLNESS DISCOUNT CERTIFICATION FORM (Form IB07) Alabama state employees who have participated in a worksite wellness screening and have since taken correctly documented steps to control identified ...

1673. Provider Screening Form IB13 - Alabama

INSTRUCTIONS: ALABAMA PROVIDER SCREENING FORM (Form IB13) Alabama state employees who choose not to participate in Worksite Wellness screenings may instead submit health screening results through a healthcare provider. T ...

1674. Annual Tobacco User Premium Discount Application IB06 - Alabama

INSTRUCTIONS: ALABAMA ANNUAL TOBACCO USER PREMIUM DISCOUNT APPLICATION (Form IB06) Alabama state employees who are tobacco users apply for a premium on their insurance using a form IB06. This document can be obtained fro ...

1675. Non-Tobacco User Discount Application IB05 - Alabama

INSTRUCTIONS: ALABAMA NON-TOBACCO USER DISCOUNT APPLICATION (Form IB05) Alabama state employees may apply for a discount on their state-administered health insurance if they are not tobacco users. This is done by filing ...

1676. Health Insurance Enrollment IB02 - New employees only - Alabama

INSTRUCTIONS: ALABAMA HEALTH INSURANCE ENROLLMENT FORM (Form IB02) Alabama state employees file for health insurance for themselves and qualifying dependents using a form IB02. This document can be obtained from the webs ...

1677. Certificate of Authorization Sopplemental - Alabama

INSTRUCTIONS: ALABAMA CERTIFICATE OF AUTHORIZATION SUPPLEMENTAL FORM An Alabama professional engineer or land surveyor may serve as the principal or responsible charge at more than one building site by filing the form di ...

1678. Application for Examination - Alabama

INSTRUCTIONS: ALABAMA APPLICATION FOR EXAMINATION (Form 3) Alabama residents who wish to be considered for employment by the state should submit a form 3. This application for examination can be obtained from the website ...

1679. Alabama Department of Agriculture And Industries Internship Application - Alabama

INSTRUCTIONS: ALABAMA DEPARTMENT OF AGRICULTURE AND INDUSTRIES INTERNSHIP APPLICATION To apply for an internship with the Alabama Department of Agriculture and Industries, use the document discussed in this article. This ...

1680. RSA 100-C Change of Beneficiary Form - Alabama

INSTRUCTIONS: ALABAMA CHANGE OF BENEFICIARY FORM PRIOR TO RETIREMENT (Form RSA 100-C) Alabama public employees who wish to change the beneficiaries of their retirement benefits and state-administered plans do so using a ...