EMPLOYEE FORMS & LINKS

Employee Documents

Forms

IRS Withholding Calculator

Direct Deposit Authorization Form - IN

Direct Deposit Authorization Form - FL

Important Employee Information - IN

Important Employee Information - FL

Vacation Request

M&S Profit Sharing Distribution Request Form

Profit Sharing Plan Beneficiary Change Form

FuturePlan QP Sep. From Service Dist. Req. Form

Employee Benefits

Health Insurance

Unified Group Services

UGS Group Benefit Change Form

UGS Benefit Claim Form

UGS Prescription Deductible Out-of-Pocket Form

UGS Other Insurance Questionnaire

Important Notice About Rx Drug Coverage & Medicare

Life Insurance

OneAmerica American United Life Insurance Co.

OneAmerica AUL Beneficiary Change Form

OneAmerica Term Life Insurance Beneficiary Basics

Subcontractor & Vendor Documents

FirstCare Clinic
1201 Piper Blvd. Suite 24
Naples, FL 34110
(239) 260-5307
Open: Mon.-Fri. 8 a.m. - 5 p.m.

FirstCare Walk-in Clinic of Naples, FL

Employee Information

Employee Rights & Other Notices

This Organization Participates in E-Verify

USCIS E-Verify Website

Right to Work - English

Right to Work - Espanol

Polygraph Protection Act

Alcohol & Drug-Free Worksite

OSHA Job Safety & Health

CHIP Notice - English

CHIP Notice - Spanish

Worker's Comp - Florida

Worker's Comp - Indiana

Veteran Benefits & Service Poster - IN DOL

Watch Out for Scammers! - SSA Alert

Consolidate Appropriations Act (CAA)
Machine Readable File Link

Unified Group Services CAA Link

Healthcare Bluebook Info Sheet

UGS & Healthcare Bluebook PlanDesign+ FAQ

Health & Wellness

Assured Partners Health & Productivity Guidebook

Past AssuredPartners Newsletters

February Health & Productivity Newsletter

March Health & Productivity Newsletter

April Health & Productivity Newsletter

July Health & Productivity Newsletter

Coronavirus Links

Click on these links for more information on COVID-19.

Coronavirus Live Well, Work Well