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Documents sorted by SEQ in Ascending Order within category

Employee Benefits & Benfit Forms12 documents

  • BCBS Plan Summaries
    document seq 0.00
    Blue Cross Blue Shield Health Plan Summaries
  • Blue Cross Blue Shield Enrollment & Change of Information Form
    document seq 0.00
  • Dental Enrollment Form
    document seq 1.00
    Delta Dental Membership Enrollment Form
  • Delta Dental Membership Maintenance Form
    document seq 1.25
    Changes with Delta Dental Insurance
  • Delta Dental Plan Summary and Rates
    document seq 1.50
  • Health Insurance Rates
    document seq 2.00
    Health Insurance Rates
  • HSA Contribution Form
    document seq 3.00
    HSA Contribution Form
  • MSRS Change Form
    document seq 5.00
    Minnesota State Retirement System Personal Information Request (Should be sent by the employee to the contact information shown on the forms.)
  • MSRS Contribution Form
    document seq 5.50
    Minnesota Deferred Compensation Participant Enrollment Agreement (Should be sent by the employee to the contact information shown on the forms.)
  • National Insurance Benefit Enrollment Form
    document seq 6.00
    Supplemental Life and AD&D Insurance
  • PERA Change Form
    document seq 7.00
    For use in changing address or beneficiary designation.
  • SelectAccount HSA Enrollment Form
    document seq 8.00
    Employer offered Health Savings Account Application

Forms2 documents

  • Address Change Form
    document seq 1.00
    Send to hr@willmarmn.gov or deliver to City Hall HR Director
  • Form W-4 (2017)
    document seq 4.00
    Complete Form W-4 so that your employer can withhold the correct federal income tax from your pay.

Policy & Procedure Forms4 documents

  • Accident/Incident Investigation Report
    document seq 0.00
    To be completed immediately after incident, even where there is no injury.
  • First Report of Injury
    document seq 0.00
    The First Report of Injury (FROI) form is the reporting document for all work-related injury claims. It provides basic information necessary to start the claim.
  • Personnel Policy & Procedures
    document seq 0.00
    City of Willmar Personnel Policy and Procedures
  • Employment Policies, Practices and Procedures
    document seq 0.00
    Details on Human Resources policies, practices and procedures that apply to staff.