Employee Information & Forms

 

If you don't find the information or form you are looking for, please contact Human Resources by e-mail or phone 701-667-3204.

 

Benefits 

Health Insurance Premium Rates July 2017-2019

Employee Benefits Overview

Change in Life Status Form

Deferred Compensation Plan Highlights

Dependent Care Reimbursement - Explanation of Benefits

Dependent Care Reimbursement - Plan Document

Health Care Reimbursement - Explanation of Benefits

Health Care Reimbursement - Plan Document

Life Insurance Beneficiary Designation Form - Dearborn National

Long Term Disability Insurance Employee Benefit Booklet

Long Term Disability Insurance Policy

NDPERS Continuation of Group Insurance Coverage (COBRA) Form 14120

NDPERS Dakota Wellness Plan - July 2015

NDPERS Frequently Asked Questions About Change in Health Plan Carrier - Feb. 2015

NDPERS Health Certificate of Insurance - July 15

NDPERS Health Insurance Application or Change Form

NDPERS Sanford Health Pharmacy Handbook - July 2015

NDPERS Sanford Health PPO & Basic Benefit Overview - July 2015

NDPERS Sanford Health "Understanding Your Explanation of Benefits" - July 2015

NDPERS Sanford Health "What Services Require Preauthorization?" - July 2015

Premium Reduction - Explanation of Benefits

Premium Reduction - Plan Document

Retirement Participant Request for Distribution - City of Mandan Retirement Plan & Trust

Retirement Participant Request for Distribution - Deferred Compensation

Request to Donate Leave

Request to Receive Donated Leave

Employment

Designated Medical Provider for Work-Related Injuries - Poster

Direct Deposit Enrollment Form

Employee Updates Form

Hire - Probationary - Promotion - Review Process

IRS Form W-4 2017

Mandan Municipal Code Chapter 20 - Personnel Regulations & Benefits

Travel Expense Voucher

Policies

Drug Free

Fraud

Grievance Form

Harassment & Conflict Resolution Training

Workplace & Sexual Harassment

Identification Badge Policy

Safety Orientation Requirements for New Employees

Safety Wellness Policy

Safe Driver Policy

Safety

Safety & Wellness Charter

Safety Goals

Safety Management Program

Injury, Illness and Property Damage Procedures

NDWSI Quick Reference Guide for Workers

Supervisor Information

Employee Assistance Program - Supervisory Training

Job Requisition Form

WSI Employer's Guide to Workers Compensation Policy

Training

 WSI - LMS Login Instructions 

All Document Links

 

Attached Document or FileBeneficiary Designation Form - Dearborn National  
Attached Document or FileBenefits Overview 2018  
Attached Document or FileChange in Life Status Form  
Attached Document or FileDeferred Compensation Plan Highlights  
Attached Document or FileDependent Care Reimbursement - Explanation of Benefits  
Attached Document or FileDependent Care Reimbursement - Plan Document  
Attached Document or FileDesignated Medical Provider for Work-Related Injuries - Sanford Occupational Medicine - Poster  
Attached Document or FileDirect Deposit Enrollment Form  
Attached Document or FileDistribution Form Plan 8144 Defferred Compensation  
Attached Document or FileDistribution Form Plan 9021 Trust  
Attached Document or FileEmployee Assistance Program Brochure  
Attached Document or FileEmployee Assistance Program - Supervisory Training  
Attached Document or FileEmployee Data Change Form  
Attached Document or FileHealth Care Reimbursement - Explanation of Benefits  
Attached Document or FileHealth Care Reimbursement - Plan Document  
Attached Document or FileHire - Probationary - Promotion - Review Process  
Attached Document or FileInjury, Illness and Property Damage Procedures  
Attached Document or FileIRS Form W-4 2017  
Attached Document or FileJob Requisition Form  
Attached Document or FileLearning Management System Login Instructions  
Attached Document or FileLong Term Disability Insurance Employee Benefit Booklet  
Attached Document or FileLong Term Disability Insurance Policy  
Attached Document or FileMandan Municipal Code Title 4 - Personnel Regulations & Benefits  
Attached Document or FileNDPERS Dakota Wellness Plan - July 2015  
Attached Document or FileNDPERS Frequently Asked Questions About A Change in the Health Insurance Carrier - Feb. 27, 2015  
Attached Document or FileNDPERS Health Certificate of Insurance - July 2015  
Attached Document or FileNDPERS Health Insurance Application or Change - Form 58792  
Attached Document or FileNDPERS Sanford Pharmacy Handbook - July 2015  
Attached Document or FileNDPERS Sanford Health PPO Benefit Overview -July 2015  
Attached Document or FileNDPERS Sanford Health Understanding Your Explanation of Benefits - July 2015  
Attached Document or FileNDPERS Sanford Health "What Services Require Preauthorization?" - July 2015  
Attached Document or FileN.D. Workforce Safety & Insurance Quick Reference Guide For Workers  
Attached Document or FilePolicy - Drug Free  
Attached Document or FilePolicy - Fraud  
Attached Document or FilePolicy - Grievance  
Attached Document or FilePolicy - Harrassment Conflict Resolution Training  
Attached Document or FilePolicy - Workplace & Sexual Harassment  
Attached Document or FilePolicy - ID Policy  
Attached Document or FilePolicy - Safety & Wellness  
Attached Document or FilePolicy - Safety Orientation  
Attached Document or FilePolicy - Safe Driver  
Attached Document or FilePremium Reduction - Explanation of Benefits  
Attached Document or FilePremium Reimbursement - Plan Document  
Attached Document or FileRequest to Donate Leave - Fillable PDF Form  
Attached Document or FileRequest to Receive Donated Leave - Fillable PDF  
Attached Document or FileRetirement Participant Request for Distribution - City of Mandan Employee Retirement Plan & Trust  
Attached Document or FileRetirement Participant Request for Distribution - Deferred Compensation Plan  
Attached Document or FileSafety Goals  
Attached Document or FileSafety Management Program  
Attached Document or FileTravel Expense Voucher - Updated 01 08 18  
Attached Document or FileWSI Employers Guide to ND Workers Compensation Policy  
Attached Document or FileNDPERS COBRA Form 14120  
Attached Document or FileSafety & Wellness Charter  
Attached Document or FileCITY_OF_MANDAN_NDPERS_Health_Ins_Premium_Rates_(Sanford)_July_2017-2019.pdf  
Attached Document or FileWSI - LMS Login Instructions