Employee Forms

Payroll/HR Forms

If you have questions about the following resources, please contact us at (801) 443-1090 or service@helpside.com

Looking for New Employee Paperwork?

New employee and rehire paperwork now must be initiated by your work site manager through their MSS login. Click below or contact us for more details.
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Employee Policy Guide

We encourage all employees to read these important details about working with Helpside and your worksite employer.
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Manual de Empleado (Español)

Alentamos a todos los empleados a leer estos detalles importantes sobre cómo trabajar con Helpside y su empleador en el lugar de trabajo
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Background Check Authorization

Complete this form online if your employer requires a background check as a condition of employment.
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W-4 Change Instructions

Instructions for changing your W-4 tax allowances through the Employee Self-Service Portal (ESS)
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2018 IRS Withholding Calculator

The IRS encourages everyone to use the Withholding Calculator to help you make sure you have the right amount of tax withheld from your paycheck at work.
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Direct Deposit Change Instructions

Instructions for employees to add, change, or remove direct deposit information themselves through the ESS.
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Global Cash Card Enrollment Form

Complete this form online through DocuSign to sign up to have your paycheck deposited to a Global Cash Card debit card.
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Payroll Deduction Authorization

Complete this form online to authorize certain deductions from your paycheck.
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Employee Address Change Request

Complete this form to request a change to your address.
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Employee FMLA Request Form

Complete the Family or Medical Leave Request Form online using DocuSign.
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Benefits

Traditional Benefits

Health, Dental and Vision Enrollment Form

Eligible employees can complete this form to enroll in health, dental and/or vision coverage online through DocuSign.
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Forma de Inscripción Médica, Dental y de la Visión (Español)

Este es un nuevo formulario de inscripción que puede ser llenado para servicios médicos, dentales y de visión.
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Dental and Vision Enrollment Form

Eligible employees can complete this form to enroll in dental and/or vision coverage.
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Benefits Change Form (Medical, Dental and Vision)

Requests for changes must be submitted within 31 days of a Qualifying Event. This can be completed online using DocuSign.
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2018 Health Savings Account Enrollment and Change Form

Complete this form to enroll in or make changes to your HSA election. This form can be completed online using DocuSign.
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Benefits

EMI Participant Resources

Understanding Your EMI Health Medical Card

Your EMI Health ID card contains a lot of useful information for you and your provider.
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How to Read an Explanation of Benefits (EOB)

Download the Explanation of Benefits document to help you better understand how EMI processes claims.
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Finding Participating Providers

Download this document to learn how to locate a participating provider for plans managed by EMI Health.
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How to Sign Up for a My EMI Health Online Account

My EMI Health is an online services system for viewing benefit, eligibility and claims information.
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WellVia Telemedicine

WellVia for EMI Health gives plan participants access to a doctor over the phone anytime, anywhere, for a $0 co-pay.
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Benefits

Flexible Spending Account Forms

How Flexible Spending Works

Learn about the different spending plans and which one would benefit you the most.
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National Benefit Services (FSA Online Access)

Visit National Benefit Services (FSA Online Access) and learn how to submit claims and find balances.
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FSA and Dependent Care Enrollment Form

Complete this form to enroll in the flexible spending account. This form can be completed online using DocuSign.
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FSA Direct Deposit and Debit Card Enrollment Form

Complete this form to enroll in direct deposit or request a debit card for your FSA account.
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FSA and Dependent Care Claim Form

Download this fillable form to submit a claim for the medical or dependent care FSA.
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FSA and Dependent Care Change of Status Form

Submit a change of status for the medical or dependent care FSA. Changes must be submitted within 30 days of a Qualifying Event.
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Sample FSA Medical Expenses

Download this sample list of expenses that are commonly reimbursable through a medical flexible spending account.
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Benefits

Reliance Standard Supplemental Benefits

Reliance Standard Supplemental Benefits Website

View detailed information including rates for Life, LTD, STD, Critical Illness, Accident and Hospital Indemnity.
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Supplemental Benefits Enrollment Form

Complete this form online to apply for Life, LTD, STD, Critical Illness and/or Accident Insurance coverage.
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Hospital Indemnity Enrollment Form

Complete this form online to apply for Hospital Indemnity Insurance coverage.
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Group Life Insurance Designation of Beneficiary

Complete this form to change your beneficiary designation for life insurance.
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Aspectos destacados del plan Seguro de vida colectivo voluntario a término (Español)

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Aspectos destacados del plan Seguro voluntario colectivo por discapacidad a largo plazo (Español)

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Instrucciones para completar la solicitud de inscripción sin prueba de asegurabilidad (Español)

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Benefits

401(k)

401(k) Online Enrollment Instructions

If your worksite employer offers a 401(k) through Helpside, read these instructions on enrolling in the 401(k) plan.
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Instrucciones para completar la solicitud de Helpside 401(k) (Español)

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401(k) Enrollment Form

If you worksite employer offers a 401(k) through Helpside, complete this form to enroll in the 401(k) plan.
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Forma de Inscripción 401(k) (Español)

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401(k) Rollover Form

Complete this form to rollover an existing 401(k) into the plan with Helpside.
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Forma de Inscripción 401(k) Rollover (Español)

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401(k) Participant Data Change Form

Complete this form to change your name, address, deduction amount or other personal information.
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401(k) Beneficiary Designation Form

Complete this form to designate or change the beneficiary for your 401(k).
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401(k) Distribution Request Form

Complete this form to request a distribution from your 401(k).
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401(k) Loan Application Form

Complete this form to request a loan from your 401(k).
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Benefits

Additional Miscellaneous Benefits

Senior Benefits Insurance Company Website

Find answers to the important questions surrounding Medicare, Social Security and Long Term Care.
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Personal Insurance and Retirement Planning Questionnaire

Download the fillable Personal Insurance and Retirement Planning Questionnaire to get more information about these options.
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Personal Insurance (Home, Auto, Etc.) Quote Info Sheet

Download this fillable Personal Insurance (Home, Auto, etc.) Quote Information Sheet to obtain a no-obligation quote.
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Work Comp and Safety

Workers’ Compensation and Safety Resources

How to Report a Work-Related Injury

We encourage employees to make themselves aware of this policy so they are prepared should an injury occur.
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Designated Providers — Utah

Search for a participating medical provider in Utah in the event of a work-related injury.
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Designated Providers — Idaho

Search for a participating medical provider in Idaho in the event of a work-related injury.
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Designated Providers — Nevada

Search for a participating medical provider in Nevada in the event of a work-related injury.
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Supervisor’s Incident Report of Work-Related Injury

This form is to be completed for all work-related injuries, regardless of whether medical treatment is necessary
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Tutorials

Tutorials

How to View and Print Your Pay Stub-PDF

This PDF tutorial will help employees view and print a copy of their pay stub through the Employee Self-Service (ESS) portal.
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How to View and Print a Copy of Your W-2- Video

This video tutorial will help employees view and print a copy of their W-2 through the Employee Self-Service (ESS) portal.
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How to View and Print a Copy of Your W-2-PDF

This PDF tutorial will help employees view and print a copy of their W-2 through the Employee Self-Service (ESS) portal.
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