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Employees should use this form when requesting future time off or reporting previous time off. This form also gives your employees the opportunity to indicate a Family Medical Leave absence, although it is not required.
Use this checklist to determine if your parking area may present accessibility challenges so you can take the appropriate corrective action.
Use this checklist to determine if public areas in your facility may present accessibility challenges so you can take the appropriate corrective action.
Use this checklist to determine if your restroom may present accessibility challenges so you can take the appropriate corrective action.
Use this form whenever a workplace accident, injury or illness occurs to properly document your investigation.
Provide this form to an employee if the employee has coverage for himself/herself plus any other family members and coverage is being ended due to termination of employment or reduction in hours. You need to send out additional COBRA notices to those individuals indicated on the form who do not reside with the employee.
Use this form to notify an applicant of adverse employment action that is being taken against him or her, based at least in part on the results of a consumer report. This notice also must include a statement explaining the consumer’s (applicant or employee) right to dispute directly with the consumer reporting agency.
Provide this form to the surviving spouse, registered domestic partner, guardian or a conservator of an estate (Affiant) in order to allow collection of the Decedent's salary or other compensation.
This form is used when an employer leases employees from another employer, and the employer with the employees being leased wants assurance from the leasing employer that the leasing employer will cover workers' compensation for the leased employees. This form must be completed before leased employees begin working for the leasing employer.
Use this calendar as an example of an alternative workweek schedule, noting the restrictions associated with alternative workweeks. Limits placed on employers and employees regarding alternative workweek schedules make them difficult to implement properly.
Use this form to create your company's alternative workweek policy.
This checklist guides you through creating and implementing an alternative workweek policy. You must file the appropriate information with the Department of Industrial Relations, and maintain the appropriate records to document your compliance with alternative workweek requirements.
Use this checklist if you disagree with the EDD’s final determination regarding an unemployment insurance claim.
Use this checklist if you have appealed the EDD’s decision for a UI claim to an administrative law judge and still believe the decision is incorrect.
Use this form if you are planning to hire a minor to work in the entertainment industry. This form is required by law.
Use this Division of Labor Standards Enforcement (DLSE) application when employing minors to work in the entertainment industry. This form is not a permit.
Use this form to record an employee's attendance.
Use this form to keep a record of an employee’s attendance throughout his or her employment.
Use this form to refer an injured employee to a doctor for initial treatment.
An employee uses this form to authorize that a physician may release the information included in the Medical Certification to the employer for determining eligibility for family/medical leave.
Use this form to obtain written authorization from the consumer (applicant or employee) before running a credit report for employment purposes. Allow the consumer to request a copy of the report and provide this form to them along with the required Notice of Intent to Obtain Consumer Report.
An employee or former should sign this form to authorize an employer or former employer to release various information regarding his or her employment.
Review this chart to determine your responsibilities under family/medical and pregnancy leave laws.
This form lists regulations that apply to the employment of minors. Review this list to make sure that the intended job duties and working conditions are in compliance with state and federal regulations.
This chart describes leaves of absence, whether they are legally required, if state mandated wage replacement is available, whether health benefits must be continued during the leave, whether use of sick, vacation or PTO can be required and whether sick, vacation or PTO accrue during the leave.
Send this notice to the health/disability insurance carrier when any qualified beneficiary becomes subject to Cal-COBRA because of a qualifying event. You must notify the employee’s carrier within 31 days of the event.
Send this notice to an employee at least 30 days before a current group benefit plan terminates because of a change in group plans. You must send information about the new group benefit plan, benefits information, premium information, enrollment forms, instructions, etc., necessary to allow the qualified beneficiary (employee) to continue coverage. Send this notice via certified mail and keep a record of the mailing on file.
This poster outlines an employee's right for disability leave related to pregnancy under the California Family Rights Act (CFRA). You must post this notice in a place commonly used by employees, such as a break room.
This poster outlines an employee's right for disability leave related to pregnancy under the California Family Rights Act. You must post this notice in a place commonly used by employees, such as a break room.
This brochure outlines an employee's right for disability leave under the California Family Rights Act (CFRA). You must give this brochure to each employee.
A CalOSHA-created spreadsheet containing all three required forms to report workplace injuries.
Use this form to help you determine which Cal/OSHA safety standards apply to your company and what corresponding training is recommended.
This policy covers the use of company cell phones, such as prohibiting the use of the cell phone while driving or using the cell phone for noncompany business.
Give this form to employees and any dependents covered by the company’s group health plan as of the COBRA qualifying event. Complete each of the 11 sections before sending and retain a copy with a copy of the COBRA Notice. The employee may need to provide this document to certify any medical advice, diagnosis, care or treatment that was recommended or received for a condition within six months prior to enrollment in a new plan.
Use this form when an employee requests leave to care for a close family member or next of kin who has a serious injury or illness relating to military service. California employers - note especially the stated limitations relating to medical information as this information is confidential and protected in California.
An employee may use this notice to have her physician certify that she may return to work.
Have the employee's health care provider complete this medical certification as needed. This form is used for employee's taking leave under Pregnancy Disability Leave separately or in conjunction with the Family Medical Leave Act.
An employee may use this notice to have her physician certify that a transfer is medically advisable because she has been disabled as a result of pregnancy, childbirth or a related medical condition.
Use this form when an employee requests leave due to a qualifying exigency relating to a family member's military service. California employers - note especially the stated limitations relating to medical information as this information is confidential and protected in California.
Give this notice to your selected provider when requesting an investigative consumer report on an applicant or employee.
Use this form to obtain updated address and personal contact information from employees.
This form is used to file an unfair labor practice charge against an employer.
This form is used to file an unfair labor practice charge against an employee group or union.
This form is used to file an unfair labor practice charge against an employer, employee group or union.
If your company wants to use an insurance broker, use these questions when interviewing potential brokers to determine the best match for your company.
Begin using this COBRA administration guide when an employee is hired and refer back to it when a qualifying event occurs. Doing so ensures you use the proper, required forms relating to COBRA (20 or more employees) and Cal-COBRA (2 to 19 employees), as applicable.
Modify this form according to the coverage plans that you offer and send it out with all COBRA notices. The employee is required to fill out and return the form to the plan administrator within 60 days of a qualifying event or the date he/she was notified of COBRA continuation rights.
Use this form to provide notice to the plan administrator within 30 days of an employee's loss of coverage due to termination, reduction in hours, death, or employer bankruptcy.
Use this form between September 1, 2008 and December 31,2009 to document information relating to employees receiving the COBRA subsidy.
This notice must be sent to all qualified beneficiaries (not just covered employees) who experienced a qualifying event at any time from September 1, 2008 through February 28, 2010, regardless of the type of qualifying event, and who have not yet been provided an election notice. This model notice includes updated information on the premium reduction as well as information required in a COBRA election notice. Note: Individuals who experienced a qualifying event (that was a termination of employment) in December 2009 but who were not eligible for COBRA coverage until January 2010 were likely not provided proper notice. These individuals should get the updated General Notice AND the full 60 days from the date the updated notice is provided to make a COBRA election.qualified beneficiaries, not just covered employees, who experienced a qualifying event at any time from September 1, 2008 through December 31, 2009, regardless of the type of qualifying event, and who either have not yet been provided an election notice or who were provided an election notice on or after February 17, 2009 that did not include the additional information required by ARRA. This full version includes information on the premium reduction as well as information required in the COBRA Continuation Coverage election notice.
Individuals who were "assistance eligible individuals" as of October 31, 2009 (unless they are in a transition period - see below), and individuals who experienced a termination of employment on or after October 31, 2009 and lost health coverage (unless they were already provided a timely, updated General Notice) must be provided notice of the changes made to the premium reduction provisions of ARRA by the 2010 DOD Act by February 17, 2010;
Individuals who are in a "transition period" must be provided this notice within 60 days of the first day of the transition period. An individual's "transition period" is the period that begins immediately after the end of the maximum number of months (generally nine) of premium reduction available under ARRA prior to its amendment. An individual is in a transition period only if the premium reduction provisions would continue to apply due to the extension from nine to 15 months and they otherwise remain eligible for the premium reduction.
Note: To some extent, the groups listed above overlap - creating a situation where an individual may be entitled to multiple notices. Providing the Premium Assistance Extension Notice by the earliest date required will satisfy the notice requirement(s).
Insurance issuers that provide group health insurance coverage must send the Alternative Notice to persons who became eligible for continuation coverage under a State law - this applies to Cal-COBRA. Because continuation coverage requirements vary among States, the DOL is recommending that issuers modify this model notice as necessary to conform it to the applicable State law. Issuers may also find the model Premium Assistance Extension Notice or the updated model General Notice appropriate for use in certain situations.
Cal-COBRA employers should verify that their carriers have this notice and have updated it accordingly.
The sample code in this form was developed by the California Department of Occupational Safety and Health. It is a suggested code, is general in nature and is intended as a basis for preparation of a code that fits the specific contractor's operations more exactly.
Use this form to certify an employee's agreement not to disclose confidential company information, either during the term of his or her employment or at any time thereafter, except as required in the course of employment with the company.
Use this form to document and verify that an employee has received, read, and is familiar with the policies and procedures contained in the employee handbook.
Employees who engage in consensual workplace relationships should sign this document after meeting with their supervisor or the HR director to ensure all policies are reviewed and the company is advised of the relationship.
If your company has more than 50 employees, provide this information to an employing going on pregnancy leave if she is eligible for family/medical leave.
It is important to determine the credibility of those testifying as part of a harassment complaint investigation. Use these guidelines to help you determine the credibility of an interviewee.
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