Skip to Main Content
Do Not Show Again
Create a Website Account
- Manage notification subscriptions, save form progress and more.
Website Sign In
How Do I...
Human Resources Administrator/Safety Coordinator
Direct Deposit Form
W4 - Federal Withholding
W4 - State of Iowa Withholding
Personal Claim Form - Mileage, Meals, Etc.
IPERS Enrollment/Beneficiary Designation
IPERS Contribution Rates
The County offers medical insurance to all full-time employees and to qualified part-time employees. There are three plans available, and either Single or Family coverage levels.
Medical Election Form
- An overview of costs and coverage for all 3 plans.
Wellmark BC/BS Website
- Creat an account at Wellmark and track your claims, sign up for electronic delivery of your EOBs, view deductibles, etc.
My Wellmark Information
Health Equity/Wageworks Website
- Create an account at Wageworks to manage your flex accounts online, file claims, etc.
Health Equity/Wageworks Enrollment Form
- Complete even if waiving coverage.
Health Equity/Wageworks Claim Form
Health Equity/Wageworks Dependent Care Reimbursement Form
Plan 1 - Full Plan Document
Plan 2 - Full Plan Document
Plan 3 - Full Plan Document
Plan 1 Summary of Benefits and Coverage
Plan 2 Summary of Benefits and Coverage
Plan 3 Summary of Benefits and Coverage
Life Insurance Beneficiary Form
HSA Deferral/Election Form
- Plan 3 only - Complete even if not deferring extra funds.
Dental Enrollment Form
- Complete even if waiving coverage. The County covers 100% of a single policy for all insurance-eligible employees, and the equivalent ($28.92) towards any other tier (plus spouse, family, etc.).
Dental Benefit Information
Vision Enrollment Form
- Voluntary, only complete if you want to enroll in the vision plan, or continue the vision policy you already have through the County.
Vision Benefit Information
Doctor on Demand
Acumen Wellness Physical Form
Wellness Physical Information Sheet
FMLA - Request for Leave
Certification for Employee's Serious Illness or Injury
Certification for Family Member's Serious Illness or Injury
General Safety Manual - Effective March 1, 2020
Employee Injury or Illness Notification Form
Public Incident Review Report - Investigation Form
Unsafe Conditions Report
HIPAA Training Login Link
Employee Handbook - Effective 4-5-22
Washington County Employment Application
Notice of Privacy Practices for Employee Assistance Program (EFR)
Notice of Privacy Practice for Washington County
Budget & Finance
Slideshow Left Arrow
Slideshow Right Arrow