Document Center / Browse Documents / City of Fort Dodge, Iowa

Document Center

You are here: Home \ Document Center\ Browse Documents

Document Center Home | Log In

Browse All | Home | By Type | By Department | By Topic

You're now viewing results for Division: Employee Benefits. Reset this filter and view all results.

Title

Document Type

Department / Division

Category

Topic

Year

Documents 1-25 of 38

Date	Title	Views	Size
04/10/2024	Primary Care Provider Selection Form	100	74 KB
08/02/2023	PSF Plan B	233	303 KB
08/02/2023	SBC PSF Plan B	227	937 KB
08/02/2023	PSF Plan A 2024	205	300 KB
08/02/2023	SBC PSF Plan A	219	934 KB
08/02/2023	City of Fort Dodge Summary Plan Description 2023	226	346 KB
08/02/2023	July 2023 Health Insurance Summary	225	334 KB
12/02/2022	Delta Dental Change Form	322	954 KB
12/02/2022	The Standard Enrollment and Change Form	319	236 KB
12/02/2022	The Standard Benefit Highlight Sheet- Class 3	321	66 KB
12/02/2022	The Standard Benefit Highlight Sheet- Class 2	306	65 KB
12/02/2022	The Standard Benefit Highlight Sheet- Class 1	309	65 KB
01/26/2022	COVID-19 Test Kit Reimbursement Claim Form	376	190 KB
01/05/2022	Wellness Benefit Verification Form	366	213 KB
12/30/2021	IGHCP Health Enrollment Form	356	1,026 KB
12/29/2021	457 Deferred Compensation Plans Contribution Change Form	317	100 KB
10/07/2021	2022 FSA Election Form	332	173 KB
10/07/2021	2022 HSA Election Form	303	28 KB
05/18/2021	EBS Flex Enrollment Form Mid-Year	454	233 KB
05/18/2021	EBS Flex Change Form	364	220 KB
04/01/2021	EBS Request for Reimbursement	497	128 KB
10/15/2020	FSA Mobile App Flyer	336	251 KB
10/15/2020	EBS Flex Spending Enrollment Form	361	173 KB
04/15/2020	Wellmark Application for Health Ins Form 7/1/2020	604	1,026 KB
04/01/2020	FCCRA Emergency Leave Request Form	638	551 KB

Documents 1-25 of 38

Communications

City Hall

819 1st S Ave
Fort Dodge, IA 50501
Get Directions