The following list includes many frequently used DAS-HRE forms and policies in one central location for the user's convenience. Several of these forms are also found in the Managers and Supervisors Manual and other locations on the DAS-HRE website. Where that is the case, a link to the respective Chapter in the Manual or other resource has been included.
This information is divided into the following sections for convenience:
HRA Information: 2021 Enrollment and Change Period
Administrative Rules
The Department of Administrative Services' primary rule chapter is 11 of the Iowa Administrative Code.
Agency Human Resources Contacts
List of Agency Human Resources Contacts
Benefits
HRE Benefits website Benefits forms and other information can be accessed at this website.
2019-2020 Deduction Schedule PDF
2020 Added-Value Tax Matrix PDF
2020 IowaBenefits Automatic Health and Dental P-1 Processing Schedule PDF
2020 Iowa Benefits Automatic Life P-1 Processing Schedule PDF
Coverage Beginning and Ending Dates
Coverage Effective Dates PDF (Updated 06/24/19)
Health and Dental insurance Premiums
2020 health and dental insurance premiums PDF (All employees except SPOC-covered employees)
2020 SPOC health and dental insurance premiums PDF
COBRA
COBRA website
COBRA Notification/Election form PDF
2020 COBRA premiums PDF
Health insurance application PDF
Delta Dental application WORD
Death of Employee Checklist PDF
Flexible Spending Accounts
2020 Changes to FSA Accounts Video of June 17, 2020 webcast.
2020 Changes to FSA Accounts slides
Flexible Spending Accounts Benefits after leaving employment brochure
Health Insurance
2020 Sick Leave Insurance Program (SLIP) premiums PDF
Benefit videos
Wellmark's Find a Provider
Where to get care posters
Where to get care and save PDF
Know the cost and save PDF
Know your condition and save PDF
Life Events
Life Events website (updated 05/13/2020)
Life Events Matrix PDF
Life Insurance
2020 Life Insurance premiums PDF (All employees except SPOC-covered employees)
2020 SPOC-covered life insurance premiums PDF
Waiver of Life And Long Term Disability Insurance PDF
Benefit video
Updating your beneficiaries in IowaBenefits
IowaBenefits
IowaBenefits link
IowaBenefits Instructions
Terminating an individual in IB participating in FSA
Updated 12/11/2019
Employment
I-9 Form (Employment Eligibility Verification)
Note: Chrome and Firefox users must right-click and select "Save link as" to download the I-9 form to their computer. The form can then be opened in Adobe Acrobat for completion. Internet Explorer users may click the link to complete the form within the browser, or may save the form to their computer to complete.
Steps in the Hiring Process 552-0492
Confidential Personal Data Form 552-0569
Powerpoint Presentation: Revised DAS Confidential Personal Data Form Information for HRAs
Enrolling Interns in the State of Iowa Internship Program
Family and Medical Leave Act (FMLA)
Family and Medical Leave Act forms are available at the:
Family and Medical Leave website
FMLA State of Iowa Policy
Fiscal Year End Processing
Insurance Billings Updated 02/26/2019
Manual
Monthly Insurance Billing Reconciliation Manual PDF
Monthly Balancing Materials
Reconciliation Worksheet
Billing Adjustment Forms
Health and Dental Forms
Trustee Report Adjustments (TRA) (M-005-04) PDF
State Share Transfer - Health & Dental (M-0335) PDF
Refund Form (M-0334) PDF
Transfer Between Carriers (M-0576) PDF
Life and LTD Forms
State Share Transfer - Life & LTD (M-005-01) PDF
Supplemental Life Payment (M-005-02) PDF
Refund Form (M-0334) PDF
Training Materials
Training Slides
Internships
Internship Development Program
Layoff
Layoff Plan Merit Covered Employees 552-0752
SPOC Layoff Plan 552-0753
Recall and Outplacement Instructions for Merit-Covered Employees 552-0231B
Retention Point Calculation Worksheet 552-0106
Samples
Sample Layoff Plan - Merit-Covered
Sample Layoff Plan - SPOC-Covered
Sample Layoff Letter - Merit Covered
Sample Layoff Letter - SPOC-Covered
Sample Recall Letter
Life Insurance
Life Insurance Claim Application PDF (to be completed by agency)
Beneficiary Statement PDF (method of benefit payment)
Long Term Disability Insurance
Please contact the Life and LTD Specialist for application.
Manuals and Other Resources
Centralized Payroll Manuals
Managers and Supervisors Manual
Monthly Insurance Billing Reconciliation Manual PDF
Military Leave
Military Leave of Absence Manual
Iowa Code 29A.28
11 IAC 63.9(8A) Military Leave
Forms:
Military Leave Checklist for State of Iowa Employees (552-0796)
Military Leave of Absence Request (Exceed 30 Days) (552-0797)
Request for Military Leaves Dates (552-0798)
State of Iowa Military Leave Performance/Increase (552-0799)
Military Service - Voluntary Written Notice of Intent Not to Return (552-0800)
Pay
Special Pay/Appointment Action 552-0125
Signature Authorization Form 552-0109
Agreement for Recouping Education Payments 552-0707
Pre-Audit
Excel Calculators (for calculating vacation and sick leave payouts, dates, pay adjustments, pay increases, and more)
Pre-Audit Calculators (protected)
Pre-Audit Calculators (unprotected)
Pay Period Calendars
2017 Pay Period Calendar
2018 Pay Period Calendar
2019 Pay Period Calendar
2020 Pay Period Calendar
2021 Pay Period Calendar
2022 Pay Period Calendar
Step Increase Date Schedules
Step Increase Schedule FY17
Step Increase Schedule FY18
Step Increase Schedule FY19
Step Increase Schedule FY20
Step Increase Schedule FY21
Presentations from HRA Trainings
2017 HRA Training Presentation 08-23-17
2015 PA Training Powerpoint - Excel Calculators
Employees Moving To/From Executive Branch and...
Department of Transportation
Regents Institution
Judicial Branch, Legislative Branch, or Community Based Corrections
Additional Resources (cheat sheets, checklists, and more)
P1 and M5 Types and Approval Levels - Updated!
Appeal Board Claim Process
Applicant Tracking System Requirements for P1 Approval
Calculations for Pay Adjustments/Term leave Pay
Checklist - Terminations
Checklist - Regular Retirements (Non-SLIP)
Dates Cheat Sheet
Donated Leave Forms & Deduction Information
Documentation Required for Pre-Audit
Email Subject Line
Helpful Links
HRIS Cheat Sheet
HRIS – Table of Codes
Leave Code Chart and Definitions
Payroll Processing Times Calendar
Postal Service Abbreviations
Reemployment vs. Reinstatement
Transfer vs. Reassignment
Termination Code Guidance
When to Process an M5 or a P1
P-1 Type Descriptions (sorted by P-1 number)
001 New Hire - Permanent Position
055 Transfer to SLIP
099 Reinstatement
219 Home Address/Home Phone Change
239 Tax Status Change
249 Automatic Deposit Change
300 Taxable Fringe Benefit
304 Credit Union Deduction Change
400 Types Terminations
402 Retirement
470-475 SLIP Calculation
501 Leave of Absence
502 Leave Code Correction
620 Merit Increase
636 Pay Increase Due for Past Pay Period
677 Reassignment in Lieu of Layoff (Outplacement)
839 Health Insurance Opt-Out Correction
844 Move Pay/ Income Not Subject to Retirement/ Workers Comp Pay
845 Catastrophic Leave/ Other Pay Adjustment/ Term Leave Pay/ Sick Leave Pay (Legislative and Judical branches only)
846 Catastrophic Leave/ Other Pay Adjustment/ Term Leave Pay/ Sick Leave Pay
849 Settlement Pay
Reasonable Accommodation
Request for Reasonable Accommodation 552-0574
Relocation
Agreement for Recouping Payments 552-0751
Calculation of Mortgage Interest Differential 552-0703 This form must be opened in Internet Explorer (IE).
Calculation of Market Value Differential 552-0704 This form must be opened in Internet Explorer (IE).
Calculation of Income Tax Assistance Payment 552-0705 This form must be opened in Internet Explorer (IE).
IRS Tests for Preparing Relocation Expense Claims 552-0706 This form must be opened in Internet Explorer (IE).
Statement of Ownership of Principal Residence 552-0668 This form must be opened in Internet Explorer (IE).
Moving Company Bid Sheet 552-0702 This form must be opened in Internet Explorer (IE).
Relocation Expenses Recap
Travel Payment for Relocation Expenses
Travel Payment for Relocation Subsistence
Safety
NAICS - Partially Exempt Industries
New Employee Safety Orientation video
OSHA Recordkeeping Forms and Requirement Guide
OSHA Recordkeeping Decision Tree
OSHA Recordkeeping Resources
OSHA 300, 300A Forms and Electronic Recordkeeping (Recording)
Slide Deck
OSHA 300 form slide deck handout
Severe Weather Information
Severe Weather Policy
Severe Weather FAQ
Severe Weather Request for Assistance form
Sexual Harassment
Sexual Harassment Policy for Executive Branch Employees
Sexual Harassment Policy Reference Guide
Sick Leave Insurance Program (SLIP)
Sick Leave Insurance Program Enrollment 552-0713
Sick Leave Insurance Program Calculation Worksheet (for estimates only)
Sick Leave Insurance Program Checklist for Human Resources Associates
State Human Resource Policies
This section lists the more frequently accessed policies of DAS-HRE and Iowa state government.
Equal Opportunity, Affirmative Action and Anti-Discrimination Policy
State of Iowa Employee Handbook
Employee Assistance Program Policy
FMLA State of Iowa Policy
Substance Abuse
Substance Abuse Policy Guidelines for Supervisors
Relocation
Violence Free Workplace Policy
Employee Complaint Form (fillable)
Steps in the Hiring Process 552-0492
Taxable Benefits Processing
Taxable Benefits (P1 Type 300-301) Processing on HRIS
Telework
Temporary Services
Temporary Staffing Services Vendor Request 552-0647
Temporary Staffing Information
Unemployment Insurance Management
Workers' Compensation
Workers' Comp Benefit Election Form
Workers' Compensation First Report of Injury or Illness
Workers’ Compensation Provider List
Lasy updated 07/14/2020