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Human Resources Information for HRAs

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:

Administrative Rules Non-SLIP Retirement
Agency Human Resources Contacts Pay
Benefits Pre-Audit
Central Payroll Reasonable Accommodation
Employment Relocation
Family and Medical Leave Act (FMLA) Safety
Fiscal Year-End Processing Sexual Harassment
Insurance Billings Severe Weather Information
Internships Sick Leave Insurance Program (SLIP)
Iowa Administrative Code State Human Resources Policies
Layoff Taxable Benefits Processing P1 Type 300-301
Life Insurance Telework
Long Term Disability Insurance Temporary Services
Manuals and Other Resources Unemployment Insurance Management
Military Leave Workers' Compensation
  WorkSmart - HR Resources


Administrative Rules

The Department of Administrative Services' primary rule chapter is 11 of the Iowa Administrative Code.

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Agency Human Resources Contacts

Agency Human Resources Contacts

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 2023 Benefit Information
(passcode: @2023HRAOpenEnroll)
Slides of the benefits training presentation 

HRE Benefits website Benefits forms and other information can be accessed at this website.

2022-2023 Health and Dental Deduction Schedule PDF
2023 Added-Value Tax Matrix PDF 

Coverage Beginning and Ending Dates 
Coverage Effective Dates PDF (Updated 06/24/19)

Health and Dental insurance Premiums
2023 Health and Dental Premium -All Employees PDF (All employees except SPOC-covered employees) 
2023 Health and Dental Premiums -SPOC-covered Employees PDF

COBRA website 
COBRA Notification/Election form PDF 
2023 COBRA Premiums  PDF
Health insurance application PDF 
Delta Dental application PDF

Benefit videos 
Wellmark's Find a Provider 

Leave Programs
Managing Your Leaves Website 

Life Events 
Life Events website (updated 05/13/2020) 
Life Events Matrix PDF

Life Insurance
2023 Life Insurance Premiums  PDF  (All employees except SPOC-covered employees) 
2023 Life Insurance Premiums for SPOC-covered Employees  PDF

Waiver of Life And Long Term Disability Insurance PDF

Updated 12/14/2021

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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

NEOGOV Resources
NEOGOV Webinar

Enrolling Interns in the State of Iowa Internship Program

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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

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Fiscal Year End Processing

2022 Fiscal Year-End Processing - Compensatory, Holiday, Family Care, and Other Balances
FMLA 2022 Fiscal Year-End Information

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Insurance Billings Updated 09/30/22

Billing Adjustment Forms

Arrears Forms

Health and Dental Forms (Only to be used for exceptions and corrections that can no longer be done in the system)
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 (Only to be used for exceptions and corrections that can no longer be done in the system)
State Share Transfer - Life & LTD (M-005-01) PDF
Supplemental Life Payment (M-005-02) PDF
Refund Form (M-0334) PDF

Training Materials
HRA Helps and Example Letters
Example Letter Template:  Bill for Outstanding Arrears  Coming Soon 
Example Letter Template:  Second Notice Bill for Outstanding Arrears  Coming Soon


Internship Development Program

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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

Sample Layoff Plan - Merit-Covered
Sample Layoff Plan - SPOC-Covered
Sample Layoff Letter - Merit Covered
Sample Layoff Letter - SPOC-Covered
Sample Recall Letter

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Life Insurance

Life Insurance Claim Application PDF (to be completed by agency) 
Beneficiary Statement PDF (method of benefit payment)
Beneficiary Life Claim Letter (example to be sent with beneficiary statement)

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Long Term Disability Insurance

LTD Employee and Physician Statement  PDF (to be completed by the employee)
LTD Employers Statement  PDF  (to be completed by the agency)

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Manuals and Other Resources

Managers and Supervisors Manual 

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Military Leave

Iowa Code 29A.28
11 IAC 63.9(8A) Military Leave

Military Leave Checklist for State of Iowa Employees
Request for Military Leaves Dates
State of Iowa Military Leave Performance/Increase
Military Service - Voluntary Written Notice of Intent Not to Return

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Non-SLIP Retirement

Non-SLIP Retirement Process Checklist


Special Pay/Appointment Action 552-0125
Signature Authorization Form 552-0109
Agreement for Recouping Education Payments 552-0707

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Excel Calculators - For calculating vacation and sick leave payouts, dates, pay adjustments, pay increases, and more

Pay Period Calendars
2020 Pay Period Calendar
2021 Pay Period Calendar
2022 Pay Period Calendar
2023 Pay Period Calendar
2024 Pay Period Calendar

Step Increase Date Schedules
Step Increase Schedule FY20 
Step Increase Schedule FY21 
Step Increase Schedule FY22
Step Increase Schedule FY23
Step Increase Schedule FY24 

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)
Appeal Board Claim Process
Calculations for Pay Adjustments/Term leave Pay
Checklist - Terminations
Checklist - Regular Retirements (Non-SLIP)
Dates Cheat Sheet
Documentation Required for Pre-Audit
Email Subject Line
Helpful Links
HRIS Cheat Sheet
HRIS – Table of Codes
Postal Service Abbreviations
Reemployment vs. Reinstatement
Transfer vs. Reassignment
Termination Type Guidance

P-1 Type Descriptions (sorted by P-1 number)
001 New Hire - Permanent Position
099 Reinstatement
219 Home Address/Home Phone Change
400 Types Terminations
402 Retirement
501 Leave of Absence
620 Merit Increase
636 Pay Increase Due for Past Pay Period
849 Settlement Pay

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Reasonable Accommodation

Request for Reasonable Accommodation 552-0574

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Agreement for Recouping Payments 552-0751
Calculation of Mortgage Interest Differential 552-0703 
Calculation of Market Value Differential 552-0704 
Calculation of Income Tax Assistance Payment 552-0705  
IRS Tests for Preparing Relocation Expense Claims 552-0706 
Statement of Ownership of Principal Residence 552-0668 
Moving Company Bid Sheet 552-0702 
Relocation Expenses Recap
Travel Payment for Relocation Expenses
Travel Payment for Relocation Subsistence

questions Questions? Send an email to Centralized Payroll

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Ergonomic Office: Self-Assessment - Enroll through the Learnsoft LMS

Severe Weather Information

Severe Weather Policy
Severe Weather FAQ
Severe Weather Request for Assistance form

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Sexual Harassment

Sexual Harassment Policy for Executive Branch Employees
Sexual Harassment Policy Reference Guide

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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

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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 
Violence Free Workplace Policy
Employee Complaint Form (fillable)
Steps in the Hiring Process 552-0492 

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Taxable Benefits Processing

Taxable Benefits (P1 Type 300-301) Processing on HRIS

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Telework Program

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Temporary Services

Temporary Staffing Services Vendor Request 552-0647
Temporary Staffing Information

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Unemployment Insurance Management 


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Workers' Compensation

Workers' Comp Benefit Election Form 
Workers' Compensation First Report of Injury or Illness
Workers’ Compensation Provider List

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Last updated 03/02/23