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Employee Benefits, Forms, and Resource Information
Human Resources Services for Employees
The Human Resources Team is dedicated to providing support and assistance to the County’s many employees and retirees. If you have any questions regarding payroll, compensation, classification, IMRF, employee health benefits, and wellness services, and retirement feel free to contact us via telephone, email, or stop in Rooms 249 and 250.
Benefit Forms & Resources
- 2023 Open Enrollment Presentation
- 2023 Election Form (PDF)
- 2023 Premium Rates (PDF)
- 2023 Benefit Guide (PDF)
- Employee Benefits Information
- Employee Handbook
- Opt Out Form (Coming Soon)
- HIPAA Medical Release Form (PDF)
- Curalinc EAP Services Presentation
- Safety Documents
- 2023 Payroll Schedule (PDF)
Employee Compensation
- LaSalle County Payroll Sheet
- Address Name Change Form
- Direct Deposit Cancellation Form
- Emergency Contact Form
- W-4 Form - Federal
- W-4 Form - Illinois
- Voluntary Resignation and Retirement Letter
Holiday Benefits
Illinois Municipal Retirement Fund (IMRF)
- Log-in necessary for “Member Access”
- Employer Cost and Participation Information
- Most Commonly Used Forms
Wellness Resources
Voluntary Benefits
Medical (Blue Cross Blue Shield)
- 2023 PPO 250/500 Benefit Plan Summary
- 2023 PPO 1500/3000 Benefit Plan Summary
- 2023 HDHP w/ H.S.A. Benefit Plan Summary
- Prime Therapeutics Mail Order
- Prime Therapeutics New / Refill Prescription Order Form
- Standard Drug Lists
- Standard Procedures – Wellness visit (Adults)
- Standard Procedures – Wellness visit (Children)
- MDLive Information
- 24/7 Nurseline – PPO Plans
- 2020 1095C Form – Model Notice
- 2023 Model Notices – Health Insurance
- 2023 IL Consumer Coverage Disclosure Notice
BCBS
- Member Services – Available for all employees and covered members on the County’s insurance plans
- Visit their website
- Log-in necessary for “Blue Access for Members”
- Understanding your E.O.B. (Explanation of Benefits)
- Well on Target – Wellness Services available to health insurance members
- Blue Access Mobile
- MDLive Virtual Visits
- Find a Doctor
- What do I do if I need medical care in a foreign country?
- Healthcare coverage when you are traveling or living abroad
- BCBS Claim Form for foreign travel claims
- Livongo Program
- BCBSIL Transparency in Coverage – JSON
COBRA
Dental (Delta Dental)
Vision (VSP)
Dearborn Life Basic and Supplemental Life Insurance
- New Beneficiary Assist Program
- Basic Term Life, AD&D Plan coverage
- Supplement Life Insurance Plan
- Enrollment Change Form
- Beneficiary Form