Get Termination / Less Than 80 / Transfer Check List - State Of Wyoming - Wyoming

This guide provides clear instructions for completing the Termination / Less Than 80 / Transfer Check List for the State of Wyoming. This document is essential for managing employee transitions, ensuring compliance, and providing necessary benefits information.

Follow the steps to accurately complete the checklist.

1. Click the ‘Get Form’ button to access the Termination / Less Than 80 / Transfer Check List. This action will allow you to open the form in your preferred online editor.
2. Begin by completing the top portion of the form for each employee. You will need to input the employee's name, Social Security Number (SSN), date of termination, last day worked, date of hire, agency name, date of birth, agency number, and employee address including city, state, and zip code.
3. Identify the relevant section to fill based on the circumstances: Section 1 for Termination/Retirement, Section 2 for Less than 80 Hours, or Section 3 for Transfers.
4. If selecting Section 1, indicate whether the termination is involuntary by selecting 'Yes' or 'No.' Provide explanations for COBRA continuation benefits and continuation of voluntary benefits. Additionally, specify if the employee is on a split premium and notify the spouse's agency of the employee's termination.
5. In Section 1, determine if the employee qualifies for life conversion and explain the benefits of paying premiums pre-tax for the remainder of the current year. Verify if the employee qualifies as a retiree based on the service requirements listed and discuss any applicable retiree subsidies.
6. For Section 2, if applicable, explain Workers Compensation, FMLA, or benefits related to working less than 80 hours, and include the original date of injury for Workers Compensation.
7. For Section 3, fill in the transfer date and specify the agency number to which the employee is transferring. Also, detail the start date of military leave and provide the name of the agency to which the individual is transferring.
8. After all relevant fields are completed, obtain necessary signatures from the Benefit Specialist and the employee.
9. Once you have verified all information for accuracy, save your changes and consider downloading or printing the completed form for your records.

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