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For your convenience we have provided following forms, links and resources that you will need for ongoing employment. You can print the forms, fill them out and fax to (775) 853-5466, mail to 890 East Patriot Boulevard Suite E, Reno, NV, 89511, or scan them and send via e-mail back to us at the e-mail addresses listed below.
Human Resources
Sales
Celeste Peterson –
Celeste.Peterson@AppliedBusinessNV.com
Lesslie Bauer -
Lesslie.Bauer@AppliedBusinessNV.com
Megan Annis –
Megan.Annis@AppliedBusinessNV.com
Angela Atchley–
Angela.Atchley@AppliedBusinessNV.com
Mindy Stewart -
Mindy.Stewart@AppliedBusinessNV.com
Payroll
Michelle Miles -
Michelle.Miles@AppliedBusinessNV.com
Jennifer Clark-
Jennifer.Clark@AppliedBusinessNV.com
Kathy Roope-
Kathy.Roope@AppliedBusinessNV.com
New Hire Employment Packet
Generic Employment Application
W-4 Form
I-9 Form
Drug Screen Authorization
Prohibited Harassment Policy
Direct Deposit Authorization Form
Workplace Safety
Insurance Enrollment Packet
Premium Deduction Authorization Form (Required)
Saint Mary’s PPO/H.S.A. Insurance Enrollment Form (Medical)
Saint Mary’s HMO Insurance Enrollment Form (Medical)
SelectDent Enrollment Form(Dental)
V S P Enrollment Form (Vision)
Wells Fargo H S A Enrollment Form
Employment Forms
Personnel Action Form
Direct Deposit Authorization Form
C-1 Form
Benefit Action Forms
Saint Mary’s PPO/H.S.A. Insurance Enrollment Form (Medical)
Saint Mary’s HMO Insurance Enrollment Form (Medical)
FSA Enrollment Form
FSA Reimbursement Form
V S P Enrollment Form (Vision)
SelectDent Enrollment Form(Dental)
Wells Fargo H S A Enrollment Form
Related websites and contact information:
Saint Mary’s Health Plans:
www.saintmaryshealthplans.com
Phone numbers: HMO 800-863-7515
PPO/HSA 800-433-3077
SelectDent:
www.ddsppo.com
Phone number: 866-616-4888
VSP:
www.vsp.com
Phone number: 800-877-7195
Wells Fargo H S A:
https://healthbenefits.wellsfargo.com
Phone number: 866-890-8309
Benefit Information
Saint Mary’s/Lakonia Health Plans Medical Summary of Benefits
Benefit Poster
SelectDent Summary of Benefits
VSP Summary of Benefits
FSA Eligible Expenses
HSA FAQs and Basics
401K Forms
Slavic 401K Enrollment Form
Slavic 401K Change Form
Slavic Rollover Request Form
Related website and contact information:
https://www.slavic.net
Phone number: 800-356-3009
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890 E. Patriot Blvd., Suite E • Reno, NV 89511 • Phone (775) 853-5433 • Fax (775) 853-5466