Foomamka
Hoos waxaa ku taxan dhammaan foomamka loo baahan yahay si aad isu diiwaan geliso ama aad u cusboonaysiiso dheefahaaga Carewell. Foomamka waxaa lagu habeeyaa dheef ama qayb ahaan.
Dooro dheef ama qayb si aad u aragto foomamka
Ilkaha
Araga + Maqalka
Barnaamijka Caawimaadda Shaqaalaha
Kaalmada Kharashka Daryeelka Caafimaadka
Wakhtiga Fasaxa Lacagta leh
Muhiim – Xogtaada mar kasta ha ahaato mida saxda ah
Si aad xaq ugu yeelato dheefaha Carewell, Carewell SEIU 503 waa inay fayl ku hayso magacaaga, jinsigaaga, Lambarkaaga Soshiyaal Sekuyuritiga, taariikhdaada dhalashada iyo ciwaankaaga guri ee haddadan. Waa inaad sidoo kale xaqiijiso in macluumaadkaaga gobalka uu hayo uu yahay kii ugu danbeeyay. Ogoow: Soo gudbinta macluumaadkan wuxuu awood u siin doonaa Carewell SEIU 503 inay kaa diiwaangeliso dheefaha Ilkaha, Aragga + Maqalka, iyo Barnaamijka Caawimaadda Shaqaalaha ee Carewell SEIU 503 haddii aad xaq u ledahay.
- Soo gudbi foomka kore si aad macluumaadkaaga ugu cusboonaysiiso Carewell SEIU 503.
- Raac tilmaamaha hoose si aad u cusbooneysiiso macluumaadkaaga shakhsiyeed ee Gobolka iyadoo ku xiran nooca shaqaale ee aad tahay.
Shaqaalaha Daryeelka Guriga (HCW)
Cusbooneysii cinwaankaaga xafiiska goobta APD/AAA ee deegaanka. Iskuduwaha/karraaniga HCW ee deegaanka ayaa ah qofka ku haboon in lala xidhiidho.
Shaqaalaha Taageerada Shaqsiyeed ee ODDS
Buuxi Foomkan Beddelida Macluumaadka (PDF) si aad u hubiso in DHS ay ku hayso macluumaadkaaga hadda jira faylka.
Shaqaalaha Taageerada Shaqsiyeed ee OHA
Buuxi Foomkan Cusboonaysiinta Macluumaadka Bixiyaha (PDF) si aad u hubiyo in OHA ay ku hayso macluumaadkaaga hadda jira faylka. Ku buuxi dhammaan qaybaha foomka marka laga reebo kuwan:
- “Complete this section for an organization, group or agency (U buuxi qaybtan urur, koox ama wakaalad)”
- “Taxonomy code changes (Koodhka Taxonomy wuu isbedelaa)”
Foomamkeena dijitaalka ah waxaa inta badan lagu helaa luuqadaha Isbaanish, Ruush, Fiyatnaamiis iyo Simplified Chinese. Si aad foomka ugu buuxisid luuqadda aad doorbideyso, guji calanka Maraykanka ee jira dhinaca midifg ee kore ee foomka, ka dibna dooro luuqadda aad doorbideyso.

Ilkaha
Benefits Waiver Form
Foomka Racfaanka U-qalmitaanka iyo Lacag-celinta
Waa in la raaciyaa marka la gudbiyo warqad sharaxaysa sababta aad u codsanayso racfaan.
Araga + Maqalka
Foomka Sheegashada Lacag Celinta Aragga Ameritas (kaliya LASIK)
Foomka Sheegashada Lacag Celinta Maqalka ee Ameritas
Foomka Ka dhaafitaanka Dheefaha
Foomka Racfaanka U-qalmitaanka iyo Lacag-celinta
Waa in la raaciyaa marka la gudbiyo warqad sharaxaysa sababta aad u codsanayso racfaan.
Foomka Lacag-celinta Xubinta VSP
Ku dalbo magdhawyada elektaroonig ahaan adiga oo ka dalbanaya bogga VSP ee barta vsp.com. Waa inaad akoon ka samaysato marka hore.
Barnaamijka Caawimaadda Shaqaalaha
Foomka Ka dhaafitaanka Dheefaha
Foomka Racfaanka U-qalmitaanka iyo Lacag-celinta
Waa in la raaciyaa marka la gudbiyo warqad sharaxaysa sababta aad u codsanayso racfaan.
Kaalmada Kharashka Daryeelka Caafimaadka
Wixii ah Qorshayaasha La ansixiyay
Xog-uruurinta cusboonaysiinta ee 2023
Warqadaha Sannadlaha ah ee 2023
Foomamkani waxay kooxda Dheefaha Carewell SEIU 503 ogolaanshaha u siinayaan inay kaa caawiyaan diiwaangelinta iyo ilaalinta caymiskaaga daryeelka caafimaadka. Warqadani ma aha codsi caymis caafimaad.
Oggolaanshaha HIPAA
Bayaanka Is Af-Garashada
Oggolaanshaha Siideynta Foomka Macluumaadka
Buuxi tan haddii aad u baahan tahay inaad u ogolaato xubin qoyskaaga ka tirsan ama saaxiib aad aaminsan tahay inuu su'aalo kuu weeydiiyo, balamo qabto ama xaqiijiyo macluumaad adiga oo ku matalayo.
Wakiilka VIP ah ee Foomka Diiwaanka
Foomka Oggolaanshaha Iskaashiga Bulshada ee OHA
2023 warqadaha sannadlaha ah ee AoR ee aan VIP-ahayn
Foomka Macluumaadka Diiwaangelinta
Foomka Lacag Wareejinta Elektrooniga ah
Waa in la soo raaciyaa marka lasoo gudbinayo koobi ah jeeg maran.
Foomka Sheegashada Lacag-celinta Caafimaadka
Waa in la soo raaciyaa marka lasoo gudbinayo koobi Dukumiintiga Sharaxaada Dheefahaaga ama biilkaaga.
Foomka Lacag-celinta ee Ameriflex
Foomka Kharashka Dib-u-habaynta Lacag-celinta Sare
Waa in la raaciyaa marka la gudbinayo dukumentiyada canshuurta.
Foomka Racfaanka U-qalmitaanka iyo Lacag-celinta
Waa in la raaciyaa marka la gudbiyo warqad sharaxaysa sababta aad u codsanayso racfaan.
Kaalmada Kharashka Daryeelka Caafimaadka
Wixii ah Medicare
Foomka Lacag-celinta ee Ameriflex
Warqadaha Kaalmada Kharashka Daryeelka Caafimaadka ee Medicare
Oggolaanshaha Siideynta Foomka Macluumaadka
Foom Dijitaal ah
Buuxi tan haddii aad u baahan tahay inaad u ogolaato xubin qoyskaaga ka tirsan ama saaxiib aad aaminsan tahay inuu su'aalo kuu weeydiiyo, balamo qabto ama xaqiijiyo macluumaad adiga oo uu ku matalayo.
Foomka Lacag Wareejinta Elektrooniga ah
Waa in la soo raaciyaa marka lasoo gudbinayo koobi ah jeeg maran.
Foomka Sheegashada Lacag-celinta Medicare
Waa in la soo raaciyaa marka lasoo gudbinayo koobi ah biilkaaga sare.
Foomka Racfaanka U-qalmitaanka iyo Lacag-celinta
Waa in la raaciyaa marka la gudbiyo warqad sharaxaysa sababta aad u codsanayso racfaan.
Wakhtiga Fasaxa Lacagta leh
Xirmada Codsiga Dheefta PTO
Foomka W-9
Foomka Lacag Wareejinta Elektrooniga ah
Waa in la soo raaciyaa marka lasoo gudbinayo koobi ah jeeg maran.
Foomka Magacaabista Ka-faa'iidaystaha
Dheefahan, waxaanu kugu boorinaynaa inaad buuxiso Foomka Magacaabista Ka-faa'iidaystaha si qofka aad doorato u helo lacagtaada PTO ee aadan sheegan haddii ay dhacdo geeridaada.