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

Wixii ah Qorshooyinka Loo ansixiyay
Medicare

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.

 

  1. Soo gudbi foomka kore si aad macluumaadkaaga ugu cusboonaysiiso Carewell SEIU 503.
  2. 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

      Digital Form

      Foomka Racfaanka U-qalmitaanka iyo Lacag-celinta

      Foom Dijitool ah

      Waa in la raaciyaa marka la gudbiyo warqad sharaxaysa sababta aad u codsanayso racfaan.

      Araga + Maqalka

      Foomka Sheegashada Lacag Celinta Aragga Ameritas (kaliya LASIK)

      Foom PDF ah

      Foomka Sheegashada Lacag Celinta Maqalka ee Ameritas

      Foom PDF ah

      Foomka Ka dhaafitaanka Dheefaha

      Foom Dijitool ah

      Foomka Racfaanka U-qalmitaanka iyo Lacag-celinta

      Foom Dijitool ah

      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

      Foom Dijitool ah

      Foomka Racfaanka U-qalmitaanka iyo Lacag-celinta

      Foom Dijitool ah

      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

      Foom Dijitool ah

      Warqadaha Sannadlaha ah ee 2023

      Foom Dijitool ah

      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

      Foom Dijitool ah

      Bayaanka Is Af-Garashada

      Foom Dijitool ah

      Oggolaanshaha Siideynta Foomka Macluumaadka

      Foom Dijitool 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 ku matalayo.

      Wakiilka VIP ah ee Foomka Diiwaanka

      Foom Dijitool ah

      Foomka Oggolaanshaha Iskaashiga Bulshada ee OHA

      Foom Dijitool ah

      2023 warqadaha sannadlaha ah ee AoR ee aan VIP-ahayn

      Foom Dijitool ah

      Foomka Macluumaadka Diiwaangelinta

      Foom Dijitool ah

      Foomka Lacag Wareejinta Elektrooniga ah

      Foom Dijitool ah

      Waa in la soo raaciyaa marka lasoo gudbinayo koobi ah jeeg maran.

      Foomka Sheegashada Lacag-celinta Caafimaadka

      Foom Dijitool ah

      Waa in la soo raaciyaa marka lasoo gudbinayo koobi Dukumiintiga Sharaxaada Dheefahaaga ama biilkaaga.

      Foomka Lacag-celinta ee Ameriflex

      Foom Dijitool ah

       Foomka Kharashka Dib-u-habaynta Lacag-celinta Sare

      Foom Dijitool ah

      Waa in la raaciyaa marka la gudbinayo dukumentiyada canshuurta.

      Foomka Racfaanka U-qalmitaanka iyo Lacag-celinta

      Foom Dijitool ah

      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

      Foom Dijitool ah

      Warqadaha Kaalmada Kharashka Daryeelka Caafimaadka ee Medicare

      Foom Dijitool ah

      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

      Foom Dijitool ah

      Waa in la soo raaciyaa marka lasoo gudbinayo koobi ah jeeg maran.

      Foomka Sheegashada Lacag-celinta Medicare

      Foom Dijitool ah

      Waa in la soo raaciyaa marka lasoo gudbinayo koobi ah biilkaaga sare.

      Foomka Racfaanka U-qalmitaanka iyo Lacag-celinta

      Foom Dijitool ah

      Waa in la raaciyaa marka la gudbiyo warqad sharaxaysa sababta aad u codsanayso racfaan.

      Wakhtiga Fasaxa Lacagta leh 

      Xirmada Codsiga Dheefta PTO

      Foom Dijitool ah

      Foomka Lacag Wareejinta Elektrooniga ah

      Foom Dijitool ah

      Waa in la soo raaciyaa marka lasoo gudbinayo koobi ah jeeg maran.

      Foomka Magacaabista Ka-faa'iidaystaha

      Foom Dijitool ah

      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.

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