Government » Jobs » Employment Information

New Employee Resources

heron standing on heron statue in mirror pondWelcome to the City of Salem! Here you will find benefits enrollment forms and information to assist you with electing your benefits options.

The City of Salem has five collective bargaining units that are represented under labor contracts. Your benefits are determined by your labor contract. If you are unsure of the contract for your position, please contact Human Resources for assistance.

Salem Housing Authority employee benefits are administered by CIS. Additional information is available online on the Salem Housing Employee Benefits page.

All employees are required to adhere to the human resources rules.

Required - New Hire Benefit Forms

Forms are due to Human Resources within 30 days of hire date. Forms are also available in the NEOGOV system. 

New Employee Benefits Forms Checklist

Form Description
1. Health Insurance Enrollment, Waiver, Change form Complete this form to enroll or waive coverage in the City of Salem health insurance plans.
2. Health Insurance Coordination of Benefits form Complete this form to report that you or your dependents have other health insurance coverage.
3. Flexible Spending Accounts (FSA) Enrollment or Waiver form 2026 Complete this form for enrollment or waiver in the flexible spending accounts 
4. Standard Insurance Life, ADD, LTD Voluntary Enrollment Beneficiary Form Complete this form to designate or update your beneficiary on the City provided Life Insurance and AD&D policy.

 

The form is also used to enroll in the voluntary additional life insurance within 31 days of hire within the guaranteed issue limits of $100,000 employee, $20,000 spouse, and $10,000 child(ren).

 

This form is also used to enroll in the voluntary AD&D coverage of $25,000 - $300,000 for Employee only or Employee + Family.
5. Electronic Disclosure form Complete this form to acknowledge the City's intent to deliver plan documents and notices electronically.
6. Health Hub Service Agreement New Hire form Complete this form to agree to the terms of use for the Health Hub employee health clinic.
7. Health Insurance Opt-Out Waiver Incentive form Complete this form only if you wish to waive coverage on the City of Salem health plans because you have other qualifying health insurance. Documentation of enrollment in qualifying coverage is required. Medicare and Medicaid (OHP) do not qualify as other qualifying health insurance for the opt-out incentive. 
8. Health Savings Account (HSA) Enrollment form 2026 Complete this form only if you elect to enroll in the HDHP medical plan or you qualify for the opt-out waiver incentive and are HSA plan eligible per IRS rules. 


Voluntary Benefits Documents

Form or DOCUMENT Description
Voluntary Additional Life Insurance Summary flyer Enrollment in the voluntary additional life insurance is available within 30 days of hire within the guaranteed issue limits of $100,000 employee, $20,000 spouse, and $10,000 child(ren) or can be elected at any time with application directly to Standard Insurance. Flyer includes rates for available options. Dependent coverage is only available with employee enrollment. 
Voluntary ADD Insurance Summary flyer Enrollment in the voluntary AD&D coverage of $25,000 - $300,000 for Employee only or Employee + Family is available at any time.  Flyer includes rates for available options. 

Benefits Documents and additional forms

Document Description
2026 Employee Benefits Guide Information regarding your benefits including costs of health insurance premiums
457 Voya Automatic Enrollment Notice New Employee AFSCME, Unrepresented, SCABU, PCEA, and IAFF new hire employees are enrolled in a 1% salary paycheck deduction auto-enroll process and will receive a packet from Voya with the option to opt-out or change amount prior to deadline. 
457 Voya Automatic Enrollment Notice New Employee SPEU and SPEU-S SPEU and SPEU-S Sergeants new hire employees are enrolled in a 3% salary paycheck deduction auto-enroll process but can choose to opt-out or change amount prior to deadline.
2026 Cigna HDHP SBC  Summary of Benefits Coverage for the Cigna High Deductible Health Plan (HDHP) medical plan 
2026 Cigna PPO OAP SBC  Summary of Benefits Coverage for the Cigna PPO OAP medical plan 
2026 Kaiser Permanente SBC  Summary of Benefits Coverage for the Kaiser Permanente medical plan 
Kaiser Permanente Enrollment Guide Kaiser Permanente medical plan enrollment guide
Cigna Resource Guide  Cigna medical plans enrollment guide   
Moda/Delta Dental Enrollment Guide Moda/Delta Dental Traditional plan enrollment guide with plan summary
Willamette Dental Enrollment Guide  Willamette Dental enrollment guide with plan summary 
HRAVEBA Benefits Guide  HRAVEBA enrollment guide
2026 BHS FSA Packet  Flexible Spending Accounts (FSA) enrollment packet 
2026 Domestic Partner Policy with Imputed taxable values Non married domestic partners of any gender are eligible for health insurance coverage if the requirements are met per the policy. A copy of the state domestic partner registration or the domestic partner health insurance affidavit form must be included with your enrollment form. The IRS requires an imputed tax of the health insurance coverage value unless the partner qualifies as a health insurance tax eligible dependent. 
Domestic Partner Health Insurance Affidavit form  Complete this form as agreement to the criteria of a domestic partnership for health insurance coverage.  
Domestic Partner Certification for Dependent Tax Status form  Complete this form if you are requesting to waive the imputed tax on the value of the health insurance coverage of a domestic partner as they qualify as a health insurance tax eligible dependent. You should make this determination in consultation with a tax professional. 
Disabled Dependent Certification form  Complete this form only if you are enrolling a child over age 26 on your health insurance plans and the child will qualify as a disabled dependent.

Required Notices

Notice Description
Cobra General Notice Health plan coverage continuation rights under COBRA.
Health Plan Annual Required Notices Health plans are required to provide certain notices to eligible health plan members.
HIPAA Notice of Privacy Practices Notice of the City of Salem's privacy practices related to protected health information.
Marketplace Coverage Options Notice Required notice of Marketplace coverage options.

Benefits by Employee Group