Due to scheduled maintenance, Member Self-Serve (MSS) and Employer Self-Serve (ESS) will be intermittently unavailable on Sunday, Feb. 2.

Employer Forms

	Authorization for ACH Debits
	Employer Accounting of Member Compensation
	Employer Certification of Member Enrollment
	Employer Information Form
	Model Pick-Up Resolution for employers with existing pick-up plans
	Model Pick-Up Resolution for employers who do not currently participate in a pick-up plan
	New Member Information Form
	Members Medical Questionnaire and Physicians Certification
	Pre-Employment Physical Requirements
	Work History Report
	Employer Payment Remittance
	Statement Concerning Your Employment in a Job Not Covered by Social Security