HR FORMS

• Customer Service

–Employee Complaint Form–
-Your Voice Your Thoughts – English Version / Spanish Version

• Insurance 

–20-21 Employee Benefits Program (Sonoma County)–
–20-21 Employee Benefits Program (Mendocino and Lake Counties)– 
–USleb: Free Mobile Benefits App–
–Medicare Prescription Drug Coverage – 2019–
–2014 Health Reimbursement Arrangement Welcome Packet–
-Participant Quick Start Guide-

        –Submit Your Claim Receipt– (Open in Google Chrome- https://ebsbenefits.lh1ondemand.com)

There are a few ways to get reimbursed: 

• Follow the hyperlink on the first page of the Welcome Packet. You will fill out your info, and attach scanned copies of your receipts. 
• Print and fill out the second page (it can be mailed or faxed, but faxing should have the quickest turnaround.)
• Download the EBS app. 

Logging in the first time will be your first initial, last name, and last 4 of your ssn.