Employees and Retirees

ADA Notice & Procedure

Americans with Disabilities Act (ADA) Title I

Americans with Disabilities Act (ADA) Title II

ADA Accommodation Request Form

ADA Response to Accommodation Form

Employee Self Service Website:  https://selfservice.racinenet.org/MSS/

Employee Self Service Open Enrollment Guide 2021

Employee Self Service – Open Enrollment Webinar

Employee Self Service Training Opportunities Guide

How to Update Your Address through Employee Self Service

How to Update Your Emergency Contacts through Employee Self Service

How to Update your Phone Number through Employee Self Service

How to Update Your W-4 through Employee Self Service

Flexible Spending Account - United Healthcare Dependent Care Claim Form

Flexible Spending Account - United Healthcare Medical Reimbursement Claim Form

FMLA Questions and Answers

FMLA Employee Guide

FMLA Supervisor Guide

FMLA - Attending Physicians Report

FMLA - Employee Serious Health Condition (WH-380-E)

FMLA - Family Member's Serious Health condition (WH-380-F)

FMLA - Military Caregiver Leave - Current Service Member

FMLA - Military Caregiver Leave - Veteran Service Member

FMLA - Military Leave

FMLA Request Form

FMLA Notice of Rights

FMLA Policy

Families First Coronavirus Response Act Policy

Families First Coronavirus Response Act Request Form

2021 Holiday Schedule

         Microsoft Outlook - Email

ACH Deposit Form for Medicare B Reimbursement

Direct Deposit Form

Retiree Health Insurance Premium Form

Affirmative Action Plan

City of Racine Employee Handbook

City of Racine Safety Manual

Your Rights Under USERRA

The City of Racine partners with Cities and Villages Mutual Insurance Company (CVMIC) for a variety of training's. City 

employees may access these training's through CVMIC by visiting www.cvmic.com and entering your login information. If

you need your login information, please contact Human Resources at (262) 636-9175.

Employee First Report of Incident

Witness Statement

Supervisor Review of Injury or Illness

Authorization for Treatment, Disclosure of Medical Records and Payment for Worker's Compensation Injury

Beneficiary Designation Form

Emergency Contacts Form

Notice of Change in Vital Statistics Form

Retirement Notice Template