Enroll in Yurcor Employer of Record

If you have been invited to work for a business or staffing supplier through Yurcor Employer of Record, please follow the instructions provided by Yurcor or your recruiting contact. Otherwise, to enroll in the Yurcor Employer of Record service for individual consultants, follow these steps:

1. Call 800.445.5775 and review the service with Yurcor.
2. Download the enrollment forms, sign, and fax them back to 561.278.1408.
   Yurcor must receive all forms to activate your account. Complete all forms whether or not you are enrolling for benefits.
3. Start instructions will be emailed to you as soon as your enrollment paperwork is completed and Yurcor executes an agreement with your client.

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Enrollment Forms

		Provider		Program		Form
		Yurcor		Employer of Record		Checklist
		Yurcor		Employer of Record		Agreement
		Yurcor		Employer of Record		W-4 State W-4*
		Yurcor		Employer of Record		I-9
		Yurcor		Employer of Record		Direct Deposit
		Yurcor		Employer of Record		COBRA (Ref only)
		Cigna PPO		Health		Enroll  Decline
		Guardian		Dental, Life, Disability		Enroll/Decline
		Spectera		Vision		Enroll/Decline
		Fidelity Investments		401(k) Retirement		Enroll
		Alliance Capital		529 College Savings		Call

* Employees living/working in the following states are required to complete a State Withholding Certificate (State W-4). In other states, the Federal W-4 will continue to be used for state tax calculation purposes.
State W-4: | Washington DC | Georgia | Hawaii | Indiana | Iowa | Kentucky | Louisiana | Maryland | Michigan | Missouri | North Carolina | Ohio |

Benefits

		Program		Provider		Description
		Health		Cigna PPO		Std  High  Doctor Lookup
		Dental		Guardian PPO		Plan
		Vision		Spectera		Plan  Contacts Covered
		Life		Guardian		$25,000 Term Life
		Long-Term Disability		Guardian		60% of Salary
		401(k) Retirement		Fidelity Investments		Fund Description | SPD
		529 College Savings		Alliance Capital		Plan  News
		iPay Statements		ADP		Instructions

Premiums

Effective through May 31, 2009

		Program		Employee		Employee + One		Employee & Children		Family
		Health - Std		$ 411.10		$ 801.65		$ 1,188.08		$ 1,188.08
		Health - High		536.24		1045.67		1,549.74		1,549.74
		Dental		39.88		*85.33		78.06		123.52
		Vision		9.75		14.79		25.99		25.99
		Life		Free		-		-		-
		LT Disability		Free		-		-		-