You are in TEST MODE
To exit 'test mode', disable the testing trigger code found in guideroot panel.

Your decision to resign or retire is significant. You are encouraged to review information on how this decision will impact your benefits with Hennepin County. Information can be found by visiting Benefits summary


Employee name search  

Please include a minimum of 2 or 3 letters of the beginning of the first name and last name.  Search is 'case-sensitive'.

First name

Last name

Email address

Department


Employee information

Home address

To change your address on the county payroll system, log into APEX and follow directions.

Click Yes to add an alternate supervisor, who will be notified of your work accommodation request.  The supervisor that was automatically filled in is your supervisor as listed in Apex.



Supervisor name search  

Please include a minimum of 2 or 3 letters of the beginning of the first name and last name.  Search is 'case-sensitive'.

First name

Last name

Email address

Department



Alternate supervisor search  

Case sensitive (e.g. upper case first letter).  Please enter at minimum the first two letters of both first and last name and press Search

First name

Last name

Email address

Department


Retirement

Developers:  This field reformats the retirement date - so it formats correctly in the emails sent to payroll contact and approving supervisor(s).    Currently NOT WORKING as needed. (goldplating)

Things you need to know about retirement:

  • The last day worked and the retirement date CANNOT be different.
  • Retirement date cannot be changed once this form is submitted.

NOTE: Any remaining balances in vacation or PTO will be paid in severance, depending on your participation in the Health Care Savings Plan (HCSP).

Resignation

Things you need to know about resignation:

  • Your resignation date is your last day worked.
  • Unused vacation/PTO hours will be paid out.

NOTE: Any vacation/PTO balances will be paid in severance, depending on your participation in the Health Care Savings Plan (HCSP).

Complete this form if you are age 50 or older

Developers:  In order to get the 'preferred phone number' on the left to format correctly - I had to remove the 'max character' property setting.  This field shows what it formats to if we leave the max char set.

Last day on county payroll - must be a scheduled work day

After completing this form, you will receive a letter from the Benefits Division detailing which current benefits you can continue and their cost after retirement. Most benefits (health, dental, vision, life insurance) end on the last day of the month of your retirement date.

Who is eligible for the Early Retiree Health Insurance Program (ERHIP)?

  • Non-union regular employees or unclassified employees who were hired or rehired on or before 1/1/2007
  • Elected officials who took office on or before 1/1/2007
  • Union regular employees who did not opt out of ERHIP and were hired or rehired on or before 1/1/2008
  • I am at least age 55 at the time of termination and have 20 years of county service.
  • I am at least age 62 but less than 63 at the time of termination and have 15 years of county service.
  • I am at least age 63 but less than 64 at the time of termination and have 14 years of county service.
  • I am at least age 64 but less than 65 at the time of termination and have 13 years of county service

You must email proof from your pension plan that you qualify for and have applied for a full pension or you will not receive the county contribution: HR.Benefits@hennepin.us

    You must email proof from your pension plan that you qualify for and have applied for a full pension or you will not receive the county contribution: HR.Benefits@hennepin.us

      Your department may contact you with questions about the resignation or retirement date you provide.

      If I have any questions regarding how my resignation or retirement date will impact the benefits for which I am eligible, I understand that I must contact the Human Resources Service Center via email HR.ServiceCenter@hennepin.us or phone: 612-348-7855.

      By signing this Resignation or Retirement Notice, I understand that Hennepin County will process my separation of employment as indicated above.

      Some specific browsers or devices may not work properly with the signature field. If you have issues, please try another device.

      Developers:  This field reformats the retirement date - so it formats correctly in the emails sent to payroll contact and approving supervisor(s). 

      Supervisor

      Please review the information on this form and sign below.

      Some specific browsers or devices may not work properly with the signature field. If you have issues, please try another device.

      This is a simple check to make sure who is getting the emails - in test mode.  It will not overwrite the supervisor name (above) - or the payroll contact name in the email(s).  Changing this value does nothing to the test.  If this email is incorrect - then we need to change the email addresses manually in the hidden panel.

      Hidden fields

      This sets the AF to 'test' mode - when the code in the guideroot panel is enabled.  Function here is to replace leader email addresses with the employee email address used at the beginning of the form (assuming the person testing is using their own employee information to test).


      FDM stage(s)

      This is used to control when the form stage value changes.  We only want the form stage value to change at the INITIALIZE of the form - NOT when the user is updating data

      • No default value
      • If null, formstage is ready to fire render code
      • Once the GET service is complete (DB Search ID), this value is set to "0".  Currently, nothing fires if this value = 0.
      • Value is set to "1" (Ready to SUBMIT), after the UPDATE service is finished.
      • Once the user SUBMITS, the value is nulled.  
      • This value is not saved in the DB

      Form stage(s)

      Form stage:  this component controls what the user sees - when compared to the approve/deny process.  

      For example: Intitialize - this is a new form, that has not been submited.

      • Employee sign date - controls "Waiting for Supervisor"
      • Supervisor sign date - controls "Complete"

      This switch stops the form from being 'resubmitted' after it has been completed and signed.

      Takes its value directly from db.table



      Alternative supervisor information


      Supervisor information

      APEX search on value commit.

      Change this email if you want the test emails to be sent somewhere other than the supervisor.  Note: changing the email address may cause the form to search APEX for new results.  This is okay.


      Assigned supervisor

      Change this email if you want the test emails to be sent somewhere other than the assigned supervisor (supervisor or the alternate - if chosen).  


      HR contact information (not used on form - yet)

      This returns EID from the apex_newvw_prd used in the FDM. 

      This returns last namefirst name from the apex_newvw_prd used in the FDM.


      Payroll contact information

      1. This returns last namefirst name from the apex_newvw_prd used in the FDM.

      2. Use the value from the search (1) and use a new APEX search on value commit

      This returns last name, first name from the apex_newvw_prd used in the FDM.

      Change this email if you want the test emails to be sent somewhere other than the payroll contact.

      Old and Busted

      Worn out, used up, overplayed, and/or cliched to the point of monotony. The opposite of new hotness.

      set in AdobeShare\properties\REQUEST_properties.xml

      set in AdobeShare\properties\REQUEST_properties.xml