HomeMy WebLinkAbout*Other - Human ResourcesGrant County
_� �rf � `' Department of Human Resources
March 12, 2024
Re: Unpaid Self -Pay Insurance Premiums — Rosario Xochicali Cortez
Rosario Xochicali Cortez is a former Grant County employee who worked as a Peer Support
Specialist with Renew from September 19, 2022, through January 22, 2024, when she voluntarily
resigned for personal reasons.
While employed with Grant County Rosario moved into leave without pay status during pay periods
11/17/2023,12/15/2023,12/29/20231 01/12/2024, 01126/2024, and 02/09/2024.
Rosario was sent self -pay premium notices on 11/17/2023, 12/15/2023, 01/02/2024, 01/12/2024,
and 01/26/2024, with a Final Notice mailed on 02/12/2024. Rosario owes the health plan $348.84
in unpaid leave without pay premium for medical as well as voluntary benefits.
Laurissa Perez
Benefits & Payroll Specialist
Board Action on Employee Request: Forward to Auditor's Office for collections or for,
amount due ($348.84) for unpaid pay periods 1. 1/ 17/2023, 12/15/2023, 12/29/2023.) 01/12/20241
01/2-6/2024, and 02/09/2024.
.,forgive debt 7 send forward to Auditor for collection
�in d- -ter, v fi-a 1 r
Danny E'/Stone, Vice Chair Date of'Action
Rob Jori; Ez'rnmis'sioner
Grant r
County Human Resources — PO BOX 37 — 35 C Street NW, Ephrata, WA 98823 — (509) TD4-2011