Fiscal Employer Agent (Fea): Enrollment Process

01. Submission of Participant Enrollment and Employee Packets for Department Approval. The provider must submit the following for participant enrollment and employee packets to the Department for approval. (3-17-22) a. The participant enrollment packet must include: (3-17-22) i. FEA authorization form; (7-1-25) ii. Employer Appointment of Agent - IRS Form; (3-17-22) iii. Tax Information Form; and (3-17-22) iv. Employer information including; (7-1-25) (1) Instructions for completing forms; (3-17-22) (2) Payroll schedule, including deadlines for submission of time cards; (3-17-22) (3) Sample employment agreements; (3-17-22) (4) Sample Request for Vendor Payment form; (3-17-22) (5) Sample independent provider agreement; and (3-17-22) (6) Other sample employment agreements as needed. (3-17-22) b. The employee enrollment packet must contain: (3-17-22) i. Employee Information Form; (3-17-22) ii. I-9 Employment Eligibility Form; (3-17-22) iii. W-4 Employee Withholding Allowance Certificate; (3-17-22) iv. Pay selection agreement; (3-17-22) v. Direct deposit authorization (optional); and (7-1-25) vi. Sample time sheets and instructions for completion. (7-1-25) 02. Distribution of Participant Enrollment and Employee Packets to Participant afte r Department Approval. The provider must distribute Department-approved participant enrollment packets an d employment packets to the participant within two (2) business days after the participant requests the packets. (3-17-22) a. To enroll a participant, the provider must: (3-17-22) i. Enroll the participant within two (2) business days of receipt of completed paperwork; and (3-17-22) ii. Log and maintain an electronic record of all enrollment paperwork, which includes participant SS P cost and authorization sheets. (7-1-25) b. To enroll an employee, the provider must: (3-17-22) i. Enroll the employee within two (2) business days of receipt of completed paperwork; and (3-17-22) ii. Log and maintain an electronic record of all the employee’s paperwork that includes th e employment agreements. (3-17-22)