North Carolina Innovations Waiver

NC Innovations Employer Packet Form 2678 Form SS-4 GEN-58 Innovations Employer Agreement NC Employee Termination Form Authorization to Obtain PHI Information Form Withdrawal to Obtain PHI Information Form NC Client and Employer Change of Information Form NC Dept. of Commerce POA SAMPLE NC Dept. of Commerce POA

NC Innovations Employee Packet Form I-9 Form NC-4 Form NC-4EZ Form W-4 HR Profile Background Check EVV Live-In Caregiver Attestation NC Innovations Pay Selection and Direct Deposit Form NC Innovations Employee Change Information Form NC Vaya Hep B Form

NC Innovations Overtime Request Form NC Innovations Employee Rate Form NC MCO 2025-2026 Payroll Schedule NC Trillium 2025-2026 Payroll Schedule

NC Bonus and Reimbursement Request Guide Common Terms Acronyms and Abbreviations for the NC Innovations FAQ Document for Self-Directed Services for Employer of Record (EOR) on the NC Innovations Waiver Employee Background Check Payment Request Form Alliance Max Pay Rates Trillium Max Pay Rates Partners Max Pay Rates Vaya Max Pay Rates

NC Vendor EFT Form NC Online Purchase Request Form NC Vendor Payment Form W-9 Accrued Funds Payment Request Form

MCO Referral Form NC Client termination form Case Worker DCI Access Request