On this site you may access forms which are available to be viewed and printed. To access any of the following forms, click on the form you are interested in, and then use the print feature in the application it is displayed in. To view PDF files you need to get Adobe Acrobat Reader.

2008-09 Benefit Enrollment

Our annual open enrollment time has begun. All forms are due in the Human Resources office no later than June 6, 2008.

Medical

Medical Insurance Premium Summary

Contact HR to make ANY change in your health insurance enrollment (i.e. plan, level or family members covered).

Reimbursement Election Form for Plan C or HDHP Employee Only Coverage

Medical Insurance Waiver Form

Dental/Vision

Dental/Vision Premiums

Contact HR to make ANY change to your dental/vision enrollment.

Coast to Coast

Plan Summary

Enrollment Form

Provider Directory

Tax Saver 125 - Flex Spending

Information Document

Enrollment Form

Remember enrollment materials are due in HR no later than June 6th. Please contact Kristi Jones, Tina Kyser or Mimi Bartley with any questions.

 

Medical

Provider Directories

Mail Order Prescription Form

Dental

Group Dental Claim Form

Flexible Spending

Flexible Spending Accounts Reimbursement Request (1 of 2)

Flexible Spending Accounts Reimbursement Request (2 of 2)

Vision (For non-participating doctors)

Vision claim forms

Payroll

Direct Deposit

Tax Forms

Federal W-4

Iowa W-4