Action: To Add a spouse to medical/dental/vision/optional life insurance/optional AD&D effective the date of marriage.
Forms » Choices Enrollment Form
- Optional Health Care Reimbursement Account
Action: To start account, or increase dollar amount of election; new or increased amount can only be used after the date of marriage.
Forms » Change of Status | Election Form & Compensation Reduction Agreement (In office pick-up)
Action:You may wish to reassign beneficiary status for the following:
Basic Life/AD&D » use the reverse side of the Choices Enrollment (In office pick-up).
Final Salary Payout »
PERS Enrollment Card (In office pick-up)
Action: Change number of exemptions.
Forms » W4
We've got the answers to your questions concerning, Insurance Group Numbers, Care Provider Networks, Coverage ID Cards, and more. Please visit the Quick Questions site.
For additional information or assistance regarding all benefits, please contact: