Forms

Many of these forms are in the .pdf file format. To read and print them you may need to download the latest version of Adobe® Acrobat® Reader (free) from the Adobe site.

All forms must be printed, completed and signed before submission to the Human Resources Department. Electronic submission of forms is not available at this time.

Enrollment Form 2016	Group Disability Phone Claim Instructions- CIGNA
Group Change of Beneficiary Form The Hartford	LTD Claim Form- Cigna
STD Paper Claim Form- CIGNA	STD Evidence of Insurability Form - CIGNA
Group Life Claim Form- MetLife - The Hartford	LTD Evidence of Insurability Form - CIGNA
Group Life Conversion Form - MetLife - The Hartford
Group Life Portability Application - MetLife - The Hartford	FSA MedCom Claim Form
Group Life Waiver of Premium - MetLife The Hartford	FSA MedCom In Home Daycare Provider Receipt
Group Life Claimants Affidavit - MetLife
Group Life Consumer Privacy Notice - MetLife	Vision Out of Network Claim Form - EyeMed
Evidence of Insurability - The Hartford
Claim Form - Delta Dental	AFLAC Forms Library
Unum Life Service Form - English Spanish	Accident Wellness Form - Aflac
Life Claim Form - Unum	Cancer Wellness Form - Aflac
Unum Life Application	Hospital Indemnity Wellness Form - Aflac