Forms

ENROLLMENT FORMS

• Air-Evac Application Form
• SHBP Disabled Dependent Continuation of Coverage

SHORT TERM DISABILITY

• AFLAC Forms Library
• AFLAC Short Term Disability Claim Form

LONG TERM DISABILITY

• Start a claim online use group number 68098-2LTD2011
• Voya Forms Library – Choose Disability
• Employee Claim Forms:
• Disability Income Insurance Claim – Employee
• Employer Claim Forms:
• Disability Income Insurance Claim – Employer
• Long Term Disability – Occupational Demands- Employer
• Physician Claim Forms:
• Attending Physician’s Statement of Impairment and Function
• LTD Privacy Notice – Voya

GROUP LIFE FORMS

OCHS GROUP LIFE

• EOI -Evidence of Insurability
• Notice of Death Form

OUT OF NETWORK VISION AND DENTAL

• Vision Claim Form – BCBS Out-of-Network
• Dental Claim Form

AFLAC– Accident & Cancer

• AFLAC Forms Library
  
• AFLAC Cancer Claim
• AFLAC Cancer Wellness Benefit Claim Form
• AFLAC Accident Claim
• AFLAC Accident Wellness Benefit Claim Form
• AFLAC Waiver of Premium when disabled

VOYA CRITICAL ILLNESS & HOSPITAL 

• Voya Claims Library for all current forms/needs
• Wellness Claim – Critical Illness or Hospital or File Wellness Online
  Use Group Number 68098-2CCI & Account Number 0001
  
  Portability for those employees leaving The School System
• Port Rates – Compass Port Form – Privacy Notice
  
  To file a Critical Illness Claim, include the Election Form from your most recent enrollment with the following claims:
• Employee Statement – Employer Form – Physicians Statement – Release Authorization

MEDCOM/FSA FORMS

• MedCom Forms Library – Pick the one you need!
• MedCom Flex Claim Form
• MedCom Dependent Day Care Receipt
• MedCom Flex Direct Deposit Form
• MedCom Flex Spouse Card Request Form
• Dependent Request
• MedCom Flex Family Status Change Form
• MedCom Flex Regular Recurring Expense Claim Form

INDIVIDUAL LIFE

• Individual Shenandoah Life Change Form (Includes Beneficiary Changes)
• Individual Shenandoah Life Lost Policy Form
• Individual Shenandoah Life Cash Surrender Form
• Trustmark Beneficiary Change Form or Service Form
• Unum Online E-Sign Policy Requests
• Unum Life Change Form (Includes Beneficiary Changes)
• Unum Life Application