Disability Income Protection

• Proposal Information
• Long-Term Disability Enrollment Form ( PDF)
• Long-Term Disability Premium Statement
• Short-Term Disability Premium Statement
• Long-Term Disability Claim Form
• Short Term Disability Claim Form
• Notice of Conversion Form
• Conversion Form
• Participation Agreement

Group Life Insurance

• Proposal Information
• Beneficiary Form
• Supplemental Life Enrollment Application
• Extended Employee Application
  • Medical Underwriting: HIPAA Release Authorization
• Notice of Conversion Privilege Form
• Conversion Form
• Claim Statement
• Disability Claim - Waiver of Premium
• Accidental Dismemberment Claim Form
• Accelerated Benefit Claim Statement
• Group Life Premium Statement
• Long-Term Disability Enrollment Form
• Surviving Family Claim Statement
• Supplemental Life Premium Statement
• Supplemental Life Premium Statement - Age Classifications

Opti-Vision Discount Vision Program

• Request a Proposal

Section 125/TABS/Flexible Benefit Plans

• Proposal Information
• Participation Agreement

Self-Funded Dental & Vision

• Proposal Form
• School Claims Service: Dental & Vision Forms
• SCS Online Forms Administration (login required)

Travel Accident Coverage

• Prudential Life Claim form
• Prudential Accidental Injury Claim form
• Administrator Option: BUSINESS TRAVEL ACCIDENT
  INSURANCE BENEFICIARY FORM
• Board Members: BUSINESS TRAVEL ACCIDENT INSURANCE
  BENEFICIARY FORM
• Board Member 24-Hour Enrollment/Beneficiary Form

Volunteer Risk Management Program

• Claim Form (Excel spreadsheet)