Other Forms
Other Forms
Other Forms
Medical Reimbursement & Dependent Day Claim Form (Updated 1/2022)
Flex deadline is every Friday. Reimbursements are payable the 2nd Thursday after deadline.Qualifying Event Matrix (updated 09/2024)
What benefits can be changed based on a qualifying event.Delta Dental Claim Form
Used to send your claim to Delta Dental when your provider is non-participating.Disability Claim - How to file a claim
AFLAC For disability dates 1/1/24 and after
Customer service 800-206-8826 available 1/2/2024
Short Term Disability Claim Form
The Standard Company 1-800-368-2859
Do not use after 12/31/23Long Term Disability Claim Form
The Standard Company 1-800-368-1135
Do not use after 12/31/23Cigna Claim Form
Used to send medical claims to Cigna.