Forms and Important Information

2022 Narrated Provider Benefit Presentations & Webinars
2022
2022 General Enrollment Packet
2022 Summary of Benefits Booklet
2022 Change Request Form
2022 Change Beneficiary Form
2022 Medicare Summary of Benefits Booklet
2022 Medicare Comparison Summary
2022 Medicare Switch Enrollment Form
2022 Life Insurance Medical History Statement
2022 Domestic Partner Packet
2021
2021 Summary of Benefits Booklet
2021 Medicare Summary of Benefits Booklet
2021 General Enrollment Packet
2021 Medicare Plan Comparison Sheet
2021 Change Beneficiary Form
2021 Change Request Form
2021 Medicare Supplement Benefits Outline
2021 Express Scripts Formulary Link
2020/21 Service Credit Purchase Table
Advance Health Care Directive
Affidavit of Domestic Partnership
Life Insurance Medical History Statement
Medicare Switch Enrollment Form
2021 Express Scripts Formulary Link
Archive
2021 Narrated Provider Benefit Presentations
2020 Summary of Benefits Booklet
2020 Rate Sheet
2020 Medicare Plan Comparison Sheet
2020 Medicare Supplement Benefits Outline
Service Credit Purchase Table
2019 Summary of Benefits Booklet
2019 General Enrollment Packet
2019 Rate Sheet
2018 Switch Enrollment Packet Information
2017 Enrollment Packet
2017 Summary of Benefits Booklet
2018 Summary of Benefits Booklet