Benefits Online Forms

Important: Caremark Prescription Drug Claim Form Has Changed
Your prescribing physician's information is now required.
See Step 2 of the new form (also available below) for updated submission requirements.

pencilAnnuity Plan Beneficiary Designation
pencilCaremark Prescription Drug Claim
pencilCatastrophic Benefit Claim (Active members only)
pencilChange of Address
pencilDental Claim
pencilDependent Life Insurance Enrollment
pencilDependent Student Certification (Retirees only)
pencilEnrollment (Active members only)
pencilEnrollment (Retirees only)
pencilHearing Aid
pencilHIPAA Authorization
pencilLife Insurance Beneficiary Designation
pencilMedical Equipment Benefit
pencilVision Benefit - Direct Reimbursement Claim Form
pencilReimbursement for Real Estate Legal Services