Forms & Documents

Enrollment/Waiver Forms

To download a file right click on the "Download File" link and select either "Save Link As..." or "Save Target As...".

Dental Waiver Form

Last Updated: Feb 24, 2016

Employee Health Enrollment Form

Last Updated: Feb 15, 2017

Employee Life Insurance Form

Last Updated: Mar 20, 2018

This notice only applies to employers with 20 or more employees and that are subject to Federal Rules & Regulations regarding COBRA.

Last Updated: Jul 9, 2021

Life Waiver Form

Last Updated: Feb 24, 2016

Medical Waiver Form

Last Updated: Mar 20, 2018

Notice of Open Enrollment and Special Enrollment

Last Updated: Oct 6, 2015

Report Employee Termination Form

Last Updated: Oct 6, 2015

Spouse Business Statement

Last Updated: Aug 22, 2017