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Human Resources Files
Health Benefits Information/Forms
 NameCreatedAction
AFLAC_SRA.pdf
Flexible Spending Account
12/13/2016
Calculation_Charts_2017.pdf
Use this worksheet and charts to calculate your combined Health Benefit Contribution
1/18/2017
COBRA Vision rates_16.17.18.pdf
Rates for vision benefits under COBRA
5/30/2017
COBRA Vision rates_1617.pdf6/13/2016
DELTA DENTAL BENEFITS SUMMARY.pdf12/13/2016
Delta Dental Fillable.pdf
Delta Dental Enroll/Change Form
5/31/2017
SEHBP_App_HA-0890-0816.pdf
Enrollment Form (must be printed on legal size paper)
11/7/2016
Student_Documentation_Form.pdf
Delta Dental form to be completed annually and submitted directly to Delta Dental for dependents who are full-time college students.
10/25/2016
VSP BENEFITS SUMMARY.pdf12/13/2016
VSP_1617.pdf
Enrollment Form
12/16/2016
Waiver Form.pdf6/13/2016
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