Dental

• Dental - Board of Regents MetLife Enrollment Form
• Dental - Board of Regents MetLife Change Form
• Dental - Board of Regents MetLife Claim Form
• Dental - Humana CompBenefits Access Claim Form
• Dental - Humana CompBenefits Access Enrollment Form
• Dental - Humana CompBenefits Access or PPO Change Form
• Dental - Humana CompBenefits Creditable Coverage Form
• Dental - Humana CompBenefits PPO Claim Form
• Dental - Humana CompBenefits PPO Enrollment Form

Disability

• Disability - Unum Long Term Disability Claim Form
• Disability - Unum Disability Authorization Form
• Disability - Unum Evidence of Insurability Form

Flexible Spending Account

• Flexible Spending Account - Change Form
• Flexible Spending Account - Debit Card Guide
• Flexible Spending Account - Dependent Day Care Automatic Reimbursement Form  
• Flexible Spending Account - Orthodontia Automatic Reimbursement Form
• Flexible Spending Account - Reimbursement Claim Form

Health Savings Account

• Health Savings Account - HSA Payroll Deduction Form

Leave of Absence

• Leave of Absence - FMLA Leave Request
• Leave of Absence - FMLA Medical Evaluation (Return to Work)
• Leave of Absence - Certification of Qualifying Exigency for Military Family Leave
• Leave of Absence - Certification of Serious Injury or Illness of Covered Service Member for Military Family Leave
• Leave of Absence - Certification of Health Care Provider for Family Member's Serious Health Condition
• Leave of Absence - Certification of Health Care Provider for Employee's Serious Health Condition
• Leave of Absence - Notice of Eligibility and Rights & Responsibilities
• Leave of Absence - Designation Notice

Life Insurance

• Life Insurance - Board of Regents CIGNA Life Insurance Enrollment/Evidence of Insurability Form
• Life Insurance - Board of Regents CIGNA Beneficiary Designation Form
• Life Insurance - Board of Regents CIGNA Conversion Form
• Life Insurance - Permanent Whole Life Claim Form
• Life Insurance - Unum Supplemental Life Beneficiary Designation Form
• Life Insurance - Unum Supplemental Life Evidence of Insurability Form
• Life Insurance - Unum Supplemental Life/AD&D Change/Cancellation Form
• Life Insurance - Unum Critical Illness Claim Form
• Life Insurance - Unum Conversion Form
• Life Insurance - Unum Portability Form
• Life Insurance - Unum Portability Rates
• Life Insurance - Unum Change Request Form for Additions and Cancellations

Medical

• Medical - Open Access POS Change Form
• Medical - Open Access POS Claim Form
• Medical - Open Access POS Enrollment Form
• Medical - BlueCross BlueShield International Claim Form
• Medical - BlueChoice HMO Emergency Claim Form
• Medical - BlueChoice HMO Enrollment Form
• Medical - BlueChoice HMO Change Form
• Medical - BlueChoice HMO Cancellation Form
• Medical - HSA Open Access POS Change Form
• Medical - HSA Open Access POS Claim Form
• Medical - HSA Open Access POS Enrollment Form
• Medical - Health Savings Account Payroll Deduction Form
• Medical - Kaiser HMO Enrollment and Change Form
• Medical - Tobacco Use Affidavit Form

Retirement

• Retirement - 403(b) Salary Reduction Agreement Form
• Retirement - 403(b) Salary Cancellation Form
• Retirement - 457(b) Deferred Compensation Agreement Form
• Retirement - 457(b) Cancellation Form
• Retirement - Georgia Defined Contribution Refund Form
• Retirement - Election Form
• Retirement - Optional Retirement Plan Quarterly Change Form
• Retirement - Teachers Retirement System Waiver (Over 60) Form
• Retirement - Teachers Retirement System Change Form
• Retirement - Teachers Retirement System Employment Verification for Returning Retiree Form
• Retirement - Teachers Retirement System Refund Application Form
• Retirement - Teachers Retirement System Release of Information Authorization Form

Sick and Vacation Leave

• Sick and Vacation Leave - Request Form

Vision

• Vision - Enrollment and Change Form

• Vision - Out-of-Network Claim Form

Open Enrollment

• 2011 Open Enrollment Submit Instructions