Enrollment

New Employee or Eligible for a change in benefits?  Enroll now!

how to log in and use self-service

Forms

  • Benefits Authorizations
  • Influenza Vaccine Reimbursement Form
  • Vision

  • Davis Vision Claim form
  • Cigna/NY Life [accident, hospital care, Life, AD&D, Short and Long Term Disability]


    Dependent Affidavits [for dependents on your plan]

    Health Savings Account [for High Deductible Plan]

    HIPAA Release

    Retirement Plan [for voluntary contributions]