Forms

Vision

Cigna [accident, supplemental life insurance, long term disability]

• Cigna Accidental Injury Wellness Claim Form
• Cigna Accidental Injury: How to Submit a Claim
• Cigna Accidental Injury Claim Form
• Beneficiary Designation Form
• NY Life Basic and Supplemental Life and Accidental Death & Dismemberment (AD &D) Claim Form
• NY Life Short Term Disability Claim Form
• NY Life Long Term Disability Claim Form

Dependent Affidavits [for dependents on your plan]

• Affidavit of Marriage
• Domestic Partner Packet

Health Savings Account [for High Deductible Plan]

• HSA Salary Reduction Agreement

HIPAA Release

• IBC Authorization for Disclosure of Health Information
• Health Advocate Authorization form

Retirement Plan [for voluntary contributions]

• Salary Reduction Agreement
• Salary Reduction Catch-Up