Forms
- Alternate other health insurance (OHI) verification formDownload PDF
- Appeal request form and guideDownload PDF
- COBRA continuation coverage formDownload PDF
- Continuity of care request formDownload PDF
- Enrollment packetDownload PDF
- Extended eligibility applicationDownload PDF
- Life insurance beneficiary designation formDownload PDF
- Loss of time form and checklistDownload PDF
- Medical and vision claim formDownload PDF
- Non-union to union classification transferDownload PDF
- Plan 150 enrollment formDownload PDF
- Prescription refills by mail formDownload PDF
- Protected health information (PHI) release authorizationDownload PDF
- Retiree enrollment applicationDownload PDF
- Waiver of coverage for the Culinary Health Fund PlanDownload PDF