FORMS ARE FOR FAMILY STATUS CHANGES ONLY
If you are a New Hire you must log into Lawson ESS (Employee Self Service link) to elect your benefits.
Completed forms along with supporting documentation of the event must be received with 31 calendar days of the family status change. IMPORTANT: If your 31st day falls on a weekend or holiday, your forms must be received in the Risk Management & Employee Benefits Office by the last working day prior to your 31st day.
All forms are fillable and in alphabetical order by type of benefit. Open in Chrome.
Cafeteria (Section 125) This form is mandatory and required for all changes.
Cancer Insurance- Allstate
Catastrophic Sick Leave Bank (CSLB)
Dental Insurance- Delta Dental
Disability Insurance - The Hartford
Health Flexible Spending / Dependant Care (FSA)- NBS
Health Insurance - BCBS
Health Savings Account (HSA)- HSA Bank
Hospital Indemnity (HIB)
Life Insurance- (Basic/Group Term / Whole Life)- UNUM
TRS Beneficiary Form
Vision Insurance- Avesis