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Benefits Procedures and Forms

Benefits   Issue Date  MS Word Files   MS Excel Files   PDF Files   Web Pages 
2007 Open Enrollment Benefits Worksheet 2007-09-18      MS Excel Document   PDF Document    
HMO Health Plans Comparison Sheet 2006-12-13         PDF Document    
CSU Health Rate Premiums 2007-08-16          PDF Document   Web Page 
HCRA/DCRA Enrollment Form 2007-10-04          PDF Document    
DCRA/HCRA Reimbursement Account Claim Form and Instructions 2006-07-12    MS Word Document   MS Excel Document   PDF Document    
Dental Comparison Units 1,2,3,4,5,6,7,9 and C99's, Executives, MPPs and FERP Annuitants          PDF document    
Dental Comparison Unit 10 and Teaching Associates          pdf document    
Dental Comparison Units 8, Annuitants and Exempt Employees (except Teaching Associates)          pdf document    
Health Benefits Enrollment Worksheet 2007-12-13         pdf document    
PPO Health Plans Comparison Sheet 2006-12-13         PDF Document    
TSA Cancellation Form 2006-07-12          PDF Document    
TSA Establishment Form 2006-07-12          PDF Document    
TSA Salary Reduction Agreement 2008-02-08          PDF Document    
Vision Benefits [ Summary ] 2006-07-12             Web Page 
Vision Out-of-Network Reimbursement Claim Form 2008-02-08          PDF Document    
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If you have trouble accessing any of these documents, please contact the office whose form it is. For DAF office hours, locations and phone numbers, start here.