Forms
Ameriben: Coordination of Benefits (COB) Form
Flores and Associates: FSA Dependent Care Reimbursement Claim Form
Evidence of Insurability (EOI) Forms
- Unum and Cigna EOI forms must be mailed to each company and postmarked by November 16, 2012.
- Aetna EOI forms must be filled out and returned to the Benefits and Wellness office and must be received by 5 P.M. on November 16, 2012.
| Voluntary Life Insurance (Aetna) EOI |
| Short Term Disability (Cigna) EOI |
| Long Term Disability (Cigna) EOI |
| Long Term Care (Unum) EOI click here to request enrollment packet |
Tools and Resources
Advantage Plan Information
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Employee Information: |
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Plan Comparison Cost Estimator (Microsoft Excel required)
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Sworn Retiree Information: |
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Plan Comparison Cost Estimator (Microsoft Excel required)
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Other Helpful Information
Links to External Websites Tools
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www.MyAmeriben.com - Once logged in you can access your COB, WebMD Symptom Checker, Ask a Doctor, and Hospital Compare.
