Benefit Forms

Benefit Forms


 Benefit Forms

Health Plan Information: 

Medical Insurance Forms

Blue Cross Blue Shield Member Application for Payment Consideration

Blue Cross Blue Shield Online Visits (Formally Amwell)

Online Doctor Visits Information

FAQs about online visits

What is an online visit? 

Healthcare Bluebook - Transparency Tool

Arcadia Flexible Spending Forms- (Health FSA & Dependent care accounts)

Debit Card Flyer
Health Equity- Health Savings Account & Limited Purpose FSA

Vision Plan Information

Voluntary Benefits:

*NEW 2019* Nationwide Pet Insurance
Pet Insurance Benefit Video /Enrollment Page

My Pet Protection Plan 

Plan Coverage

Plan Summary

ESS Instructions

  • Member portal- You can use this to:
    • File a Claim
    • Update contact information
    • Check Claim Status
    • Review your policy

    *NEW 2019* CIGNA Information/Forms

    Cigna Discounts and Programs- No additional Cost! 

    Accident Insurance

    Critical Illness Insurance

    Hospital Indemedity Insurance 

    How to file a claim for- Accident, Hospital & Critical Illness


    Life Insurance

    AD&D - Accidental Death & Dismemberment Insurance 

    Short Term Disablity 

    Long Term Disablity 

    UNUM Information/ Forms 

    Life Insurance - Beneficiary Change Form
    Life Insurance - Evidence of Insurability Form
    UNUM Critical Illness Claim Form
    UNUM Critical Illness Health Screen Claim Form

    Retirement Plans:

    Empower (fka: Great West) 457 Forms  

    MERS Forms

    Other Information:

    Livingston County Flexible Benefits

    Tuition Reimbursement 

    2019 Open Enrollment