Important! Submit ALL forms to Bev Fitts in AF Gray.
Kaiser Medical
- Kaiser Base Summary of Benefits
- Kaiser Buy Up Summary of Benefits
- A Smarter Approach to Health
- Information on Added Services
- Enrollment Form
- Member Cancellation Coverage Form
- Privacy Statement
- Waiver Card
- Listing of providers and locations near you
Providence Medical
Willamette Dental
- Dental Benefits Summary
- Provider List by Location
- Enrollment Form
- Willamette Dental Online Forms Library
Principal Dental
- Dental Benefits Summary
- eService Brochure
- Enrollment Form
- Coverage Change Form
- How to Access Dental Providers
Cafeteria Plan
- Summary Plan Description
- Enrollment and Declination Form
- Benefit Analysis Worksheet
- Request for Reimbursement Form
- Change Request Form
- Change of Status Form
- EFT Direct Deposit Form
- Web Instructions Flyer
Please also visit the FAQ Page for answers to Frequently Asked Questions.
Long Term Disability and Group Life
- Enrollment Form for Group Coverages
- Long Term Disability (LTD) Benefit Summary
- Group Term Life / AD&D Benefit Summary
- Beneficiary Change Form
- Privacy Notice
- Life Insurance Claim Form
- Disability Claim Form
- Identity Theft Consultation
- Employee Assistance Program
- Employee Assistance Program Q and A
- Legal Services
Kaiser/Providence Base Summary of Benefits