• Benefits Home Page
• Health
• Medical
• Dental
• Vision
• Life/Disability/Travel
• Life Insurance
• Disability
• Travel Assistance
• Retirement
• 401(k)
• Non-Qualified Plans
• Flex Reimbursement/EAP
• Flexible Spending
• Employee Assistance
• Wellness
• Forms
• Provider Links
• TeamHealth Home Page

Medical

• United Claim Form
• Caremark Mail Order Claim Form
• Caremark Claim Form
• Medicare D Notification - Creditable Coverage
• Medicare D Notification HDP - Non Creditable Coverage

Tobacco

• Non-Tobacco User Affidavit

Dental

• Delta Dental Claim Form

Vision

• EyeMed Vision Claim Form

Life Insurance

• Life Insurance Beneficiary
• Evidence of Insurability (EOI)

Disability

• File STD Claim Form
• Evidence of Insurability (EOI)

Travel Assistance

• Travel Assistance Brochure

401(k)/Retirement

• 401(k) Rollover Contribution Application
• SERP Enrollment Form
• QDRO
• Letter of Determination

Flexible Spending Account/HSA

• WageWorks Healthcare Spending Claim Form
• WageWorks Dependent Care Claim Form
• WageWorks Eligible Expense Guide
• OptumHealth Bank Health Savings Account (HSA) Application

Employee Assistance Programs

• Care24 Flyer
• Unum EAP Brochure

Wellness

• Healthy Living Initiative Tracking
• Tobacco Cessation Prescription Reimbursement
• Tobacco Cessation Course Completion
• BMI Tracking Summary
• Weight Loss Program Reimbursement
• Weight Loss Goal Completion
• Health Coaching Application
• Wellness Exam Co-Pay Reimbursement

Qualifying Events

• Qualifying Event Notification Form