Documents you should keep up to date on.
Medical and Benefit Forms
- Medical & Vision Claim Form
- Enrollment Form – Non-Medicare Retiree
- Enrollment Change Form
- Life-AD&D Enrollment/Change Form (SFFBT)Highlight
- Life-AD&D-LTD Enrollment/Change Form (WSCFF) Highlight
- Life-AD&D-LTD Medical History (WSCFF)
Plan Booklets and Policies
- Plan Booklet – Dental – 2022 (full review of benefits)-Kristi to send new 2024
- Life and Disability Insurance Policy through SFFBT Kristi is getting Jen new document)
- Plan Booklet-Group Long Term Disability Insurance (WSCFF policy)
Guides & Benefit Summaries
- Summary of Benefits and Coverage – Classic – 2024 (brief overview)
- Summary of Benefits and Coverage – Economy – 2024 (brief overview)
- Delta Dental PPO Benefit Plan Summary – Actives 2023
- Delta Dental Benefit Plan Summary – Retirees 2019
- Enrollment Guide Active 2024-Highlight
- Enrollment Guide Retiree 2024-Highlight
- Life ADD and Long Term Disability (WSCFF Guide)
- BPAS – VEBA – Enrollment Guide 2022
- BPAS – FAQ VEBA HRA (highlight)
Other
- Summary Annual Report – PYE 2022
- Home – Non Discrimination Notice-2020
- Home – Pin Request Dependent Web
- Pin Request Form
- Home Shared Admin and Website Email
- Notice of Creditable Coverage – 2023
- Premium Assistance – Medicaid & CHIP 2023
Important Links/Portals
- Delta
- Premera
- BPAS
- The Standard
- WPAS