Forms and Brochures

2019 It's Your Choice website

Health Insurance Application

2019 It's Your Choice Decision Guide

2019 Health Plan Map

2019 Health Plan Resource Page

Navitus Member Portal

Serve You - Prescription Mail Order Vendor

Sick Leave Escrow Application

Sick Leave Credit Conversion Program Brochure

2018 Health Insurance Information

2019 HSA Website

HSA Enrollment Application

HSA Contribution Change Form

Health Savings Account Brochure

Health Savings Account Participant Guide

HSA Beneficiary Designation

All HSA-related forms and brochures available on the TASC website

Life Insurance Application

State Group Life Insurance Beneficiary Designation Form (Used for both SGL and WRS accounts)

State Group Life Insurance Brochure/Plan Certificate

LifeSuite Brochure

Income Continuation Insurance Application

Income Continuation Insurance Brochure

VSP Vision Website

VSP Vision Application for 2019 coverage

VSP Vision Brochure

Delta Dental Website

Delta Dental PPO Application

Plan Summary

2019 Dental Plan Comparison Chart

Delta Dental Continuation/Retiree Form (employer section must be completed by agency)

AD&D Application

AD&D Plan Summary

Zurich Travel Assist Brochure

CyberScout Identity Theft Brochure

AD&D Beneficiary Designation Form

2019 ERA Website

Health Care FSA Application

Dependent Care FSA Application

Limited Purpose Health Care FSA Application

Parking and Transit Application

Change of Election Form

ERA Participant Guide

All ERA-related forms and brochures available on the TASC website

Full Enrollment Form

Quick Enrollment Form

Beneficiary Designation

Investment Planning Guide

For more information, see the WDC Website

Beneficiary Designation

Beneficiary Designation Alternate

Election to Participate in the Variable Fund

Election to Cancel Variable Fund Participation

Benefit Information Request

Edvest Informational Flyer

Edvest Enrollment Booklet

Payroll Contribution Form