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Enrolling when newly eligible in November 2016

​Post-Open Enrollment Corrections

Active Employee Correcting Errors Made During Open Enrollment
COBRA Correcting Errors Made During Open Enrollment 
Retiree Correcting Errors Made During Open Enrollment
Self-pay Correcting Errors Made During Open Enrollment
​FSA Correcting Errors Made During Open Enrollment

​2017 Enrollment

Employee Core and Optional
Commuter Account
Oregon Flexible Spending Account  - for same-sex domestic partners by registered certificate
Long-term Care Insurance
Covering Others
Affidavit of Dependency
Affidavit of Domestic Partnership
Grandchild by Affidavit
Domestic Partner for Tax Status
Domestic Partnership Termination
Midyear Change
Midyear Tobacco-use Change
Flexible Spending Account
Healthcare FSA Prepay Request
Qualified Reservist Distribution Request
Life & Disability Insurance
Transfer Premium Payment
Disability Insurance Claims Packet (pdf)
Life Insurance Claims Packet (pdf)
Medical History Statement (pdf)
Medical History Statement Online
Optional Life Insurance Portability (pdf)
Retiree Life Conversion Packet (pdf)
Retiree Life Insurance Application (pdf)
Retiree Life Insurance Termination
MEDEX Travel Assist Program
Long Term Care Insurance
UNUM long term care insurance coverage
Long Term Care Continuation Form
Transfer Premium Payment
Other Forms
Beneficiary Designation
CDL Exam Eligibility Voucher
Flexible Spending Account Claims
VSP Reimbursement