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Post Open Enrollment for 2016 Benefits

Correction: Active Employee Core and Optional Benefits

Correction: 2016 Flexible Spending Accounts

Correction: 2016 Oregon Flexible Spending Account- only for same-sex individuals with Registered Certificate of Domestic Partnership

Correction: Retiree Plan Change

Correction: Self-Pay

Correction: COBRA 

2016 Enrollment​

Employee Core and Optional
Commuter Account
Oregon Flexible Spending Account - only for same-sex individuals with Registered Certificate of Domestic Partnership
Long-term Care Insurance
Covering Others
Affidavit of Dependency
Affidavit of Domestic Partners
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

Health Assessment Exemption

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