AFLAC
    • AFLAC Cancellation Form
    • AFLAC Supplemental Accident and Sickness Insurance Selection Form

AZ State Retirement (ASRS) Forms
    • ASRS Beneficiary Form
    • ASRS Address/Name Change Form

Dental Claim Forms
    • United Concordia Claim Form

Flexible Spending Account Forms
    • Flexbenefits Open Enrollment Form
    • UnitedHealthcare Flexbenefits Health and Dependent Care Claim Form

Health/Dental Insurance Forms
    • Employee Benefits Enrollment & Change Form
      Use this form to enroll in or make changes to your District Benefits at open enrollment or for a qualifying event.

HIPAA Privacy Forms
    • HIPAA Privacy Notice
    • HIPAA Privacy PHI Authorization Form

Life Insurance Forms
    • Beneficiary Designation/Change Form
    • Supplemental Life Insurance Enrollment Kit

Long Term Disability (LTD) Forms
    • Long Term Disability Application
    • Long Term Disability Income Plan

Medical Claim Forms
    • United Healthcare Claim Form
    • Medco Rx Claim Form
    • Medco Mail Order Form
    • Medicare Part D Notice of Creditable Coverage

Short Term Disability (STD) Forms (Enter information on line)
    • Summary of Benefits
    • Short Term Disability Enrollment Form
    • Short Term Disability Claim Form

United Pet Care (UPC) Forms
    • UPC Member Change Form (Enter information on line)