Forms and Documents
Cigna Medical & Dental
Group #3333634
Medical Reimbursement Claim Form
Pharmacy Reimbursement Claim Form
Prescription Drug List Changes Effective 01.01.2021
3-Tier Pharmacy Value Prescription Drug
Cigna 90 Now - 90 Day Presciption Fill
Cigna 90 Now - Pharmacy Directory
Dental DHMO Reimbursement Claim Form
Dental DHMO Patient Charge Schedule
Vision Service Plan - VSP
Health Savings Account - HSA
Short Term Disability
Benefits Guide and Summary Plan Descriptions
Summary of Benefits and Coverage
Effective July 1, 2022-June 30, 2023
TSA Consulting Services 403(b), Roth 403(b), and 457(b)
Arizona State Retirement - ASRS
Long Term Disability -Employer #300040
LTD Claim Application - [Employee Claim]
Long Term Disability Employee Guide
Beneficiary Form - Online submission
Address/Name Change - Paper form
The Hartford
Group #681370
File A Claim - Claimant Statement
Life Insurance
Group #213993
Sun Life Certificate of Life Insurance Coverage
Sun Life Evidence of Insurability Form (online submission)
Sun Life Evidence of Insurability Form (paper form)
Sun Life Death Claim - Claimant Statement (paper form)
Conversion Notice (paper form)
Portability Notice (paper form)