Open Enrollment Information

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The Document Center provides easy access to public documents. Click on one of the categories below to see related documents or use the search function.

Categories always sorted by seq (sub-categories sorted within each category)
Documents sorted by SEQ in Ascending Order within category

Medical, Dental, & Vision11 documents

  • Community Blue (CB3) Plan Summary.PDF
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  • Coordination of Benefits Form.pdf
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  • Dental Buy-up Plan Summary.PDF
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  • Dental Core Plan Summary.PDF
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  • Dependent Child Affidavit.pdf
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  • Dependent Spouse Affidavit.pdf
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  • Flexible Blue (FB3) Plan Summary.pdf
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  • Open Enrollment Guide.pdf
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  • Simply Blue (SB3) Dual Family Plan Summary.pdf
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  • Simply Blue (SB3) Single Plan Summary.pdf
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  • VSP Vision Plan Summary.PDF
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CIGNA10 documents

  • 2013 Performance Dashboard.pdf
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  • Accident Enrollment Form.pdf
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  • Accident Summary Rate Sheet.pdf
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  • AD&D Rate Sheet.pdf
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  • Dependent Child Affidavit.pdf
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  • Critical Illness Enrollment Form.pdf
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  • Critical Illness Summary Rate Sheet.pdf
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  • Evidence of Insurability.pdf
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  • Life - AD&D Enrollment Form.pdf
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  • Life Rate Sheet.pdf
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401K5 documents

  • 2013 Performance Dashboard.pdf
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  • 401(k) Midwest Beneficiary Form.pdf
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  • 401(k) Midwest Change Form.pdf
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  • 401(k) Midwest Initial Enrollment Form.pdf
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  • 401(k) Midwest Rollover Contribution Form.pdf
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