Filling Out Forms
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Employee Insurance Policies
Insurance Enrollment/Changes
All enrollment forms and/or change forms for health and dental insurance coverage are due to the Fiscal Office within 30 days of the event. Late notification may result in employees forfeiting their right to insurance coverage for themselves or dependents. It may also result in employees forfeiting any right to reimbursement due to possible over-payments. Contact Emily Vediz-Benefits Administrator in the Fiscal Office with any changes, (620) 724-6117, (620) 724-4196 Fax. Summary of Benefits and Coverage Blue Cross Blue Shield of Kansas Option 1 Option 2 Option 3 29 -100 Meaningful Access Taglines 0517.pdf (updated 2019) This notice has important information about your application or coverage through Blue Cross and Blue Shield of Kansas. Look for key dates in this notice. You may need to take action by certain deadlines to keep your health coverage or help with costs. You have the right to get this information and help in your language at no cost. Please call 1-800-432-3990. Advance Insurance Company of KS This document contains information relating to the life insurance policy provided by Advance Insurance Company of Kansas to Crawford County employees. COBRA This document contains information regarding your rights to continued group health care coverage. Certificate of Coverage Important Notice of Your Right to Documentation of Health Coverage Insurance Forms Miscellaneous forms for Blue Cross and Blue Shield of Kansas, MetLife, and Advance Life Insurance Company of Kansas. |
Shaking Hands
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