Previous Year Benefits Information (2005)

Notice
HIPAA Privacy Notice

Publications
Guide to Reading An EOB
2005 Benefits & Enrollment Guide
2005 Humana $300 Deductible PPO Plan: 80/20 and 70/30 Options
2005 Humana $1000 Deductible PPO Plan: 80/20 and 70/30 Options
2005 Humana $3000 Deductible PPO Plan: 80/20 and 70/30 Options
Safeguard HMO Dental Plan
SafeGuard Indemnity Dental Plan
Spectera Vision Plan Benefit Plan
2005 Retiree Stand Alone Prescription Plan
Notice of Plan Change: Policy 642563-A
Notice of Plan Change: Policy 642563-B

Forms (PDF format, click here to download Adober Reader)
Humana Medical Claim
Humana Choice Care Physician Nomination Form
Safeguard Indemnity Dental Claim
Standard Life Insurance Conversion Request Form
Domestic Partner Affidavit
Termination of Domestic Partnership
Humana Mail Order Prescription Form
401(k) Retirement Savings Plan Beneficiary Designation Form
457 Deferred Compensation Plan Beneficiary Designation Form
Employees´ Retirement Fund (ERF) Beneficiary Designation Form

Web sites
HUMANA Insurance - PPO
Blue Cross Blue Shield - HMO
SafeGuard Dental Plans
Spectera Vision