Non-Affiliated Support Staff

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Instructions For New Members
General Benefit Information Sheet
Benefits for Non-Affiliated Support Staff

     Medical Insurance
          Priority Health POS 100% Medical Summary
          Priority Health POS 80% Medical Summary
          Important Priority Health Rx Information
          Priority Health Enrollment Form
          Priority Health Change Form
          Priority Health Member Reimbursement Claim Form
          Mail Order Rx Form
               -Contact Fringe Benefits at 933-1720

     Cash in Lieu of Medical Insurance
          Enrollment Form
          Daycare Monthly CIL Information
               -Day Care Positions Memo
               -Child Care List

     Optional Dental Insurance
          SET SEG Dental Summary
          SET SEG Dental Enrollment
          SET SEG Dental Claim Form

     Optional Vision Insurance
          SET SEG Vision Summary
          SET SEG Vision Enrollment
          SET SEG Vision Claim Form

     Life Insurance
          SET/SEG Life Insurance Enrollment Form

     Reimbursement Accounts
          BASIC Reimbursement Claim Form