Forms
Here you can find Claim Forms, Annual Wellness Benefit Forms, Flex Spending Reimbursement Form, & Dependent Care Account Forms. If you can't find what you are looking for please contact Lucy at Central Office.
AFLAC Critical Illness Claim Form
AFLAC Hospital Indemnity Claim Form
AFLAC Wellness Benefit Claim Form
Guardian Critical Illness Claim Form
Guardian Hospital Indemnity Claim Form
Guardian Wellness Benefit Claim Form
Mutual of Omaha Evidence of Insurability (EOI)
Mutual of Omaha Life Insurance Death Claim Form
Mutual of Omaha Short Term Disability Form
Cafeteria Plan (Flex Spending)
Dependent Care Account Change Form
Dependent Care Eligible and Ineligible Expenses
Dependent Care Reimbursement Form
FSA Eligible and Ineligible Expenses
USD 394 Pre-School/Daycare Salary Deduction Authorization
Butler County Interlocal Pre-School/Daycare Salary Deduction Authorization