The following are descriptions of summary plans:

• Blue Care PPO 250 Health (Now PPO 150 deductible)
• Blue Care PPO 500 Health (Now PPO 300 deductible)
• Vision Benefits of America
• Defined Contribution Retirement Plan
• Tax Deferred Annuity Plan GRSA

• Summary of Benefit Coverage for 2013-2014 (PPO 300)
• Summary of Benefit Coverage for 2013-2014 (PPO 150)

2013-2014 Benefit Book	2012-2013 Benefit Book

You may also click here to view a printable, pdf version of our 2012-2013 Benefit Book.

Please print our forms double-sided whenever possible.

Creative Benefits Forms

Creative Benefits Information

Universal Enrollment form

Blue Cross Authorization Form

Other miscellaneous forms are as follows:

Medical Forms

• Medical Insurance Enrollment and Change Form (Blue Cross PPO)

Vision Forms

• Vision Benefits of America Enrollment and Change Form

Dental Forms

• Delta Dental Enrollment and Change Form

Life Insurance

• Cigna Insurance Enrollment and Change Form
• Evidence of Insurability Form for Additional Life Insurance (For printing on 8.5 x 14 legal paper)
• Evidence of Insurability Form for Additional Life Insurance (For printing on 8.5 x 11 standard paper)

Thinking about Retiring?

Information to help you make the right decisions when the time is right for you

• "Aging Gracefully & Retiring Well"

For more benefit information, you can visit these benefit websites: