2021 FORMS & DOCUMENTS

forms
Pre-65 forms
post-65 forms
Hardship fund

Open enrollment form

Copper Plan

IRS 13441A Form

ALL MEMBERS
2021 DOCUMENTS
Pre-65 DOCUMENTS

GENERAL INFORMATION

CARRIER MATERIALS

POST 65 DOCUMENTS

GENERAL INFORMATION

CARRIER MATERIALS

ENROLLMENT FORMS

ENROLLMENT FORMS / PRICING

Two forms are required for enrollment for The Hartford Plans

DENTAL

MISC DOCUMENTS

MISC DOCUMENTS

HEALTH SAVINGS ACCOUNT

HARDSHIP FUND

LIFE INSURANCE

HELPFUL TOOLS

dsra benefit trust documents

2021 FINANCIALS

SUMMARY PLAN DOCUMENT

TRUST AGREEMENT

QUARTERLY TRUST
FINANCIAL REPORTS

2010 FINANCIALS

2009 FINANCIALS

summary PLAN DOCUMENT

2020 FINANCIALS

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Benistar DSRA Benefit Trust Customer Service/Call Center

1-888-588-6682

DSRA Benefit Trust website  - 2020