FORMS & DOCUMENTS

Medical form with stethoscope
forms
Pre-65 DOCUMENTS

GENERAL INFORMATION

2023 Guide to Benefits Cover Letter
POST 65 DOCUMENTS

GENERAL INFORMATION

2023 DSRABT COVER LETTER
Hardship fund
2022 Pre-65 forms
2022 post-65 forms
ALL MEMBERS
Pre-65 DOCUMENTS

GENERAL INFORMATION

POST 65 DOCUMENTS

GENERAL INFORMATION

CARRIER MATERIALS

VISION

DENTAL

CARRIER MATERIALS

ENROLLMENT FORMS

Two forms are required for enrollment for The Hartford Plans

MISC DOCUMENTS

MISC DOCUMENTS

HEALTH SAVINGS ACCOUNT

HARDSHIP FUND

HELPFUL TOOLS

LIFE INSURANCE

Open enrollment form

Copper Plan

IRS 13441A Form

Open Book