2020 FORMS & DOCUMENTS

forms
Pre-65 forms
post-65 forms
Hardship fund

Open enrollment form

Copper Plan

IRS 13441A Form

ALL MEMBERS
2020 DOCUMENTS
Pre-65 DOCUMENTS

GENERAL INFORMATION

CARRIER MATERIALS

POST 65 DOCUMENTS

GENERAL INFORMATION

CARRIER MATERIALS

ENROLLMENT FORMS / PRICING

ENROLLMENT FORMS

Two forms are required for enrollment for GRIP and SMIP Plans

DENTAL

MISC DOCUMENTS

MISC DOCUMENTS

HEALTH SAVINGS ACCOUNT

HARDSHIP FUND

LIFE INSURANCE

HELPFUL TOOLS

dsra benefit trust documents

2020 ELECTION INFORMATION

2020 FINANCIALS

SUMMARY PLAN DOCUMENT

TRUST AGREEMENT

DSRA Benefit Trust website  - 2020

Benistar DSRA Benefit Trust Customer Service/Call Center

1-888-588-6682