| Document | File Type |
|---|---|
|
Accidental Dismemberment or Loss of Sight Claim Form |
|
|
American Fidelity Health Savings Account |
|
|
Application for Coverage for Other Dependent Children |
|
|
Application for Life Premium Waiver – For use by entities WITH the EGID Disability Plan |
|
|
Application for Life Premium Waiver – For use by entities WITHOUT the EGID Disability Plan |
|
|
Certification of Previous Coverage |
|
|
Change of Address Form |
|
|
COBRA Packet |
|
|
Common-Law Spouse Certification |
|
|
Dependent Attachment Form |
|
|
Disability Benefits Beneficiary Designation |
|
|
Disability Reimbursement Agreement |
|
|
Disabled Dependent Assessment |
|
|
Durable Power of Attorney |
|
|
Electronic Fund Transfer Authorization |
|
|
Exclusion for Spouse Coverage |
|
|
Medicare Complaint Form – Health or Prescription Coverage |
|
|
TRICARE Supplement |
|
Forms
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Last Modified on
Jul 17, 2025
