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Summarized Listing
Friday, September 29, 2023
DGS P&P
Insurance Services
Division of General Services
Insurance Services
Employee Benefits Program
Policies and Procedures
Forms -
HEALTH
Native Traditional Healing Procedures
Native Traditional Healing Benefit Form
WellDyneRx Member Registration
WellDyneRx Preferred Drug List
WellDyneRx Mail Order Prescription Delivery Service Registration
WellDyneRx Reimbursement Claim Form
Forms -
LIFE
MetLife Grief Counseling Flier
MetLife Plan Summary
MetLife Beneficiary Designation Form
Addendum - Primary Beneficiary
Addendum - Contingent Beneficiary
MetLife Claim Form
MetLife Accidental Death & Dismemberment Claim Form
MetLife Accelerated Benefit Option Form
MetLife Optional Term Life Plan Summary
MetLife Optional Term Life Application
MetLife Statement of Health Form
Forms -
SHORT-TERM DISABILITY
Short-Term Disability Instructions
Short-Term Disability Sick leave Form
Short-Term Disability Preliminary Statement of Disability
Short-Term Disability Attending Physician Statement
Risk Management
Policies and Procedures
Forms
Workers Compensation
Policies and Procedures
Forms
Report of Injury
Traditional Healing Expense(s) Claim Form
Travel Expense Report
Medical Waiver Statement Form
Consent to develop Medical & Wage Information
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