Important Document

• 2020 APH OE Guide

 

Forms 2020

To fill out these forms you will need to download a copy to your computer. You may do this by using one of these two methods.

1. Click the link and once the document open, press the download button found within the page.
2. Highlight the link and then press the Context Menu key command (Shift + F10), then select “Save Link As”.

Once filled out and saved, please deliver them to Theresa Close.

 

• APH Enrollment Form
• Health Savings Account Deposit Form
• HSA Authorization Form
• FSA and Dependent Care Enrollment Form
• FSA Election Certificate Form

Humana Documents PDF Version

• OE Kit PDF
• Summary of Benefits and Coverage Plan Type NPOS PDF
• Summary of Benefits and Coverage Plan Type NPOS-HDHP PDF

 

Humana Documents in MS Word Format

• OE Kit Word Doc
• Summary of Benefits and Coverage Plan Type NPOS Word Doc
• Summary of Benefits and Coverage Plan Type NPOS-HDHP Word Doc

Other Forms

PTO Balance Form (On-line MS Forms Version)