Print pdf Print Email

Health Benefits Insurance Forms


		Director Janet A. Tofani Phone: 530.2069; FAX: 530.2097 jtofani@okumc.org
		Health Benefits Home
		Insurance Forms

	*	Group Health Plan Document Your Health Care Benefit Program for Oklahoma Conference of the United Methodist Church. (Administered by BlueCross BlueShield of Oklahoma)
	*	Health Benefit Plan Report 2 Description of The Oklahoma Conference Health Benefit Plan
	*	Health Insurance Preminums
	*	Benefits Schedule Self-Funded Medical Plan
	*	Health Insurance Enrollment Form PDF Word
	*	Prescription Drug Plan Covered PDF
	*	Maxcare Plan 630-Prescription Drug Plan PDF
	*	Creditable Coverage Letter Important Notice from Oklahoma Conference of the United Methodist Church Health Plan Regarding Your Prescription Drug Coverage and Medicare
	*	Employee Assistance Program
	*	Delta Dental Summary Plan Description (2009) Delta Dental Summary Material Modification (2011)
	*	Vision Flyer
		Delta Dental Employee Enrollment Form
		Delta Dental Program Highlights (2011)
	*	VSP Enrollment Form-Vision PDF WORD
	*	Aetna Clergy Life Enrollment form Note* fill in section C - Employee Information: #1-6 & #10; Sign and date at the bottom.
	*	Aetna Life Insurance Designation of Beneficiary form

Main Sections