Appoquinimink School District Benefits -- Program Overview

Forms

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	Program Overview
	Medical/Prescription Drugs
	Dental
	Vision Care
	State Group Life Insurance
	Life and AD&D Insurance
	Long-Term Disability Insurance
	Flexible Spending Plan
	Employee Assistance Program
	Behavioral Health / Emotional Wellbeing
	Disability Insurance
	Administrative Information
	What Happens When...?

Benefits-related Forms and Documents

The following forms are in PDF format and require the Adobe Acrobat Reader. Most browser software automatically provides this plug-in. You may also download the Adobe Acrobat Reader from the Adobe Web site.

Benefit	Related Forms
Medical/Prescription Drugs	Spousal Coordination of Benefits CVS Reimbursement Form Dependent Coordination of Benefits - Aetna Dependent Coordination of Benefits - BCBS
Dental	myCigna.com
Vision
State Group Life Insurance	Enrollment (go to www.lifebenefits.com) You can enroll anytime
Life and AD&D Insurance	Group Life Conversion
Long-Term Disability Insurance	Hartford LTD Claim Form Cigna LTD Claim Form
Flexible Spending Accounts	Flexible Spending Account Claim Form

Important Legal Information:
Appoquinimink Benefits Online provides only an overview of your benefits from Appoquinimink School District and The State of Delaware. Appoquinimink School District and The State of Delaware reserve the right to amend or to terminate any benefit plan at any time, with or without notice. Review more important legal information about your benefits plans.