This form is completed by employees to request reimbursement for adoption expenses.
Employees participating in the Alternative Retirement Plan complete this form to change their ARP provider.
This form is used to submit institutional and professional claims for benefits for covered services received outside the United States, Puerto Rico, and the U.S. Virgin Islands.
This form is completed by employees to submit a medical claim to Anthem.
This form is used by employees to request reimbursement for prescriptions paid out of pocket.
This form can be used for a pre-treatment estimate or for a claim for an actual service.
Employees must complete this form each semester when requesting educational benefits.
Employees must complete this form each academic year when requesting educational benefits for a qualified dependent.
Employees requesting supplemental life insurance above the guaranteed issue amount must complete the EOI submission.
Employees can apply for a disability benefit using the OPERS Disability Benefit Application Packet.
Benefits eligible employees may elect to contribute to the designated Ohio state retirement plan or an alternative retirement plan.
Employees use this form to start, stop, or make a change to their 403b or 457 Supplemental Retirement Account (SRA).
Employees can apply for a disability benefit using the STRS Disability Benefits Application.
Employees can submit a claim for UNUM Long Term Disability.
Employees can submit a claim for UNUM Short Term Disability.
Employees that have received eye care services (exam, contacts, or glasses) from an out of network provider may submit a claim to request partial reimbursement.