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Dental:

 

 

Prescription

 

 

Optical:

SCMEBF Claim Form

Claim Form

Participating Provider List
(2 pages) (2 pages) (2 pages)

Participating Provider List

 

 
(6 pages)    

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Tax:

Bereavement Benefit:

Survivors Benefit:

Participating CPA's

Designation of Beneficiary Form

Designation of Beneficiary Form 

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Eligibility:

COBRA:

Authorization Release: 

Student Verification

Enrollment Form

Authorization for Release of Information

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Retiree Self-Pay Enrollment:

Statement of Dependence

Age Extension for a

Disabled Dependent

Self-Pay Enrollment Letter & Form

Enrollment Form

Enrollment Form

(4 pages)

(2 pages)

(3 pages)

(Please be advised that these forms will automatically be sent to you upon your retirement)

   

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Benefit Reference Guide

Legal Reference Guide

Dental Fee Schedule

(Jan 2008)

(Jan 2008)  

(Jun 2009)

 

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Benefit Reference Guide Update

2014 Newsletter

2014 Newsletter

(Jan 2013)

(Issue 2)

(Issue 1)

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2013 Newsletter

2013 Newsletter

2012 Newsletter

(Issue 2)

(Issue 1)

(Issue 2)

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2012 Newsletter

2011 Newsletter

Voice Article

(legal paper)

(legal paper)

(2012)

Print double-sided & fold

Print double-sided & fold

 

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2010 Newsletter 2009 Newsletter 2008 Newsletter
(legal paper) (legal paper) (legal paper)
Print double-sided & fold Print double-sided & fold Print double-sided & fold
     

               

Updated 08/11/2014

 

 

 

 

 

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