Health Insurance

Title Get Item
AFSCME Employee Family / Medical Leave Request Checklist and Certification of Health Care Provider Form Download
Dependent Age 19 to 26 Enrollment and Change Form Download
Form 11: Application to Continue Part Cost Premiums Download
FY 2016-17 GIC Open Enrollment Change Form Download
GIC Benefit Decision Guide for Employees 2015-16 Download
GIC Benefit Decision Guide for Retirees and Survivors 2015-16 Download
GIC Employee Benefit Decision Guide Download
GIC Health Insurance Plan Changes Summary Download
GIC HSCA/DCAP Participant Handbook Download
GIC Retiree Benefit Decision Guide Download
Group Health Continuation Coverage Under COBRA Election Notice and Application Download
Health Insurance Plan Payroll Deduction Authorization Form Download
Health New England Enrollment Add Termination Form Download
Insurance - Employment Status Change Form-1A Download
MA Group Insurance Commission Enrollment and Change Form (Form 1) Download
Postdoctoral Health Insurance Plan Overview Download
UMA/PostDoctoral Health Insurance Plan: BCBS New PPO Member Transition of Care Request Download
UMA/PostDoctoral Health Insurance Plan: BCBS Non-Covered Medications Download
UMA/PostDoctoral Heath Insurance Plan: BCBS Step Therapy Medications Download
UMA/Unit B Health Insurance Enrollment form Download
UMass AFSCME Unit B Explanation of Coverage (English) Download
UMass AFSCME Unit B Health Insurance Enrollment Book (English) Download
UMass AFSCME Unit B Health Insurance FAQs (English) Download
UMass AFSCME Unit B PPO Benefits Summary (English) Download
UMass AFSCME Unit B PPO Benefits Summary (Spanish) Download
UMass AFSCME Unit B PPO Chiropractic (English) Download
UMass AFSCME Unit B PPO Chiropractic (Spanish) Download
UMass AFSCME Unit B PPO Prescription Co-Pays (Chinese) Download
UMass AFSCME Unit B PPO Prescription Co-Pays (Chinese) Download
UMass AFSCME Unit B PPO Prescription Co-Pays (English) Download
UMass AFSCME Unit B PPO Prescription Co-Pays (Khmer) Download
UMass AFSCME Unit B PPO Prescription Co-Pays (Korean) Download
UMass AFSCME Unit B PPO Prescription Co-Pays (Russian) Download
UMass AFSCME Unit B PPO Prescription Co-Pays (Spanish) Download
UMass AFSCME Unit B PPO Prescription Co-Pays (Vietnamese) Download
UMass AFSCME Unit B PPO Summary of Benefits and Coverage (Chinese) Download
UMass AFSCME Unit B PPO Summary of Benefits and Coverage (Chinese) Download
UMass AFSCME Unit B PPO Summary of Benefits and Coverage (English) Download
UMass AFSCME Unit B PPO Summary of Benefits and Coverage (Khmer) Download
UMass AFSCME Unit B PPO Summary of Benefits and Coverage (Korean) Download
UMass AFSCME Unit B PPO Summary of Benefits and Coverage (Russian) Download
UMass AFSCME Unit B PPO Summary of Benefits and Coverage (Vietnamese) Download
UMass Amherst PostDoctoral Health Insurance Plan overview effective 07/01/16 Download
UMass Amherst/Postdoctoral Enrollment/Add/Termination Form Download
UMass Amherst/Postdoctoral Health Insurance Plan Overview Download