FORMS 

• Authorization Form (for filing an FMLA or disability claim) 
• Beneficiary Form for Final Pay Check (Submit original to HR) 
• Beneficiary Form for Life Insurance (Submit original to HR) 
• Beneficiary Form for MBERP (Submit original to HR) 
• Beneficiary Form for Police and Fire Statutory Death Benefit (Submit original to HR) 
• EyeMed Claim Form 
• EyeMed Out of Network Claim Form 
• Flexible Spending Account Claim Form 
• Flexible Spending Account Direct Deposit Form 
• Flexible Spending Account Enrollment Form 
• FMLA Policy 
• FOP Enrollment Form 
• General Employees Enrollment Form 
• General Employees Change Form 
• Hartford Life Claim Form 
• Human Rights Complaint Form 
• Human Rights Complaint Form Instructions 
• Humana Medical Claim Form 
• IAFF Enrollment Form 
• MetLife Dental PPO Claim Form 
• Retiree Change Form 
• Retiree Enrollment Form 
• Voluntary Benefits Cancellation Form