AD&D

• Enrollment Form
• Beneficiary Designation Form
• Conversion Form
• Life Claim Form
• Waiver of Premiums Form
• Dismemberment Claim Form

Dental

• Dental Claim Form

Health

• Medical Claim Form
• Maintenance Prescription Drug Form
• Medco by Mail Prescription Enrollment Form
• Prescription Reimbursement Form
• International Claim Form

Life Insurance

• Employee Enrollment Form
• Dependent Enrollment Form
• Beneficiary Designation Form

Retirement

• Beneficiary Designation Form - SERS
• Beneficiary Designation Form - TIAA-CREF
• TIAA-CREF Online Application
• Voluntary Salary Reduction Agreement - Supplemental Retirement
• Retirement Plan Selection Form - Part-Time Employees
• Phased Retirement Application

Vision

• Vision Claim Form

Other

• Online Grant In Aid Form (Penn State University & Pennsylvania College of Technology)
• Sickness and Accident Supplement Claim Form
• Post Doc Benefit Enrollment Form