Employee Benefit Form

• 403(b) Salary Reduction Agreement Form (pdf)
• 457(b) Voluntary Salary Reduction Agreement Form (pdf)

- B -

• BlueCross BlueShield Claim Form (pdf)
• BlueEdge Electing Flexible Spending Account Form (pdf)

- F H -

• Flex Reimbursement Claim Form (pdf)
• HealthChoice Claim Form (Web Site)

- I -

• IRS Section 125 Qualifying Event Checklist (pdf)
  Flexed Premiums & Un-reimbursed Medical
• IRS Section 125 Qualifying Event Checklist (pdf)
  Dependent Care Only
• Insurance Enrollment / Change Form (pdf)

- L -

• Life Insurance - Beneficiary Change Form (pdf)
• Life Insurance - Evidence of Insurability (pdf)
• Life Insurance - Retiree Beneficiary Change Form (pdf)
• Life Insurance - Waiver of Premium Disability Claim (pdf)
• Life Conversion Form (pdf)
• LTD (AFA) Claim Form (pdf)
• LTD (AFA) Proof of Insurability Form (pdf)
• Life and LTD Enroll / Change Form (pdf)

- O -

• OSU Life and LTD Election/Change Form (pdf)
• OTRS Personal Data Form (pdf)
• OSU Personal Information Form (pdf)

- T -

• TIAA-CREF Beneficiary Change Information (pdf)
• TIAA-CREF Change of Address Form (pdf)
• TIAA-CREF Funds Upon Termination Of Employment (pdf)

- W -

• Workers' Compensation Supervisor Claims Reporting Information (pdf)