ABC Corner (for Agency Benefits Coordinators) 

Open Enrollment Information

Enrollment Procedures for Open Enrollment April 20, 2009 – May 18, 2009

Benefits Materials Order Form

Affidavit for Domestic Partnership and Domestic Partner’s Dependents

Aetna Slides

CareFirst Slides

United Healthcare Slides  

Forms and Other Helpful Information

Enrollment Forms July 2009 - June 2010:

• Active & Satellite Employees  
• Direct Pay 
• Retirees

BAS On-Line Access Instructions 

BAS Registration Form 

Family Medical Leave Act Notification (FMLA)  

HEARTS Form 

LAW - Military Notification Form 

Military Leave - Key Tips for Coordinators

Military Leave Benefits Information 

Non-Payment of Benefit Deduction letter 

Notice of Termination for Health Benefits - Regular Employees 

Notice of Termination for Health Benefits - Satellite Agencies

Retroactive Adjustment Form with Instructions  (Updated 10/09)

Transfer Notification Form