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Adding Dependents?
Important Note: The Human Resources/Civil Service will require all employees adding dependents during Open Enrollment to provide valid proof of eligibility by November 21, 2012. Become Smoke Free!
Sign-up for the free MHN Tobacco Cessation Coaching program today! The program can be completed by telephone in seven sessions over a six week period. All employees and their family members are eligible for this free service, offered by the EAP Plan. Give them a call at (888) 779-2225. Click here for program information Important forms you may need…
Certification of Other Comparable Coverage Opt-Out of Medical Coverage Form Group Optional Life Insurance Application (Dearborn National) Evidence of Insurability (EOI) (Darborn National) 2013 Non-Tobacco User Affidavit Form Retiree Benefits Enrollment Form Affidavit of Dependent Eligibility Group Life Insurance Application |


