Summary of Benefits - HIP Prime 2020

Summary of Benefits - HIP Low Cost 2020

Summary of Benefits - Empire 2020

Change of Beneficiary - Life Insurance

Change of Beneficiary - Life Insurance

CVS Caremark Rx Mail Service Order Form

CVS Caremark Rx Reimbursement Claim Form

Dental Claim Form - Ameritas

Direct Deposit Cancellation Form

Empire Claim Form - Inside NYS

Empire Claim Form - Outside NYS

Excess Major Medical

Excess Major Medical - Vision

Fitzharris - Proof of Student Status

Flex Benefits Claim Form - BRI

Flex Benefits Educational Brochure - BRI

Flex Benefits Login Info - BRI

Flex Benefits Plan Highlights - BRI

HIP Medical Claim Form

HIP Rx Claim Form