TERMS AND CONDITIONS
To review a specific Term and Condition, click the name of the insurance carrier/benefit plan, which will take you directly to the appropriate page.
CAPITAL HEALTH PLAN/MEDICAL
FLORIDA BLUE/MEDICAL
DELTA DENTAL & DAVIS VISION
ARAG/LEGAL SERVICES
METLIFE/ACCIDENTAL DEATH AND DISMEMBERMENT
METLIFE/TERM LIFE INSURANCE
METLIFE/LONG TERM DISABILITY
FLEXIBLE SPENDING ACCOUNTS
CAPITAL HEALTH PLAN/MEDICAL
FLORIDA BLUE/MEDICAL
BLUE CROSS BLUE SHIELD OF FLORIDA/MEDICAL
CONTINUED
DELTA DENTAL & DAVIS VISION
ARAG/LEGAL SERVICES
AUTHORIZATION
By indication on the online system, I am requesting enrollment, cancellation or a change in the legal plan. I understand that the change in coverage will not become effective until the date assigned by the underwriter of the plan. I authorize my employer to deduct or cancel deductions for the cost of the plan as indicated on the online system, and as may be modified or adjusted, from my wages or salary.
CNA/LONG TERM CARE
METLIFE/ACCIDENTAL DEATH AND DISMEMBERMENT
METLIFE/TERM LIFE INSURANCE
METLIFE/LONG TERM DISABILITY
BLANET FRAUD WARNING
FLEXIBLE SPENDING ACCOUNTS
I understand my elections for a Health and/or Family/Dependent Care Flexible Spending Account are binding for the remainder of the current plan
year.
I understand that at no time during the plan year may I change my Health Care Flexible Spending Account election amount even if I experience an IRS
Qualifying Event.