ATTENTION: For 2010 forms, please use the forms listed on the Open Enrollment Website.

Please go to the main HR Forms page to view all HR Forms

MEDICAL/DENTAL FORMS

• Medical/Dental - Enrollment/Change Form

• Medical/Dental - Spouse or Qualified Domestic Partner Certification

• Medical/Dental - Student Certification/Change Form

• Medical/Dental - Certification of Dependents With Disabilities

• Medical/Dental - Extended Dependent Certification

• Uniform Medical Plan Claim Form

• Uniform Medical Plan Prescription Claim Form

• Uniform Medical Plan Vision Hardware Claim Form

• Uniform Dental Plan Claim Form

LIFE INSURANCE FORMS

• Life Insurance - Enrollment Form
• Life Insurance - Change Form
• Life Insurance - Change in Beneficiary
• Life Insurance - Evidence of Insurability
• Life Insurance - Nonsmoker Certification

LONG-TERM DISABILITY FORMS

• Long Term Disability - Enrollment/Change Form
• Long Term Disability - Evidence of Insurability

RETIREMENT FORMS - WWURP (Western Washington University Retirement Plan)

• WWU Retirement Plan (WWURP) Enrollment/Change Form

RETIREMENT FORMS - DRS (Department of Retirement Systems)

RETIREMENT FORMS - OPTIONAL

OPTIONAL BENEFITS

• 2009 FSA and DCAP Enrollment Form
• FSA and DCAP Claim Form
• Guaranteed Education Tuition (GET) Program Payroll Deduction Form
• Washington State Combined Fund Drive

MISCELLANEOUS