Open Enrollment Forms 2022
Updated October 13, 2022
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DayForce Instructions
DayForce Open Enrollment Instructions
Forms: Please completely fill out these forms and do not skip any highlighted areas.
First Reliance Standard Life Insurance Company (Evidence of Insurability Form)
Health Savings Account (HSA) Account Information Form
Lake Shore Savings Bank HSA Enrollment Form
BPAS 403B Change of Beneficiary Form
Informational Sheets
TRC – Green Plan OE Presentation Final
TRC – HSA Plan OE Presentation Final
TRC – Non HSA Plan OE Presentation Final
TRC Summary of Dental Benefits
New York State Disability/Paid Family Leave
Independent Health Find a Doctor
Independent Health Telemedicine Benefit
Independent Health Medical Help Line
Independent Health $0 Preventative Care Services