New enrollments or changes are made through   https://www.employeenavigator.com/benefits/Account/Login

Register with the Company ID: CowetaCountySchools

PIN is the last 4 of your Social Security Number

• Combined Enrollment/Change Form

Enrollment and changes must be completed through the SHBP-ADP Website

• SHBP Decline Acknowledgement

• Cobra Vision – EyeMed

Out of Network Claims

• MetLife Dental
• EyeMed Vision

Evidence of Insurability will be completed electronically through the enrollment system

Online EOI Instructions

Disability Claims

Disability Intake Instructions:
https://www.mylincolnportal.com/customer/public/login 
Registration Code COWETA
Review the status through the Lincoln Portal

Life Claims

Instructions:Coweta County will initiate the Proof of Death Claim through the Portal
https://www.mylincolnportal.com/customer/public/login
Registration Code COWETA
Review the status of claims through the Lincoln Portal

Continuation of Life Benefits after Termination

Portability Request – please call 1-877-321-1015, Group Number is SA3-890-LF0384-01 to request a quote.
You must submit the Port Form with your premium to continue. Note: Port Rates are not the same as active rates.

Conversion Request– please call 1-877-321-1015, Group Number is SA3-890-LF0384-01

Prior to 2021: Life Voya

• Forms Library – Waiver of Premium and Related Required Forms
• Forms for- Group Life Claim  & Settlement Option
• Group Life Conversion Request or Group Life Portability Request

Prior to 2021: Disability Voya

• Forms Library – Short/Long Term Disability Claims
• Related Disability Required Forms

• MedCom Forms Library– Pick the one you need.
• MedCom Flex Claim Form and Direct Deposit Authorization
• MedCom In Home Day Care Receipt
• MedCom Flex Dependent Card Request Form
• MedCom Flex Direct Deposit Form
• MedCom Flex Family Status Change Form
• MedCom Flex Enrollment Form
• MedCom Recurring Reimbursement Request

Claims

• AFLAC Forms Library
• AFLAC- Waiver of Premium when disabled due to Cancer
• AFLAC – Cancer Claim Form
• AFLAC – Wellness Benefit Claim Form for Cancer Policy
• AFLAC – Payment Authorization for Direct Bill, Manual setup or Choose Aflac Always once you have logged into aflac.com for your policy holder service.
• AFLAC Life Claim Form
  • Aflac Life Claim Physician Statement (claim within 2 years of issue)
• AllState/American Heritage – Cancer Claim Form

• Shenandoah Life, call 1-800-848-5433 or the Houze office at 1-800-523-7135
• Shenandoah Life Claim Form
• Trustmark Life Claim  1-8077-201-9373
• Trustmark Life Claim or File a Claim | Trustmark (trustmarkbenefits.com)
• Unum Life Claim call 1-800-874-7481
• RealStar/ING/Voya Life Claim call 1-888-238-4840

• Trustmark Beneficiary Change Form or Service Form or Direct Bill Request
• Shenandoah Individual Life – Lost Policy Form
• Shenandoah Individual Life – Change Form
• Shenandoah Individual Life – Cash Surrender Form
• Unum Service Forms Online- E-sign
• Unum Service Form  (pages 1-2 are instructions…do not print or return to Unum). Fill in and send pages 3-4.
• Unum Whole Life Application Unum 10/10 Term Life Application
• Voya Surrender Form (old policies)

• Voya Claim- including Wellness
• Voya Port (continuation) request Employee and Spouse/Child

• Forms Library – Critical Illness and Related Forms
• Wellness Claim Form Group Name: Coweta County Board of Education, Group Number is 31053-1
  File online through https://voya.com/claims or fax 844-449-2553
• Employee Statement & Consumer Privacy Notice, Employer Statement, Attending Physician Statement, Health Release Authorization,
• Compass Port Form and Port Rates – Must be completed within 31 days of coverage termination

• Voya Hospital Claim
• Voya Hospital Port (continuation) request Employee and Spouse/Child
  Port Rates: Employee and Spouse/ Child(ren)
• Wellness Claim- Initiate Online

• Student Accident Claim Form