These forms are in either a .doc or a .pdf file format. To read and print the .pdf you may need to download the latest version of Adobe® Acrobat® Reader (free) from the Adobe site.

All forms must be printed, completed and signed before submission to the Payroll & Benefits Department. Electronic submission of forms is not permitted at this time.

Enrollment / Changes

New enrollments or changes are made through

Register with the Company ID: CowetaCountySchools

PIN is the last 4 of your Social Security Number

State Health Medical

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

Group Life and Disability

Evidence of Insurability will be completed electronically through the enrollment system

Online EOI Instructions

Disability Claims

Disability Intake Instructions: 
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
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

Prior to 2021: Disability Voya

Critical Illness Claim

Dental and Vision

Out of Network Claims

Student Accident

AFLAC Cancer


Voya Hospital Indemnity

Individual Life Claims

  • Shenandoah Life, call 1-800-848-5433 or the Houze office at 1-800-523-7135
  • Trustmark Life Claim  1-8077-201-9373
  • Unum Life Claim call 1-800-874-7481
  • RealStar/ING/Voya Life Claim call 1-888-238-4840