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.
Flexible Spending Accounts
- 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