Forms & Documents

Open Enrollment

• Open Enrollment Information Home Page

Prescription

• No Cost Generic Preventive Drug List HSA only
• Three-Tier prescription plan with Value Prescription Drug List
•  No Cost-Share Preventive Medications list for both medical plans
• Express Scripts Pharmacy, home delivery pharmacy
• Express Scripts home delivery order form
• FAQ’s about Express Scripts Pharmacy
• Accredo, Cigna specialty pharmacy
• Cigna 90 Now Pharmacy Directory
  
   

Medical

• OAP Central
  

• OAP West
  

• OAP East
  
  

• Local Plus Provider Directory
• 2021 Option 1 OAP Deductible Plan Summary and Coverage 
• 2021 Option 2 OAP Deductible Plan w/ H.S.A Summary and Coverage 
• 2021 Option 3 LocalPlus IN Deductible Plan Summary and Coverage 
• 2021 Option 4 LocalPlus IN Deductible Plan w/ H.S.A Summary and Coverage 
• Healthy Pregnancies, Health Babies
• Expecting? A Healthy Start Program
• MDLive
• MDLive Frequenty Asked Questions
• MDLive Welcome Kit
• Cigna Convenience Care Clinics
• Life Management Programs
• Mycigna.com how to register
• "My Health Assessment" how to get started
• MDLive  Welcome Kit
• Getting urgent and emergency care outside the U.S

Forms & Documents

• Flu Shot Forms 2021
• Principal Vision Benefit Overview 
• 2020 Health Savings Account Contributions and Incentives
• Health Savings Account Contribution Change Form
• Williamson County Government Amended and Restated Premium Conversion and Flexible Benefit Plan
• Authorization to Disclose Consent Form
• Beneficiary Designation Life Form 
• Critical Highlights
• Critical Illness Application
• Critical Illness Brochure
• Critical Illness Overview
• Critical Illness Rates
• Delta Dental Plan Document
• Evidence of Insurability Form Employee Life and/or LTD
• FSA Medical Enrollment Form
• FSA Dependent Day Care Enrollment Form
• Short Term Disability (STD) Claim Form - Transamerica 
• Short Term Disability Brochure - AFLAC
• Voluntary Benefit Termination Form
• How to Report a Long Term Disability Claim
• Supplemental Long Term Disability Overview and Enrollment Form