Benefits / Forms

Forms:

Medical / Dental / Vision Change Form - Login to BenefitFocus Portal to make change.

Breast Pump Reimbursement Claim Form - No restrictions on purchase.

ASI C la im F o r m - Return to ASI for processing

Dental Claim Form - Return to Ameritas for processing

Out-of-Network Medical Claim Form - Return to HealthLink for processing

Out-of-Network Vision Claim Form - Return to NVA for processing

MedTrak Mail Order Prescriptions - Return to MedTrak for processing

403(b) Salary Reduction Form-Return to Employee Benefits for processing

457(b) Salary Reduction Form-Return to Employee Benefits for processing

Purchase Service Credit Transfer Request Form - CPS must sign, then return to TIAA for processing

Beneficiary Change Forms:

Non-Teacher Retirement Beneficiary Change Form - Return to the retirement office for processing

Teacher Retirement Beneficiary Change Form - Return to the retirement office for processing

Landmark Bank HSA Beneficiary Change Form - Return to Landmark Bank for processing

Kansas City Life Insurance Beneficiary Change Form- Return to Employee Benefits office for processing

The Columbia Public School District does not discriminate on the basis of race, color, religion, gender identity, gender expression, sexual orientation, national origin, ancestry, disability, age, or use of leave protected by the Family and Medical Leave Act, in its programs, activities, or with regard to employment. The Columbia Board of Education is an equal opportunity employer. Inquiries regarding Columbia Public Schools’ compliance with IDEA and Section 504 regulations should contact Special Services at 1818 West Worley, Columbia MO, 65203 (573) 214-3462.

Benefits

Beneficiary Change Forms:

Columbia Public Schools