Form for the member’s physician to complete if the member cannot manage property, finances or business affairs because of an impairment in the ability to receive and evaluate information or make or communicate decisions even with the use of technological assistance.
Only available to participants enrolled in a High Deductible Health Plan (HDHP).
A Health Savings Account (HSA) is an individually-owned, tax-advantaged account that you can use to pay for current or future eligible medical expenses. With an HSA, you’ll have the potential to build more savings for health care expenses or additional retirement savings through self-directed investment options.
Plan Year
2026
Program Option
State Employee and Retiree Health Plan & Supplemental Benefits
Learn about our Insurance Help page, how to contact Health Plan and Vendors, additional benefits from Delta Dental, and other mental health support programs.
Each year, recipients of disability benefits must complete and submit form(s) to ensure that their benefits continue without interruption. It is crucial that all required forms are submitted timely to prevent suspension of the benefit.
Save on a wide variety of everyday medical, dental, vision, day care, parking, and transit expenses with a pre-tax savings account. It’s a tax break that’s simple to use.
Plan Year
2025
Program Option
State Employee and Retiree Health Plan & Supplemental Benefits
Save on a wide variety of everyday medical, dental, vision, day care, parking, and transit expenses with a pre-tax savings account. It’s a tax break that’s simple to use.
Plan Year
2026
Program Option
State Employee and Retiree Health Plan & Supplemental Benefits
