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Municipal Employees Benefits Open Enrollment 2018

Mandatory Forms that MUST be filed with HR include the following:
ALL Employees MUST file the: Health Enrollment Form
Employees MUST also file their specific FSA (Flexible Spending Account) form
 Non-Union Employees FSA Form  MSEA Employees FSA Form
 Police Supervisory FSA Form  Pro-Tech Employees FSA Form
 Police FSA Form  Public Works FSA Form
 Fire FSA Form  

FSA (Flexible Spending Accounts) and HRA (Health Reimbursement Account) Explanations
 FSA & HRA Eligible Expenses
 Over the Counter Expenses with or without Prescription
 Guide Dog Service Animal Benefits

Miscellaneous Change in Circumstances Forms
 Life Change Form
 IPP (Income Protection Plan) Form
 Legal Shield, ID Shield Enrollment Form
 VSP (Vision) Enrollment Form | VSP Plan Summary
 Dental Enrollment Form

Health Insurance Plan Summaries:  Dental Plan Summaries:
 POS-C 2018
 PPO 500 2018
 PPO 1500 2018
 Dental High Option Summary 2018
 Dental Low Option Summary 2018

27 Pine Street
Lewiston, ME 04240
Ph: (207) 513-3000
TTY/TDD: (207) 513-3007
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