Payroll / Benefits

• • Human Resources Cumulative Beneficiary Change List with links
  • Payroll Beneficiary Designation Form
  • 2026 Fillable Benefits Election/Change Form

State Health Medical Forms

• SHBP Retirement/Surviving Spouse Form
• SHBP Employment Transfer Form

Dental / Vision

• MetLife Dental – Out of Network Claim
• BlueCross Blue Shield Vision – Out of Network Claim
• Blue Cross Vision Disabled Dependent Determination

Aflac Wellness & Claim Form

• AFLAC Forms Library
• AFLAC Always – Setup Direct Bill
• Payment Authorization for manual setup
• AFLAC Wellness (Accident Policy) Claim Form
• AFLAC Accident Claim Form
• AFLAC Wellness (Cancer Policy) Claim Form
• AFLAC Cancer Claim Form
• AFLAC Life Claim Form
  • Aflac Life Claim Physician Statement (claim within 2 years of issue)
• AFLAC Life Service Form – Changes
• AFLAC Waiver of Premium when disabled

Critical Illness and Hospital – VOYA / ING

• Claims Library for All Forms
• Critical Illness Wellness
  • Wellness Claim Form Use Group Policy Number 66364-6CCI
  • File Online or fax 844-449-2553
• Critical Illness Claim
  • File Online
  • Critical Illness Claim Form
  • Employer Statement,
  • Attending Physician Statement
  • Health Release Authorization
• Hospital Indemnity Claim
  • File Online
  • Claim Form
  • Health Release Authorization
  • Employer Statement
  • Physician Statement
• Portability Request – Critical Illness and Hospital
  • (Must be submitted within 30 days of termination to continue on direct pay) 
  • Employee Port Form – Critical Illness & Hospital Portability Rates– Quarterly Payment Only
  • Spouse/Child Form (due to employee death) Spouse/Child Critical Illness & Hospital Portability Rates
  • Consumer Privacy Notice

FSA – MedCom

• MedCom Forms Library– Pick the one you need
• MedCom Flexible Spending Claim Form
• Direct Deposit Authorization
• Flexible Spending Account Daycare Provider Receipt
• Flexible Spending Account Repetitive Transaction Expense Form
• Flexible Spending Account – Dependent Card Request

Genomic Life

• Continuation after Termination of Employment

Group Life – VOYA

• Evidence of Insurability
• Forms Library
• Employee Portability Request Form
• Spouse Portability Request Form
• Port Rates
• Conversion Request
• Brochure of Conversion
• Proof of Death Claim
• Consumer Privacy Notice

Disability – New York Life

• Intake Brochure – This document provides information on how an employee and the employer can contact NewYork Life to initiate a Disability claim, and also provides an overview of the claims process.Online: myNYLGBS.com Register Your Account First. Then choose Coverage>Disability (print your confirmation page)By Phone: 888.842.4462 7AM – 7PM CST

Whole Life VOYA / ING

Call 800-537-5024 for Whole Life Questions

• Voya Life Service Request Form or Cancellation Form
• EFT Direct Bill Setup
• Voya Forms Library

Call 888-238-4840 to report a death and start the claims process.

• Application and Underwriting Authorization
  Child Whole Life Rates

Wellness Signup

• Enrollment Form

Exit Acknowledgement for Benefits Eligible Employees

Bibb County Schools_Separation Notice updated 6.3.2025

Voya 

Call 800-537-5024 for Whole Life Questions

• Voya Life Service Request Form
• EFT Direct Bill Setup

• • Portability Request – Employee and Spouse (Must be submitted within 30 days of termination to continue on direct pay)
    Critical Illness Portability Rates and Hospital Indemnity Portability Rates

Aflac

• AFLAC Always – Setup Direct Bill
• Payment Authorization for manual setup