Retiree Forms
These forms are to be completed after meeting with a benefits representative:
- Blue Medicare Rx Enrollment Form- Enrollment form for Medicare Part D (prescription plan)
- Information Update Form- To update your address or other personal information
- Retiree Computing & Confidentiality Agreement Form(PDF)- Statement of retiree privileges and computing agreement
- Retiree Health Account Reimbursement Claim Form
- Retiree Medical Plan Enrollment Form
- Retiree Health Account Election Form- Please contact Human Resources at (312) 915-6175
