Benefits & Forms
Here you will find almost any benefits form you might need. Just print a copy of the form, complete it, and then submit it as instructed.
If you are unsure about whether or not you need to submit a form, or which form you need to complete, please contact the Division of Health & Human Services at 240-313-2350.
Below are the links to all of the benefit forms.
Employee Benefits & Forms
- Wage & Salary Study – 4/10/2018
- Employee Assistance Program – EAP
- Medical (https://www.aetna.com/)
- Medical Care Management (https://www.aetna.com/)
- CVS Caremark Link
- Dental (www.deltadentalins.com)
- Vision (www.myuhcvision.com)
- Model Creditable Coverage Disclosure Notice
- HIPPA Notice to Employees
- Summary of Employees’ Retirement Plan