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Employee Benefits Forms and Brochures

 

HEALTH

    DENTAL & VISION

LIFE

BENEFITS FORMS

    MISCELLANEOUS FORMS      

  OTHER CARRIERS

STATE OF MISSISSIPPI

HEALTH APPLICATION

DENTAL / VISION APPLICATION

GUARDIAN INSURANCE

 

State of   Mississippi Life Insurance Application

 CHANGE IN STATUS FORM

 EMPLOYEE ASSISTANCE PROGRAM

SUPPORT SERVICES

MISSISSIPPI COLLEGE SAVINGS

MACS & MPACT

WELLNESS EXAM GUIDELINES

 Dental ID Card

 Evidence of Insurability (Late Enrollee)

BENEFITS CONTACT INFORMATION 

American Fidelity

GAP Claim Form

MACS & MPACT

PAYROLL DEPOSIT INFORMATION

2018 SUMMARY OF BENEFITS for BASE AND SELECT COVERAGE

 Vision ID Card

 Portability Packet for Life Insurance

Online Enrollment Instructions

Affordable Care Act Information - Marketplace 

LEGALSHIELD

IDSHIELD INFO

CURRENT HEALTH INSURANCE RATES

 Dentist Nomination Form

Beneficiary Designation Online Instructions 

COBRA  

American Fidelity

Change Forms 

LEGALSHIELD

IDSHIELD

APPLICATION

PROJECTED HEALTH INSURANCE RATES - JANUARY 1, 2019

 Guardian Anytime Website

State Life Ins Beneficiary Designation Form 

HIPAA Privacy Notice 

American Fidelity Reimbursement Form 

MISSISSIPPI

DEFERRED

COMPENSATION

2018 HEALTH BENEFIT CHANGES

 Guardian Dental and Vision Benefit Summary  

 Conversion Brochure

 Notice of Enrollment Rights

 American Fidelity Disability Claim Form

 TELAMED

 

HEALTH INSURANCE  REFERENCE GUIDE 

 New Dental & Vision Rates effective 1-1-19

 State Life Insurance Plan Certificate

 

 

 

GLOSSARY OF MEDICAL TERMS 

2019 - 2020 Dental & Vision Benefit Summary 

State Life Insurance Rates 

 

 

 

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DCS is committed to providing a work environment that is free of discrimination. It is the policy of DCS that all applicants and employees are entitled to equal employment opportunity regardless of race, color, religion or creed, gender (includes pregnancy or related medical conditions), national origin, age, disability, veteran status or other protected characteristics as required by local, state and federal law.

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5 E. South Street • Hernando, MS 38632
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