Health Insurance Forms & Publications

Overview Kwasi Yeboah Jr

Health Insurance Forms & Publications

Below you may download the current Health Insurance Handbook and various health insurance enrollment forms.

Health Insurance Handbook

2020 Health Insurance Handbook
2019 Health Insurance Handbook
2018 Health Insurance Handbook

Health Insurance Enrollment/Change

CTPF Form 350: Health Insurance Enrollment/Change

Proof of Prior Creditable Prescription Drug Coverage

CTPF Form 309: Proof of Prior Creditable Prescription Drug Coverage

MedPay Enrollment

CTPF Form 301: MedPay Enrollment

HIPAA Authorized Representative Designation

CTPF Form 345: HIPAA Authorized Representative Designation