Skip to content
MySLC
Home
Academics
Campus Life
Employee
Student
Login
Search
main navigation
Search
Search
User ID:
Password
Forgot Password?
You are here:
Employee
>
Benefits
>
Insurance Benefits
>
Medical
>
Medical Plan Forms
Insurance Benefits
Menu
Quick Links
Insurance Benefits
Eligibility
Medical
Managed Care Health Insurance
Summary of Benefits Documents
Medical Plan Forms
Dental
Vision
Flexible Spending
Life Insurance
Disability Insurance
Supplemental Pet, Legal, IT Theft Insurance
Cancer Supplemental Plan
Auto & Homeowners Insurance
COBRA Rights
Children's Health Insurance Program
Medical Coverage in Retirement
Supplemental Benefits Flyers
Quick Links
Public Website
MySLC on Instagram
MySLC on Twitter
MySLC on Facebook
Sidebar
Medical
Send to Printer
Medical Plan Forms
Search
Search
Clear search
Handouts list view
Handouts card view
2022 Medical Forms
Toggle 2022 Medical Forms
Title
Description
File type
Medical Enrollment & Change Form
.pdf
Payflex FSA Enrollment Form
.pdf
Payflex Health Savings Account (HSA) Form
.pdf
Waiver of Health Insurance
.pdf
OptumRX Mail Order Prescription Form
.pdf
Trustmark Medical Claim Form
.pdf
OptumRX Prescription Claim Form
.pdf
MySLC Help