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NEW EMPLOYEE FORMS
Job Application
Employment Eligibility Verification (I-9)
Confidentiality Agreement
Vet-100 Survey
Emergency Contact Form
Direct Deposit Form
Legal Domicile
Name/Address Change
SCA employees - Memorandum For QNEC
Acknowledgement of PTE Health Welfare Paid into QNEC- Part-Time
Acknowledgement of PTE Health Welfare Paid into QNEC-HR
Acknowledgement of Notice of Waiting Period for SCA - HR
Acknowledgement of Notice of Waiting Period for SCA- Full-Time
Employee Manual

ADMINISTRATIVE
Time Sheet
Timesheet Instructions
Employee Manual Receipt and Acknowledgment Form
Employee Action Notice
Leave Request Form
STFL Form (Vermont Only)
STFL (Vermont Only) & FMLA
Employee Action Notice

2010 Federal Holidays

IMAP Employee
Timesheet Instructions
Timesheet Labor Codes
Base Year Expense Report Instructions
Base Year Expense Report Taxi and Baggage Logs
Base Year Expense Report Team Codes
Base Year Expense Report
CM Timesheet
EL Timesheet
ER Timesheet
FR Timesheet
GT Timesheet
IR Timesheet
PM Timesheet

LABOR LAWS
EEOC
Americans with Disabilities Act (ADA)
ADA Public Law 101-336
Family & Medical Act (FMLA)-Domestic Employees only
FMLA Public Law 103-3-Domestic Employees only
FMLA Employee Form - Certification of Health Care Provider-Domestic Employees only

TAX FORMS
IRS Forms
State Tax Forms
Form 673 - Foreign Earned Income Exemption
W4 Form

NEW AETNA DOMESTIC INSURANCE FORMS
2010 Domestic Benefits enrollment Form
2010 Domestic Open Enrollment Letter
2010 Domestic Rate Sheet
2010 Contract Open Access Managed Choice
How to Find a Provider in Your Area
Vision One
Integrated Health and Disability Auth
Dental Benefit Summary
Employee Retirement Income Security Act (ERISA)
Using Your Aetna Vision Benefits

CLAIM FORMS
Medical Claim Form
Dental Claim Form
Rx Claim Form
Vision Claim Form

SHORT-TERM DISABILITY (STD)
Short-Term Disability Forms
Choctaw Behavioral Health Clinician Statement
Choctaw Attending Physician Statement
Choctaw Disability Employee Request for Information
Choctaw HIPAA Auth Form

INSURANCE BOOKLETS
Open Choice Medical - Booklet
Open Access Managed Choice - Booklet
Open Access Managed Choice - Summary of Coverage
Traditional Choice - Booklet
Traditional Choice - Summary of Coverage
PPO Dental (Passive) Expense Coverage - Booklet
PPO Dental (Passive) Expense Coverage - Summary of Coverage
Life Insurance - Booklet
Life Insurance - Summary of Coverage (Non-Corporate)
Life Insurance - Proof of Death
Long Term Disability - Summary of Coverage (Non-Corporate)
Temporary Disability Income - Summary of Coverage
Temporary Disability Income - Booklet

All You Need to Know about H1N1 Flu

NEW AETNA INTERNATIONAL INSURANCE FORMS
2010 International Enrollment Form
2010 International Employee Rate Sheet
2010 International Open Enrollment Letter
Aetna Global Benefits
Dental Indemnity Plan
International Employee Assistance Program (IEAP)
How Aetna Pays OON Claims *Simplified*
International Temp Card
Pharmacy
PPO Bermuda plan design
Medical, Dental, Vision and Rx Claim Form.pdf
Proof of Death
How to Submit a Life Claim
PPO & Prescription Drug Forms
Life and Accidental Death Forms
Comprehensive Dental Forms
Long-Term Disability Forms
Vision Forms
Make strides toward a healthier lifestyle
Fast Facts - Pre-trip Planning Resources
Take a virtual tour of your AGB Benefits!
AGB Fast Facts - Aetna Navigator

LONG-TERM DISABILITY (LTD)
Long-Term Disability Forms

NEW CLAIM ADDRESS FOR AGB:
Aetna Global Benefits/Aetna
P.O. Box 981543
El Paso, TX 79998-1543
USA

NOTE: All original enrollment paperwork must be mailed to:
Robin French
CMSE Insurance Manager
2101 W. Arkansas
Durant, OK 74701

401(K)
General Information
Enrollment Form*
Beneficiary Form*
Custodian Form*
Investment Performance Review
Rollover Form
Catch-Up Contribution Form
Contribution Change Form
Early Withdrawal of Benefits Form
QNEC Form
Principal Plan Summary
404(c) Notice
Understanding Investing (Investor Profile Quiz Included)
Russell LifePoints
Principal LifeTime Portfolios
Principal Managed Account Program
PMAP Disclosure Document
Redemption Fee & Transfer Restriction
Fund Transfer Restrictions
Principal Blackout Notice
2005 Summary Annual Report
Retirement Plan Check-Up
EGTRRA Tax Credit Info
How to Read Your Statement
Educational Materials
Investment Performance History
Termination Memo*
Principal Termination Contact*

Provider Link

NOTE: Fax all 401(k) paperwork to:
           Latisha Potter
           (580)924-5764
           or email to: lpotter@cmse.net

           Original paperwork must be mailed to:
           CMSE-CAE-CPRE-CCS 401K Plan
           Attn: Latisha Potter
           2101 W. Arkansas
           Durant, OK 74701

WORKERS COMPENSATION
Domestic Claim Form

International Claim Form

FMLA Employee Form - Certification of Health Care Provider-Domestic Employees only

NOTE: All Workers Comp paperwork must be faxed to:
           (580) 924-5764
           Attn: Trina Dunegan
           Workers Comp Manager
           2101 W. Arkansas St.
           Durant, OK 74701

FINANCE FORMS
EXPENSE REPORTS
Travel Request
Expense Report
Local Travel Expense Report
TDY Travel Expense Report
PCS Travel Expense Report
Miscellaneous
CME/CEU Expense Report

INSURANCE PREVIOUS TO AETNA

CIGNA INSURANCE
US Employees

CIGNA INSURANCE
Overseas Employees

MEDICAL - All
Dental Claim Form
Vision Claim Form
Medical Claim Form
Pharmacy Claim Form
Life Insurance Claim Form

Claim Form

DOMESTIC INSURANCE BOOKLETS
Preferred Provider Medical Benefits
Puerto Rico Preferred Provider Medical Benefits
Comprehensive Medical Benefits
Texas Dental Choice
Dental Preferred Provider Insurance
Puerto Rico Dental Plan
Vision Care Insurance