Change of Address Form - use this form for name and/or address changes
Direct Deposit - please include a copy of your VOIDED check in order to sign up for Direct Deposit
Accounts Payable Direct Deposit - for employee mileage reimbursements, travel or any other non-payroll payments
Appeal Form - You may appeal to OEBB about dependent eligibility decisions, enrollment errors and omissions, Healthy Futures, or missed enrollment timelines.
Opt Out Form - In accordance with the participation requirements for OEBB opt-out provisions, OAR 111-040-0050 and the District's association agreements, members who elect not to participate in the OEBB Health Plan including medical, pharmacy, dental and vision coverage wil be entitled to receive a monthly financial incentive.
Health and Safety Forms
SAIF/801 Form - fillable - form must be opened in Adobe to enable fillable feature
Short Term Disability (STD)