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Forms
Enrollment
or Change Form
Oral Health, Total Health Enrollment
Form
Enrollment
Form for Section 125
Claim
Reimbursement Form for Section 125
IMPORTANT: To avoid delays please verify
with your Human Resource or Payroll Dept that OEA Choice Trust is
your Section 125 plan administrator.
Direct
Deposit Form for Section 125
Direct
Debit Application Form
Drug
Reimbursement Form
Auto Pay Enrollment Form for Section 125
IMPORTANT: ONLY Groups with OEA Choice
Trust Medical Plans are eligible to enroll in the Auto Pay option.
List of Covered Expenses for Section 125
Orthodontia Worksheet for Section 125
Authorization
to Disclose Medical Information
Affidavit
of Marriage and Domestic Partner
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