Capital Administrative Services

Forms

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The following forms are available through Adobe Reader.  Contact your Post Tax Benefits Coordinator to check enrollment eligibility or to acquire additional forms. 

Not all plans are available in each agency.  Go to the Available Benefits section for your agency for a list of approved programs. 

Brochures

Enrollment Applications

Change, Claim and Conversion Forms

Payroll Deduction Authorization Forms

Refund Request Forms

Miscellaneous Deduction Payment Forms

 

Brochures

  AFLAC Accident Insurance

 

 

 

 

 

  Alta Group Term Life Insurance

 

 

 

 

 

 

  Alta Long Term Disability Insurance

    

   Biweekly Agencies/Monthly Agencies

 

 

 

 

  ARAG Prepaid Legal Insurance

 

 

 

 

 

  Hartford Accidental Death & Dismemberment Plan

  (AD&D)

 

 

 

 

 

  Hartford Group Term Life Insurance

 

 

 

 

 

  Hartford Long Term Disability Insurance

 

 

 

 

 

            Hyatt Prepaid Legal Expense Plan

                Department of Children & Families

                   Agency for Persons with Disabilities

                   Department of Transportation

 

 

 

  Long Term Care At a Glance

 

  Marsh Voluntary Benefits

 

 

 

  Reliance Standard Life Insurance

    Agency for Persons with Disabilities

    Department of Children & Families

    Department of Agriculture & Consumer Services

    Department of Elder Affairs

    Department of Juvenile Justice

    Department of Highway Safety & Motor Vehicles

    Department of Law Enforcement

    Department of Revenue

    Department of Transportation

 

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Enrollment Applications

Alta Group Term Life Insurance

(required outside an open enrollment period)

Alta Long Term Disability Insurance

Health Questionnaire

(required outside an open enrollment period)

ARAG Prepaid Legal Insurance

Hartford Accidental Death & Dismemberment

Hartford Group Term Life Insurance

Hartford Long Term Disability

Hyatt Prepaid Legal Expense Plan

Department of Children & Families

Agency for Persons with Disabilities

Department of Transportation

Reliance Standard Life Insurance

Department of Law Enforcement

Department of Revenue

Department of Transportation

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Change Forms

Alta Group Term Life Beneficiary Designation

Hartford Group Term Life Beneficiary Designation

Hartford Accidental Death & Dismemberment Beneficiary Designation

Reliance Group Term Life Beneficiary Designation
Reliance Policy Change

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Conversion Forms

Hartford Accidental Death & Dismemberment

Hartford Long Term Disability

Hartford Group Term Life

Reliance Portability Application

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Claim Forms

Alta Long Term Disability

Alta Group Life Dismemberment
Alta Group Life
Alta Group Life Waiver of Premium

Hartford Accidental Dismemberment

Hartford Accidental Death

Hartford Group Term Life

Hartford Long Term Disability

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Payroll Authorization Forms

Florida Prepaid Tuition Expense Plan Deduction Form

Florida Investment Tuition Plan Deduction Form

PRD Authorization - DC
PRD Authorization - DCF/APD
PRD Authorization - DJJ
PRD Authorization - DOACS
PRD Authorization - DOEA
PRD Authorization - DOH
PRD Authorization - DOR
PRD Authorization - DOT
PRD Authorization - FDLE
PRD Authorization - HSMV

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Refund Request Forms

Request for Refund- DC
Request for Refund- DCF/APD
Request for Refund- DJJ
Request for Refund- DOACS
Request for Refund- DOEA
Request for Refund- DOH
Request for Refund- DOR
Request for Refund- DOT
Request for Refund- FDLE
Request for Refund- HSMV

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Miscellaneous Deduction Payment Forms
Miscellaneous Deduction Payment - DC
Miscellaneous Deduction Payment - DCF/APD
Miscellaneous Deduction Payment - DJJ
Miscellaneous Deduction Payment - DOACS
Miscellaneous Deduction Payment - DOEA
Miscellaneous Deduction Payment - DOH
Miscellaneous Deduction Payment - DOR
Miscellaneous Deduction Payment - DOT
Miscellaneous Deduction Payment - FDLE
Miscellaneous Deduction Payment - HSMV

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