Forms and Publications

Employee Benefits

e.g. Def Comp, YMCA Info, Svgs Bonds

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Blue Cross Blue Shield of Illinois Website
- Application & Policy Change .pdf
  - Directions .pdf
- BCBS for Questions & Information
  Prescription Drugs, Other Services - Vision, Mental Health, Breast Cancer Screenings, Well-Child Care, Dental, etc.
- Medical Highlight Sheet .pdf
  - Medical Claim Form .pdf
  - Co-Pays.pdf
- Dental Highlight Sheet .pdf
  - Dental Claim Form .pdf
- BCBS Vision Discount Program - Davis Vision (effective 01/01/2008)
- Discount Vision Program
  - Laser Vision Correction .pdf
  - Contact Lens .pdf
  - Discount Vision Program Providers
- Employee Health Care Benefits Booklet .pdf
- Insurance Buy Out Program - .pdf
- Student Dependent Certificate .pdf
- Prescription Drug Program Highlight Sheet .pdf
  - Prescription Drug Card Claim Form .pdf
- '04 Introductory Letter for PrimeMail, Prim Therapeutices' mail service.pdf
- COBRA -Continuation of Health Insurance .pdf

- Commencing Jan. 1, 2003

What is FSA Flexible Spending Account .pdf
- '08 Enrollment Packet .pdf
- Enrollment. pdf
- Automatic Claim Submission Authorization Form
- Authorizing Reimbursement via Direct Deposit .pdf
- Health Reimbursement Claim Form .pdf
- Dependent Reimbursement Claim Form .pdf
- Eligible Health Care Expenses (472KB) .pdf
- Physician Statement (93KB) .pdf
- Plan Summary (138KB) .pdf
  - 2008 Plan Year Amended 2/20/2008
- Over-the-Counter-Drugs (Reimbursable) .pdf
- Mileage Reimbursement Rate is (0.19) as of 3/19/2008

MISC INFORMATION -(PDF's)

DEFERRED COMPENSATION
- ICMA
  - Contribution Limits
- NACO/PEPSCO Nationwide
  - Contribution Limits
- IMRF - ILLINOIS MUNICIPAL RETIREMENT FUND (800-ASK-IMRF)
  
  275-4673
  - IMRF service credit information .pdf
  - IMRF Numbers
  County #2996
  Forest Preserve # 0944

Q: When will I be vested in IMRF (Illinois Municipal Retirement Fund)?
A: After eight years of employment

FEDERAL TAX ID NUMBERS
    County #36-6006548
    Forest Preserve # 36-6009176
    PBC # 36-3026498

SAVINGS BOND INFORMATION
- Savings Bonds I .pdf
- Saving Bonds EE .pdf
- Series EE Savings Bonds to earn fixed rates beginning with May 2005 issues (5/4/2005) .pdf

VOLUNTARY LIFE INSURANCE
- NCPERS Plan Benefits - Voluntary Life Insurance Plans $16/$12/$9 (effective 6/01/2002) .pdf
- Enrollment Letter --October 5, 2007.pdf
- Voluntary Life Insurance purchase instruction (effective 06/07) .pdf
YMCA FORMS