Forms
2010 Active Employee Application (PDF - 233 KB)
2010 Kentucky Retirement System Retiree Application (PDF - 135 KB)
2010 Kentucky Teachers' Retirement System Retiree Application (PDF - 128 KB)
2010 Judicial and Legislative Retirement Systems Retiree Application (PDF - 82 KB)
2010 Update Form (PDF - 49 KB)
2010 Add Form (PDF - 61 KB)
2010 Drop Form (PDF - 158 KB)
Non-Smoker Affidavit (PDF - 33 KB)
Post-Tax Request Form (PDF - 42 KB)
Authorization for Release of Information
Shortfall Refund Request (PDF - 7.94 KB)
Health Insurance Refund Request For KY Employees(PDF-9.52 KB)
Web Billing form (PDF-25KB)
Pre Tax Request Form 2010 (PDF-204KB)
Insurance Coordinator Verification Form (PDF - 39 KB)
Transmittal Log (PDF - 10 KB)
Medicaid Eligibility/Termination Form and Instructions (PDF - 40 KB)