Internal Healthcare Forms

for employees

resources for employees

Internal Healthcare Forms

This page is intended for Geauga County employee use only.

Title
File
Date
Year Category
CEBCO/Anthem Medical Booklet Enhanced 1C Plan 2024 CEBCO-Anthem-Enhanced-Plan-1C-Benefit-Booklet-2024.pdf Jun 26, 2024 2024-06-26 Healthcare Information
CEBCO/Anthem Medical Booklet Basic 4D Plan 2024 CEBCO-Anthem-Basic-Plan-4D-Benefit-Booklet-2024.pdf Jun 26, 2024 2024-06-26 Healthcare Information
2024 Wellness Program Info and Instruction 2024-Wellness-Program-Info-and-Instruction.pdf Jan 23, 2024 2024-01-23 Internal Healthcare Forms
2024 Anthem 4D Plan Summary 2024-Anthem-4D-Plan-Summary.pdf Nov 22, 2023 2023-11-22 Healthcare Information
2024 Anthem 1C Plan Summary 2024-Anthem-1C-Plan-Summary.pdf Nov 22, 2023 2023-11-22 Healthcare Information
Healthcare Insurance Waiver 2024 Healthcare-Insurance-Waiver-2024.pdf Oct 2, 2023 2023-10-02 Healthcare Forms
Healthcare and Dental Contribution Rates 2024 Healthcare-Dental-Contribution-Rates-2024.pdf Oct 2, 2023 2023-10-02 Healthcare Information
Anthem Healthcare Booklet 2024 Anthem-Healthcare-Booklet-2024.pdf Oct 2, 2023 2023-10-02 Healthcare Information
Injury Reporting Packet for Supervisor InjuryReportingPacket-Supervisor.pdf Feb 22, 2023 2023-02-22 Workers' Compensation
Injury Reporting Packet for Employee InjuryReportingPacket-Employee.pdf Feb 22, 2023 2023-02-22 Workers' Compensation
Deferred Compensation Options Deferred-Comp-Options-v2.pdf Nov 22, 2022 2022-11-22 More Benefit Information
Employee Assistance Program:  ComPsych EAP Suite of Services Employee-Assistance-Program-ComPsych-EAP-Suite-of-Services.pdf Oct 18, 2022 2022-10-18 More Benefit Information
Healthcare Enrollment Form HealthcareEnrollmentForm-2023.pdf Oct 6, 2022 2022-10-06 Healthcare Forms
Healthcare Change Request Form HealthcareChangeRequestForm-2023.pdf Oct 6, 2022 2022-10-06 Healthcare Forms
CEBCO Transparency in Coverage Rule CEBCOTransparencyInCoverageRule.pdf Jul 20, 2022 2022-07-20 Healthcare Information
Anthem Life Employee Application Form AnthemLifeInsApp.pdf Jan 10, 2022 2022-01-10 More Benefit Information
Delta Dental Video Presentation Oct 20, 2021 2021-10-20 Healthcare Information
CEBCO Program and Apps 2022 2022-CEBCO-Programs-and-Apps.pdf Oct 20, 2021 2021-10-20 Healthcare Information
CEBCO Healthcare Phone List – 2022 2022-Healthcare-Phone-List.pdf Oct 20, 2021 2021-10-20 Healthcare Information
Delta Dental Summary of Benefits Delta-Dental-Summary-Benefits.pdf Oct 1, 2020 2020-10-01 Healthcare Information
Delta Dental Insurance Card Delta-Dental-Insurance-Card.pdf Oct 1, 2020 2020-10-01 Healthcare Information
Anthem Life Certificate of Coverage AnthemLifeCertificateOfCoverage.pdf Aug 18, 2020 2020-08-18 More Benefit Information
Anthem “Live” Health Online Setup Anthem-Live-Health.pdf Jan 6, 2020 2020-01-06 More Benefit Information
Anthem Annual Routine Preventative Eye Exam 2018-CEBCO-Routine-Eye-Exam.pdf Dec 19, 2018 2018-12-19 Healthcare Information
Section 125 Summary Plan Description Section125SummaryPlanDescription.pdf Oct 16, 2017 2017-10-16 More Benefit Information
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