Forms and Documents

FY22 Documents

Life Events (Formerly Family Status Changes)   

Claim Forms

Note: FY22 Claim forms for Hospital Indemnity, Accident, and Short-Term Disability can be found on the MetLife Microsite. FY22 Vision claim forms can be found on the EyeMed Microsite or the Vision Page.

Please Note: If you need to make a change to the amount deducted for an HSA, please call the Benefits Division at 605.773.6027 or email to request the proper form.

  • Second Level Appeal External Review Form