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CLASSIFIED - ACTIVE

2019-2020 TEAMS 1 RATES

PSUSD BG TEAMS I RATES 19-20 12.5.19.pdf 694.39 KB (Last Modified on Friday at 3:50 PM)

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2019-2020 TEAMS II RATES

PSUSD BG TEAMS II RATES 19-20 12.5.19.pdf 716.78 KB (Last Modified on Friday at 3:52 PM)

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2019-2020 GRANDFATHER RATES

PSUSD GRANDFATHERED TEAMS RATES 19-20 12.5.19.pdf 707.27 KB (Last Modified on Friday at 3:40 PM)

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TEAMSTER/CLASSIFIED FORMS

TEAMSTERS ENROLLMENT/CHANGE FORM

Teams Enrollment Form 4.04.17.pdf 445.02 KB (Last Modified on August 25, 2017)

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TEAMSTERS LIFE INSURANCE BENEFICIARY DESIGNATION FORM

Teams Life Insurance Beneficiary Designation Form.pdf 82.94 KB (Last Modified on August 25, 2017)

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TEAMSTERS CHANGE OF ADDRESS FORM (SEND TO NWA)

NWA Change of Address Form.pdf 42.76 KB (Last Modified on August 25, 2017)

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DENTAL

DELTA DENTAL PPO INCENTIVE PLAN SUMMARY

Delta Dental PPO Incentive Plan Summary 2017.pdf 536.76 KB (Last Modified on February 21, 2018)

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DELTA DENTAL PPO PLAN SUMMARY

Delta Dental PPO Plan Summary 2017.pdf 531.58 KB (Last Modified on February 21, 2018)

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DELTACARE USA HMO PLAN SUMMARY

DeltaCareUSA HMO Plan Summary 2017.PDF 372.31 KB (Last Modified on February 21, 2018)

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DELTA DENTAL ENROLLMENT/CHANGE FORM

Delta Dental Enrollment Form Active.pdf 212.24 KB (Last Modified on August 25, 2017)

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LIFE

LEGAL

METLAW - ENROLLMENT FORM

MetLaw Enrollment Form 8.15.17.pdf 148.09 KB (Last Modified on August 25, 2017)

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COBRA

COBRA RATES

COBRA Rates Oct. 2019-Sept. 2020.pdf 75.12 KB (Last Modified on November 26, 2019)

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COBRA VISION ENROLLMENT FORM

Vision Enrollment Form - COBRA.pdf 44.85 KB (Last Modified on October 17, 2017)

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COBRA DENTAL ENROLLMENT FORM

Delta Dental Enrollment Form COBRA.pdf 180.83 KB (Last Modified on October 17, 2017)

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