Are you a newly hired employee and classified as a Courtesy Clerk?
Please fill out the following form(s)
Have you worked at least 4 months of qualifying hours and are you classified as a Standard General Employee?
Have you worked at least 25 months of qualifying hours and are you classified as an Ultra General Employee?
Have you worked at least 72 months of qualifying hours without a break in service and are you classified as a Premier General Employee?
Are you in the process of retiring, and/or a current retiree?
You have responded no to all questions in your ENROLLMENT FORM SELECTION GUIDE. If you feel you have marked a response in error, you may click the “START OVER” button to repeat the questions. If you have further questions, please call Health and Welfare Services department at 1-800-552-2400
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