Open Enrollment Forms 2025

Updated October 15, 2024

You must have a PDF reader to open and complete these files online. The download Adobe Reader, please click the icon below.

DayForce Instructions

DayForce Open Enrollment Instructions

---

Forms: Please completely fill out these forms and do not skip any highlighted areas.

First Reliance Standard Life Insurance Company (Evidence of Insurability Form)

---

Lake Shore Savings Bank HSA Brochure

---

Lake Shore Savings Bank HSA Enrollment Form

---

AIG Beneficiary Designation Form

Informational Sheets

TRCS-Union-and-NonUnion-HSA-Plan-SBC

---

TRCS-UnionNonUnion-NONHSA-Plan

---

Pro-Flex FSA Expenses

---

TRCS Full Plan Comparison Page

---

TRCS Summary of Dental Benefits (coming soon)

---

VSP Vision Care Benefits

---

VSP Vision Care Doctor List

---

VSP Vision Care Provider List

---

Independent Health MyIH App

---

Independent Health Find a Doctor

---

Independent Health Telemedicine Benefit

---

Independent Health Medical Help Line

---

Independent Health $0 Preventative Care Services

---

TRCS Prescription Benefits

---

403b Summary Plan Description (coming soon)

---

Vendor Contact List