ALL COMPLETED FORMS FROM THIS PAGE SHOULD BE TURNED IN TO THE BOOKKEEPING OFFICE AT THE WARREN DISTRICT ADMINISTRATION OFFICE

Affidavit of Spousal Health Care Coverage

ARBenefits Enrollment Form

•      Information for 2018 Health Care Requirements
•      How to complete the online Health Assessment
•       Spousal affidavit form
•       Primary Care Provider Form….employee will fax this to ARBenefits

Data Path HSA Application

• HSA Account login instructions

Delta Dental Enrollment/Change Form

Direct Deposit Change Form