STA Benefit Trust Documents

Benefit Booklet

Dental Benefits

Dental Benefits (Update)

Guardian Dental

Legal Plan

Life Insurance Benefits

Unum Travel Assistance

Vision Plan - VSP

Forms

Affidavit for Domestic Partnership

Affidavit for Financial Interdependence

Application for Continuation of Domestic Partnership

Appointment of a Personal Representative

COBRA Information

COBRA Notice Form #3

Family and Medical Leave Act (FMLA)

Fitzharris Address Change Form

Fitzharris Application

General Notice of COBRA Continuation Coverage Rights

Instructions for Enrolling Domestic Partners

Payroll Deduction Authorization

Privacy Notice

Proof of 12-Month Residency

Request for Domestic Partner Application

STA Benefit Trust Policies and Practices

STA Member Form

STA Trust Privacy Notice

STA Benefit Trust Maternity Leave Form

Unum Death Beneficiary Card

Unum Life Benefit Planning Benefit