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Employee Benefits Information
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Claim Forms
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Claim Forms
Below, please find various flexible benefit claim forms to aid in the process of processing a claimed benefit.
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CONTACT
Claim Forms
Flexible Benefits Specialist
Phone
404-463-3589
Email
HRA.Flexbenefits@doas.ga.gov
View All Division Contacts
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RELEVANT LINKS
Human Resource Administration
Claim Forms And Documents
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Priority
Date
File Type
Alphabetically
01/13/15
Specified Illness Claim Form
01/13/15
Delta Dental Claim Form
01/13/15
Long Term Care Coverage Form
01/13/15
Blue View Walmart Claim Form
01/13/15
Accelerated Benefit Option Claim Form
01/13/15
Accidental Death & Dismemberment Claim Form
01/13/15
Life Waiver of Premium Claim Form
01/13/15
Vision ID Card Printing Instructions
01/13/15
Dependent Care Spending Account Claim Form
01/13/15
Health Care Spending Account Claim Form
01/13/15
Aflac CAIC Specified Illness Health Screening Form
10/17/17
How to File a Disability Claim
10/17/17
Disability Claim Form
07/15/19
Short Term Disability Claim Packet - State of Georgia
07/15/19
Long Term Disability Claim Packet – State of Georgia