Alachua County, Florida


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Benefits Forms

  • Blue Cross Blue Shield website 
    • Blue Cross Blue Shield Enrollment Form
    • Blue Cross Blue Shield Health and Financial Change Application
    • Dependent Eligibility Verification Form
    • Prior Coverage Affidavit
    • Claim Forms 

  • Flexible Spending Account Forms
    • Medical Spending Reimbursement Form 
    • Dependent Care Reimbursement Form
    • Flexible Spending Account Worksheet


  • Florida Combined Life Dental
    • Enrollment Form
    • Change form - BlueDental Care prepaid plan
    • Change form - BlueDental Choice high or standard option  
    • Dental Claims Form

  • CompBenefits
    • Vision Change Form
    • Enrollment Form and Enrollment Booklet
  • Minnesota Life
    • Beneficiary Change Form  


  • ICMA website
    • 457 Enrollment form
    • Roth IRA enrollment form
    • 457 plan deferral amount change form
    • Roth IRA change form
  • Nationwide Retirement Solutions
    • Deferral Amount Change Form

 

 

 

 


Government
  • Departments / Offices
    • Administrative Services
      • Risk Management
        • Benefits Forms
        • Provider's Phone Numbers & Links
        • Employee Benefits
        • Retiree/Cobra Info
        • Insurance premiums
        • Frequently Asked Questions
        • Health & Fitness Links
        • Florida Trek

Stay Informed
& Get Involved

  • Video On Demand
  • eGov Services
  • News / Press Releases
  • Newsletters
  • Channel 12 Schedule
  • Commission Audio
  • A.C.C.E.S.S.
  • Advisory Boards


Submit a request for non web related service. e.g. Pothole on your road, etc.




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Copyright © 1996-2008 Alachua County Florida.
This website is a public service. Please read the Legal Disclaimer.
Website designed and engineered by Alachua County ITS.Applications Division
For more information read about this website. Version 2006 (v4.7.1)

Under Florida law (Statute 119.011), all information, including e-mail, written letters, documents and phone messages,
sent to the Alachua County Board of County Commissioners is subject to Public Records law. This includes the sender's e-mail address,
home address or phone number if shown in the message, the content of the message and any associated attachments to the mail.
Also please be aware that electronic correspondence (e-mail) is made available on the Commission's public archive site immediately upon being sent.
Instead, contact Alachua County Offices by phone or in writing.

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