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Benefit Plan Information and Forms Select a document from the menu tree below. All forms require the Adobe Acrobat Reader. Benefit Guide 2012-2013 Benefit Guide 2011-2012 2012-2013 Enrollment Form Dental Plan Summary & Rates Provider List OraQuest Home Page Vision Plan Summary & Rates Block Vision Home Page Disability Plan Summary Plan Rates Claim Form Division Policy Numbers for Claims Check claim status online - instructions Unum Website Cancer Plan Summary Plan Brochure Claim Form Wellness / Cancer Screening Information Direct Deposit Authorization APL Website Accident Plan Summary & Rates Claim Form Loyal American Website Critical Illness - Aquilla ISD & Buckholts ISD Plan Summary Rate Sheet Application Loyal American Website Medical 2012-2013 TRS Enrollment Guide TRS ActiveCare Highlights 2011-2012 TRS Enrollment Guide TRS Application and Change Form Application to Split Premium TRS Website MEDLink Brochure Claim Form APL MEDLink Video American Public Life Home Page Life Plan Summary Evidence of Insurability / Enrollment Form Portability Application Conversion Application Voluntary life and AD&D Booklet Free Online Will Preparation Dearborn National Website Identity Theft Plan Summary ID Watchdog Website Reimbursement Plan 2012 - NBS Flex Flex Brochure FSA Claim Form Dependent Care Worksheet Direct Deposit Request Form Orthodontic Payment Worksheet Participant Web Login Instructions 2011 - MGM Flex Flex Guide Flex Flyer without Flex Card Sample Receipt Health Care Reimbursement Claim Form Dependent Care Claim Form Direct Deposit Form MGM Website Cobra Continuation of Coverage		Enrollment Links Employee Login Enrollment Instructions Administrator Login Quick Links > FBS Homepage > CBG Homepage > NBS Flex > APL MEDLink Video Combined Benefits Group, Inc. PO Box 164195 Austin, TX 78716 Local: (512) 261-6458 Toll Free: (800) 749-6458 Fax: (512) 261-6975 www.cbg-online.com Financial Benefit Services, LLC 2121 N. Glenville Drive Richardson, Texas 75082 Local: (469) 385-4640 Toll Free: (800) 583-6908 Fax: (469) 385-4641 www.fbsbenefits.com
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