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Open Enrollment for
Under Age 65 Retirees
(cover letter & calculation rate chart)
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Health Insurance Application
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Instructions for Application
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Health Insurance Handbook
SITE LINK 
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2008 Dependent ADD Form
DOWNLOAD 
This form must be used for any qualifying event (QE) that allows you to ADD dependents to your plan. You must complete a Health Insurance Application for election changes such as option changes, new coverage, new waiver or to begin a cross-reference plan.
- 2008 Dependent DROP Form
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This form must be used for any qualifying event (QE) that allows you to DROP dependents from your plan. You must complete a Health
Insurance Application to request other coverage election changes such as electing new coverage, option changes, new waiver or to cease a cross reference plan.
- QUALIFIYING EVENT chart
with documentation requirements
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- Are You Turning 65 soon?
DOWNLOAD 
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Health Insurance Application
DOWNLOAD 
-
Open Enrollment for
Under Age 65 Retirees
DOWNLOAD 
-
Health Insurance Handbook
SITE LINK 
-
Kentucky Employees Health Plan
KEHP
DOWNLOAD 
- 2007 Dependent ADD Form
DOWNLOAD 
This form must be used for any qualifying event (QE) that allows you to ADD dependents to your plan. You must complete a Health Insurance Application for election changes such as option changes, new coverage, new waiver or to begin a cross-reference plan.
- 2007 Dependent DROP Form
DOWNLOAD 
This form must be used for any qualifying event (QE) that allows you to DROP dependents from your plan. You must complete a Health
Insurance Application to request other coverage election changes such as electing new coverage, option changes, new waiver or to cease a cross reference plan.
- Speak up About Diagnostic Imaging with your Doctor
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