An Official Website of the Commonwealth of Kentucky
2026 Employee Benefits Enrollment Change Form2026 Retiree Enrollment Change Form2026 ADA Active Enrollment Form2026 Dental Insurance Enrollment/Change Form2026 Vision Insurance Enrollment/Change Form2026 KEHP Federal Post Tax Request Form2026 Open Enrollment Exception FormChecklist for New EmployeesMedicaid Eligibility Termination Form Tobacco Use Change Form
2026 Benefit Selection Guide Digital Magazine2026 Benefits Selection Guide2026 Benefits Grid2026 How to Enroll2026 Premiums2026 BSG 508 Compliant2026 ADA Benefits Grid
COBRA RightsNotice of Privacy PracticesKEHP Authorization for Release of InformationKEHP Request for Accounting of DisclosuresKEHP Request for Alternate CommunicationsKEHP Request for RestrictionsKEHP Request to Amend PHIKEHP Request to Inspect or Copy PHI2026 Legal Notices2026 Terms and Conditions2026 Tobacco Use Declaration2026 Women's Health and Cancer Rights Act Notice
Member-Friendly ACA Preventive Services ListACA Preventive Services ListKEHP Preventive Drug List2026 Value Formulary Quick ReferenceKEHP Value Formulary Drugs Requiring Prior Authorization – Non Specialty
Life Insurance and ADD Certificate of Coverage2026 OE Life Plan Summary2026 MetLife RatesMetLife Enrollment Change FormMetLife Portability ApplicationMetLife Privacy NoticeMetLife Portability v. Conversion BrochureMetLife Conversion Application
2026 LivingWell CDHP SBC2026 LivingWell PPO SBC2026 LivingWell Basic CDHP SBC2026 LivingWell HDHP SBC2026 Uniform Glossary
2026 RX SPD LivingWell CDHP2026 RX SPD LivingWell PPO2026 RX SPD LivingWell Basic CDHP2026 RX SPD LivingWell HDHP
2026 Guía de Selección de Beneficios2026 FORMULARIO DE INSCRIPCIÓNCAMBIO DE BENEFICIOS PARA EMPLEADOS2026 FORMULARIO DE EXCEPCIÓN PARA LA INSCRIPCIÓN ABIERTAResumen de Bronce VisionResumen de Plata VisionResumen de Oro VisionResumen de Bronce DentalResumen de Plata DentalResumen de Oro Dental
Exception FormEmployee Benefits Enrollment Change FormRetiree Enrollment Change FormADA Active Enrollment FormDental Insurance Enrollment/Change FormVision Insurance Enrollment/Change FormKEHP Federal Post Tax Request FormChecklist for New EmployeesMedicaid Eligibility Termination Form Tobacco Use Change Form2025 Summer Transfers – BOEs Only
2025 RX SPD LivingWell Basic CDHP2025 RX SPD LivingWell HDHP2025 RX SPD LivingWell CDHP2025 RX SPD LivingWell PPO2025 Healthcare FSA SPD2025 Waiver Limited Purpose HRA SPD2025 Waiver General Purpose HRA SPD2025 Child Adult Daycare FSA SPD2025 Integrated HRA SPD2025 Voluntary Carrum Health SPD2025 LivingWell PPO Medical Benefit Booklet2025 LivingWell Basic CDHP Medical Benefit Booklet2025 LivingWell CDHP Medical Benefit Booklet2025 LivingWell High Deductible Health Plan
2025 Benefit Selection Guide Digital Magazine2025 Benefits Selection Guide2025 Benefit Selection Guide in Spanish2025 How to Enroll2025 Benefits Grid2025 ADA Benefits Grid2025 What's New or Changing2025 Premiums2025 BSG 508 Compliant
COBRA RightsNotice of Privacy Practices2025 Medicare Prescription Drug Creditable Coverage NoticeKEHP Authorization for Release of InformationKEHP Request for Accounting of DisclosuresKEHP Request for Alternate CommunicationsKEHP Request for RestrictionsKEHP Request to Amend PHIKEHP Request to Inspect or Copy PHI2025 Legal Notices2025 Terms and Conditions2025 Tobacco Use Declaration2025 Women's Health and Cancer Rights Act Notice
Member-Friendly ACA Preventive Services ListACA Preventive Services ListKEHP Preventive Drug ListValue Formulary Quick ReferenceKEHP Specialty Drugs Requiring Prior AuthorizationValue Formulary Drugs Requiring Prior Authorization
2025 Life Insurance and ADD Certificate of CoverageMetLife Enrollment Change FormMetLife Portability ApplicationMetLife Privacy NoticeMetLife Portability v. Conversion BrochureMetLife Conversion Application2025 MetLife Rates
2025 LivingWell CDHP SBC2025 LivingWell Basic CDHP SBC2025 LivingWell PPO SBC2025 LivingWell HDHP SBC2025 Uniform Glossary
2025 FORMULARIO DE INSCRIPCIÓNCAMBIO DE BENEFICIOS PARA EMPLEADOS2025 FORMULARIO DE EXCEPCIÓNResumen de Bronce VisionResumen de Plata VisionOroResumen de Oro VisionResumen de Bronce DentalResumen de Plata DentalResumen de Oro Dental
Follow Us On Facebook Twitter YouTube LinkedIn
© Commonwealth of Kentucky. All rights reserved.
Kentucky.gov
