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2026 Documents, Forms and Legal Notices ​

Forms 

2026 Employee Benefits Enrollment Change Form
​​2026 Exception Form​​
2026 Federal Post Tax Request Form​​
2026 Summer Transfer Form
​Checklist for New Employees​​
Medicaid Eligibility Termination Form​​​ ​​
Tobacco Use Change Form​​​

Documents

​2026 Benefit Selection Guide Digital Magazine​
​​​2026 Benefits Selection Guid​e​​
2026​​​ Benefits Gri​d​​​​
2026 Premiums​​

​​Legal Notices

​​COBRA Right​s​
Notice of Privacy Practices
KEHP Authorization for Release of I​nformation​​
​KEHP Request for Accounting o​​​​f Disclosures​​
​KEHP Request for Al​ternate Communications​
KEHP Request for Restrictions​
KEHP Request to Amend PHI​
KEHP Request to Inspect or Copy PHI
2026​ Legal Notices
​​2026​ Terms and Conditions​​
​2026 Tobacco Use Declaration
​2026 Women's Health and Cancer Rights Act Notice​
​2026 Medicare Prescription Drug Creditable Coverage Notice

Pharmacy

Member-Friendly ACA Preventive Services List
ACA Preventive Services List
KEHP Preventive Drug List​
​KEHP Specialty Drugs Requiring Prior Authorization​​​
KEHP Value Formulary Quick Reference​
KEHP Value Formulary Drugs Requiring Prior Authorization – Non Specialty​​

​Life Insurance​​​​

​2026​​​ MetLife Rates
​Life Insurance and ADD Certificate of Coverage​​​​
Life Insurance Plan Summary​​​​​
​MetLife Enrollment Change Form​​​​​

Summaries of Benefits and Coverage

2026 LivingWel​l CDHP SBC
2026 LivingWell PPO SBC
2026 LivingWell Basic CDHP SBC​
2026 LivingWell ​HDHP SBC
2026 Uniform Glossary​

Summary Plan Descriptions and Medical Benefit Booklets​

2026 RX SPD LivingWell CDHP​
2026 ​RX SPD LivingWell PPO​​​
2026 RX SPD LivingWell Basic CDHP​
2026 RX SPD LivingWell HDHP
​​​​​2026 Healthcare FSA SPD​​
​2026 Child Adult Daycare FSA SPD​​
​2026 LivingWell CDHP​
​2026 LivingWell PPO​
​2026 LivingWell Basic CDHP​
​​2026 LivingWell HDHP
​2026 Integrated HRA SPD
2026 Waiver General Purpose HRA SPD
​2026 Waiver Limited Purpose HRA SPD

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​2026 Guía de Selección de Beneficios
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