PSW Retiree website Archive:
- 2011-Revised-Active-Benefits-OE-Announcement-9-6-11
- 2011M_CareClaim_Form
- 2013-Medicare-A-and-B-Premium-Claim-Form
- 2014-Medicare-A-and-B-Premium-Claim-Form
- BlueCross-HIPAA-AUTHORIZATION.ecbef0ae-d172-4ce9-a86e-457b26992a66
- Caremark-Prescription-Benefits-Guide.d99ce969-0081-4b44-84fa-ef7a72be4b69
- CCF09142009_00001.e64be091-4b94-49e6-8aca-9d736014ec34
- CCF12222008_00001.ef202ad2-996c-4c89-a1c0-0998a291c8e5
- Change-of-Address
- CLAIM-RESEARCH-FORM
- CoreSource Decision Support Tools.a17eef96-bb25-4a90-a7aa-71a049192fc0
- Coresource HIPAA Auth.8f7ccec7-ce86-42cb-ac12-4bb3005f0235
- Coresource Palatine WEB Mail Form (2).9d8ec8ea-2cc0-475d-95a0-de4ab107dc38
- Coresource PPO Claim Form.1b62b77c-3905-410f-a701-1f09a7af7001
- Coresource Pre-Admission Review Process.257ed33d-f33e-4adc-9f7a-886769008777
- Dental-Comparison-in-retirement-11-1-2012
- Dental-Comparison-in-retirement
- directdeposit-form.4165a537-a34f-4f9c-98cf-2a5a2d195bb2
- Feed your health – Kaiser Permanente.35da1287-52e5-41c0-ad89-e76e68c3ecc3
- Feed your health – Kaiser Permanente.fd0569c5-c6d4-4458-a915-a7f9e0fa8d24
- Hartford Beneficiary Designation Form.1f959cd6-e1f1-4327-ae00-8088549fb38e
- Hartford Life Certificate of Coverage.8d906165-cb18-4b46-8159-5c5bc840ff31
- Hartford Life Insurance Benefit Summary.4513d459-9b42-40ac-a74b-a21272aabb6d
- Hartford_Beneficiary_Designation_Form.e50d6faf-9f09-4eef-a1e8-cff3996d73ed
- ING-Life-Booklet-8-9-2012.c9413cd3-4b46-4230-90b5-29e778b11183
- January-2013-Newsletter-edfj-01-08-2013-B
- Kaiser Expense Reimbursement Form1
- Kaiser Health Roads Benefit Brochure.0f10c65d-aa1f-43c5-af70-6c3d6c822fbb
- Kaiser Health Roads Benefit Brochure.7a21fa10-733e-4649-bd07-30787261080e
- Kaiser Post September 1, 2004 retirees under age 65.4747f20d-25e6-4ef5-8189-e7890ad72fb4
- Kaiser Post September 1, 2004 retirees under age 65.c12d8593-3982-4e8d-813b-f76ca6a28cef
- Kaiser Senior Advantage Pre September retirees over age 65.ce1ea256-105e-420a-b000-3839e2972166
- Kaiser Travel Brochure.12f2aab7-1d0f-4f19-9ba5-913cd73a7c98
- Kaiser Travel Brochure.dad9e3a9-59bf-4e2e-8da5-45e2a52f51fa
- Kaiser_Expense_Reimbursement_Form1
- Kaiser-ER-Claim-Form.85e8154b-4329-403d-9278-7d80cece3497
- KAISER-HIPAA-Authorization-Form-Feb2012.417bd6ce-451c-4e22-b37d-97d56a3e1353
- M_CareClaim Form
- Medco Mail Order RX Order Form.c095b9a2-d4bd-4559-8345-61783b800c8e
- Medco Mail Order RX Order Form.d047283f-c5fc-4a0a-9285-e6a9ad4223db
- Medco Retail RX Claim Form.22ea3968-7a27-4bea-b821-bdd2c4352d40
- Medco Retail RX Claim Form.84517f9b-dec9-4f6e-ae7a-91c8b7b2ec2e
- Medicare 2006
- Medicare B Claim and Documentation Request Form1
- Medicare_Part_B_Factsheet
- Medicare-Claim-Form
- Medicare-Reimbursement-Letter
- Medicare-Reimbursement-Program
- Participating-Pharmacies-List.e58eed15-6f69-4db7-9071-11b2bd18dc7c
- PCCD_Kaiser_Medical_Expense_Reimbursement_Form_revised_10-09-2012
- PCCD-Kaiser-Medical-Expense-Reimbursement-Form-2-8-11
- PCCD-Kaiser-Medical-Expense-Reimbursement-Form-revised 8-9-13
- PCCD-Medicare-SPD-Restated-2-22-2012
- PCCD-Mobile-Apps-Flyer-Retirees-4-29-2013
- PCCD-Self-Funded-Retiree-Summary-Post-July-1-2004-Retirees.daa298c9-9e30-4f28-a8c7-fbfa8cc6dfef
- PCCD-Self-Funded-Retiree-Summary-Pre-July-1-2004-Retirees.b175930b-735a-435a-8fb0-35a1433a15c5
- Pension Dynamics Direct Deposit Form
- Peralta – 2012 $0 HMO Benefit Summary.d4c0a138-e943-42a8-a5a8-413c91e46568
- Peralta – 2012 $0 Senior Advantage Benefit Summary.f8d61fc7-e700-4c6c-8012-20a2a7e69167
- Peralta – 2012 $10 HMO Benefit Summary (2).dcd9e2fd-be37-4e8b-b1bd-45bd21cc4e09
- Peralta – 2012 $10 Senior Advantage Benefit Summary.068ecb38-dbc2-4439-836f-b63ba9d26a65
- Peralta – 2012 $15 HMO Benefit Summary.0275a657-9751-419b-8be1-8766b026bfc3
- Peralta – 2012 $15 Senior Advantage Benefit Summary.b3f4fe56-e398-4615-bf84-8b5ef5cb7c3e
- Peralta – 2012 Medicare Cost Benefit Summary.b04232b6-8968-465e-bd17-d0ab7ec504b2
- Peralta – 2012 Medicare OOA Benefit Summary.d1c84dd1-d173-4c09-aa47-85bbb4407fa6
- PERALTA COMMUNITY COLLEGE DISTRICT medicare spd.5b323864-9d9d-43f8-9b0f-7d8078c076ab
- peralta contract 1997-2000.953e5822-f607-4692-b1e8-68205e9b97a9
- Peralta contract 2000-2003.748d78a6-4d4e-4a8a-9726-8c9ec3473c48
- peralta contract 2004-2009.a988a28b-5092-44b0-8075-fa86ac222bc1
- Peralta Creditable Coverage Notice AFTER MAY 15 06.c838d8d5-a6d3-4d59-8585-235b34818ec5
- peralta initial letter.02b5b486-ab4a-479f-ae7b-bcccecfda98e
- Peralta-2013-2014-Monthly-Contribution-Rate-Matrix-Active-EE-5-2-2013
- peralta-retiree-faqs-10-11-2011
- Peralta-Retiree-Medicare-FAQs.6f843868-895e-4f2f-831e-5eb3489a9764
- PMI Dental Plan (Senior Advantage Members Only).47958a6e-3827-4365-8914-46342ff889a1
- Post September 2005 Retirees under Age 65.24c38d74-368e-4be2-b876-d74e633f12b3
- Pre September 2005 under age 65.5995fa39-df2d-431b-9aaa-5c796d06a01b
- Retiree-Medicare-AB-Claim-Form
- RETIREE-OPEN-ENROLLMENT-CHANGE-FORM-4-26-2012
- REVISED-Coresource-Claim-Form-031708.95bfe21a-312f-4339-802e-2a0204ebd771
- Spectera Vision Benefit Guide.0ef6ad58-33f2-4808-8ce3-2ad0852a9b5a
- Spring-2012-Peralta-Retiree-Open-Enrollment-4-26-12-FINAL
- SSA-Medicare-Booklet-May-2013
- Survivor-Guidance-Info-09-21-2010
- Survivor-Guidance-Information-8-1-2013
PDF files