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For Your Employees Medical Insurance Prescription Drug Option Dental Insurance Vision Insurance Life & AD&D Dependent Life Voluntary Life Long Term Disability Short Term Disability Personal Accident Insurance	For Your Bank Financial Institution Bond Directors' & Officers' Liability Property & Casualty Lenders Single Interest Mortgage Protection Flood Solutions Bank Owned Life Insurance	For Your Customers Accidental Death & Dismemberment Individual Preferred Medicare Companion	WBA Insurance Trust Members About the Trust Bank Login Medical Login Life, LTD, STD Employee Login Medical Registration Medical Login Pharmacy Registration/Login Dental Registration/Login Administration Important Information Plan Documentation NonDiscrimination Requirements Continuation/Conversion Forms Provider Directories Pharmacy Information Wellness Information HIPAA Privacy Notice Gramm Leach-Bliley	About Us WBA Employee Benefits Corporation Staff Information

Please read the Important Information section before proceeding.

Employee Enrollment Forms

Employee Enrollment Form Used to enroll employees for bank benefits. Please use the Waiver of Coverage if an employee is voluntarily terminating coverage.

Waiver of Coverage Used when an employee voluntary declines or terminates a coverage.

Change Notice Used to make name or address changes.

Termination Notice Used to terminate an employees coverage. Please use the Waiver of Coverage if an employee is voluntarily terminating coverage.

Claim Forms

Life

Long Term Disability

Short Term Disability

Waiver of Premium