Notices and Forms

Affidavit of Domestic Partner

Beyond Your Benefits

Creditable Coverage Disclosure

Medicare Enrollees

Declination of Healthcare Coverage Affidavit

Dependent Documentation Requirements

Domestic Partner Eligibility

Newly Eligible Adult Child Dependent Package

Social Security Notice

Creditable Part D Notice

Are you Enrollment Ready?

Your enrollment journey begins here. Click below to get important enrollment information and learn what's changing.

Retiree Benefits

Making an informed enrollment decision is important. Make sure you know which options are best for you.

Tools & Resources

The tools and resources that will help you get the most out of your benefits.

Notices & Forms

Review your plan document, notices or download the forms you need.

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Office of Risk and Benefits Management
1501 N.E. 2nd Avenue, Suite 335
Miami, Florida 33132
Mon - Fri, 8 a.m. to 4:30 p.m. ET
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305-995-7129

FBMC Service Center
Mon - Fri, 7 a.m. to 7 p.m. ET
1-855-MDC-PS4U (1-855-632-7748)