For your convenience all of the required forms are now online. Each form comes in an easy to read and use pdf format.

The forms maybe completed in one of two ways:

  1. Print the form and complete by hand, OR;
  2. Complete the form on your computer, then print and sign.

Send completed forms via interoffice mail, postal service, or in person, to CAPC's benefits staff representative listed in the Contact information of this website. FORMS MAY NOT BE ELECTRONICALLY TRANSMITTED

Vision Insurance

Humana

Summary of Vision Benefits

Download Form

Enrollment Form

Humana Benefits Enrollment Form

Download Form

Change Form

Humana Benefits Change Form

Download Form

Waiver Form

Humana Vision Care Waiver Form

Download Form

Cancellation

Humana Vision Cancellation Form

Download Form

Vision Benefits

New vision benefits

Contacts Direct

Glasses.com

Rates

Vision Plan Premiums

Vision Premuims on 3rd page

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