Notices/Forms

Enrollment and Change Form

To enroll an employee or to make employee changes please complete the attached enrollment/change form and send it to your current Mercer contact.

Email it to CBS.HBP.Billing&Eligibility@mmc.com or fax it to 1-319-887-4220.

Crystal Ruth (515-365-1114) is the contact for housing authorities in Alabama, Arkansas, Florida, Georgia, Kansas, Louisiana, and Missouri.

Alicia Schossow (515-365-1013) is the contact for housing authorities in Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee, and Texas.

Important Information for Newly Enrolled Employees

Life Insurance Information

Portability and Conversion at a glance

Conversion Application

Portability Application

The Standard’s Death Claim Packet

Instructions for completing the Death Claim Packet

Waiver of Group Health Benefits

Wellness Bonus Program shared by the Housing Authority of St. Louis County, MO

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