FROM:                         BENEFITS OFFICE

DATE:                          April 16, 2024



If you have not had a chance to verify your annual enrollment information (MEMBER DATA) then please do so as soon as possible to avoid the disruption of Medical, Dental, Prescription & Vision claim processing.  Please review information listed below:

There are two ways of submitting the verification form to the Benefits Office.  You may file it electronically or via paper form. If you choose to file it electronically, it will be available until September 30, 2024. Go to and log into the Member Dashboard.  Click on the link for Verification Form.  This will allow you to review the information the Benefits Office has on record for you and your covered dependents.  Please review carefully.  The only changes you can make on-line will be your home address, phone number and e-mail address.  Those items will be outlined in gold.  Please sign (electronically) at the bottom of the form and click “Submit”.

If you want a paper form and/or if you find any information listed that is incorrect other than your home address, phone number and e-mail address, you will need to call the Benefits Office (309-764-8080) and ask for a form to be sent so you can make those corrections and mail it back to the Benefits Office.   Again this is for verification of Member Data only.  This has nothing to do with open enrollment which ended March 29, 2024.

If you do not complete this form electronically and/or return the paper form to the Benefits Office by September 30, 2024, you and any covered dependents will be termed, lose coverage effective October 1, 2024, and Cobra will be sent.