2024
Benefits Info
Effective Plan Dates: Jan 1, 2024 - Dec 31, 2024

Service Provider Contacts

Enrollment Contacts

Forms & Documents

2024 Legal Notices
Liberty Capital Formulary 2024 with cover and grids
Premium Assistance Application Form
WellSpan Adoption Assistance Program Policy
SAR WellSpan Health
WELLSPAN CHAMBERSBURG HOSPITAL EMPLOYEE BENEFITS PLAN SAR 2022
WELLSPAN CHAMBERSBURG HOSPITAL EMPLOYEE BENEFITS PLAN SAR 2021-2022
Spousal Medical Insurance Verification Form
How to Enroll Your Dependents
Family Relief Fund - Guidelines and Application