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Benefits

Retiree Benefits Enrollment Form

Use this form to enroll in Health, Dental, or Vision coverage with UK as a UK Retiree.

07/01/2014 (revision date)
Click to view form (pdf or doc): Retiree Benefits Enrollment Form
Submission Options
Submit paper form to Employee Benefits Office, 112 Scovell Hall
Email form back to benefits@email.uky.edu