Bi-State Development
One Metropolitan Square
211 North Broadway, Suite 700 St. Louis, MO 63102 ©2023 Bi-State Development. All Rights Reserved.
EMPLOYEE RESOURCES
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Manage Your Benefits

The People Behind Progress

Manage Your Benefits

 

Forms & Brochures

Beneficiary Designation Forms

Standard Life Insurance Beneficiary Form

Misc Payments Beneficiary Designation

Pension Beneficiary Designation Form

Contributions

2023 Active ATU Contribution Rates

2023 Active IBEW Contribution Rates

2023 Active Salaried Contribution Rates

2023 ATU Retiree Contributions

2023 IBEW Retiree Contributions

2023 Salaried Retiree Contributions

Employment Verification Forms

The Work Number/Talx Brochure

Financial Forms

Lincoln Financial 401(k) Enrollment Guide

Lincoln Financial 401(k) Rollover Request

Goverment Tax Withholding Forms

Federal Withholding Form W-4 (Employee)

Illinois Withholding Form W-4 (Employee)

Missouri Withholding Form W-4 (Employee)

 

Health & Welfare Program Forms

Medical-Dental-Vision Enrollment Form

Paylocity FSA Enrollment Brochure & Claim Form

Beneflex SECTION 213 FSA Expenses

Delta Dental Benefits 24

Delta Dental Benefits 24 Login

Delta Dental Claim Form

Express Scripts Claim Form – Employees & Retirees < Age 65

Express Scripts Claim Form – Retirees > Age 65

Eye Med Brochure

EyeMed Out of Network Claim Form

CIGNA Claim Form

Medicare Certificate of Creditable Coverage

Release of Information

Full-Time Call-A-Ride Optional Life Application

Full-Time Salaried Optional Life Application

IBEW Optional Life Application

HIPAA Information & Forms

HIPAA Disclosure Release Form

HIPAA Notification Communication

Notice of Privacy Practices (2017)

Breach Notification Log

Breach Policy – Protected Health Information

Miscellaneous Forms

Employee Change Form

Total Fitness Member Application Form

Total Fitness Waiver and Release Form

 

Pension Estimate & Retirement Declaration Forms

Call Milliman at 1-877-265-7703 for a Pension Estimate (estimate only based on potential retirement date) or a Pension Packet (retirement documents at least 30 days prior to declared retirement date)

Submit completed forms by mail to:
Milliman Inc.
1301 Fifth Avenue, Suite 3800 
Seattle, WA 98101

 

Completed enrollment and beneficiary forms should be sent to the Benefits Dept. as follows:

Interoffice Mail:  Benefits – Mail Stop 125

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USPS:

Bi-State Development/Benefits

211 N. Broadway, Suite 700

St. Louis, MO 63102

ATTN: Mail Stop 125