CONTACT INFO Kelly Rector email Barb Goode email ..................................... DENNY & ASSOCIATES 636.887.4700 / phone 866.858.0920 / toll free 636.887.3081 / fax 1022 Peruque Crossing Court, Ste. B O'Fallon, MO 63366	WELCOME to Urethane Roller Specialist Benefits Directory Denny & Associates, Inc. has provided our valued customers with easy access to all benefits and downloadable insurance forms. Please feel free to contact your representative or Denny & Associates with any questions. We hope that this helpful tool will make your insurance needs easier. Thank You! Medical Benefits with All Savers All Savers Base Plan (CNE-3500/50%) Benefit Summary PDF All Savers Buy-Up Plan (3500/20%) Benefit Summary PDF All Savers Buy-Up Plan (3500/0%) Benefit Summary PDF New Hire Benefit Selection Sheet PDF All Savers Rate Grid PDF All Savers Enrollment & Change Form PDF All Savers Website website All Savers Provider Directory website Basic & Voluntary Life, Dental & Voluntary Vision with Principal Principal President Life Benefit Summary PDF Principal Officers Life Benefit Summary PDF Principal All Other Members Life Benefit Summary PDF Principal Voluntary Life Benefit Summary PDF Principal Voluntary Life Rate Grid PDF Principal Dental Benefit Summary PDF Principal Voluntary Vision Benefit Summary PDF Principal President Enrollment Form PDF Principal Officers Enrollment Form PDF Principal All Other Members Enrollment Form PDF Principal Website website Principal Dental Provider Directory PDF Principal Vision Provider Directory website eService Instructions for Employees PDF How to pull a billing statement Word How to pull forms - including conversion forms Word How to pull Principal booklets Word How to pull reports - including disability claims Word Ordering ID Cards Word Workers Compensation with Missouri Employers Mutual Injury Reporting Kit Steps To Follow PDF Authorization to Obtain Information PDF Work Comp Authorization for Medical Treatment PDF Work Comp Declination of Medical Treatment PDF Employers Physical Capacities Requirements-Return to Work Physic PDF Report of Injury Fax Cover Sheet PDF Incident Corrective Action Form PDF Incident Investigation Report PDF Incident Witness Statement PDF MeM - Report of Injury Form PDF Injury Reporting Kit Injured Employee Kit PDF Employee Incident Injury Report PDF Pay Your Way Auto EFT PDF Pharmacy Coupon PDF Compliance All Savers Base Medical (CNE-3500/50%) Summary of Benefits & Coverage PDF All Savers Buy-Up Medical (3500/20%) Summary of Benefits & Coverage PDF All Savers Buy-Up Medical (3500/0%) Summary of Benefits & Coverage PDF All Savers Base Medical (CN-3500/20%) Certificate of Coverage PDF All Savers Buy-Up Medical (3500/20%) Certificate of Coverage PDF All Savers Buy-Up Medical (CN-3000/0%) Certificate of Coverage PDF Principal President Life Certificate of Coverage PDF Principal Officers Life Certificate of Coverage PDF Principal All Other Members Life Certificate of Coverage PDF Principal Voluntary Life Certificate of Coverage PDF Principal Dental Certificate of Coverage PDF Principal Voluntary Vision Certificate of Coverage PDF ERISA Wrap Document SPD PDF Section 125 Plan Document PDF Section 125 Summary Plan Description PDF Medicare Part D Creditable Coverage Disclosure Notice WORD NGF Standard Notice WORD
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