Part-Time Faculty Medical Insurance Reimbursement Application

Click here for a PDF of the Application Form. 

 http://or.aft.org/047540?action=downloadasset&assetid=2dc6a6c1-f109-4851-bc43-d80e8ce62664

Click here for a WORD version of the Application Form 

 http://or.aft.org/047540?action=downloadasset&assetid=6efda7d7-e41a-4331-bcbe-cc6fcbf605e4

Reimbursement is for your individual premiums ONLY.  Premiums that you paid to cover spouses and other family are not reimbursed by this Union fund.

Please be sure your evidence of premiums paid demonstrates that you paid the premium(s) during the term in which you are applying, and that these premiums are for you only.

Late or incomplete applications will not be considered.  

To apply for reimbursement,

(1) fill out a form (below) for each term, and

(2) return it before each term’s deadline, and

(3) include the required premium payment evidence, to:

United Employees of Columbia Gorge Community College

P.O. Box 1106, The Dalles, OR 97058

There is no grace period for missed deadlines.

Additional Resources