31![STATE OF HAWAII VOLUNTARY EMPLOYEES’ BENEFICIARY ASSOCIATION (VEBA) TRUST FOR THE HAWAII STATE TEACHERS ASSOCIATION (HSTA) POSTEMPLOYMENT BENEFITS STATE OF HAWAII VOLUNTARY EMPLOYEES’ BENEFICIARY ASSOCIATION (VEBA) TRUST FOR THE HAWAII STATE TEACHERS ASSOCIATION (HSTA) POSTEMPLOYMENT BENEFITS](https://www.pdfsearch.io/img/67e41a2aaace6b177a487ef1e0ab9741.jpg) | Add to Reading ListSource URL: ags.hawaii.govLanguage: English - Date: 2012-11-28 13:43:44
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32![STATE OF HAWAII VOLUNTARY EMPLOYEES’ BENEFICIARY ASSOCIATION (VEBA) TRUST FOR THE HAWAII STATE TEACHERS ASSOCIATION (HSTA) POSTEMPLOYMENT BENEFITS STATE OF HAWAII VOLUNTARY EMPLOYEES’ BENEFICIARY ASSOCIATION (VEBA) TRUST FOR THE HAWAII STATE TEACHERS ASSOCIATION (HSTA) POSTEMPLOYMENT BENEFITS](https://www.pdfsearch.io/img/18695ad355dbb008bc0167fc3cdc9fd1.jpg) | Add to Reading ListSource URL: ags.hawaii.govLanguage: English - Date: 2012-11-28 13:43:44
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33![Account Change Form Email, fax or mail completed form to third-party administrator Montana VEBA HRA Third-Party Administrator (TPA) Rehn & Associates | PO Box 5433 | Spokane, WA[removed] | Phone: ([removed] | Fax: Account Change Form Email, fax or mail completed form to third-party administrator Montana VEBA HRA Third-Party Administrator (TPA) Rehn & Associates | PO Box 5433 | Spokane, WA[removed] | Phone: ([removed] | Fax:](https://www.pdfsearch.io/img/8b6369ec754fd0fca4344561443b71df.jpg) | Add to Reading ListSource URL: benefits.mt.govLanguage: English - Date: 2014-03-31 18:15:00
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34![Participant Status Change Form Termination / Separation / Retirement / Reduction of hours / COBRA notice E-mail, fax, or mail completed form to third-party administrator. Montana VEBA HRA Third-party Administrator REHN Participant Status Change Form Termination / Separation / Retirement / Reduction of hours / COBRA notice E-mail, fax, or mail completed form to third-party administrator. Montana VEBA HRA Third-party Administrator REHN](https://www.pdfsearch.io/img/48a44bed7f827a030fa7e2c6981456bd.jpg) | Add to Reading ListSource URL: benefits.mt.govLanguage: English - Date: 2013-08-14 12:13:20
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35![WELCOME Dear Montana VEBA HRA Participant: Plan Summary WELCOME Dear Montana VEBA HRA Participant: Plan Summary](https://www.pdfsearch.io/img/c08769d8f1023ecfdb5866321ff51edc.jpg) | Add to Reading ListSource URL: benefits.mt.govLanguage: English - Date: 2013-08-14 12:13:25
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36![Enrollment Form Return completed form to your employer Montana VEBA HRA Third-Party Administrator (TPA) Rehn & Associates | PO Box 5433 | Spokane, WA[removed] | Phone: ([removed] | Fax: ([removed] | Email: Mont Enrollment Form Return completed form to your employer Montana VEBA HRA Third-Party Administrator (TPA) Rehn & Associates | PO Box 5433 | Spokane, WA[removed] | Phone: ([removed] | Fax: ([removed] | Email: Mont](https://www.pdfsearch.io/img/5dd237f8371db73216c9e3eaef940494.jpg) | Add to Reading ListSource URL: benefits.mt.govLanguage: English - Date: 2014-03-31 18:15:00
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37![Systematic Premium Reimbursement Form E-mail, fax, or mail completed form and itemized verification to third-party administrator. Instructions on reverse. Montana VEBA HRA Third-party Administrator | Rehn & Associates PO Systematic Premium Reimbursement Form E-mail, fax, or mail completed form and itemized verification to third-party administrator. Instructions on reverse. Montana VEBA HRA Third-party Administrator | Rehn & Associates PO](https://www.pdfsearch.io/img/89ffc3799e2ab6cd54b50802ecc0c8ea.jpg) | Add to Reading ListSource URL: benefits.mt.govLanguage: English - Date: 2013-08-14 12:13:21
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38![Montana State Agency Employee/Participant Questions & Answers QUESTIONS & ANSWERS What is the State of Montana VEBA Health Reimbursement Montana State Agency Employee/Participant Questions & Answers QUESTIONS & ANSWERS What is the State of Montana VEBA Health Reimbursement](https://www.pdfsearch.io/img/b687c7849931a686bc7d75e815b2a88b.jpg) | Add to Reading ListSource URL: benefits.mt.govLanguage: English - Date: 2013-08-14 12:13:25
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39![Election of Limited VEBA HRA Plan Coverage E-mail, fax, or mail completed form to third-party administrator. Montana VEBA HRA Third-party Administrator (TPA) Rehn & Associates | PO Box 5433 | Spokane, WA[removed] | Pho Election of Limited VEBA HRA Plan Coverage E-mail, fax, or mail completed form to third-party administrator. Montana VEBA HRA Third-party Administrator (TPA) Rehn & Associates | PO Box 5433 | Spokane, WA[removed] | Pho](https://www.pdfsearch.io/img/1810454de596b6f9842c7b58978b10bd.jpg) | Add to Reading ListSource URL: benefits.mt.govLanguage: English - Date: 2013-08-14 12:13:28
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40![STATE HUMAN RESOURCES DIVISION[removed]Subchapter 19 Montana VEBA HRA STATE HUMAN RESOURCES DIVISION[removed]Subchapter 19 Montana VEBA HRA](https://www.pdfsearch.io/img/46e98f80ebbcd857c49f798409c0efb1.jpg) | Add to Reading ListSource URL: benefits.mt.govLanguage: English - Date: 2013-08-23 11:09:47
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