For your convenience, all benefit forms are now available online. Each form comes in an easy to read and use pdf format.

The forms maybe completed in one of two ways:

  1. Print the form and complete by hand, OR;
  2. Complete the form on your computer, then print and sign.

Send completed forms via interoffice mail, postal service, or in person, to the County’s benefits staff representative listed in the Contact information of this website. FORMS MAY NOT BE ELECTRONICALLY TRANSMITTED

Supplemental Insurance/Forms


Joshua Scott

Ind. Sales Agent - Aflac

email: Joshua Scott

Office Phone : 850-572-6431


Colonial Life

Wayne A. Rimmer

District General Agent

223 W. Gregory Street, Pensacola, FL 32502

Cell: 850-336-4542


American Heritage

Diane McNease

McNease & Assc. Inc.

Office Phone : 850-453-0088

Office Fax : 850-453-7010


Liberty National

Liberty National Website