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


Melissa Tyler

Ind. Sales Agent - Aflac

Office Phone : 251-391-3443



Colonial Life

Wendy Wesolowski

District General Agent

Cell: 901-921-1876


American Heritage/AllState

Diane McNease

McNease & Assc. Inc.

Office Phone : 850-453-0088

Office Fax : 850-453-7010


Liberty National

Tim Reeves

Office Phone : 850-324-8833

6202 North 9th Ave, Ste 1A, Pensacola, Fl, 32504

Liberty National Website