Below are the enrollment forms for NAPA Transportation, Inc.’s company-sponsored insurance plans.
To enroll, click the appropriate link below, complete the form in full, and submit it. Once submitted, the forms will be sent directly to Human Resources.
Please note: You are eligible to enroll in benefits only if you are within your 90-day new hire enrollment period or have experienced a qualifying life event within the past 30 days.
Medical/Dental/Vision Enrollment Form
Click here to enroll in NAPA’s Medical, Dental, or Vision insurance plans.
Mutual of Omaha Enrollment Form
Click here to enroll in the following voluntary insurance plans: Short Term Disability, Long-Term Disability, Critical Illness, Accident, Life/AD&D, Hospital Indemnity.
Spouse Verification Form
Click here to enroll your spouse in NAPA’s medical insurance plan. If this form is not completed by your insurance effective date, your spouse’s health insurance coverage may not be activated.
Life Insurance Beneficiary Form
Click here to add or change your beneficiaries for your company paid & voluntary life insurance policies.
customer frequently asked questions customer frequently asked questions