Sushi Avenue

Membership Requests and Actions

2-7-19 Received email from Delta, KoKo Lay’s dependents will be added effective 11-1-18 as was requested earlier. Advised KoKo of this. KoKo copied Stephen Kumji in reply to my email abvo.

1-15-19 Per email from Delta, Tyler Ness terminated from Delta 12-12-18

1-2-19 Received Tyler Ness Cancel request from Stephen K, fwd to Delta. Cancelled off Blue Cross

Forms

Blue Cross 2019 Employee Enrollment Waiver Form

Delta Dental Employee Enrollment Form 2019