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Health Dental Vision Insurance

Central Peninsula Hospital self-insures our health care plan. This means that we assume all of the financial risk for providing health care benefits, rather than paying an insurance company to assume this risk. Moda Health is the claims administrator for our medical, vision, dental and prescription drug plans. The main goal of this plan is to provide a high level of coverage for employees and their families as well as reduce costs. 

For Health Insurance Elections,
select and fill out the appropriate forms:

To complete the forms, first download and fill in your information. 
Signatures can be added by clicking the "Sign" icon at the top of the page
 Completed forms may be saved and emailed to srandall@cpgh.org or printed and dropped off in HR. 
Paper copies of forms are available outside the HR Department.

Health Insurance
Enrollment Form

Complete this form ONLY
to enroll, change Plans
or to add/drop dependents


Health Reimbursement

Complete this form ONLY 
if you are signing up
for the Redoubt Plan
for the first time


Health Savings

Complete this form ONLY if
you are signing up
for the Iliamna Plan


of Coverage

Complete this form ONLY if
you are declining
to purchase health insurance


    Still have questions?  Contact CPH Human Resources at extension 4771 or email Stephanie Randall at srandall@cpgh.org