Hy-Vee Elective Benefits

HVEB Product Brochures and Applications

Limited Indemnity Benefit Plan (Part-time Health Option)

Health Option Missed Premium Payment Form

Part-time Dental Insurance

Group Voluntary Accident

Group Voluntary Accident Application

Outpatient Claim Form

Group Voluntary Critical Illness Application (GVCI2)

Group Voluntary Critical Illness Brochure (GVCI2)

Group Voluntary Term Life

Group Universal Life

Cancer Insurance

Cancer Insurance - Illinois

Vision Brochure & Application

Pre-Tax Election Form 2014-2015

Pre-Tax Waiver Form 2015

NOTE: Effective January 1, 2015, the Group Voluntary Accident and Critical Illness plans will automatically be pre-taxed for full and regular-time employees unless the above pre-tax waiver form is completed and returned to Midwest Heritage Insurance Services.

Pet Insurance


  1. Accident Coverage
  2. Hospital Indemnity Coverage
  3. Short-term Disability Coverage

Products offered by Midwest Heritage Insurance Services are not insured by the FDIC or any other Federal Government Agency, are not a deposit or obligation of, or guaranteed by Midwest Heritage Bank, may involve investment risks, including possible loss of principal amount invested, and may lose value.

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