Employees shall use this form to report all work-related injuries, illnesses or “near miss” events (which could have caused an injury or illness) – no matter how minor. This form shall be completed by employees as soon as possible and given to a supervisor for further action.
For more information, contact
David Jenkins
Senior Account Executive
david.jenkins@americanfidelity.com
901.458.9252 ● 800.465.2129
North Mississippi Branch Office
126 South Flicker Street
Memphis, TN 38104
americanfidelity.com
VALIC Website
Offerings to ICC Employees:
VALIC Representative
David Stratton Contact Number: 601.605.3590 Email: david.stratton@corebridgefinancial.com www.valic.com
Mississippi Deferred Compensation Plan and Trust Website
Mississippi Deferred Compensation Plan & Trust Agent
Zach Carey 111 E. Capitol St., Suite 260 Jackson, MS 39201 Phone: 662.701.9469 www.mdcplan.com
BrightView Credit Union website
State and School Employees' Health Insurance website Department of Finance and Administration Office of Insurance P.O. Box 24208 Jackson, MS 39225-4208
Contact Numbers:
Blue Cross & Blue Shield of Mississippi: 800.709.7881 Active Health: 866.939.4721 Catalyst Rx: 866.757.7839 AHS State Network: 800.294.6307 Office of Insurance: 866.586.2781 Membership Department: 888.249.6132 Health Risk Assessment (HealthQuotient): www.webmdhealth.com/mississippi
Public Employees Retirement System (PERS) 429 Mississippi Street Jackson, MS 39201-1005 Office: 601.359.3589 Fax: 601.856.9876
Employee Services