Forms & Resources

  
2017 Open Enrollment Benefits Materials

2017 Open Enrollment Booklet


Benefits Overview
                   
Full-Time Employee

 
Anthem
                   
Anthem Benefits Booklet
                   Standard Plan SBC
Choice Plan SBC            Uniform Glossary              

                   Claim Form

Anthem 360 Program
  Savvy Member Guide
  Blue Card
  Future Moms
  Nurseline
  Condition Care
  Complex Care
  Mobile App


Express Scripts
   Choice Plan (Single)
   Choice Plan (Family)
   Standard Plan
                   Standard Plan Preventive Medications List
                   Choice Plan Preventive Medications List
                   Rx Mail Order Form 
                   Claim Form

Castlight
  Getting Started with Castlight
  Castlight FAQ
  Castlight Mobile
                  
Delta Dental
                   
Delta Dental Benefits Booklet

Dependent Eligibility Certification and Validation
                   
Dependent Eligibility Certification and Validation

Vision
Full-Time
  VSP Benefit Summary
  Dependent Eligibility Certification Validation Form

Part-Time
  VSP Benefit Summary
  Change Form
 
Health Savings Account
                 
HSA Information Packet          
                  HSA Advantage Online Application
                  HSA Transfer Form
 
Flex Spending Accounts
                  General Purpose FSA / Dependent Care FSA Enrollment Brochure
    
                  Limited Purpose FSA insert

                  FSA Claim Form

                

Life Insurance

                   Paper Medical Underwriting Application
                   Online Medical Underwriting Application

                   Basic Life Summary - Class 1 - Admin, Hourly, 12 Month Faculty
                   Basic Life Summary - Class 2 - 9 Month Faculty, Salary Deferral Faculty
                   
Additional Life Summary

                   Port and Convert FAQ
                   Portability Group Insurance Form
                   Conversion Group Insurance Form


 Short Term Disability
  STD Summary
  STD FAQ
  Maternity STD Guidelines FAQ

 Long Term Disability

                   LTD Summary
                   LTD FAQ

                   Paper Medical Underwriting Application
                   Online Medical Underwriting Application


Travel Assistance

                   Travel Assistance Flyer

                   Travel Assistance Website


LegalShield

                   Cancellation and Service Form

UNUM
Customer Service Form: Cancellation/Beneficiary Changes Process Outline

Accident
Benefits
Accident Insurance Claim Form

Critical Illness/Cancer
Benefits
Critical Illness/Cancer Claim Form
Group Critical Illness/Cancer Certificate of Coverage

Hospital Indemnity
Benefits

Short Term Disability
Benefits
Short Term Disability Claim Form Short Term Frequently Asked Questions

Whole Life
Benefits
Whole Life Insurance Claim Form          

 Long Term Care
                   Long Term Care Request for Premium Quote


Retirement Plans
Summary of Retirement Plans 2016
                   
403(b) Defined Contribution Plan Document
                   
457(b) Deferred Compensation Plan Document
Enrollment Booklet 403(b) Enrollment Booklet 457(b) Easy Access Guide

             

     PERF at a Glance