Benefits Summary (Benefits in Brief)

• Benefits FAQs
  
• Full-Time Employees 
• Part-Time Employees 
  

Customer Service Contact Information

• Full-time Employees' Insurance Provider Contact Information
  
• Part-time Employees' Insurance Provider Contact Information
  

Dental

• Delta Dental PPO Summary of Benefits
• DeltaCare USA Benefits and Copay Schedule
  
• Delta Dental Enrolment/Change Form
  
• Delta Dental Continuous Orthodontic Care Form
  
• Delta Dental Claim Form for Nonparticipating Providers
  
• 2012 Medical and Dental Contribution Tables - Full-Time

Domestic Partner

• Domestic Partner Guidelines
  
• Domestic Partner FAQs
  
• Domestic Partner Important Tax Information
  
• Domestic Partner Affidavit
  
• Domestic Partner Termination Affidavit
  

Flexible Spending Accounts 

• 2011 Important Changes to FlexSave Benefits
  
• Flexible Spending Account Enrollment Form 2012
  
• Health Care/Dependent Care Flexible Spending Account Bulletin
  
• FLEXSAVE Dependent Care Reimbursement Form
  
• FLEXSAVE Spending Account Claim Form

Life Insurance

• Basic Life Insurance and AD&D Enrollment Form
  
• Booklet for Standard Life Insurance
  
• Beneficiary Change Form
  
• Medical History Questionnaire (Online Completion)
  
• Medical History Questionnaire (Printable pdf.)
  

Medical

• Dependent Verification Form/Instructions
  
• Anthem Plan Form
• Anthem Plan Booklet
  
• 2012 Group Insurance Enrollment Form - Part-Time
  
• 2012 Group Insurance Enrollment Form - Full Time
  
• Adult Dependent Child Enrollment Form
  
• Medical Mutual Medical Claim Form
  
• Medical Mutual Plan Booklet
  
• Medical Plans Comparison Chart 2012
  
• Opt-Out Affidavit 2012
  
• 2012 Medical and Dental Contribution Tables - Full-Time
  
• Adult Dependent Child Enrollment Rates 2012
• COBRA Rates Chart 2012
  

New Hire Orientation

• New Hire Presentation

Prescription

• Caremark Prescription Plan Booklet and Mail Order Form
  

• Caremark Prescription Reimbursement Form
  
• Medicare Part D Disclosure Notice
  

Retirement Programs

• 403(b) Tax Deferred Annuity Provider List
  
• 457 Deferred Compensation Provider List
  
• Alternative Retirement Plan (ARP) Provider List
  
• Declaration of Prior State Service (.doc)
  Declaration of Prior State Service (.pdf)
  
• OPERS Personal History Record
  
• Salary Reduction Agreement for Tax Deferred Annuity and/or Deferred Compensation
  
• Social Security Windfall Notification
  
• Statement Concerning Your Employment in a Job Not Covered by Social Security (.doc)
  Statement Concerning Your Employment in a Job Not Covered by Social Security (.pdf) 
• Transaction Authorization Form
  
• Retirement Plan Election Form OPERS/STRS  (Full-Time Faculty, Unclassified, & Classified Staff)
  

Tuition

• Proof of Dependency Status
  
• Tuition Benefit Request for ROTC Staff, Retirees & Disabled Employees
  
• Tuition Benefit Request for Dependents of ROTC Staff, Retirees & Disabled Employees
  

Vision

• EyeMed Vision Plan Booklet
  
• EyeMed Vision Provider List
  
• EyeMed Vision Claim Form 

Voluntary Group Long-Term Disability

• Long-Term Disability Enrollment Form
  
• LTD Summary