Make Sure you are on the right track by completing our benefits checklist! Remember, all forms should be returned to the benefits administrator at your parish, school or agency; do not send the forms to the benefit provider. Have you:
Elected what type of medical coverage you are choosing (PPO, HMO, Blue Advantage) and filled out the appropriate enrollment form? If you are not enrolling in medical coverage, have you filled out the Waiver of Health Benefits form?
Medical Enrollment Form
Waiver of Health Benefits
Elected what type of dental coverage you are choosing (PPO, HMO) and filled out the appropriate enrollment form? Please note that when you enroll in the Dental plan, you can not drop coverage until Open Enrollment.
Dental Enrollment Form
Filled out the Life and Long Term Disability form and determined if you want to participate in the Supplemental Life Insurance Plan? If you choose to participate, you need to fill out the Supplemental Life portion of the Life and Long Term Disability Enrollment Form. If electing 3X or 4X coverage, you also need to fill out an Evidence of Insureability Form.
Life and Long Term Disabilty Form
Evidence of Insurablity
Determined if you want to participate in the Short Term Disability Plan? If you choose to participate, you need to fill out the Short Term Disability Enrollment Form. Please note that coverage amounts are ONLY available in increments of $25. Please call HR if you need assistance with the form.
Short Term Disability Enrollment Form
Determined if you want to participate in the Flexible Spending Account? If you choose to participate, you need to fill out the Flexible Spending Account Enrollment Form. Please make sure that you fully understand the differences between the Health and Dependent Care accounts.
Flex Spending Enrollment Form
Reviewed the information on the 403(b) and Share Plan. Remember, if you do not make another election or opt out, you will be auto enrolled at 3% by your fourth paycheck. Call Mass Mutual if you want to participate at a different rate or if you wish to opt out. Mass Mutual can be reached at 1-800-74-FLASH.