Benefit Forms and Information

Medical Insurance (Wellmark)

  1. Medical Plan Designs
  2. Health Plan 500 SPD
  3. Health Plan 500 SBC
  4. Health Plan 750 SPD
  5. Health Plan 750 SBC

Dental Insurance (Delta Dental)

  1. Dental Plans
  2. Dental Basic Plan SPD
  3. Dental Basic Plan SBC
  4. Dental BuyUp Plan SPD
  5. Dental BuyUp Plan SBC

Vision Insurance (Avesis)

  1. Vision Plan

Deferred Compensation

  1. Nationwide Flyer
  2. Nationwide Deferred Compensation Enrollment Form
  3. Nationwide Retirement-457 Brochure
  4. Payroll Deduction Authorization Form

Legal Services

  1. LegalShield IDShield Plan Rates
  2. LegalShield and IDShield Plan Information
  3. LegalShield IDShield Qualifying Status Change
  4. Legal Shield_ID Shield_Quick Start Guide_after enrolled (PDF)
  5. Legal Shield_Quick Start Guide_after enrolled (PDF)

Flexible Spending

  1. BHC Flex Plan
  2. FSA Claim Form

Life Insurance

  1. MNL EOI Evidence of Insurability form 07.01.14 (PDF)
  2. MNL EOI Helpful Hints (PDF)
  3. MNL Supplemental Ins Rates (PDF)