 |
Medical Insurance Information |
|
|
|
|
|
|
|
Notice of Prescott College Employee Benefit Plan's Privacy Practices (HIPAA)
This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully. |
|
| : |
 |
Acrobat |
 |
Word |
|
|
| |
| |
|
| Domestic Partner Employee Enrollment Form |
|
| : |
|
Acrobat |
|
|
|
|
| |
|
Hospital GAP (American Fidelity Assurance)
Application |
|
| : |
|
Acrobat |
|
|
|
| Brochure |
|
|
|
|
|
| : |
|
Acrobat |
|
|
|
|
| Reimbursement |
|
| : |
|
Acrobat |
|
Word |
|
|
|
| |
|
|
|
|
|
| Accident Select (Trans America) |
More Info Coming Soon! |
| Cancer Select (Trans America) |
More Info Coming Soon! |
|
|
Salary Reduction Agreement/Enrollment (Flex Spending)
This form is required for pre-tax salary deductions. Medical
premiums can be deducted on a pre-tax basis. |
|
| Section 125 Dependent Daycare Reimbursement |
More Info Coming Soon!
|
| |
| Section 125 Medical/Daycare Reimbursement |
More Info Coming Soon!
|
| Tuition Waiver - contact Human Resources - Due by March 15 |
|
|
|
|
|
|
|
|
| TIAA-CREF Authorization for Payroll Deductions |
|
| : |
|
|
|
|
|
|
Group Long Term Disability Insurance
Information (Principal) |
|
Group Long Term Disability Booklet Certificate
Summary of Benefits, How to be Insured, Description of Benefits,
Claim Procedures, Statements of Rights |
|
| : |
|
Acrobat |
|
|
|
|
Group Long Term Disability Policy Information
Policy Administration, Individual Requirements & Rights,
Benefits |
|
| : |
|
Acrobat |
|
|
|
|
|
|
Life Booklet Certificate (Principal)
Summary of Benefits, How to be Insured, Description of Benefits,
Claim Procedures, Statements of Rights |
|
| : |
|
Acrobat |
|
|
|
|
Life Policy Information (Principal)
Policy Administration, Individual Requirements & Rights,
Benefits |
|
| : |
|
Acrobat |
|
|
|
|
| Life Policy Information (Trans America) |
More Info Coming Soon!
|
|
| |
|
|
|
|
|
|
|
|
|
|
|
|
