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Benefits Documents and Forms

Health Insurance
2014 Plan Comparison

2014 Unity Basic Health Plan
2014 Unity Enhanced Health Plan


Unity Provider Listing

2014 Lifestyle Allowance Reimbursement Form and Instructions

2013 Lifestyle Allowance Reimbursement Form and Instructions 
 
Unity Services Discount
Dependent Enrollment Form

Retirement Savings Plan 403(b) & 401(k)

403(b)
Age 50+ Catch-Up Contribution Form
Beneficiary Designation Form
403(b) Enrollment Booklet

401 (k)
Age 50+ Catch-Up Contribution Form
Beneficiary Designation Form
401(k) Enrollment Booklet

MetLaw / Legal Services Plan
Legal Service Plan

Mid-Year Benefits Changes
What Benefit Changes Can I Make? Benefit/Enrollment Change Form
Dental Insurance
2014 Plan Comparison

EyeMed Vision Insurance
Vision Plan Summary
Out-of-Network Claim Form
Out-of-Network Benefits Summary

Flexible Spending Account (FSA)
Plan Brochure
Eligible Expense List
Claim Form
Claim Form Dependent Care
EBS One Debit Card
Order Additional Debit Cards
Direct Deposit Form
Expense Calculator

 Life Insurance
Beneficiary Designation Form

Voluntary Benefits - The Farmington Company
Accident Insurance
Critical Insurance
Cancer Insurance
Whole Life Insurance
Voluntary Benefits Summary


 
Jump to Instructions for…
 Enrolling or Adding Dependents  
 Life Insurance Beneficiary 
 Unity Services Discount