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Benefits Documents and Forms

Health Insurance
2014 Plan Comparison
2015 Plan Comparison
2015 Unity Basic Health Plan
2015 Unity Enhanced Health Plan
 
Healthy Lifestyle Reimbursement
2014 Healthy Lifestyle Reimbursement Form
2015 Healthy Lifestyle Reimbursement Form 

Find a Rochester Regional Provider
RRHS Domestic Provider List - effective 1/1/15
 
Flexible Spending Accounts (FSA)
Plan Brochure 
Eligible Expense List
Claim Form - Medical
Claim Form - Dependent Care
EBS One Debit Card
Order Additional Debit Cards
Direct Deposit Form
Expense Calculator

Life Insurance
Beneficiary Designation Form

MetLaw / Hyatt Legal Plan
Legal Services Plan

Open Enrollment Resources 
 What's New in 2015
 2015 Foresight Magazine
 2015 Health Reference Guide
 2015 Maintenance Medications 


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

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

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

Jim Snook Memorial Employee Emergency Fund  
Jim Snook Loan Policy and Application

Miscellaneous
Dependent Eligibility Chart
Domestic Partner Enrollment Requirements
Domestic Partner Enrollment Instructions

Mid-Year Benefits Changes
What Benefit Changes Can I Make?
Benefit/Enrollment Change Form


 



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