HR - Links and Resources

2014 Benefits Enrollment

(Open Enrollment Dates: November 11 – December 11, 2013) All employees eligible for benefits MUST complete a Benefits Enrollment Form for 2014 (electronic form accessible through MYFranciscan employee login;  or see Human Resources for a paper form)

Reference Materials:

Highmark BCBS HealthInsurance Coverage - Core Grid
Highmark BCBS HealthInsurance Coverage – Buy-Up Grid

Highmark Blue CrossBlue Shield Enrollment Application
Highmark Blue CrossBlue Shield Member Change Form

Davis Vision Plan Grid

Davis Vision Benefits Booklet

MetLife Dental Benefits

MetLife Enrollment Form

HRA Schedule for 2015


Summary of Benefits and Coverage (SBC) Notice
SBC for Highmark BCBS Core Plan
SBC for Highmark BCBS Buy Up Plan

Notice of Opportunity to Enroll Extension of Dependent Coverage to Age 26

Grandfathered Health Plan Disclosure Notice

Notice of Continuation of Coverage Rights Under COBRA

Met Life Privacy Disclosure

Notice of Prescription Drug Coverage and Medicare

Notice of Women’s Health and Cancer Right Act of 1998 (WHCRA)

Notice Regarding Pharmacy Network Change

New Health Insurance Marketplace Coverage Options

Highmark BCBS Notice of Privacy Practices

Links and Resources


Employee Optional Group term Life Premiums

Term Life Benefits Summary

AD & D Benefits Summary

Anthem Personalized Enrollment Form

Ohio Insurability Information Request Form


Social Security Administration

TIAA-CREF Retirement Accounts  
Summary Plan Description for the Defined Contribution Plan  
Web Seminars
Strength & Stability
Staying on Track  

IRS Web Site and Tax Forms
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