2022 Health Screenings
2022 Wellness Screening Scheduling Instructions
2022 Wellness Screening Occupational Health Clinic Option
Helpful Tips for Your Wellness Screening Lab Draw
View and/or print forms and information sheets below by clicking on the document title.
NOTE: Life changes (e.g. marriage, birth of a child, divorce) that create an opportunity for or require a change in coverage must be reported to the Benefits Department within 30 days of the qualifying event.
2022 UPDATES & CHANGES
NEW-2022 Open Enrollment Benefits Video
NEW-Beam Dental Benefits Summary
Online Enrollment for 2022
2022 Open Enrollment Forms-Internal Link
2022 Open Enrollment Forms-External Link
2022 MEDICAL/DENTAL COVERAGE
All basic medical plan packages include health and dental coverage options.
2022 Health Savings Account vs Flexible Spending Account
Health Savings Account-Old National Bank
Magellan Rx Member Website Guide
OPTIONAL SPECIALIZED COVERAGE
VISION PLAN
LIFE & ACCIDENTAL DEATH/DISMEMBERMENT & SHORT AND LONG TERM DISABILITYSymetra-Beneficiary Designation Form
Symetra-Supplemental Life Application
Symetra-Evidence of Insurability Application
Estate Guidance
Financial Information & Resources
Legal Support
Confidential Counseling
Summary of Life Benefits-All Others
Summary of Short Term Disability Benefits
Summary of Long Term Disability Benefits
SUPPPLEMENTAL ACCIDENT & SICKNESSColonial Life-Accident Policy
Colonial Life - Critical Illness Policy
Colonial Life - Whole Life & Long Term Care
Colonial Life-Policyholder Service Guide
FLEXIBLE SPENDING ACCOUNTS
Enrolled employees have pre-tax program options to assist them in managing their medical and/or childcare expenses.
Flex Medical Debit Card Website
Flex Medical Reimbursement Form
Flex Childcare Reimbursement Form
GENERAL NOTICES
A selection of medical health related City policies
Family Medical Leave Information
Grandfathered Health Plan Notice
RETIREMENT BENEFITS
Retirement plans & savings options.
457 Plan-Lincoln Financial Group
WELLNESS BENEFITS
Guidelines for Healthy Lifestyle Benefit
Healthy Lifestyle Reimbursement Form
Managed Care Concept-Chronic Care Program
Managed Care Concept-Healthy Track
Daavlin Home Phototherapy Benefit
Community Loan Center Of Northeast Indiana
FEDERAL TRANSPARENCY in COVERAGE RULE
www.aga-tpa.com/machine-readable-files
This link leads to the files that are made available in response to the Federal Transparency in Coverage Rule and includes negotiated service rates and out-of-network allowed amounts between health plans and healthcare providers. The machine-readable files are formatted to allow researchers, regulators, and application developers to access and analyze data more easily.