- *** OPEN ENROLLMENT ***
- Service Awards
- Vacation Policy
- La Petite Academy - Child Care
- Early Learning Center Child Care
- Culture of Diversity
- Business Operations Resources
- Human Resources Policies
- Holiday Schedule
- Employee Assistance Program
24/7/365 phone support
Scott Park Campus
Academic Services, Suite 1000
Hours: 8:30 a.m. to 5 p.m.
- 2015 OPEN ENROLLMENT
- BENEFITS HOMEPAGE
- New Hire Benefit Information
- 2014 Healthcare
- Benefit Forms
- Benefits Glossary of Commonly Used Terms
- Domestic Partners
- Employee Assistance Program (EAP)
- Employee Wellness Program-Rocket Wellness
- Flexible Spending
- Life Insurance
- Long Term Disability
- Northwest Ohio Hearing Clinic
- Retiree Benefits
- Retirement System
- Required Legal Notifications
- Tax Deferred Annuities -- 403b/457
- Tuition Waivers
- Vacation Policy
- Work Life / Childcare
- Healthcare Reform Exchange Notice
Below you will find the necessary forms for enrollment in Healthcare, HSA/FSA, Life Insurance & Retirement Benefits.
For detailed Plan Summaries or Premiums please visit the 2013 Healthcare Page.
1. HEALTHCARE Election Form: Use this form to elect healthcare coverage for yourself and any qualified dependents.
- If adding a spouse or dependent children to your plan, you must provide a copy of your marriage license and/or your child's birth certicficate unless we already have the copy in our files.
2. Health Savings Account (HSA) Form: Did you elect the Medical Mutual CDHP? If yes, please complete this form. If no, go to #3.
3. Spousal/Domestic Partner Healthcare Eligibility Affidavit: Did you enroll a spouse or domestic partner on your Paramount ES or OBA/FrontPath PPO Plan? If yes, complete sections A & B on this form, print the form and have your spouse's employer complete section C if applicable. If no, go to #4.
4. Adult Child Certification: Are any of your dependent children age 19 or older? If yes, please compete and print this form for every dependent age 19 or over and return with your HEALTHCARE Election form in your completed packet. If no, go to #5.
5. Chard Snyder Flexible Spending Account Enrollment Form: If you wish to enroll in a medical or dependent care flexible spending account, please complete the enrollment form. If no, please go to #6.
6. Life Insurance Enrollment Form (Full Time Employees Only): Use this form to provide Beneficiary designation and additional/dependent life elections if applicable.
8. For information on HIPAA, COBRA, Michelle's Law, CHIPRA and other important notifications please visit our Required Legal Notifications Page.