Concordia College

Benefit Forms

Blue Cross & Blue Shield of Minnesota
Phone: 866.870.0348
Group# EP606-W0

• Health/Dental Enrollment Form
• Life Event Change Form

Delta Dental of Minnesota
Delta Dental of Minnesota
P.O. Box 330
Minneapolis, MN 55440-0330
Phone: 800.448.3815
Group# 50814 

• Health/Dental Enrollment Form
• Life Event Change Form

Long-Term Disability:

The Hartford (effective 1/1/09): Forms are available from the Human Resources Dept.

Life Insurance:

 The Standard (effective 1/1/09): Forms are available from the Human Resources Dept.

Flexible Spending Accounts (FSA):

Discovery Benefits, Inc.;
3216 13th Avenue South
Fargo, ND 58103
Phone: 701.451.3399
Fax:     701.451.3245

• FSA Enrollment Form
• Discovery Benefits FSA Web site
• Reimbursement Form
  
  

Retirement Plans 403(b):

TIAA-CREF
Phone: 800.842.2776
Group# 0527

• Enrollment Packet - Contact the Office of Human Resources if enrolling an account for the first time.
• Agreement for Salary Reduction
• Change Beneficiaries

Family Medical Leave Act (FMLA):

• Employee Request for Medical Leave

Tuition Discount

•  Concordia Tuition Discount Information
•  Concordia Tuition Discount Application
•  Concordia Language Villages Tuition Discount Information
•  Concordia Language Villages Tuition Discount Application
•  Oak Grove Lutheran Schools Tuition Reduction Information and Application

•  Eligibility Form and one of the following three:
•  ELCA Colleges - application form
•  Council of Independent Colleges – application available from Human Resources
•  Tuition Exchange College – application form available from Human Resources