Benefit Forms and Links

2012 Open Enrollment
November 14-30, 2011
All forms are due by 5pm CST on November 30th.

Open Enrollment Information and Instructions:
Open Enrollment Information and Instructions

Health Insurance:
Enrollment Form
Side by Side Plan Comparison

Dental Insurance:
Enrollment Form  (to cancel coverage use this form and write Cancel)
Dental Plan Summary
ID Card

Flexible Spending Account (FSA):
Flexible Spending Enrollment Instructions 
Flexible Spending Guide

Life Insurance:
Enrollment Form 
Beneficiary Designation Form 
Evidence of Insurability

Long Term Disability:
Benefit Summary  
Enrollment Form 
Evidence of Insurability

Retirement Plans 403(b):
TIAA-CREF
Use the joint TIAA CREF/Concordia College site to:

Employee Assistance Program (EAP):
The Hartford
800.96.HELPS
800.964.3577
www.guidanceresources.com
ID: HLF902
Company Name: abili


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2011 Benefit Information

Life Event Change Form

DENTAL INSURANCE:
MetLife
Concordia College Group #146289
www.metlife.com/mybenefits
Customer Service: 800.942.0854  

Enrollment Form
Enrollment Booklet - Dental Benefits
Dual Plan Summary


FLEXIBLE SPENDING ACCOUNTS (FSA):
Discovery Benefits, Inc.
3216 13th Avenue South
Fargo, ND 58103
Phone: 701.451.3399
Fax:     701.451.3245


HEALTH INSURANCE:
Blue Cross & Blue Shield of Minnesota
Phone: 866.870.0348
Group# EP606-W0 ($250/$500 plan)
Group# EP606-W3 ($750/$1,500 plan)

2011 Enrollment Forms and Tools


PHARMACY MAIL ORDER:
PrimeMail Pharmacy


LIFE INSURANCE:
The Standard
Phone: 503.321.7000  
Policy# 146968-A 


LONG-TERM DISABILITY:
The Hartford
Phone: 800.523.2233  
Policy# GLT-677664  


RETIREMENT PLANS 403(b):
TIAA-CREF
Phone: 800.842.2776
Group# 0527

Use the joint TIAA CREF/Concordia College site to:


EMPLOYEE ASSISTANCE PROGRAM (EAP):

Lakeland's Employee Assistance Program
1010 32nd Avenue South
Moorhead, MN 56560
218.233.7524  
Emergency: 800.223.4512  

The Hartford (for those enrolled in Long Term Disability)
800.96.HELPS
800.964.3577
www.guidanceresources.com
ID: HLF902
Company Name: abili

CHIROPRACTIC CARE PROVIDERS


CREDIT UNION MEMBERSHIP:
Northland Educators Credit Union


FAMILY AND MEDICAL LEAVE ACT (FMLA):
FMLA Poster: Employee Rights and Responsibilities under FMLA

Concordia's FMLA Policy
Employee Request for FMLA

Information For:

current students
faculty and staff		 parents
alumni		 high school students
admitted students