老王论坛

• Important Notices
• Health Reform FAQ
• HIPAA - Notice of Privacy Practices
• Medicare Credible Coverage Notice

Download the Medical/RX Rate Sheet below to see the premiums for medical and prescription coverage for 老王论坛 employees.

• 2024-2025  Medical Rates
• International Prescription Mail Order Program

United Healthcare/UHC

• Welcome new members to UHC
• Teladoc Health - Diabetes Management
• Teladoc Health - FAQ
• Virtual Visits
• UHC - Provider Look-Up Tool
• Submitting Claims through Health Plan
• Prescription Reimbursement Request Form
• United Healthcare Service - Where to go for Medical Care

Benefit Enrollment via Paylocity

• How to Enroll in Benefits

Buy-Up Plan

• Plan Summary
• Summary of Benefits and Coverage
• Pharmacy Benefits Summary

Base Plan

• Plan Summary
• Summary of Benefits and Coverage
• Pharmacy Benefits Summary

High Deductible Health Plan (HDHP)

• Plan Summary - HDHP
• Summary of Benefits and Coverage - HDHP
• Pharmacy Benefits Summary - HDHP

HIPAA

• Notice of Privacy Practices

Spousal Coordination

• Spousal Coordination Form
• Spousal Coordination FAQ

Health Care Credit

• Health Care Credit Memo

School of Optometry Employee Optometry Services 

• 老王论坛 Eye Institute
• School of Optometry with Insurance

Heritage Vision Plan

• Heritage Vision Plans Enrollment Form
• Heritage Vision Plans Member Handbook
• Heritage Vision Plans Benefits/Rates

School of Dentistry Employee Dental Services 

• Dental Services Summary
• Non-Covered Dental Services

UNUM Dental Plan

• Dental Benefit Summary
• Dental FAQ
• Dental Cost
• Dental Insurance Policy
• Group Dental Certificate of Coverage

The University offers a flexible spending reimbursement account (known as FSA or FLEX) for certain eligible medical and dependent care expenses.  This plan offers tax savings opportunities to eligible employees.

FSA open enrollment is only once per year.  If you miss the annual deadline, you will need to wait until next year to participate, unless you have a change in family status.  Watch your employee email account for notification of the annual enrollment period and instructions.

Paylocity Flexible Spending Accounts (FSA)

• FSA Eligible Expenses
• 2024 FSA Plan Year Contribution Limits
• Paylocity FSA Claim Form
• Paylocity Mobile App
• Customer Support
• Plan Document
• Summary Plan Description

The University offers a health savings account plan (known as HSA) for certain eligible medical expenses.  This plan offers tax savings opportunities to eligible employees. HSA open enrollment is once a year.  If you miss the annual deadline, you can enroll any time during the year.  Changes to your contribution amount can also be made during the plan year.

Health Savings Account (HSA)

• HSA/FSA Comparison
• 2025 Plan Year Contribution Limits
• Optum HSA Intro
• HSA Rollover Transfer Form
• Optum HSA Online Tool
• Optum HSA Qualified Expenses

The University of 老王论坛 has established a Tuition Remission Benefit program for eligible employees, their spouses and children. Refer to the documents below for information on the program and taxation issues as well as the application form for the benefit.

Tuition Remission Program Policy

• Tuition Remission Policy - Revised July 1, 2017
• Tuition Remission Policy: Frequently Asked Questions - Revised January 11, 2017

Tuition Remission Taxation Policy

• Tuition Remission Taxation Policy
• Tuition Remission Taxation: Frequently Asked Questions

Application Form

• Application for Tuition Waiver - Revised July 1, 2017

• Basic Life, Voluntary Life and AD&D Insurance Summary
• Basic Life and AD&D Beneficiary Designation form
• Basic Life and AD&D Booklet
• Voluntary Life and AD&D Enrollment form
• Voluntary Life and AD&D Evidence of Insurability form
• Voluntary Life and AD&D Booklet (Non-Union)
• Voluntary Life and AD&D Booklet (Union Faculty)
• Life and AD&D Insurance Portability
• Portability Rates
• Life and AD&D Insurance Conversion
• Portability vs. Conversion FAQ

• Unum Total Leave - How to File a STD/FMLA Claim
• Short Term Disability Policy
• STD/LTD - Administrator/Faculty (Class 1)
• STD/LTD - Staff (Class 2)
• STD/LTD - UDMPU Faculty (Class 3)
• STD Summary Plan Document
• Long Term Disability Policy
• Administrator Short Term Disability Pay Election Form
• Faculty Short Term Disability Pay Election Form
• Family Medical Leave Employee Pay Election Form
• Staff Short Term Disability Pay Election Form
• LTD Booklet
• LTD Booklet (UDMPU)
• FMLA Policy
• Intermittent FMLA Timesheet
• Employee Assistance Program (EAP) - Unum
• Employee Assistant Program (EAP) - Wallet Card
• Critical Illness Summary Plan - UNUM
• Critical Illness Rates
• Group Accident Summary Plan - UNUM
• Group Accident Rates

• Handbook
• Enrollment Form
• ID Shield Cost Sheet
• ID Shield Easy Access Flyer
• ID Shield Vault Flyer

• Employee Assistance Program (EAP) - Unum
• Employee Assistant Program (EAP) - Wallet Card
• Employee Assistance Program Medical Bill Saver

• AT&T
• Bookstore - Employees Receive a 10% discount on select items in 老王论坛 Bookstores.
• Brooks Brothers
• Canine To Five Employee Flyer
• Canine To Five Perks
• Dining - Munch Money - Employees receive 10% more dollars to spend in Dining Services by purchasing Munch Money.
• Ford
• ITS - Microsoft Offce 365 & Special Pricing Purchases
• Mercy High School
• Office Depot Employee Program & Store Card
• Rocket Mortgage
• Volvo