• Retirement Healthcare Savings Plan

  For new full-time faculty and staff hired on or after January 1, 2010, Penn State is changing its approach to providing retiree healthcare benefits.

  All faculty and staff hired prior to January 1, 2010 will continue to be eligible for continuation of healthcare benefits after retirement under the provisions of HR54.

  For all of the details, click here

BENEFITS ELIGIBILITY

1. Health Plan
2. Medicare Creditable Coverage Certificate

BENEFIT FORMS

1. AD&D Conversion Form (PDF)
2. AD&D and Life Claim Form (PDF)
3. AD&D Permanent Total Disability Claim Form (PDF)
4. Beneficiary form - AD&D (PDF)
5. Beneficiary Form - Life Insurance (PDF)
6. Beneficiary Form (SERS) (PDF)
7. Beneficiary Form - TIAA-CREF
8. BlueCard Worldwide Brochure (PDF)
9. Choose or Change Benefits (ESSIC)
10. COBRA Election Form for Continuation of Benefits 2010 (PDF)
11. Dental Claim Form (PDF)
12. Flexible Benefits Election Form
13. Flexible Benefits Request for Reimbursement (PDF)
14. Flexible Benefits Request for Reimbursement Interactive Form
15. Grant-In-Aid Form - Penn State University (PDF)
16. Grant-In-Aid Form - Pennsylvania College of Technology (PDF)
17. Highmark Medical Claim Form (PDF)
18. Highmark Prescription Reimbursement Form (PDF)
19. International Claim Form BlueCard Worldwide (PDF)
20. Life Insurance Enrollment/Change Form (w/ Evidence of Good Health) (PDF)
21. Long Term Disability Conversion Form (PDF)
22. Long-Term Disability Enrollment Form/Health Statement (PDF)
23. Maintenance Prescription Drug Plan (MPDP) Enrollment Form (University Health Services Pharmacy)
24. Medco by Mail (PDF)
25. Post Doc Enrollment Form
26. Prudential Life Insurance Conversion Application (PDF)
27. Retirement Plan Selection for Part-Time Employees (PDF)
28. Sickness and Accident Supplement (SAS) Claim Form
29. TIAA-CREF Application - Retirement Plan
30. TIAA-CREF Deferred Compensation [457(b)] Application
31. TIAA-CREF Group Supplemental Retirement Annuity (GSRA) Application
32. Highmark Blue Shield Vision Claim Form (PDF)
33. Voluntary Salary Reduction Agreement (PDF)

DENTAL CARE COVERAGE

1. Dental Care Coverage
2. Basic Dental Plan Certificate of Coverage (PDF)

EDUCATION BENEFITS

1. Educational Privileges
2. nowU Guaranteed Savings Plan (529 plan)

EMPLOYEE ASSISTANCE PROGRAM (EAP)

1. Employee Assistance Program (EAP)

FLEXIBLE BENEFITS

1. Flexible Benefits
2. Flexible Benefits FAQs
3. Flexible Benefit Summary Plan Description (PDF)

HEALTH PLAN

1. 2009/2010 Health Plan
2. 2009/2010 Prescription Drug Coverage
3. Highmark Blue Shield PPOBlue Benefit Booklet
4. IMPORTANT – Routine Testing Coverage (PDF)
5. Centre County Health Initiative $100 Copayment
6. Centre County Health Initiative - Zip Codes
7. Continuing Benefits with COBRA
8. Dependents Turning Age 19
9. How to verify your dependent's status
10. Same-Day Acute Care Clinic at Penn State Family Medicine
11. Specialty Medications
12. Wellness Profile Instructions

LIFE INSURANCE

1. Group Life Insurance
2. Group Life Insurance Booklet - Age-Graded Plan
3. Group Life Insurance Booklet - Level Option Plan (for information only)
4. Life Insurance Beneficiary
5. Life Insurance Summary Plan Document (PDF)

LONG-TERM CARE

1. Long Term Care

LONG-TERM DISABILITY (LTD) AND ANNUITY PREMIUM BENEFIT (APB)

1. Long Term Disability (LTD) and Annuity Premium Benefit (APB)
2. LTD And APB Summary Plan Document (PDF)
3. LTD AND APB Amendment #1 (PDF)

PRIVACY INFORMATION

1. Health Plan Notice of Privacy Practices Effective: 1/1/03
2. Privacy Information

PROGRAMS

1. Health Matters
2. Human Resource Development Center

RETIREE BENEFITS

1. 2010 Retiree Brochure
2. 2009 Retiree Contributions
3. 2010 Retiree Contributions
4. 2009 Retiree Contribution Information for Retirees Who Were Retired & Age 70 Prior to 1/1/07
5. 2010 Retiree Contribution Information for Retirees Who Were Retired & Age 70 Prior to 1/1/07
6. Map to State College Highmark Office
7. Retiree Benefits
8. 2009/2010 Retiree Medical Benefits
9. Davis Vision Discount Program
10. How To Find a Davis Vision Provider
11. Retiree Summary Plan Document (PDF)

RETIREMENT PLANS

1. Retirement Plan Comparisons
2. Retirement Plan Frequently Asked Questions
3. Selecting a Retirement Plan

SUPPLEMENTAL RETIREMENT PLANS

1. Summary of Supplemental Retirement Plans
2. Introduction to Roth 403(b)

VISION CARE COVERAGE

1. Vision Care Coverage
2. Vision Benefit Booklet (PDF)
3. How To Find a Highmark Blue Shield Vision Provider

ACCIDENTAL DEATH AND DISMEMBERMENT

1. Accidental Death and Dismemberment Insurance (AD&D)
2. Penn State University AD&D Booklet (PDF)
3. Penn State University AD&D Policy (PDF)