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Open Enrollment for Active employees is November 3 – November 21, 2008. All elections/changes made will be effective January 1, 2009.

Current Employee Open Enrollment Brochure:


11.6 MB PDF

2009 Benefits Presentations:


The brochure shown above contains links to updated content throughout our site.


We've also added an next to links throughout the site to identify documents that have been updated with 2009 benefits information.

 

  Penn State's Employee Benefits Division is committed to providing a comprehensive benefits program designed to attract and retain high quality faculty and staff. This web site is organized to offer a comprehensive view of those programs.
 
 

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 2008 (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 and Evidence of Good Health Form (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. Retirement Plan Selection for Part-Time Employees (PDF)
  26. Sickness and Accident Supplement (SAS) Claim Form
  27. TIAA-CREF Application - Retirement Plan
  28. TIAA-CREF Deferred Compensation [457(b)] Application
  29. TIAA-CREF Group Supplemental Retirement Annuity (GSRA) Application
  30. Vision Claim Form (PDF)
  31. Voluntary Salary Reduction Agreement (PDF)

DENTAL CARE COVERAGE

  1. Dental Care Coverage Includes Information About 2009 Benefits
  2. Basic Dental Plan Certificate of Coverage (PDF)
  3. Dental Plus Plan Certificate of Coverage (PDF)

EDUCATION BENEFITS

  1. Educational Privileges

EMPLOYEE ASSISTANCE PROGRAM (EAP)

  1. Employee Assistance Program (EAP)

FLEXIBLE BENEFITS

  1. Flexible Benefits Includes Information About 2009 Benefits
  2. Flexible Benefits FAQs
  3. Flexible Benefit Summary Plan Description (PDF)

HEALTH PLAN

  1. 2008/2009 Health Plan Includes Information About 2009 Benefits
  2. 2008/2009 Prescription Drug Coverage Includes Information About 2009 Benefits
  3. 2008/2009 Highmark Blue Shield PPOBlue Benefit Booklet
  4. IMPORTANT – Routine Testing Coverage (PDF) Includes Information About 2009 Benefits
  5. Centre County Health Initiative $100 Copayment Includes Information About 2009 Benefits
  6. Centre County Health Initiative - Zip Codes Includes Information About 2009 Benefits
  7. Continuing Benefits with COBRA
  8. Dependents Turning Age 19
  9. How to Read Your PPOBlue Explanation of Benefits Form
  10. Map to State College Highmark Office
  11. Same-Day Acute Care Clinic at Penn State Family Medicine

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 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. 2008 Retiree Rates
  2. 2008 Retiree Rate Information for Retirees Who Were Retired & Age 70 Prior to 1/1/07
  3. Map to State College Highmark Office
  4. Retiree Benefits
  5. Retiree Medical Benefits - 2008

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

VISION CARE COVERAGE

  1. Vision Care Coverage Includes Information About 2009 Benefits
  2. Vision Summary Plan Document

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)
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