FORMS & BENEFIT PLAN INFORMATION - in PDF format
Summary of Benefits
Benefits Summary Sheet (one page)
Summary Description of Indirect Compensation Benefits (four pages)
Health Plan Descriptions
2009 Medical & Dental Plans Summary (6 pages) - side-by-side comparison of plan coverage and cost information.
2009 Benefits Booklet (48 pages)
2010 Benefits Booklet (44 pages)
HealthPartners Booklet and Plan Summaries
Health Savings Account (HSA) Summary (2 pages)
FAQs about HSA Accounts - from the US Dept of Treasury.
Avesis Vision Plan Summary
Health Plan Forms
2009 Benefits Election & Waiver Form- to enroll for (or waive) medical, dental, and flex benefits, or make a mid-year change to your elections due to a change in family status, during calendar year 2009.
2010 Benefits Election & Waiver Form - to enroll for (or waive) medical, dental, vision and flex benefits, or make a mid-year change to your elections due to a change in family status, during calendar year 2010.
Certification of Dependent Status Form
Certification of Dependent Status Letter - explaining new requirement to complete Certification of Dependent Status form if you cover children age 19-24 under your medical or dental plans.
ANNUAL OPEN ENROLLMENT PERIOD
The annual Open Enrollment period will take place from Nov 2 to Nov 15, 2009. Employees will be able to make changes to medical and dental plans and enroll in the flex spending accounts for the next calendar year. Personal counseling sessions with a representative from Hamline's health brokerage firm will be held Nov 2 - 4, 2009. Please call 651-523-2210 to schedule your 30 minute session.
Healthy Benefits
Find information on how you can complete a health assessment online and participate in
the Healthy Benefits program.
Flex Plan Claims - Medical and daycare reimbursement accounts are administered by a third-party company, ARC.
How to file a claim or check your account balance. Includes the reimbursement schedule of when checks are mailed by ARC if a claim has been received.
Flex Claim Form
Summary Plan Description for "Cafeteria Plan", including pre-tax premium plan and reimbursement plans (33 pages).
Retirement Plans
www.tiaa-cref.org/hamline - This web page provides information about Hamline's retirement plans, the investment options available through TIAA-CREF, and other financial tools and education. Online enrollment available by clicking the ENROLL NOW button on the web site.
Financial Education Web Seminars - Additional education from TIAA-CREF's library, topics ranging from "Just Starting Out" to "Choosing Income" at retirement.
Salary Reduction Agreement - to change the amount you're contributing to your SRA (tax-deferred annuity). To open an SRA retirement account, please contact the HR department to request an enrollment packet, or enroll online.
Salary Reduction Agreement for November and December 2009.
Salary Reduction Agreement for 2010
Defined Contribution Pension Plan - summary plan description, Hamline's 10% contribution to your retirement account.
Tax-Deferred Annuity Plan - also referred to as the supplemental retirement account - summary plan description for the plan that holds the employee's voluntary contributions.
Tuition Waiver
Hamline Tuition Waiver Guide - Booklet
2009-10 Tuition Waiver Application Form
2010-11 Tuition Waiver Application Form
National Tuition Exchange Program - www.tuitionexchange.org
The Council of Independent Colleges Tuition Exchange Program - www.cic.edu
Life and Disability Insurance
Life Insurance Summary Sheet
New Hire Enrollment Form - For life and long-term disability coverage. Return to Human Resources.
Basic Life / LTD Certificate of Coverage Booklet - complete description of basic life and long-term disability policies (53 pages).
Beneficiary Designation Form - To change your beneficiary.
Personal Health Application - For life and disability insurance applications requiring approval by Hartford Insurance Company.
Hartford Domestic Partner Affidavit - To add life coverage for a domestic partner.
Hartford Termination of Domestic Partnership Form.
Long Term Care Insurance
Referrals to Benefit Management Consultants, a broker that specializes in LTC products. Contact Linc Shea, 952-922-6625, or email lshea@bmcbenefits.com .
"What You Need to Know..." - publication from state of MN Dept of Commerce about purchasing long term care insurance.
Links to benefit related Web sites
HealthPartners- medical and dental insurance carrier.
www.healthpartners.com
Member Services: 952-883-5000, 1-800-883-2177
TIAA CREF- retirement plan investment accounts.
www.tiaa-cref.org - TIAA-CREF's web site
www.tiaa-cref.org/hamline - Hamline's microsite.
Telephone Counseling Center: 1-800-842-2776
Administration Resources Corporation (ARC) - third-party payer for flex claims. Access account balances, claim information and forms via your personal account.
www.arcbenefitaccess.com
Customer Service: 763-421-5510, 1-800-588-2020.
Employee Assistance Program - Information and personal counseling available on a wide range of topics (mental health, financial, legal, parenting...). Available to employees and family members, through Hartford Insurance's Ability Assist program. For assistance call: 1-800-964-3577. EAP Program Description www.guidanceresources.com
Travel Assistance Services - For business or vacation travels: pre-trip information, emergency medical assistance and emergency personal services. Available to employees through Hartford Insurance. US and Canada: 800-243-6108, Collect from other locations: 202-828-5885
Other benefits/information
Child Care Discount - through New Horizon Academy, 10% discount for Hamline University employees. Call New Horizon at (763) 557-1111, online at www.NewHorizonAcademy.net . Or contact Lori Larkin in HR for more information.
COBRA Election Form
COBRA - Notice of Continuation Rights - Under federal law that is commonly known as COBRA (Consolidated Omnibus Budget Reconciliation Act of 1985), employees and their families are offered the opportunity for a temporary extension of health coverage in certain instances where coverage would otherwise end (such as termination of employment). Hamline University’s medical, dental, and flex medical reimbursement plans qualify as “group health coverage” for purposes of COBRA. This notice is intended to inform you, in a summary fashion, of your rights and obligations under the continuation coverage provisions of the law. Extension of life insurance coverage is also available through Minnesota continuation laws.
2006 Employee Benefits Survey-Results - Summary of the results of the survey conducted April 2006 by the Human Resources Department and the Employee Benefits Committee.
Whistleblower Policy and Procedure - The purposes of this document are to set forth Hamline University’s policy on the reporting and disclosure of workplace misconduct and to protect those individuals reporting alleged misconduct or unlawful practices by Hamline University from retaliation in the form of an adverse action. This policy relates to matters including but not limited to fraudulent accounting or bookkeeping and illegal or unethical business practices. A service has been designed to make it as easy and safe as possible for individuals to report concerns about possible violations of the Hamline University Policy. This service, which is operated by an independent organization, is called the “Business Code of Conduct” hotline and is available around-the-clock, seven days a week. The toll-free number is 1-866-9HELP-US (1-866-943-5787).
Conflict Resolution Options
HIPAA Privacy Notice
2008 Summary Annual Reports - for medical, dental, life, disability and cafeteria plans.
