Resources

Documents

Enrollment Information Employee Premium Contribution/Costs Coresource Enrollment Form (Medical & Dental) Coresource Registration Form Coresource Medical Claim Form Sign Up for Electronic EOB Manage Your Benefits Online MES Vision Enrollment Form MOO Enrollment Form
Medical & Prescription Drug Medical Plan Document & Summary Plan Description Finding a Provider – Anthem Blue Cross Instructions for Logging Into Mycoresource.com CoreSource APP Medical Insurance Overview Medical Insurance Tips CVS Caremark Getting Started Guide CVS Caremark Readyfill Brochure CVS Caremark Mail Service Order Form Prescription Reimbursement Claim Form OneRX – Shopping Tool PPO – Summary of Benefits Coverage EPO – Summary of Benefits Coverage Coordination of Benefits (Secondary Medical Coverage) CVS/Caremark Maintenance Choice Program CVS/Caremark Generic Medication Info Medical Plan Amendment 1 Medical Plan Amendment 2 Medical Plan Amendment 3
Dental Dental Insurance Overview Dental Plan Document & Summary Plan Description Dental Claim Form Cigna Dental PPO
Vision Vision Insurance Overview Vision Insurance Overview - Non-CA Vision Claim Form MES Vision Explanation of Benefits
Hearing Aid Mutual of Omaha Hearing Discount Program Epic Hearing Discount Program
Flexible Spending Accounts FSA WageWorks Enrollment Form FSA Direct Deposit Form WageWorks URM Claim Form WageWorks DDC Claim Form FSA Plan Description FSA Plan Summary
Advanced Medical Second Opinion Advanced Medical Flyer
LiveHealth Online LiveHealth Online Information
Annual Health Benefit Notices Annual Health Benefit Notices Packet Annual Benefit Summary Plan Description

Documents

401(k) Account 401(k) Enrollment Guide 401(k) Safe Harbor Notice 401(k) Automatic Account Rebalancing Brochure 401(k) In-Service Withdrawl Form 401(k) Loan Request 401(k) Rollover Policy
Pay Periods and Pay Days DE 4 W-4 Corporate Calendar FY 2019 Direct Deposit Form (payroll) Direct Deposit Form (expense) Paperless Payroll Access Instructions
Identity Theft Protection LifeLock Membership Election Form
Financial Wellness Plan Momentum onUp Informational Flyer Momentum OnUp Sign Up Info
Accident Plan Voluntary Accident Summary Accident Claim Form Accident Health Screening Benefit Claim Form
Critical Illness Plan Voluntary Critical Illness Summary Critical Illness Form Express Benefit Form Health Screening Form
Disability Insurance Voluntary Short-Term Disability Summary
Life and AD&D Insurance Mutual of Omaha Beneficiary Form Mutual of Omaha Evidence of Insurability Form Mutual of Omaha Voluntary Life Insurance Mutual of Omaha Voluntary Life Rate Sheet
Long Term Care Insurance Long Term Care Overview Summary Plan Description LTD - Home and Community-based with InflationSummary Plan Description – B LTD - Home, Community-Based and Immediate Family Member Care with Inflation

Documents

Educational and Tuition Assistance Programs Application for Tuition Assistance Tuition Reimbursement Program Policy Info on Education Assistance Program Application for Educational Assistance
Rideshare Rideshare Points System Rideshare Reimbursement
Time Off Holiday Schedule Vacation Advance Form Your AbsencePro Program Info Leave of Absence Claim Form AbsencePro – Report Your Leave Online
Employee Assistance Program SupportLinc EAP Introduction Letter SupportLinc EAP Brochure Mental Health – Anti-Stigma Campaign

Documents

Employee Referral Program Employee Referral Policy
Employee Recognition Program Employee Recognition Guidelines Employee Recognition Nomination Form
Company Sponsored Events Company Sponsored Activity Guidelines