Benefit Summary Sheets

2009 Benefits Summary

Middlebury College Health & Welfare Benefit Plan

(Medical, Dental, Healthcare and Dependent Care FSA, Core Life, Supplemental Life AD&D, Long-term Disability, Short-term Disability, Employee & Family Assistance Program)

Plan Information

2010 Medical Dental Rates Midd

2010 Supplemental Life & AD&D Rates

2010 Summary Plan Description

2009 Summary Plan Description

Supplemental Life & AD&D Rates 2009

Medical and Dental Rates 2009

Why Enroll in a Flexible Spending Account?

Flexible Spending - Covered Expenses 
 
FSA Guide Lines for Over the Counter Drugs

Forms

Medical, Dental and Rx.

CBA Medical/Dental Claim Form (valid for claims incured after 01/01/08)

Prescription Override Form

STEP Therapy: Prior Authorization Form

Flexible Spending Accounts

Flexible Spending Account Annual Expense Worksheet  


Flexible Spending Account Claim Form 

FSA Direct Deposit Form (mail to address on top of form)

Life Insurance

Beneficiary Designation Form

Evidence of Insurability

Information Links

CBA Blue/EBPA Medical, Dental, Rx, Flex Spending 2008 
New England Mail Order Pharmacy
EFAP - The Wellness Corporation (800-828-6025)
 



Retirement Plans

Plan Information

Core Plan (401a)
Voluntary Retirement Plan (403b)
Salary Deferral Supplemental Retirement Plan (457b)

Forms

Core Plan Participant Acknowledgement (Enrollment)
Voluntary Plan Salary Reduction Agreement 
Supplemental Retirement Plan 2009 Participation Agreement

Information Links

TIAA CREF
TIAA-CREF Micro Site 


Other Information

2008 IRS Pension Plan Limits


 

Education Benefits

Plan Information

           Course Fee Reduction
           Staff Matriculation at Middlebury College
           Comprehensive Fee Credit
           Tuition Cash Grant Scholarships
         

Forms

Tuition Cash Grant Scholarship Application and Dependent Certification       

Other Documentation and Forms

Statement of Domestic Partnership
Breastfeeding Guidelines
2006 Summary Annual Reports