Benefit Summary Sheets
2008 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
Summary Plan Description 2008
Supplemental Life & ADD Rates 2008
Medical and Dental Rates 2008
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
Health & Dependant Care FSA Claim Form
FSA Allowable Items
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
Information Links
TIAA CREF
TIAA-CREF Micro Site
Other Information
2008 IRS Pension Plan Limits
Miscellaneous
Statement of Domestic Partnership
Breastfeeding Guidelines
2006 Summary Annual Reports