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Benefits

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Overview

Plan Year and Accounting

  • The Plan Year is January 1 through December 31.  Plan assets are valued daily.  Participant statements are prepared by ING as of the end of each plan quarter.

Eligibility and Entry Dates

  • You are eligible to enter the Plan if you are at least age 21 and have completed at least 3 months of employment.
  • You may enter the Plan on the entry date coinciding with or following the completion of the eligibility requirements.  The entry dates are quarterly.  Salary deferrals will commence as soon as administratively feasible (upon receipt of complete and accurate enrollment forms).

 

401(k) Documents &

ING - Retirement Plans

Forms

401(k) Beneficiary Form
401(k) Catch Up Contribution Form
401(k) Enrollment and Change Form
401(k) Rollover Form
ING Open Enrollment Flyer October 2008
401(k) Highlights-2008
Sept 2008 ING enrollment book

ING Direct

 

Medical - Dental - Vision Documents

Forms
Benefit Election Form
Guardian Authorization to Disclose Information Form
Guardian Benefits Summary
Guardian Claim Form - Dental
Guardian Claim Form - Medical
Guardian Dependent Eligibility
Guardian Enrollment and Change Form
Guardian Loss of Coverage Statement
Guardian Name or Beneficiary Change Form
Guardian Notice of Privacy Practices
Kaiser Authorization for Release
Kaiser Benefits Overview
Kaiser Enrollment Change Form
Medco Health Home Delivery Pharmacy Service OrderForm
Medco Prescription Drug Reimbursement Form
Vision Service Plan Out-of-Network Reimbursement Form
VSP - How To Use Your Vision Plan

Provider Contacts

Guardian 

Kaiser Permanente

Vision Service Plan 

 

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Flexible Spending Account

FSA Forms

Change in Status or Termination Election Form

Dependent Care Certification Form

Eligibile Healthcare Expenses

Eligible Dependent Care Expenses

Enrollment form

FAQs

FSA 2008 Overview

Medical Expense Reimbursement Worksheet

Reimbursement Request -Dependent Care Account

Reimbursement Request -Insurance Premium Account

Reimbursement Request -Medical Care Account
 
FSA Benefits Corp

Contact:  Terry Beneficial

  • Phone: (310) 310-0134, extension 9123

Fax reimbursement requests to:

  •  Fax: (310) 310-0156

 

 

Life and Long Term Care Insurance

 
Life Insurance Forms

Election of Portability Coverage

Enrollment Form for Supplemental Life

Evidence of Insurability

Life Insurance Conversion

Request for Change

Supplemental Life Overview

Supplemental Life Plan Certificate Coverage
 

Long-term Care Insurance Forms

Long-term Care Presentation

LTC Calculator and Forms

 

Prudential Insurance Company

Allstate

Metlife

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