Payroll & Benefits

DIOCESAN PROVIDED BENEFITS

Lay Employee Benefits Summary – 2023/2024

Medical

Open Enrollment Memo to Employees – 2023/2024

Anthem Medical and Vision Summary of Benefits – 2023/2024

Required Disclosure – PPACA Summary of Benefits and Coverage – 2023/2024

Required Disclosure of Your Rights and Protedtions Against Surprise Medical Bills

US Government Annual Health Plan Notices

Medical Insurance Rates – 2023/2024

Anthem Application Form

Anthem Application Form – Excel Fill-In

Anthem Application Form – Paper Form

Anthem Live Health Online Program

Anthem Certificate Request Form

Diocesan EAP Program

Delete Notice – Medical

Medicare Creditable Coverage Notice

HIPAA Privacy Notice

Lay Employees Pension Plan (Defined Benefit)

Open Enrollment Packet 2023 – Lay Employees’ Pension Plan

Pension Plan Booklet

Pension Plan – Web Portal User Guide

Retirement Benefit Example

Pension Plan Participation Waiver Form

OPEN ENROLLMENT FORMS – The following three forms are ONLY applicable during the open enrollment period (month of October) for employees that have previously opted out of participation and wish to re-join the plan.  All new hires are automatically enrolled in the Pension Plan and complete all applicable forms during the hiring process.

Pension Plan Enrollment Form

Pension Plan Beneficiary Designation

Pension Plan Employment Record Form

Tax sheltered Retirement Plan (403b Account)

403b Memo 2023/2024