Payroll & Benefits

DIOCESAN PROVIDED BENEFITS

Lay Employee Benefits – 2022-2023

Medical

Open Enrollment Employee Memo – 2022/2023

Anthem Medical and Vision Summary of Benefits – 2022/2023

PPACA Summary of Benefits and Coverage Required Disclosure – 2022/2023

Required Disclosure of your Rights and Protections Against Surprise Medical Bills

US Government Annual Health Plan Notices

Medical Insurance Rates – 2022/2023

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 Form – Medical

Medicare Creditable Coverage Notice

Lay Employees Pension Plan (Defined Benefit)

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 – 2022/2023