2017 Benefits Enrollment & Change Form

One form to enroll in most benefit programs for employees working 20+ hours per week.

Life Insurance Beneficiary Form

Application for Employee Tuition Reimbursement

Health Savings Account (HSA) Beneficiary Form

BCBSMA Fitness Benefit Reimbursement Form

Application for up to $150 annual reimbursement for health club/gym membership.

Healthcare Flexible Spending Account (HCFSA) and Health Reimbursement Account (HRA) Reimbursement Form

Health Equity reimbursement of qualified expenses from Healthcare Flexible Spending Account (HCFSA) or Health Reimbursement Account (HRA) form.

Health Savings Account (HSA) Reimbursement Form

Health Equity form for reimbursement from Health Savings Account (HSA).

2017 Dependent Care Subsidy (DCS) Reimbursement Form

Use this form to be reimbursed for 2017 Dependent Care Subsidy expenses.

Dependent Care Subsidy (DCS) Employment Verification Form

2017 Dependent Care Flexible Spending Account (DCFSA) Reimbursement Form

Use this form to be reimbursed by Health Equity for your 2017 Dependent Care Flexible Spending Account (DCFSA) expenses.

Dependent Care Flexible Spending Account (DCFSA) Woksheet

Use this form to determine how much to deposit into your Dependent Care Flexible Spending Account (DCFSA).

Employee Education Assistance

Application for employee education tuition reimbursement.

Application Form for Personal Computer Loan

The Institution offers interest-free loans from $300 to $2,500 for the purchase of a personal computer.

Application Form for Tuition Loan for Children of Employees

If you are a regular full-time employee at the Institution, you are eligible for an interest-free loan for the higher education of your children or legal dependents.