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Forms & Resources

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Forms


Open Enrollment Newsletter.pdf


2014 Open Enrollment Form.pdf

Postdoc Scholar and Postdoc Fellow 2014 Benefits Program Enrollment/Change Form

Joint Program Students 2014 Benefits Program Enrollment/Change Form

2014 Medical Plan Comparison.pdf

2014 Benefits Rate Sheet.pdf

Preventive Screening for Adults.pdf

Preventive Screening for Children.pdf

2014 Regulatory Health Insurance Notice.pdf

HRA-HSA Comparison.pdf

Get the Most Out of Every Dollar.pdf

FSAs A Simple Way to Save.pdf

Domestic Partner Affidavit (pdf) - Required to add your Domestic Partner to coverage.

Domestic Partner Form (pdf) - Required to discontinue your Domestic Partner's coverage.

Defined Benefit Retirement Plan (DB Plan) - Beneficiary Form

Resources


Dependent Care Flexible Spending Account (DC-FSA) Worksheet
 - useful tool to help you determine your annual Dependent Care FSA contribution.  When establishing a DC-FSA, employees should also consider any Dependent Care Subsidy benefits they may be eligible for.

IRS Publication 502- Medical & Dental Expenses for use in preparing your tax returns.

IRS Publication 503 - Child & Dependent Care Expenses for use in preparing your tax returns.

Employee Online - Provides the ability to review and make certain changes to personnel records including changes to medical and dental benefits. Should you need a password please complete the online request form.

Blue Cross Blue Shield of Massachusetts - link to the official BCBS of Massachusetts website.

Delta Dental of Massachusetts - link to the official Delta Dental website.

IRS Publication 969-Health Savings Accounts



Last updated: December 4, 2013
 


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