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FY 2022 ¾«¶«´«Ã½Performance Appraisal Forms

FY 2022 performance review will be due to Human Resources by Friday, November 18, 2022.

• Performance Review Exempt 2022 form
• Performance Review Non Exempt 2022 form

Position Content Document Forms

• Exempt Position
• Non-Exempt Position
• Position Evaluation Request

Reimbursement for remote access to ¾«¶«´«Ã½systems

• Policy
• Remote access monthly reimbursement certificate
• Remote access conference reimbursement certificate

Benefit Plans 2024

• 2024 Employee Benefits Guide
• 2024 BCBS Medical and Dental OE Presentation
• 2024 Wex Flexible Spending OE Presentation
• 2024 Guardian Critical Incident Accodent - Hospital - Illness OE Presentation
• 2024 Allstate Identity Theft Protection OE Presentation

Medical

• 2024 Employee Benefits Guide
• 2024 BCBS PPO Enrollment Guide
• 2024 BCBS PPO HMO Enrollment Guide
• 2024 BCBS HMO how to find a doctor
• 2024 BCBS SBC PPO_01-01-2024 to 12-31-2024_2016-01-01
• 2024 BCBS SBC BAHMO_01-01-2024 to 12-31-2024_2016-01-01
• 2024 BCBS SBC HMO Ill_01-01-2024 to 12-31-2024_2016-01-01

Dental

• 2024 BCBS Dental Plans

Vision

• Eye Med Tool Kit-1

Flexible Spending

• 2024 Wex FSA enrollment kit

Life Insurance and Disability

• 2024 BCBS Life Insurance and Disability Enrollment Kit

Other Options

• 2024 Allstate Identity Theft Protection kit
• 2024 Guardian CI Acc CIll Hosp- 2024 Enrollment kit
• 2024 Pet Benefit Solutions kit
• 2024 Transit CT Form
• 2024 Transit DC Form
• 2024 Transit IL Form
• 2024 Transit PA and Reimbursement form
• 2024 Transit Parking w Reimbursement Form
• 2024 Benefits Summary
• 2024 Benefit Contacts
• 2024 Benefits Election Form
• 2024 Medical Waiver form fillable
• 2024 Notice of Electronic Distribution of Benefit Documents
• AIP Enrollment form.pdf_fillable
• BCBS Life Insurance and Disability Enrollment Form Fillable
• BCBS enrollment form-fillable
• Guardian CI Acc CIll Hosp- Enrollment form fillable
• Wex FSA enrollment form fillable

2024 Benefit Plan Documents

Resources

Benefit Plans 2023

• 2023 Benefits Guide.pdf
• 2023 Benefits Summary
• 2023 OE BCBS BlueCare Dental Presentation
• 2023 OE Wex Flexible Spending Account Presentation
• 2023 OE Guardian Critical Incident Acc Hosp Ill Presentation
• Guardian CI Claim form Process Options - ACC CI HI
• 2023 OE Allstate Identity Protection Presentation

Health Plans

• 2023 BCBS PPO SBC
• 2023 BCBS HMO IL SBC
• 2023 BCBS BA HMO SBC
• 2023 BCBS HMO how to find a doctor
• 2023 BCBS BlueCare Dental
• 2023 EyeMed Vision Kit
• 2023 WEX - FSA and Dependent Care Enrollment Kit

Other Plans

• 2023 BCBS - Life Insurance Enrollment Kit
• 2023 BCBS - Life AD and D
• 2023 BCBS - Supplemental Life
• 2023 BCBS - Short Term Disability
• 2023 BCBS - Long Term Disability
• 2023 Guardian Critical Incident Plans - Enrollment Kit
• 2023 Pet Benefit Solutions
• 2023 Transit CT Form
• 2023 Transit DC Form
• 2023 Transit IL Form
• 2023 Transit PA and Reimbursement form
• 2023 Transit Parking w Reimbursement Form

Resources

• 2023 BCBS - EAP Employee Assistance Program Disability Resource Services
• 2023 BCBS - Beneficiary Resource Services
• 2023 BCBS - Travel Resource Services

Benefit Plan Documents 2023

• ¾«¶«´«Ã½Cafeteria Plan Summary Plan Description
• Retirement Plan Summary Plan Description

Benefit Plans 2022

• 2022 ¾«¶«´«Ã½Benefit Guide
• 2022 Benefits Summary

Medical

• 2022 BCBS PPO/HMO Enrollment Guide
• 2022 BCBS PPO Enrollment Guide
• 2022 BCBS PPO Certificate
• 2022 BCBS BA HMO SBC
• 2022 BCBS BA HMO Certificate
• 2022 BCBS BA HMO Vision Certificate
• 2022 BCBS HMO SBC IL
• 2022 BCBS HMO IL Certificate
• 2022 BCBS HMO IL Vision Certificate
• 2022 BCBS PPO SBC
• BCBS RXSS Lower Costs Flier 05 18 22
• BCBS RXSS Member FAQ BCBSIL 05 18 22

Dental

• 2022 Guardian Dental Enrollment Kit

Vision

• 2022 EyeMed Vision Benefit Summary and Kit

Flexible Spending Account

• 2022 Flex Enrollment Kit and form
• 2022 FSA Eligible Expense List

Life Insurance 2022

• 2022 BCBS Life and Disability Enrollment Kit
• 2022 BCBS Evidence of Insurability form
• 2022 BCBS Beneficiary Resource Services
• 2022 BCBS Life Disability Resource Services EAP
• 2022 BCBS Long Term Disability Insurance Plan
• 2022 BCBS Supplemental Life Insurance
• 2022 BCBS Group Term Life Insurance and AD and D Plan
• 2022 BCBS Short Term Disability Insurance Plan
• 2022 BCBS Life Travel Resource Services

Other Benefits

• Guardian CI 2022 05 Enrollment_Kit_ALA
• 2022 Pet Benefit Solutions Kit
• Allstate Identity Protection Pro-Plus-Paper Enrollment 2021 08 form ¾«¶«´«Ã½
• DC - Transit Form 2022
• IL - Transit Form 2022
• CT - Transit Form 2022
• PA - Transit Form 2022
• Parking Form and Reimbursement Form - All Locations

Retirement Plan

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• Retirement Plan Summary Plan Description SPD ¾«¶«´«Ã½TIAA 2020
• 2022 TIAA Fee Disclosure Notice Plan_Investment_Notice 07 12

2022 Benefit Plan Documents

• 2022 Notice of Electronic Distribution of Benefit Documents
• 2022 ¾«¶«´«Ã½Summary Plan Document Wrap
• 2022-ALA-Cafeteria-Plan-Summary-Plan-Description
• 2020 Creditable Coverage - Medicare Part D Notice ¾«¶«´«Ã½for 2021
• 2021 Benefit Plans Summary Annual Report SAR

Recruitment

• Personnel Staffing Request Form

Schedules

2022 Holiday Schedule

2023 Holiday Schedule

2024 Holiday Schedule

Other Human Resources links on Support

Personnel Policy Manual

Staff Change Form (new hires, promotions, terminations etc...)

Families First Coronavirus Response Act

Training Resource Library (TRL) Video Courses