Engaging Minds, Transforming Lives

Human Resources

2013 Benefits Open Enrollment Forms and Information

Official Informational Memo to Faculty and Staff


2013 Premium Rates Download 
Sample 2013 Enrollment Form Download
Don’t know what your current benefit elections are? Click on Download for instructions. Download

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2013 Enrollment Form (SU login/password required)
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Health Insurance (Blue Cross Blue Shield)  
  Summary of Benefits and Coverage (includes Prescription Drug Summary)
        Glossary of Health Coverage and Medical Terms  Download 
Prescription Drug Program (CVSCaremark)  
Prescription Drug List as of October 2012  Download 
Prescription Drug Exclusion List as of January 2013 Download 

      Prescription Plan Summary of Benefits: See Summary of Benefits and Coverage
      under Health Insurance (Blue Cross Blue Shield)

Section 125 Flexible Benefits Plan - Cafeteria Plan (Boon-Chapman)   
All about our Flexible Benefits Plan Download 
Eligible and Non-Eligible Expenses for 2013 Download 
Boon-Chapman Direct Deposit Form Download 
Dental Insurance (Guardian Dental)  
Dental Plan Description 

Vision Insurance (United Healthcare)  
Vision Plan Description Download
Vision Provider List Download
      Contact Lens Formulary List