Southwestern

Engaging Minds, Transforming Lives

Human Resources

2013 Benefits Open Enrollment Forms and Information

DOCUMENT FILE
Official Informational Memo to Faculty and Staff

Download

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)
Download 
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Health Insurance (Blue Cross Blue Shield)  
  Summary of Benefits and Coverage (includes Prescription Drug Summary)
Download                      
        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 
Download 

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