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The documentation is provided is in the Adobe Acrobat™ file format. You will need to have the free reader program installed on your computer to view and print the documentation. If you do not have the reader installed, you can click the button to the right to install it.
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General
Documents |
PDF |
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Employee Benefits Guide |
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2010 Employee Benefit Rates |
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Health Care Reimbursement Plan |
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Beneficiary Form |
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Domestic Partner Affidavit |
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Tuition Reimbursement Application |
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Tuition Reimbursement Guidelines |
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Medical
, Dental, Vision and Pharmacy Documents |
PDF |
Medical Plan Document and Amendment |
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Huntington Choice Medical Plans Plan Document |
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Medical Claim Form / Keenan HealthCare |
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Temporary Identification Card - $250 Deductible |
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Temporary Identification Card - $500 Deductible |
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EOC – Dental |
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EOC – Group Vision Care Plan |
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Express Scripts Prescription Reimbursement Claim Form |
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Member Claims Out Of Network Fax Form |
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Life / Long Term Disability |
PDF |
Life Insurance Benefit Summary |
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LTD Benefit Summary |
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Express Scripts |
PDF |
2010 Express Scripts National Preferred Formulary
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California Providers |
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FAQs |
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Retirement Benefits |
PDF |
Huntington Hospital Defined Benefit Plan Document |
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Huntington Hospital Defined Benefit Plan Document - First Amendment |
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Huntington Hospital Defined Benefit Plan Document - Second Amendment |
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Huntington Hospital Defined Benefit Plan Document - Third Amendment |
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2010 TSA Summary Plan Description |
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First Amendment |
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AIG Valic Enrollment Form |
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Annual Funding Notice |
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Summary Annual Report |
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Social Security Online Application Information |
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Catch-up Certification Form |
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Flexible
Spending Accounts |
PDF |
| Ceridian |
Request for
Reimbursement
Dependent Care Spending Account |
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Request for Reimbursement
Healthcare Spending Account |
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Health Care FSA Overview |
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Dependent Care FSA Overview |
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Health Care Expense Eligibility |
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FSA Health and Dependent Care Worksheet |
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