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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 |
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2012 Employee Benefits Guide
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2013 Employee Benefits Guide
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Flexible Benefits Plan Document
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2011 Employee Benefit Rates |
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2012 Employee Benefit Rates |
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Health Care Reimbursement Plan |
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Beneficiary Designation Form |
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Domestic Partner Affidavit |
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Adult Child Affidavit |
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Tuition Reimbursement Application |
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Tuition Reimbursement Guidelines |
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Health Care Reform and You - Fact Sheet |
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Medicare Part D – Notice of Creditable Coverage
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2011 Summary Annual Report Dental Vision Life Insurance Plan 507
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2011 Summary Annual Report Healthcare Plan 501
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Medical
, Dental, Vision and Pharmacy Documents |
PDF |
Employee Health Care Plan |
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Huntington Choice Medical Plan Summary Plan Description |
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Huntington Choice Medical Plans Plan Document |
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Medical Claim Form / Keenan HealthCare |
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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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VSP Member Claims Out Of Network Fax Form |
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Life / Long Term Disability |
PDF |
2013 UNUM Term Life Benefit Summary |
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LTD Benefit Summary |
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Express Scripts |
PDF |
Prescription Drug Claim Form
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2013 Express Scripts National Preferred Formulary
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California Providers |
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FAQs |
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Retirement Benefits |
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2010 Annual Funding Notice |
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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 2009, Plan 002 |
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Summary Annual Report 2010, Plan 002 |
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Summary Annual Report 2010, Plan 501 |
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Summary Annual Report 2010, Plan 507 |
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Social Security Online Application Information |
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Catch-up Certification Form 2012 |
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Vanguard fund Signal share class upgrade |
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Huntington QDIA Notice 2013 |
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Notice of Determination Letter 403B |
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2012 Catch-Up provision cover letter 1-9-12 |
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Catch-Up Certification Form 2012 - Updated 1-9-12 |
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PTO |
PDF |
PTO Guide |
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Paid Time Off (PTO) Cash-Out Request |
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Critical Illness Insurance Benefit Election Form Rates & Disclosures |
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MetLife MetLaw 2.0 brochure |
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MetLife MetLaw 2.0 Plan Design |
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Metlife Portability Procedures |
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Sprint Special Pricing for Huntington Hospital Employees |
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Flexible Spending Account |
PDF |
FSA Welcome Letter |
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FSA Overview Brochure |
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FSA Reimbursement Request Form |
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Changes to Health Flexible Spending Accounts |
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HFSA Eligible Expenses |
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Keenan Flex-Care Benefit Card overview |
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2013 Keenan FlexCare Section 125 Flexible Spending Account Update |
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