2021 Renewal
- New Pharmacy Benefits Manager – Caremark
- MC USA Annual Salary Adjustment Record
- Monthly Payment Plan for Congregations
- Employee Enrollment for Dental Coverage form
- VSP enrollment form
- Election Form – Premium/HSA/Dependent Care
- Election Form – Premium/Medical Expense/Dependent Care
- Change Form – Premium/Dependent Care
- Change Form – Premium/Medical Expense/Dependent Care
- Notice of Health Privacy Practices
Health Plan Forms
- Enrollment Form for Employer: Congregational Selection Form
- Enrollment Forms for Employees
- Employee Enrollment form for the following states: AZ, CA, CO, DE, FL, ID, IL, IN, IA, KS, MD, MI, MN, MT, NE, OH, OK, OR, PA, SD, VA, WA
- Employee Enrollment form for all other states 2131086 Ee Enrollment Form CEP MCUSA TCP Non-Fraternal
- NABCO North American Benefits Company — Life and disability enrollment form
- Dental & Vision enrollment form for employee
- Cancellation of coverage
- Employer HRA Enrollment and EFT Authorization
- Descripción general del plan 2020
HSA and HRA Information
- TCP Health Coverage with HSA
- Health Reimbursement Arrangement
- Everence HSAs – A Summary for Employers
- Section 125 Cafeteria Plan for Mennonite Church USA
- HRA and HSA Comparison Chart for Congregations
- Everence HSA Group Contributions
- HSA Contribution Form
- HRA Employee Direct Submission Authorization
- 2018 HSA Employee Contribution
- IRS Revenue Procedure Letter 2018
Coverage Information
- 2021 CEP SPD MCUSA HDHP $1,400/$2,800 Agg. Ded
- 2021 CEP SPD MCUSA HDHP $2,000/$4,000 Agg. Ded
- 2021 CEP SPD MCUSA HDHP $3,000/$6,000 Agg. Ded
- 2021 CEP SPD MCUSA $1,400/$2,800 Emb Ded
- SBC CEP MCUSA 2020 $1400 Individual Coverage Embedded Deductible
- SBC CEP MCUSA 2020 $2800 Family Coverage Embedded Deductible
- SBC CEP MCUSA 2020 $1400 Single Coverage HDHP
- SBC CEP MCUSA 2020 $2800 Family Coverage HDH
- SBC CEP MCUSA 2020 $2000 Single Coverage HDH
- SBC CEP MCUSA 2020 $4000 Family Coverage HDH
- SBC CEP MCUSA 2020 $3000 Single Coverage HDHP
- SBC CEP MCUSA 2020 $6000 Family Coverage HDHP
- Complete plan description: Summary of Benefits
- Group Term Life
- Overview Of Group Life And Long Term Disability **
- Group Long Term Disability Insurance
- Explanation of Benefits
- Finding a Provider for your Highmark PPO Program
- Dental Plan – (Summary of Benefits)
- Dental Plan — Comprehensive Coverage Summary Plan Description
- Dental – Prev & Basic Coverage SPD
- VSP Easy Option Plan Summary
- VSP Signature Plan Summary
Wellness Incentives & Resources
- Highmark website flyer
- 2020 Highmark Preventive Schedule
- Baby BluePrints – Maternity Education and Support Program
- BCBS Complementary Wellness Discount
- Fitness Program Discounts
- BlueCard Worldwide Brochure
- Blues On Call Brochure
- Highmark BSBC Need Answers
- The Cost of Your Health Care: What You Can Do About It
- Wellbeing Conversation Flyer
- Wellness Incentive Instructions
- Wellness Incentive Philosophy
- Wellness Accountability and Support Options
- My Wellbeing Plan & Incentive Authorization TCP
- Wellness Exam Incentive Authorization
- TCP Wellness Physical Exam Tips
- Wellbeing Accountability and Support Options
- Enrollment Form (Waived) Wellness Incentive Program
- Wellness Incentive Philosophy TCP
- Wellbeing Conversation Incentive Authorization
Subsidy