We try to do as much as we can online, but there will always be forms to deal with.
Here is a collection of links to the most important forms relating to your benefits.
Document | What it's for... | Who it's for... |
---|---|---|
Pension Forms | ||
UMPIP Contribution Election Form | Eligible clergy and laity | Specify Before-tax, Roth, and After-tax personal contribution amounts to UMPIP |
Beneficiary Designation for Retirement and Welfare Plans – Participant | Eligible clergy and laity | Name a beneficiary to receive retirement benefits in the event of participant's death |
Church EFT Pension Authorization Form | Church Financial Personnel | Authorize payments directly from church bank account for clergy pension contributions |
Group Health Benefits Forms | ||
TAC Group Health Benefits Enrollment Form | New clergy; Newly eligible TAC lay employees; Eligible clergy and lay employees during open enrollment | Enrolling in group health benefits |
TAC Group Health Benefits Change Form | Eligible clergy and lay employees | Make qualified changes outside of the Annual Open Enrollment Period, such as a change of name or address, adding dependent coverage within 30 days of a qualified life event (e.g. birth, adoption, marriage, or loss of other coverage), or termination of dependent coverage |
All Group Health Plan employee participants | Confirmation of additional insurance coverage | |
Group Health Plan participants | Reimbursement of out-of-network claims and/or out-of-pocket expenses | |
Supplemental Counseling Benefit Reimbursement Form | Standard PPO Plan participants | Reimbursement for out-of-pocket expenses paid for Supplemental Counseling Benefits |
Church financial personnel | Authorize payments directly from church bank account for clergy health coverage | |
EFT - Medical Leave Group Health Authorization | Eligible clergy on medical leave | Authorizes payments from your bank account for your Group Health contributions |
EFT – Retiree/Surviving Spouse Group Health Authorization form | Eligible retirees and surviving spouses | Authorizes payments from your bank account to maintain Group Health coverage |
Adoption Reimbursement Form | Active clergy and lay employee participants in the Group Health Plan | Expenses incurred in the adoption of a child |
Active clergy Group Health Plan participants | Reimbursement of eligible hearing aid expenses | |
Wellness Program Forms | ||
Weight Loss Incentive Form | All Wellness Program participants | Submit for a Weight Loss Incentive request |
Annual Maintenance Incentive Form | All Wellness Program participants | Submit for the Annual Maintenance Incentive |
Pregnancy Weight Loss Incentive Form | All Wellness Program participants | Submit for a Pregnancy Weight Loss Incentive request |
Bariatric Surgery |
Group Health Plan participants | Requirements and procedures for bariatric surgery benefit |