Benefits and Forms


Employee Benefits 2018

The Archdiocese provides eligible employees with quality benefits to assist with their wellbeing. As a benefit eligible employee, you are offered a quality health insurance plan which consists of medical, prescription, and dental benefits. You are also offered a retirement plan, flexible spending accounts, long term disability, an employee assistance program, an adoption assistance program, employer-paid life insurance, and voluntary life insurance.

Please see your benefits administrator at your parish/school/office/agency regarding eligibility and any benefit changes. If you are eligible to enroll, make a change, or cancel an elective benefit, all completed forms need to be submitted to your benefits administrator.


Employee Handbooks

Employee Handbook (Parishes)

Employee Handbook (Offices & Agencies)


Employee Benefit Booklets 2018-2019

Archdiocesan Lay Employee Benefits Booklet 2018 – 2019

Archdiocesan Educators Benefits Booklet 2018 - 2019


Health Insurance for Medical, RX and Dental Plan

Medical Plan Major Provisions and Comparisons

UnitedHealthcare Standard Plan – Summary of Benefits

UnitedHealthcare Premier Plan – Summary of Benefits

UnitedHealthcare Drug Formulary

Annual Rights and Resources Disclosure

Employee Health Insurance Form

Mail-Order Prescription Form

Delta Dental Summary of Benefits

Employee Health Insurance Waiver Form


403b Retirement Plan

To access your retirement plan information and/or change your Beneficiary, you may access the Retirement plans website at the following website link:

Employee Prudential Retirement Plan Get Started Guide

Employee Lay Retirement Plan Highlights - Prudential

Prudential Retirement Employee Postcard



Flexible Spending Accounts

Flexible Spending Account (FSA) Highlights

FSA Questions and Answers

FSA Medical Reimbursement Claim Form

FSA Dependent Care Reimbursement Claim Form

Flexible Spending Account Election Form


Life Insurance Plans

Hartford Basic 1x Salary Life Insurance – Summary of Benefits

Hartford Voluntary Life – Summary of Benefits

Hartford Voluntary Life Enrollment/Change Form

Hartford Personal Health Application Form

Hartford Life Beneficiary Designation Form


Long Term Disability

Unum Long Term Disability Highlights

Long Term Disability Education Information


Employee Assistance Program

Employee Assistance Plan Brochure 


Employee Wellness Incentive

The Archdiocese provides many health preventative services to eligible Archdiocesan employees. The Archdiocese provides employees preventative services such as mammogram screenings, H&H Health Associates wellness screenings, and annual flu vaccines.

Employee Wellness Form

2018 Flu Vaccine Program Schedule



Archdiocese Benefits Adminitrators Manual 2018 - 2019

Marketplace Coverage Notice

Medicare D Notice

Handout for Benefit Terminations 2018 -2019


For any employee benefit questions, please email or call 314.792.7546