For more specific information and questions pertaining to your individual situation, you can email us at HR@udmercy.edu. Someone will always be happy to assist you with all your questions and/or concerns.Cigna_Voluntary_LifeAD_D_Rates.pdfCigna Voluntary Life/AD&D RatesCigna Voluntary Life/AD&D Rates/www.udmercy.edu/hr/benefits/forms/pdf/Cigna_Voluntary_LifeAD_D_Rates.pdf101616Cigna_Life_ADD_Change_Form_1.pdfCigna Group Life/AD&D Insurance Enrollment/Change FormCigna Group Life/AD&D Insurance Enrollment/Change Form/www.udmercy.edu/hr/benefits/forms/pdf/Cigna_Life_ADD_Change_Form_1.pdf140978Cigna_Evidence_of_Insurability.pdfCIGNA Evidence of Insurability CIGNA Evidence of Insurability /www.udmercy.edu/hr/benefits/forms/pdf/Cigna_Evidence_of_Insurability.pdf169810Cigna_Beneificary_Form.pdfCIGNA Beneficiary Designation FormCIGNA Beneficiary Designation Form/www.udmercy.edu/hr/benefits/forms/pdf/Cigna_Beneificary_Form.pdf122110PPO1__Benefit_Overview_2009-10.pdfBCBS-PPO1 Benefits Overview BCBS-PPO1 Benefits Overview /www.udmercy.edu/hr/benefits/forms/pdf/PPO1__Benefit_Overview_2009-10.pdf620736BCBS_PPO1_Benefit_Guide.pdfBCBS - PPO1 Benefit GuideBCBS - PPO1 Benefit Guide/www.udmercy.edu/hr/benefits/forms/pdf/BCBS_PPO1_Benefit_Guide.pdf465043BCBS_PPO1_Form.pdfBCBS-PPO 1 Enrollment FormBCBS-PPO 1 Enrollment Form/www.udmercy.edu/hr/benefits/forms/pdf/BCBS_PPO1_Form.pdf304426PPO3_Benefit_Overview_2009-10.pdfBCBS-PPO3 Benefits Overview BCBS-PPO1 Benefits Overview /www.udmercy.edu/hr/benefits/forms/pdf/PPO3_Benefit_Overview_2009-10.pdf626665BCBS_PPO3_Benefit_Guide.pdfBCBS - PPO3 Benefit GuideBCBS - PPO3 Benefit Guide/www.udmercy.edu/hr/benefits/forms/pdf/BCBS_PPO3_Benefit_Guide.pdf465043BCBS_PPO_3.pdfBCBS-PPO 3 Enrollment FormBCBS-PPO 3 Enrollment Form/www.udmercy.edu/hr/benefits/forms/pdf/BCBS_PPO_3.pdf3213770BCBSM__RX_Plan_2009-10.pdfBlue Preferred Rx Prescription Drug CoverageBlue Preferred Rx Prescription Drug Coverage/www.udmercy.edu/hr/benefits/forms/pdf/BCBSM__RX_Plan_2009-10.pdf434207bcbsm_mail_orderBCBSM Mail Order Prescription Drug Plan (link)BCBSM Mail Order Prescription Drug Plan (link)/www.udmercy.edu/hr/benefits/forms/pdf/bcbsm_mail_orderhttp://www.bcbsm.com/member/prescription_drugs/mail_order.shtmlHealth Insurance Waiver Form.pdfHealth Insurance Waiver FormHealth Insurance Waiver Form/www.udmercy.edu/hr/benefits/forms/pdf/Health Insurance Waiver Form.pdf59949Hap Sumamry Description.pdfHAP Benefit OverviewHAP Benefit Overview/www.udmercy.edu/hr/benefits/forms/pdf/Hap Sumamry Description.pdf54482HAP_HMO_Benefit_Guide.pdfHAP (HMO) Benefit GuideHAP (HMO) Benefit Guide/www.udmercy.edu/hr/benefits/forms/pdf/HAP_HMO_Benefit_Guide.pdf395717HAP ENROLLMENT FORM.pdfHAP Enrollment FormHAP Enrollment Form/www.udmercy.edu/hr/benefits/forms/pdf/HAP ENROLLMENT FORM.pdf187338HAP Membership and Record Change Form.pdfHAP Membership and Record Change FormHAP Membership and Record Change Form/www.udmercy.edu/hr/benefits/forms/pdf/HAP Membership and Record Change Form.pdf55392Hap Senior Plus Enrollment Form.pdfHAP Senior Plus Enrollment FormHAP Senior Plus Enrollment Form/www.udmercy.edu/hr/benefits/forms/pdf/Hap Senior Plus Enrollment Form.pdf199082hap_mail_orderHAP Mail Order Prescription Drug Plan (link)HAP Mail Order Prescription Drug Plan (link)/www.udmercy.edu/hr/benefits/forms/pdf/hap_mail_orderhttp://www.hap.org/formulary/mo_prescriptions.phpSpousal_Coordination_Form.pdfSpousal Coordination for Medical Insurance FormSpousal Coordination for Medical Insurance Form/www.udmercy.edu/hr/benefits/forms/pdf/Spousal_Coordination_Form.pdf843412Spousal_Coordination_Explanation.pdfSpousal Coordination ExplanationSpousal Coordination Explanation/www.udmercy.edu/hr/benefits/forms/pdf/Spousal_Coordination_Explanation.pdf36575AETNA CHANGE FORM.PDFAETNA Change FormAETNA Change Form/www.udmercy.edu/hr/benefits/forms/pdf/AETNA CHANGE FORM.PDF167068aetna_rx.pdfAETNA Medicare Rx Plan Enrollment FormAETNA Medicare Rx Plan Enrollment Form/www.udmercy.edu/hr/benefits/forms/pdf/aetna_rx.pdf8037641Health Care Credit 2008-09 memo.pdfHealth Care Credit 2009-10 MemoHealth Care Credit 2009-10 Memo/www.udmercy.edu/hr/benefits/forms/pdf/Health Care Credit 2008-09 memo.pdf31819CVSCaremark Change Form 2008.pdfCVS/Caremark Change Form 2009/2010 (MEA only)CVS/Caremark Change Form 2009/2010 (MEA only)/www.udmercy.edu/hr/benefits/forms/pdf/CVSCaremark Change Form 2008.pdf81376UDM_LobgTermDisability.pdfUDM Long Term Care Insurance Program InstructionsUDM Long Term Care Insurance Program Instructions/www.udmercy.edu/hr/benefits/forms/pdf/UDM_LobgTermDisability.pdf3641299TIAAnewform2008.pdfUDM Salary Reduction FormUDM Salary Reduction Form/www.udmercy.edu/hr/benefits/forms/pdf/TIAAnewform2008.pdf100967Tuition_waiver.pdfTuition Waiver FormTuition Waiver Form/www.udmercy.edu/hr/benefits/forms/pdf/Tuition_waiver.pdf2569320Heritage_Vision_Plans_Enrollment_Form.pdfHeritage Vision Plans Enrollment FormHeritage Vision Plans Enrollment Form/www.udmercy.edu/hr/benefits/forms/pdf/Heritage_Vision_Plans_Enrollment_Form.pdf159405Heritage_Vision_Plans_Member_Handbook.pdfHeritage Vision Plans Member HandbookHeritage Vision Plans Member Handbook/www.udmercy.edu/hr/benefits/forms/pdf/Heritage_Vision_Plans_Member_Handbook.pdf3490516Heritage_Vision_Plans_Rates.pdfHeritage Vision Plans RatesHeritage Vision Plans Rates/www.udmercy.edu/hr/benefits/forms/pdf/Heritage_Vision_Plans_Rates.pdf73996/www.udmercy.edu/hr/benefits/forms/pdf/formsforms
