Benefit Forms and Documents 

 

New Employee Enrollment Instructions

All new employees must complete the Benefits Election Summary Form and applicable benefit enrollment form(s) listed below.  All benefit forms must be received by the Office of Human Resources within 30 days of eligibility. Failure to submit elections within the 30-day deadline will result in no insurance coverage for the entire plan year.  

 

Current Employee Enrollment Instructions (during Open Enrollment)

During the benefits open enrollment period, October 26 - November 6, 2009, current employees may switch, add, adjust or cancel insurance and/or add or remove spouse or dependent(s) from coverage.  Employees who do not initiate a change during open enrollment will automatically continue in their current benefit coverage for 2010, except for FSA plans.  Employees must re-enroll in the FSA plan annually.  Please access the benefits Enrollment Instructions for full details.  All benefit forms must be submitted to the Office of Human Resources by November 6, 2009.  

 

Benefit Forms and Documents  

Benefits Newsletter and Guide
Benefits Election Summary
Medical Insurance
Vision Insurance
Dental Insurance
Life Insurance
Pre-Paid Legal Service/IdentityTheft Shield Plan
Flexible Spending Account - Health and Dependent Plan
Waiver of Insurance
Retirement Plan
Summary Annual Report


Benefits Newsletter and Guide

Benefits Election Summary 

Medical Insurance 

Vision Insurance

Dental Insurance

Life Insurance

Pre-Paid Legal Service and/or Identity Theft Shield (PPLS/ITS)

Flexible Spending Account (FSA)

Waiver of Insurance

 Retirement Account

Summary Annual Reports



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Lawrence Technological University
21000 West Ten Mile Road • Southfield, MI 48075-1058 • © 2009 1.800.CALL.LTU