Benefits Newsletter and Guide
Benefits Election/Change Summary
Legal Shield (Pre-Paid Legal Service/IdentityTheft Shield Plan)
Flexible Spending Account - Health Care and Dependent Care Plan
Summary Annual Report (All Plans)
- Welcome to Benefits Open Enrollment Memo
- 2014 Benefits Open Enrollment Newsletter
- 2014 Benefits Guide
- 2014 Monthly Health Insurance Rates
- 2014 Insurance Providers Contact Information
2014 Election Forms
- 2014 Benefits Election/Change Summary (Form #3075) (Word version)
- 2014 Benefits Election/Change Summary (Form #3075) (Adobe version)
- Affidavit of Domestic Partner Benefits (Form #3032)
NOTE: The current BCN Healthy Blue Living HMO and Blue Cross Blue Shield of MI (BCBSM) Simply Blue PPO plans will terminate on 12/31/2013. Effective 01/01/2014, the new medical plan options will be HAP Aspire Health Engagement HMO and Alliance Health and Life (AHL) PPO. All employees will need to make a new medical election for 2014.
Plans Effective 01/01/2014
NOTE: HAP HMO Enrollment Application must include HAP HMO Personal Care Physician's Name and PCPIN information available on the HAP web site at www.hap.org.
AHL PPO Plan Information
HAP HMO Plan Information
- Summary of Benefits and Coverage
- HAP HMO Schedule of Benefits
- HAP HMO Aspire Health Engagement Membership Guide and Requirements
Mail Order Information
NOTE: Complete your 2014 FSA election(s) on the 2014 Benefits Election/Change Summary Form #3075
NOTE: Complete the 2014 RSA Insurance Election/Change Form #3076. To enroll in medical coverage, complete the HAP HMO Enrollment Application above. Your current dental and vision plans will carry into 2014 unless you submit changes.
Lawrence Tech in its sole discretion may modify, amend, or terminate the benefits provided with respect to any individual receiving benefits, including active employees, retirees, and their dependents. Although the university has elected to provide these benefits this year, no individual has a vested right to any of the benefits provided. Nothing in these materials gives any individual the right to continued benefits beyond the time the university modifies, amends, or terminates the benefit. Anyone seeking or accepting any of the benefits provided will be deemed to have accepted the terms of the benefits programs and the university's right to modify, amend or terminate them.
Every effort has been made to ensure the accuracy of the benefits information in this site. However, if any provision on the benefits plans is unclear or ambiguous, the Office of Human Resources reserves the right to interpret the plan and resolve the problem. If any inconsistency exists between this site and the written plans or contracts, the actual provisions of each benefit plan will govern. Lawrence Tech in its sole discretion may modify, amend, or terminate the benefits provided with respect to any individual receiving benefits, including active employees, retirees, and their dependents.