Employee and Student Employment Forms
Forms listed on this page include:
Employee Benefits Materials for 2021 and 2022, Compensation, Employment, FMLA, Payroll, Performance Management, Retirement, Safety, Student Workers, Travel, Worker’s Compensation
Benefits Information for the 2022 Plan year, Jan 1 – Dec 31, 2022.
2022 McPherson College Benefit Guide:
2022 McPherson College Benefit Guide
IMA Call Center for Your Health Insurance Questions Flyer 5.26.2022
College-paid benefits:
SunLife Long Term Disability 2022 Flyer
Employee Assistant Program (EAP) Flyer for 2022:
Employee-paid benefits:All costs listed are the employee costs deducted from monthly paycheck.
Medical Insurance:
BCBS of KS Health and Dental Employee Cost Form 2022
BCBS of KS 2022 Health Insurance PPO Summary Sheet ($1000, $1500 and $2500 deductible plans)
BCBS of KS 2022 Health Insurance High Deduct Summary Sheet ($3000 high deductible plan)
BCBS of KS SBC $1000 Deductible 2022
BCBS of KS SBC $1500 Deductible 2022
BCBS of KS SBC $2500 Deductible 2022
BCBS of KS SBC $3000 Deductible 2022
BCBS of KS Contract Changes for 2022
BCBS of KS ResultsRx Employee Guide 2022
BCBS of KS Drug Copay Maximization for 2022
BCBS of KS Specialty Rx Accredo Flyer for 2022
BCBS of KS Express Scripts Home Delivery Flyer for 2022
BCBS of KS BlueAccess Flyer for 2022
BCBC of KS Telemedicine (Amwell) Flyer for 2022
BCBS of KS Healthy Options for Disease Management Flyer for 2022
New Free Benefit For BCBS of KS Medical Insurance Participants for 2022:
(Eligible employees may enroll Jan 1, 2022 or after)
BCBS of KS Experian Flyer for 2022
Dental Insurance:
BCBS of KS $1500 Deductible Dental Plan Summary for 2022
BCBS of KS Buy Up No Annual Maximum Dental Plan Summary for 2022
Vision:
Flexible Spending Accounts (FSA) and Health Savings Accounts (HSA):
Flexible Spending Accounts (FSA):
Discovery Wex Medical FSA Employee Handout 2022
Flexible Spending Account (FSA) Contribution Limits & IRS Regulations Handout 2022
Discovery Wex Dependent Care FSA Employee Handout 2022
Health Spending Accounts (HSA):
Discovery Wex HSA Handout 2022
Discovery HSA Contribution Limits & IRS Regulations Handout 2022
Other worksite and supplemental insurances:
Sun Life Hospital Indemnity 2022 Flyer
SunLife Critical Illness 2022 Flyer
Sun Life Voluntary Life Insurance 2022
Sun Life Short Term Disability 2022 Flyer
Supplemental Benefits 2022 Form (including vision, life insurance, F.S.A., H.S.A., short term disability, worksite insurances):
Benefits Supplemental Insurances Employee Cost Form 2022
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Benefits Information for the 2021 Plan year, Jan 1 – Dec 31, 2021.
If you want to make any changes to your current insurance enrollment outside of the annual insurance open enrollment period, please contact your Human Resources Office at stocklib@mcpherson.edu or call (620) 242-0454.
Below are the 2021 forms and information.
College-paid benefits:
- Sun Life Basic Life Insurance 2021 – College paid
- Sun Life Long Term Disability Insurance 2021 – College paid
Employee-paid benefits:
All costs listed are the employee costs deducted from monthly paycheck.
Medical Insurance:
(see below for a new, free benefit for employees enrolled in BCBS of KS health insurance effective Jan 1, 2021)
- BCBS Enrollment or Change of Enrollment Form 2021
- BCBS Health Insurance Triple Option PPOs Summary for 2021
- BCBS of KS Summary of Benefits and Coverage $1000 Deduct 2021
- BCBS of KS Summary of Benefits and Coverage $1500 Deduct 2021
- BCBS of KS Summary of Benefits and Coverage $2500 Deduct 2021
- BCBS High Deduct Summary of Benefits and Coverage 2021
- BCBS of KS Summary of Benefits and Coverage High Deduct Plan 2021
- BCBS of KS Contract Changes for 2021 Health Insurances
- BCBS of KS TeleMed Brochure 2021
- BCBS of KS Telemed Brochure AmWell 2020(NOTE: Telemedicine may used for your local provider during their regular office hours or 24 x 7 with Amwell Telemed. Not all providers utilize AmWell Telemed. Please go to: www.bcbsks.com/telemed to see how to enroll in Amwell Telemed.)
New Free Benefit For BCBS of KS Medical Insurance Participants for 2021:
(Eligible employees may enroll Jan 1, 2021 or after)
Supplemental Benefits Enrollment Form
Benefits Supplemental Enrollment Form 2022
Dental Insurance:
Vision Insurance:
Flexible Spending Accounts (FSA) and Health Savings Accounts (HSA):
Flexible Spending Accounts (FSA):
- Discovery Dependent Care Account Brochure 2021
- Discovery Dependent Care FSA Contribution Limits and IRS Regulations Brochures 2021
- Discovery Medical FSA Brochure 2021
- Discovery Medical FSA Contribution Limits and IRS Regulations Brochure 2021
- Discovery FSA Grace Period Brochure 2021
Health Spending Accounts (HSA):
- Discovery Health Savings Account (HSA) Brochure 2021
- Discovery HSA Contribution Limits and IRS Regulations Brochure 2021
Discovery FSA/HSA Mobile App:
Other worksite and supplemental insurances:
- Sun Life Voluntary Life Insurance 2021
- Sun Life Short Term Disability Insurance 2021
- Sun Life Critical Illness (includes Cancer Coverage) Insurance 2021
- Sun Life Hospital Indemnity Insurance 2021
- Sun Life Accident Insurance 2021
- InfoArmor (Allstate) ID Protection Brochure 2021
- Employee Assistance Program (EAP) 2021 Brochure
- Who to Contact for Insurance Questions 2021
Claim Forms for SunLife Supplemental Benefits:
SunLife Accident Claim Statement
SunLife Wellness Cancer Screening Claim Form
SunLife Critical Illness Claim Statement
SunLife Hospital Indemnity Claim 2021
Certificates of Coverage for SunLife Supplemental Benefits:
SunLife Vol STD Certificate 2021
SunLife Vision Certificate 2021
SunLife Critical Illness Certificate 2021
SunLife Basic Life Certificate 2021
SunLife Basic ADD Certificate 2021
SunLife Accident Certificate 2021
SunLife Basic LTD Certificate 2021
SunLife Hospital Indemnity Certificate 2021
Associated Plan Documents:
Compensation
Employee Referral Program
- ADM #375 Employee Referral Program Form for Referring Employee
- ADM #375 Employee Referral Program Form for Supervisor Approval
Employment
- New Employee On Boarding Plan
- Confidentiality Statement and Proprietary Information Obligations Policies
- McPherson College General Information Sheet
- Guidelines for Keys
- Hiring Disclosure Form 7.2021
- Separation Checklist
Family and Medical Leave Act (FMLA)
- FMLA Certification Current Service Member 5.2018
- FMLA Health Care Certification Employee 5.2018
- FMLA Certification Family Member 5.2018
- FMLA Exigency for Military Family Leave 5.2018
- FMLA Designation Form 5.2018
- FMLA Rights and Responsibilities 5.2018
Payroll
- K-4 Form revised 2018
- Notice of Payroll Deductions for College Property Form 7.2015
- W4 Form 2022
- W-4 Education Letter 1.1.2020
- Overtime Authorization Form 11-21-2016ller
Performance Management
- Staff Annual Performance Evaluation 5.2018
- Performance Coaching Worksheet 5.2018
- Training and Career Development Plan Worksheet
Retirement 403(b)
- McPherson College Change in Investment Letter effective 4.9.2021
- McPherson College Change in Investment Letter effective 8.2021
- CREF Money Market Account Plan Sponsor FAQs 6.26.2021
Fee Disclosures:
TIAA and Legacy Lincoln:
- 403(b) Lincoln Fee Disclosure CR22882 1185 FD 12.31.2021
- 403(b) Lincoln Fee Disclosure CR22882 1162 FD 12.31.2021
- 403(b) Lincoln Fee Disclosure CR22882 1203 FD 12.31.2021
- 403(b) TIAA Fee Disclosure 500760 12.31.2021
- 403(b) TIAA Fee Disclosure Cover Letter 500760 12.31.2021
- 403(b) TIAA Fee Disclosure 3.31.2021
- 403(b) Lincoln Fee Disclosure CR22882 1162 12,31,2020
- 403(b) Lincoln Fee Disclosure CR22882 1203 12.31.2020
- 403(b) Lincoln Fee Disclosure CR22882 1185 12.31.2020
Alliance Lincoln:
- 403(b) Lincoln Fee Disclosure MPC-01 5.2022
- 403(b) Fee Disclosure Lincoln 1.1.2022
- 403(b) Fee Disclosure Lincoln 12.16.2021
Need a little help understanding fee disclosures? 403(b) Fee Explanation 5.2018
Summary Plan Descriptions:
Summary Annual Reports:
- 403(b) Summary Annual Report for Retirement Plan 2019
- 403(b) Summary Annual Report Health Insurance Plan 2019
- 403(b) Summary Annual Report Life Insurance Plan 2019
- 403(b) Summary Annual Report Disability Insurance 2019
- 403(b) Summary Annual Report Retirement Plan 2020
- 403(b) Summary Annual Report AD&D, Life and Other Supplemental Insurances Plan 2020
- 403(b) Summary Annual Report Health and Dental 2020
TIAA Customer Service 800-842-2252
Monday – Friday, 8am – 10pm, Sat 9am – 6pm (EST)
Lincoln Financial Customer Contact Center any business day, from 8:00 a.m. to 8:00 p.m. Eastern Standard Time at 800-234-3500
403(b) How to Contact Lincoln Flyer 5.26.2022
- Lincoln Sr. Retirement Consultant, Michael Stelzig: Michael.Stelzig@LFG.com for an individual retirement consultation, call him toll free at 866-434-8903 or you can use the following click 2 meet link to schedule a meeting directly with Michael https://lfg.com/mcphersonschedule
- 403(b) Lincoln Participant Website Overview 1.1.2022
- 403(b) Lincoln Participant Registration Guide 1.1.2022
Safety
Student Employment Documents
- Student Employment Handbook 6.2022
- Student Employment Handbook Acknowledgement 6.2022
- I9 List of Acceptable Documents
- Student Employment Approval Process