Employee and Student Worker Forms
Forms listed on this page: Benefits for 2021, Benefits for 2020, Compensation, Employment, FMLA, Payroll, Performance Management, Retirement, Safety, Student Workers, Travel, Worker’s Compensation
Benefits Information for 2021:
Welcome to McPherson College’s Virtual Open Enrollment: November 2, 3 and 4, 2020 for Benefits effective Jan 1, 2021
Benefits eligible employees will receive an email from MaxWellHealth.com “Welcome and Annual Open Enrollment” to begin and complete their open enrollment for 2021 benefits
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.
Health 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.)
- BCBS of KS Prime Therapeutics Pharmacy 2021
- BCBS of KS Glossary of Health Coverage and Uniform Glossary 2021
- BCBS of KS Glossary of Health Coverage and Medical Terms 2021
- BCBS of KS Rights Information 2021
New Free Benefit For BCBS of KS Health Insurance Participants for 2021:
(Eligible employees may enroll Jan 1, 2021 or after)
Supplemental Benefits Enrollment Form
Benefits Supplemental Enrollment Form 2021 10.20.2020
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
Benefits Information and Forms for 2020:
- McPherson College Benefits Guide 2020
- BCBS Health Insurance Triple Option PPOs Summary for 2020
- BCBS Health Insurance High Deductible Summary for 2020
- BCBS $1000 Deduct Summary of Benefits and Coverage 2020
- BCBS $1500 Deduct Summary of Benefits and Coverage 2020
- BCBS $2500 Deduct Summary of Benefits and Coverage 2020
- BCBS High Deduct Summary of Benefits and Coverage 2020
- BCBS Dental Brochure Low Option 2020
- BCBS Dental Brochure High Option 2020
- BCBS Enrollment or Change of Enrollment Form 2020
- Supplemental Insurances Enrollment Form 2020
- Employee Assistance Program EAP Brochure
Maestro Supplemental Insurances for 2020 the same as those for 2019.
Supplemental Benefits including EAP Information and Forms for 2019 and 2020:
- Maestro Supplemental Benefits Enrollment Form 3.2019
- Maestro FSA Eligible Expense List 2019
- Maestro FSA Medical Reimbursement Request Form 2019
- Maestro FSA Dependent Care Reimbursement Request Form 2019
- Maestro HSA Employee Benefit Guide 2019
- Maestro HSA Employee Welcome Guide 2019
- Maestro HSA Employee Investment Guide 2019
- Employee Assistance Program (EAP) Brochure 2019
- Employee Assistance Program (EAP) Wallet Card 2019
- EAP Guidance for On-Line Access 2019
- BCBS Waiver Form
- Flexible Benefit Summary Plan Document 2019
- 2018 Summary Annual Report for MC Health Insurance Plan
- 2018 Summary Annual Report for MC Life Insurance Plan
- 2018 Summary Annual Report for MC Disability Plan
Compensation
Employment
- Confidentiality Statement and Proprietary Information Obligations Policies
- McPherson College General Information Sheet
- Guidelines for Keys
- Hiring Disclosure Form 10.27.2015
- I9 10.2022
- 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
- Kansas Employee’s Withholding Allowance Certificate (K-4 2015)
- Notice of Payroll Deductions for College Property Form 7.2015
- W4-2020
- 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
- Performance Coaching Worksheet Example 5.2018
Retirement 403(b)
- SRA Agreement 1.1.2021
- McPherson College Change in Investment Letter effective 4.9.2021
- 403(b) Summary Annual Report for 2019
- 403(b) Tiaa Fee Disclosure as of 12.31.2018
- 403(b) Fee Disclosure Letter 3.27.2019
- Lincoln Fee Disclosure 12.31.2018 CR22882 162 FD
- Lincoln Fee Disclosure 12.31.2018 CR22882 185 FD
- Lincoln Fee Disclosure 12.31.2018 CR22882 203 FD
- Lincoln Fee Disclosure Letter 2018 5.24.2019
- Need a little help understanding fee disclosures? 403(b) Fee Explanation 5.2018
- 403(b) Menu Change Notice 5.5.2017
- 403(b) Summary Plan Description 1.1.2019
- TIAA-CREF Mariner Transition Letter 2.25.2015
- Lincoln Mariner Transition Letter 2.25.2015
- 2018 Summary Annual Report for MC 403(b) Retirement Plan
TIAA-CREF Customer Service 800-842-2252
Monday – Friday, 8am – 10pm, Sat 9am – 6pm (EST)
Lincoln Financial Group Customer Service 800-454-6265
Monday-Friday, 8am – 8pm (EST)
Safety
Student Worker Employment Documents
- Student Worker Handbook 7.2020
- SStudent Worker Handbook Receipt 7.2020
- I9 List of Acceptable Documents
- Student Worker Approval Process