ADA
Americans With Disabilities Act
OC Employee Disability Accommodation Request (DAR)

BENEFITS SUMMARIES
Administrative Assistants
Administrative & Professional Staff
Confidential Employees
Faculty
Non-Continuing Faculty
Safety & Security Employees
Service Employees

DENTAL
Cigna Dental Summary
Dental Claim Form
Enrollment Form
Met Life Summary
Patient Charge Schedule
Superior Dental Care
Superior Direct Connect

FLEX SPENDING
Flex Plan Highlight Sheet
Flex Spending Summary
FSA Enrollment Guide
FSA Claim Form

FMLA
FLMA Policy For Staff (excluding Faculty)
FMLA Employees Health Certification
FMLA Family Health Certification
FMLA Certification of Adoption or
Foster Care Placement
FMLA Military Health Certification
FMLA Military Family Health Certification

HEALTH INSURANCE
Child Coordination of Benefits - 2011
Child Enrollment App Form Age 26
Cigna
CIGNA Drug List Changes
CIGNA Guide to EOB's
COBRA Continuation
Dependent Coverage
Finding a Doctor by Specialty
Full-time Student Status Form
Global Emergency Medical Service
Global Assistance Wallet Card
How to Find a Doctor by Name
Lab Facilities
Medical Claim Form
Medicare Drug Plan
OCOPE Three-Tier Drug Reimbursement Form
Prescription Drug Three-Tier Program
Preventive Drug List
Safety & Security Reimbursement Form
Tel-Drug Order Form

HIPAA
Notice of Privacy Practices
HIPAA-ERISA Appeal Language
HIPAA Authorization
HIPAA Special Enrollment

LIFE and AD&D
Basic UNUM Life and AD&D
Optional UNUM Life and AD&D
Designation Card
Proof of Insurability
Summary Sheet

LONG TERM CARE
Long Term Care Information

LONG TERM DISABILITY
Long Term Disability Plan UNUM

MISCELLANEOUS
Oberlin College Financial Report FY2010
A&PS Performance Appraisal
Accident/Injury Incident Report
Business Conduct Policy Manual
Employee Change Form
Form I-9, Employment Eligibility Verification & Acceptable Documents
Reclass Form for Administrative Assts
OCOPE Contract 2010-2013
Physicians Statement (Required for Medical Leaves)
Social Security
Spousal Coordination of Benefits

PAYROLL
Direct Deposit Form
State Form
State Reciprocity
W-4

REQUIRED ANNUAL NOTICES
CHIP Notice - Medicaid and Children's Health Insurance Program
FMLA Poster
Summary Annual Reports
USERRA- The Uniformed Services Employment and Remployment Rights Act
WHCRA - Women's Health and Cancer Rights Act

TUITION SCHOLARSHIP FORMS
Administrative Assistants
Carpenters
Faculty and A&PS
Security
Service

UNION REIMBURSEMENT
Eye Reimbursement Request

SUMMARY PLAN DOCUMENTS
Summary of Health Care Benefits -
Plan A
Summary of Health Care Benefits -
Plan B
Summary of Health Care Benefits -
New Plan B (OCOPE)
Summary of Health Care Benefits -
Retirees
Quick Reference Chart, Plan A 2012
Quick Reference Chart, OCOPE Standard 2012
Quick Reference Chart, OCOPE Incentive 2012
Quick Reference Chart, SECURITY Standard 2012
Quick Reference Chart, SECURITY Incentive 2012
Quick Reference Chart, UAW 2011
Quick Reference Chart Retirees 2012

TIAA CREF
Summary Plan Description - Defined Contribution Retirement Plan (RA)
Summary Plan Description - Tax Deferred Annunity (SRA)
TIAA CREF Enrollment Form
TIAA CREF How to Enroll Online
TIAA Salary Reduction Form
TIAA Salary Reduction - OCOPE
TIAA CREF When Leaving the College

VISION
Vision Summary
Coverage Information
Vision Sample ID Card
Vision Claim Form