HR and Benefit Forms
If you would like paper copies of the forms, please stop by Human Resources in Myer Hall.
2022 Benefits Information
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2022 Open Enrollment Instructions
- 2022 Employee Benefits Brochure
- Delta Dental Plan Summary
- FSA Resources for the 2022 Plan Year
- Highmark & Benecon Open Enrollment Presentation Video (11/23/21)
- Highmark & Benecon Open Enrollment Presentation Slides (11/23/21)
- Glossary of Health Coverage and Medical Terms
- Medicare Part D 2021 Notice
- Term Life Insurance
- Employer Term Life Insurance
- Long Term Disability (Eligible Administration and Faculty)
- Long Term Disability (Eligible Hourly Employees)
- Lasik Service From Qualsight (Delta)
- Guardian Preventative Advantage
- Guardian's Oral Health Rewards Program
- Guardian Dental & Vision
- Hearing Aids From Amplifon
- Well360 Virtual Health
Access your Benefits Information Online Anytime!
Click here to access, Empliant, our online benefits portal for employees. Once logged in you will have the ability to view your current benefits elections and update personal information related to your benefits.
Benefit Plan Highlights
Summary of Benefits and Coverage
- Summary Plan Description
- $0 Deductible PPO Plan
- $250 Deductible Plan
- $500 Deductible Plan
- $500 Choice Blue Plan
- High Deductible Plan
Important Notices
Forms and Resources
Bowers Center for Sports, Fitness and Well-being
Domestic Partner Benefit Policy
Emergency Contact Instructions
Employee Assistance Programs (EAP)
- WellSpan EAP
- Unum Work-life Balance EAP
- Comparison of WellSpan and Unum EAPs
- WellSpan - Instructions for Accessing the WellSpan Worklife Portal
- WellSpan - Coping with Violence and Terrorism in the News
- WellSpan - Tips for Helping Families and Children Cope with Tragic Events
- WellSpan - Ending Your Workday Checklist
Ergonomics - Workstation Self-Evaluation Checklist
The Benecon Mobile App How-To-Guide
Benecon CDH Consumer Portal Setup Guide
Elizabethtown College FSA FAQs
Liberty Mutual Insurance Flyer
Life Insurance Beneficiary Change Form
Reasonable Accommodation Request Form
TIAA-CREF Beneficiary Change Form
TIAA-CREF Defined Contribution Summary Plan Description
TIAA-CREF Roth Contribution Option
TIAA-CREF - Salary Reduction Form