About SMU Human Resources

Benefits

Following is a list of Benefits related forms.  If you do not find the form you are looking for, it may be listed under a different category.

Health Forms and Resources

Benefits Guide

Medical - BlueCross BlueShield of Texas
$1,000/$2,000 Deductible Summary Plan Description
$2,500 Deductible PPO with HSA Summary Plan Description
$5,000 Deductible PPO with HSA Summary Plan Description
Medical Claim Form
Adult Wellness Guidelines
Children's Wellness Guidelines
Perinatal Wellness Guidelines
Prescription - Express Scripts (formerly Medco)
Health, Allergy & Medical Questionnaire
Mail Order Form
Reimbursement Form
Summary Plan Description
Dental - BlueCross BlueShield of Texas
Benefits Highlights
Claim Form
Summary Plan Description
Student Certification
Vision - VSP
Benefits Summary
Out-of-Network Claim Form
Flexible Spending Accounts - Discovery Benefits
Automatic Dependent Care Request Form
Automatic Orthodontia Request Form
Direct Deposit Enrollment/Change Form
Reimbursement Request Form
Instructions: Request a Debit Card Online
Medical Necessity Form
Receipt and Substantiation Form
Medical/Dental/Vision Rates
Benefit Rates
Life and Disability Insurance - Reliance Standard
Beneficiary Designation Form
Evidence of Insurability Form
Summary Plan Description - Accidental Death & Dismemberment
Summary Plan Description - Long-Term Disability
Summary Plan Description - Supplemental Life Insurance
Travel Assistance Brochure - WorldNet
Long-Term Care - CNA
Detailed Plan Information Booklet
Rates-Parents, etc.
Leave of Absence
Family Medical Leave Act - Certification for Dependents
Family Medical Leave Act - Certification of Health Provider
Leave of Absence Form - Staff

 

Retirement Forms and Resources

403(b) Retirement Plan
Qualified Default Investment Alternative (QDIA) Notice
Understanding the SMU 403(b) Retirement Plan
Emeriti
Emeriti ADV Privacy Notice
Emeriti Frequently Asked Questions
Medicare
Medicare and You 2014
Retiring From SMU
Retiring From SMU - 2014
SMU High Deductible Health Plans and Medicare
SMU Retiree Medical Eligibility
Social Security
How Social Security Benefits are Calculated
Understanding the Benefits 2014

 

Miscellaneous

Miscellaneous
Change of Name Form
COBRA Benefits Guide
COBRA Benefits Highlights
COBRA Rates
Dissolution of Domestic Partnership
Statement of Domestic Partnership
Termination Form