Employee Benefits, Forms and Resources
It's very important to read the instructions in the link below before completing any Tuition Remission Request forms.
Please read the instructions first and then complete the form. These forms are now in fillable PDF format. Tuition Remission Request forms are due in HR by January 5, 2016 for the 2016-2017 school year.
- Undergraduate Tuition Remission Form
- ADP & El. Ed. Degree Completion Tuition Remission Form
- Graduate Tuition Remission Form
- Tuition Exchange Information Sheet
Pioneer Educators Health Trust
Link to the Pioneer Trust page for information and forms for Health and Dental plans administered by Regence Blue Cross/Blue Shield.
Kaiser Permanente HMO and Dental HMO - www.kp.org
Customer Service 503-813-2000
Group Number 001348
Kaiser Enrollment Formfor Medical and Dental
- Medical Member Guide
- Summary of Medical Benefits
- Medical Summary of Benefits and Coverage Notice
- Kaiser Preventive Services Summary
Kaiser Discount Programs
Allegiance: Flexible Spending Accounts for medical and dependent care expenses
Customer Service 877-424-3570
www.allegianceflexadvantage.com is your secure portal to submit claims, get a list of eligible expenses and monitor your account
Group Number: 505850
This is a great way to save taxes on money you will spend for health or dependent care. George Fox pays the monthly service fees for your account and a debit card, if elected.
- Flexible Spending Account Enrollment Form
- Flex Direct Deposit Form
- Claim form for Unreimbursed Medical Expenses
- Claim form for Unreimbursed Dependent Care Expenses
- Debit Card General Info
- Flexible Spending Summary Plan Document
TIAA-CREF - 403b Retirement Plan
- Authorization for Payroll Reduction (use this form to set or change the percent you invest)
- How to Enroll Online with TIAA-CREF and George Fox University Retirement Plan Document
- Current Fund Performance and Investor Webinars
Life Insurance and Long Term Disability Insurance: LifeMap Assurance
There is no cost to full time employees for the basic benefit plans, and all plans come with emergency travel assistance.
This voluntary life insurance is available to employees who are eligible for the basic Life Insurance. You may purchase additional term life insurance for yourself, your spouse and/or your child(ren).
- Highlights: basic and optional life insurance
- Basic Life Insurance enrollment form
- Voluntary Life Insurance Enrollment form
- Life and LTD Insurance Plan Booklet
- Emergency Travel Assistance (Medex) program and wallet card
- Employee Assistance Program is available to all who are eligible for life insurance (.75 FTE or above and regular employee 1 year or longer).
Long Term Care Insurance: Genworth
Genworth is our provider for Long Term Care Insurance. This brochure is a great place to start, and includes instructions for accessing a recorded webinar if you missed the meetings on campus. Link here to a Genworth web page and a quote you can customize yourself using GroupID: georgefox and Access Code: groupltc.
LTC Solutions is a great resource if you're considering purchasing long term care insurance. Email: firstname.lastname@example.org
If you or a family member need to find licensed care professionals in your area, go to www.ltcresourceguide.com/guide and enter the George Fox employer code 000125.
Supplemental Insurance: Aflac
Aflac offers several payroll-deduction plans, including Vision, Cancer Care, Hospital Indemnity and more. www.knowquack.com
The premiums for these plans are generally deducted after taxes are calculated so you may start/stop these coverages at any time. Paul Frampton is our agent and you can contact him by phone: 503-347-7410 or by e-mail: email@example.com
Here is a list of businesses that offer discounts to George Fox employees and their families.
Forms Regarding our Coverage Related to Medicare Part D and Medicare Publications
- Medicare Part D Notice-Disclosure
- Medicare & You
- Additional Medicare Publications
- 2016 Medicare News. Medicare announces rate increases and no Social Security COLA for 2016. See articles and the Medicare website for more details: