Forms
-
Insurance - Summary Plan Descriptions
403b (Principal) Summary Plan Description Effective September 1, 2020
2021 Full Time Open Enrollment Benefit Brochure
2021 Summary of Benefits and Coverage (SBC) - Enhanced Plan
2021 Summary of Benefits and Coverage (SBC) - Base Plan
2021 Part Time Open Enrollment Benefit Brochure
2021 Annual Full Time Benefit Rate Sheet
2021 Annual Part-Time Benefit Rate Sheet
2021 Base Medical Plan Description
2021 Enhanced Medical Plan Description
AETNA: Prudent Rx Amendment - Effective September 1, 2021
2021 FSA & DCA Information Packet
FSA Amendment (allows carryover balances for 2020 & 2021 into 2022)
Medical Plan Amendments -- effective January 1, 2020
Dental Plans Comparison Description
Vision Plan
VSP Benefit Summary
Flexible Benefits Plan Summary
Flexible Spending Account Eligible Expenses -- effective January 1, 2020
January 1, 2020 FSA Amendment
Flexible Spending Account Frequently Asked Questions -- April 29, 2020
Basic Group Life insurance ($50,000)
Voluntary Life and A&D
Standard Travel Assistance Information
Standard Travel Assistance Program Description
Long Term Disability Plan
Short Term Disability Plan -
HR & Insurance Forms
403(b) Principal Beneficiary Form
2021 Attendance Calendar
Bi-Monthly Time Sheet
Employee Status Change Form (PT to FT)
Employee Status Change Form (FT to PT)
New Hire All Employees' Packet
New Hire Benefit Packet (FT)
New Hire Benefit Packet (PT)
Catholic Mutual Claim Incident Report - Liability & Property
Conference Report
Corrective Action Form
Direct Deposit Form
Education First Credit Union Information
Education First Credit Union 2019 Member Guide
Employee Evaluation Form
Employee Change Form -- Qualifying Event
Employee Diocesan Policy Manual
Employment Letter of Understanding - WORD
Employment Letter of Understanding - PDF
FMLA Employee Rights Information
FMLA Employee Certification Form
FMLA Family Certification Form
FMLA Notification Form
I-9 Homeland Security Form
I-9 Homeland Security Form Instructions
Notice of Resignation: Diocesan Offices
Notice of Resignation: Parishes
Notice of Resignation: School Laity
Ohio New Hire Reporting Form
Payroll Deduction Form
Personal Information Change Form
PTO Request
Short Term Disability Form
Spousal Form
2021 W4 Federal Tax Form
IT-4 Ohio Tax Form - revised 12/2020
W/C Incident Report
W/C Employee Injury Report Packet
Special Events Form
*Annual Open Enrollment Period is at the Diocese’s discretion
but typically held from November 1 - 15.