Please review the information in your 2023 Benefits Enrollment Guide to make the best choices for you and your family. All employees must complete a Declaration of Health Care form and the Open Enrollment Questionnaire. Please complete and return these forms to your Administrative Office or email@example.com.
Mandatory Forms – Every employee must complete both mandatory forms (this includes per diem, paid intern, seasonal or temporary, part-time and full-time employees).
Additional Form – If you are making a change to your benefit selection for 2023, you must ALSO complete this form:
Please review the information in your 2023 Benefits Enrollment Guide to make the best choices for you and your family. This year, we are offering three MVP plan options: Platinum, Gold, and Silver.
Annual Required Notices
As a plan sponsor The Roman Catholic Diocese of Burlington is required by law to periodically provide participants with various notices. These notices are on page 15 in the Benefit Enrollment Guide or by clicking the following links. COBRA, Health Insurance Marketplace, HIPAA, Women’s Health and Cancer Rights Act of 1988, and Benefit Plan Summaries. The notices require no action on your part, except that the information should be shared with any dependents enrolled in your benefits.