Resources
HR Forms
Benefits
Ever wonder how to find out which doctors accept your health insurance?
Or maybe you want to know how to change the amount you are contributing to your GSRA (Group Supplemental Retirement Account).
The answers to these and other benefits related questions are available by contacting the Jefferson Lab Benefits Staff.
Doug Roeder, HR Consultant
(757) 269-7576
Treva Ferguson, HR Consultant
(757) 269-7291
Users: For information on employee benefits, please contact your sponsoring college or university.
2011 Benefits
View the Open Enrollment Announcement
Summary of Medical Plans
Medical and Dental Changes
CHIP- Required Notice
JSA Summary Plan Description
JSA Cafeteria Plan
SURA/JSA Comprehensive
Summary Plan Description
ESS Information
Log into ESS
ESS Instruction Guide
Extension of Adult Dependent Eligibility Rules
Notice of Opportunity to Enroll
Dependent Children Benefit Extension Acknowledgement
Grandfathered Plans Notice
2011 Benefit Links:
- JSA Summary Plan Description for the Cafeteria Plan, Health Flexible Spending Plan, Dependent Care Assistance Plan
- SURA/JSA Comprehensive Health and Welfare Benefit Plan - Summary Plan Description
- SURA/JSA Tax-Deferred Annuity Plan - Summary Plan Description
- SURA/JSA Defined Contribution Retirement Plan - Summary Plan Description
Social Security Administration Benefits Calculator
TIAA-CREF
Medical Retirement
2011 Anthem Information
- Anthem Website
- Vision Information
- Find a Doctor
- Anthem Enrollment Form
- Healthkeepers Enrollment Brochure
- Healthkeepers Summary
- BlueCare Enrollment Guide
- BlueCare Summary
- KeyCare Enrollment Guide
- KeyCare Summary
- Blucare/KeyCare Prescription Summary
- HealthKeepers Prescription Summary
- HealthKeepers Vision Summary
- Anthem Member Change Form
- Anthem Blue View Vision Plan
- Blue View Out-of-network Claim Form
- BlueCare EOB
- Healthkeepers EOC
- KeyCare EOB
2011 Optima Information
- Optima Website
- Optima Enrollment form
- Optima Benefit Guide
- Vision Information
- Find a Doctor
- Optima Summary
- Optima Vantage Plans - Core Benefit Changes
- Jefferson SURA Vantage Contract
2011 Delta Dental Information
- Delta Dental Website
- Delta Dental Evidence of Coverage
- Delta Dental Summary
- Delta Dental Enrollment Application
- Find a Dentist
- Delta Dental Q and A
- Delta Dental Prevention First
- Delta Dental EOB
2011 MetLife Information
- MetLife JSA - Jefferson Lab enrollment form
- STD Plan Highlights and Rate Sheet
- Supplemental Life Rates
- Statement of Health Form
- MetLife Certificate of Insurance - Disability Insurance
- MetLife Certificate of Insurance - Life Insurance
2011 Same-Sex Domestic Partner Information
2010 Benefit Information
Additional Benefits
Plan Documents
Flexible Spending Account & Summary Annual Report
FMLA Information