Franklin Pierce University

 Human Resources Department

 

 

If you have a benefit related question, please double click the attached link to contact our Benefit Specialist

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Important Links

 

Enrollment Form

 

AZ Enrollment Form

 

Summary Plan Description

 

Schedule of Benefits

 

Mail Service Prescription Form

 

Doctors Fax Prescription Form

 

 

Med Reimb Information

 

Med Reim Plan Summary

 

Harvard Pilgrim Website

 

 


All full-time employees are eligible to enroll in the University's health plan on the first day of the month following thirty days of employment with the University.

The University reserves the right to change insurance carriers and/or make plan design changes at the conclusion of any plan year.  Premium rates are subject to change by the carriers, effective on the plan anniversary date (July 1).

 

 Domestic Partner Benefit Options

 

                Click Here      Domestic Partner Policy

 

                Click Here      Affidavit of Domestic Partnership Form

 

Effective January 1, 2006, medical, dental and vision Insurance benefits will be available to domestic partners and their legal dependents on the same basis that they are available to legal spouses and the legal dependents of those spouses.  For specific information about insurance eligibility, refer to the Domestic Partnership policy or contact Human Resources.

 

Insurance Enrollment

To add a domestic partner and/or the partner's dependents to your coverage, you must complete an  affidavit of domestic partnership and submitted along with the appropriate insurance enrollment application or change/enrollment forms.

 

©2012 Franklin Pierce University
40 University Drive
Rindge, New Hampshire 03461