Insurance Instructions

All insurances must be submitted to the Diocesan House by the 31st day of the individual’s permanent employment.                                       

 Medical/Dental Insurance:   This is a generic form provided by the Diocesan House.  Please ensure that it is completely filled out. Also ensure that the member is certain of the plan provided, changes cannot be submitted until open enrollment unless a qualifyting event occurs.

To cancel medical or dental coverage please fill out a medical/dental change form and submit it to us by fax, e-mail, or postal mail.

Life/Disability Insurance:   When filling out this form, please choose whether the member is a new hire or if you are just changing the person’s information.  Fill out the form completely including the annual salary or compensation, without this information we cannot determine the amount of the coverage the person is to receive.  Life insurance compensation is the total compensation for clergy times 2. For lay employees, it is their pay times 2. Both are rounded to the nearest $500.00.

To terminate the person's Group Life or Disability please choose Change Employee Information and then choose termination.