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Employee Benefits

Employee Benefits (Jump Sections)

• Benefits Contact Information
• Deferred Compensation
• Dental Insurance
• Employee Data Maintenance Form (EDMF)
• Flexible Spending Account Plan
• Health Insurance
• HIPAA Privacy Notice
• Life Insurance
• Retirement/PERA
• Workers' Compensation Insurance

Benefits Contact Information

• Benefits Contact Information 2012

Deferred Compensation

• Deferred Compensation Comparison Sheet
• Change Forms (complete to change your current salary deferral amount)
  • Hartford Contribution Change Form
  • ICMA Salary Deferral Change Form
  • Minnesota (MNDCP) Salary Deferral Change Form
  • Nationwide Salary Deferral Change Form
• Enrollment Forms (complete to enroll in a deferred compensation plan)
  • Hartford Enrollment Form
  • ICMA Enrollment Form
  • Minnesota (MNDCP) Enrollment Form
  • Nationwide Enrollment Form

Dental Insurance

• 2012 Dental Insurance Premium Rates
• Dental Benefit Plan Summary
• Delta Dental of Minnesota

Employee Data Maintenance Form (EDMF)

• Employee Data Maintenance Form

Employee Wellness Handbook

• Employee Wellness Handbook

Flexible Spending Account (FSA) Plan

• 2012 FSA Enrollment Form
• Online Claim Filing Instructions
• Direct Deposit Authorization Form
• Green FSA FAQ
• Health FSA OneCard Debit Card FAQs

Health Insurance

• 2012 Health Insurance Premium Rates
• 2012 HealthPartners Information Brochure
• 2012 Duluth Joint Powers Enterprise Trust Plan 3A Health Benefit (Health Partners)
• 2011 Prescription Drug Formulary (ClearScript)
• 2012 Duluth JPE Trust Rx Benefit Plan Summary
• Drug Protocol Management
• Prior Authorization/Coverage Determination Request Form (ClearScript)
• Prescription Claim Form (ClearScript)
  
  

• ClearScript Website

HIPAA Privacy Notice

• HIPAA Privacy Notice

Life Insurance

• Term Life Insurance Benefits (Minnesota Life)
• 2010 Optional Life Insurance Rates (Minnesota Life)
• Optional Life Insurance Enrollment Form (Minnesota Life)
• Benificiary Counseling
• Will Preparation
• Travel Assistance

Retirement/PERA

The City of Duluth participates in the State of Minnesota Public Employee Retirement Association (PERA). Please see their website for details.

• Retirement Benefits Summary Worksheet
• Retirement Checklist
• Coordinated PERA Plan Handbook (for all employees other than Police and Fire members)
• Police & Fire PERA Plan Handbook

Workers' Compensation Insurance

• Minnesota Workers’ Compensation FAQs
• First Report of Injury Form (City of Duluth specific form to be filled out by supervisor)