Benefits Forms and Details for 2019

2019 Benefits Booklet

2019 Working Spouse Form

About the Provider: Anthem

Anthem's website:

Anthem's Customer Service Phone Number:1-844-653-7397

Provider Search

  1. To determine if a physician is in the network, you should search the Anthem provider network
  2. Search as a Guest, click on "search by a selecting a plan/network"
  3. "What type  of care are you searching for?" select Medical
  4. "What State do you want to search in?" select your state
  5. "Select a plan/network", for members in Oho select Blue Access PPO or out of state members select National PPO (BlueCard PPO) and Continue
  6. Select your search criteria

Information for Active Employees

Information for Retiree Dependents

About the provider:  Delta Dental

Delta Dental's website

Delta Dental Customer Service: 800-524-0149

Dental Claim Form

Rates shown are monthly pre-tax full-time employee contributions.
Employee $4.78
Employee + Spouse $9.85
Employee + Child(ren) $9.24
Employee + Spouse + Child(ren) $14.24


About the provider: VSP - Vision Service Plan

VSP website

VSP phone: 800-877-7195

Vision claim form

Member summary

Vision Real Provider Choices

Rates shown are monthly pre-tax full time employee contributions.



Employee + 1




Retail provider:  CVS Caremark Options 

CVS Caremark's website

Phone: 888-202-1654

Prescription Gold Card Prescription Blue Card

Participating pharmacies

Beyond CVS, these pharmacies will accept your prescription ID card.

Mandatory generic policy

If the member or the physician wishes to use a brand name drug when the U.S. Food and Drug Administration has determined a therapeutically equivalent (“AA” or “AB” rated) generic is available, the member will pay the difference in the brand name and generic medication price, plus the generic co-payment. Members may still elect to use brand name medications if they choose, but they will be required to pay the difference in the brand name and generic medication price, plus the generic co-payment. 

From the FDA: Understanding generic medications

Plan Summary

To view the Summary of the Prescription Drug plan, click here.

Affordable Care Act - Smoking Cessation

To view Tobacco Cessation coverage, click here.

Paper Claim Forms

To view and/or edit and print a Paper Claim Form, click here

Finding low-cost Rx Options

To view flyer of the CVS Caremark Check Drug Cost tool, click here

Provider: Cigna

Cigna phone: 1-800-362-4462

Cigna's website

Short-term disability claim form

How to report a disability claim

Certificate book

Additional programs available through Cigna

Disability Financial Worry and Recovery

Healthy Rewards

Will Preparation

Identity Theft

About the coverage

Salary replacement

60%, $1,400 maximum weekly benefit. Must exhaust sick leave.

Waiting period

14 Days for Injury, 28 Days for Illness, including pregnancy

Employee cost

Varies by age and salary, 100 percent employee funded


Plan is subject to a 12/12 pre-existing condition limitation.

Provider: Cigna

Cigna phone: 1-800-362-4462

Cigna policy description  Amendment

Long-term disability claim form

About the coverage

University Provided

60% Salary Replacement, $5,000 Monthly Benefit Maximum. The elimination period before benefits are paid is the later of any accumulated sick leave or 180 days.

Supplemental Option

70% Salary Replacement, $6,000 Monthly Benefit Maximum. The elimination period before benefits are paid is the later of any accumulated sick leave or 180 days.

Employee Cost

60% Option: $0, 100% University Funded. 70% Option: Varies. Employee pays difference between 60% and 70% option. Cost varies by salary.

Provider: Securian

Securian policy description

  1. Class 1 Details
  2. Class 2 Details
  3. Class 3 Details
  4. Class 4 Details
  5. Class 5 Details

Beneficiary election 

Beneficiary election form

​Return the form to Human Resources Benefits Administration, +0602

About the coverage

University Provided Two times your annual salary. Maximum $100,000.
Accelerated Benefit Available if diagnosed as terminally ill (12 months or less life expectancy)  Contact Securian for details.
Supplemental Options Employees may purchase 1 to 5 times their annual salary up to $500,000 without an "evidence of insurabilty" medical exam. Costs varies by age and salary
Vendor Securian

Life Insurance Continuation Options

Continuation of Group Life Insurance Coverage

LifeSuite Services

Please use these forms if you sustain a work-related injury. Completion of these forms does not assure the allowance of the claim in accordance with the Ohio Bureau of Workers’ Compensation.


Information for Active Employees

FSA Reimbursement Job Aid

FSA Claim Form

FSA Annual Carry Over

Verification of Medical Expenses

Chard Snyder Mobile App

Why Your Benny Might Stop Working And What to Do About It

Approved Dental Expenses

FSA Account Summary Plan document

Flexible Spending Accounts are a smart way to pay for your out-of-pocket qualified healthcare and/or dependent care expenses. You can enjoy tax savings and a convenient debit card for your eligible expenses.

Flexible spending accounts allow employees to set aside money on a pre-tax basis to pay for eligible out-of-pocket medical and dependent care expenses, therefore reducing taxable income. The monies set aside for these accounts must be used for expenses not reimbursed by other coverage.

  • The Health Care Spending Account allows you to be reimbursed for non-covered and medically necessary medical, dental or eye care expenses. Employees can contribute a maximum of $2,700 in into a health care flexible spending account. Participants will receive a debit card for easy FSA withdrawals for eligible items.
  • The plan will continue to have a grace period for claim submissions. For all claims incurred prior to December 31, 2018, the claims must be submitted to ChardSnyder no later than March 31, 2019. In addition, FSA funds up to $500 may be carried over to the 2019 plan year. This change applies to Health FSAs only and does not apply to Dependent Care FSAs.
  • The Dependent Care Spending Account allows you to be reimbursed for child and dependent care expenses (e.g., daycare) that are required for you or your spouse to work. Employees can contribute a maximum of $2,500 or $5,000 if married and filing a joint tax return.

Information for Retirees

Healthcare Reimbursement Plan (HRA) Summary

HRA Reimbursement Job Aid

HRA Claim Reimbursement Form

Healthcare Reimbursement Plan (HRA) Summary Plan Description

Why Your Benny Might Stop Working And What to Do About It

Chard Snyder Mobile App


Provider: IMPACT Solutions

Impact Solutions’ site

IMPACT Solutions is the administrator of the University’s confidential employee-assistance program.

The IMPACT Employee Assistance (EAP) & Work/Life Program offers access to confidential professional support 24 hours a day, 365 days a year. The IMPACT program includes access to unlimited phone consultation, six complimentary face-to-face counseling sessions per person per occurrence, plus an expansive collection of resources.

The IMPACT Employee Assistance (EAP) & Work/Life Program is available 24 hours a day, 7 days a week by calling 800-227-6007.

For additional information, log on to Impact Solutions’ site for access to articles, resources and interactive features. The member logon is UAkron.

Mailing address:
The University of Akron
Human Resources, Benefits Administration
Akron, Ohio 44325-0602

Building location:
Administrative Services Building

185 E. Mill St

Send us an e-mail.

Phone: 330-972-7090
Fax: 330-972-2336

Benefits Administration staff