Benefits Forms & Links

Click on the titles to view information available by Benefit

                                                                                                               If you cannot read any of these files after downloading them, please call Human Resources at ext. 7757 and request the appropriate form.

To view Summary Plan Description (SPD) information for our Health & Welfare plans please visit:

Loyola University partners with Gallagher Benefits Services, Inc. (GBS) and their Benefit Advocate Center.  This broker partnership offers you assistance with claims questions and benefit issues. If you have any unresolved issues with our medical carrier (or any of our other providers), please feel free to call toll free 800-492-8005 or e-mail your Benefit Advocate Team at

2017 Medical, Dental & Vision Enrollment/Change Form

2017 Flexible Spending Account Enrollment Form

2017 Supplemental Retirement Contribution Form

Medical Insurance UnitedHealthcare 

Prescription Information

Other UHC information

Dental Insurance - Cigna

 AlwaysCare Vision Insurance 

 Flexible Spending Account(s)- 2017 WageWorks

2016 Cobra Professionals Inc. (CPI) 

Life & AD&D - Lincoln Financial Group - coverage begins 1/1/2016

Lincoln Life & Long Term Disability (LTD) Form

Lincoln Life & Long Term Disability Informational Summaries

Lincoln Financial Voluntary Benefits (Annual Enrollment Only - Contact HR for information)

Group Supplemental Retirement Account

Employee Assistance Program (EAP) - Aetna Horizon Health

Tuition Remission

FACHEX/Tuition Exchange Program

Adoption Assistance

Leave of Absence

Please contact Human Resources at extension 7757 to speak to a Benefits Specialist if you may need a leave of absence.

Separation Summary