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Total Rewards forms and guides

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Document Type
Name/Description File type
2018 Benefits Guide (benefits guide for the 2018 calendar year)

An overview of the many of the insurance benefits enrollment process.

2018 benefits premiums

The 2018 benefits premiums are found within the 2018 Insurance Benefits guide.

Vision slicksheet

One-page summary overview of the university Vision Plan.

Benefits Change Form for calendar year 2018

Use this form to change your insurance elections due to a family status change for the 2018 calendar year. This form cannot be used during the period of Annual Enrollment.

Benefits Enrollment Form for calendar year 2018

Benefits Enrollment Form to be used for initial benefit enrollment by new employees or by employees newly eligible for insurance. Must be received within 31 days of eligibility. This form cannot be used during Annual Enrollment.

Retiree Benefits Change Form and Retiree Beneficiary Designation Information (combo pack of forms)

Combo pack of forms, including: (1) Retiree benefits enrollment/change form to be used to change insurance elections. (2) Beneficiary designations form for basic life, supplemental life, and accidental death and dismemberment plans. Cannot be used during retirees’ Annual Enrollment period.

Note: The retiree beneficiary designation form is available on pg. 3.

Proof of relationship requirement

Proof of relationship requirements to confirm the individual or individuals to be covered are eligible under the specific definitions of the plans.

University of Missouri Affirmation of Sponsored Adult Dependent Partnership

Form for establishing a sponsored adult dependent relationship for the purpose of university benefits

Vision Out-of-network Reimbursement Form

Form for reimbursing qualified vision expenses incurred at out-of-network providers.

University of Missouri Affidavit of Termination of Sponsored Adult Dependent Partnership

Use this form to terminate a sponsored adult dependent relationship for university benefits

Accessing the EyeMed phone app

A guide for accessing the EyeMed Members App with a few simple steps.

EyeMed Insight Plan D discount program

Beginning in 2018, EyeMed is the administrator of the University of Missouri Vision Insurance Plan. Even if you aren’t enrolled in the insurance plan for 2018, you can take advantage of the EyeMed Insight Plan D discount program. This discount option is only available to employees and their family if no one in the family is enrolled in the full service vision plan.

Registering on EyeMed.com

A guide detailing how to register online at EyeMed.com.

Snapshot of EyeMed Vision Coverage

An overview of EyeMed vision coverage for the 2018 plan year.

Vision Benefit Plan Summary Plan Description (SPD) for calendar year 2018

Summary plan description overview of the Vision Benefit Plan at the University of Missouri System for the 2018 plan year.

VSP Vision Care for Life

Overview of vision insurance provided via VSP to University of Missouri System employees, retirees, and dependents

VSP Vision Savings Pass

A discount vision program that offers immediate savings on eye care and eyewear. This is not an insurance plan.