New Employee Benefits Packet

To download the files below, you may need to download the Acrobat reader using the link to the left.
   
 
Please use the New Employee Checklist as a guide for documents that need to be completed for  newly hired W-2 employees
New Employee Checklist
 
All Diocese of Palm Beach 30+ hour employees
must complete the following documents:
Diocese of Palm Beach Pension Plan Enrollment Form
Application for Membership and Design of Beneficiary Diocese of Palm Beach Pension Plan Trust
Pension Plan for Lay Employees and Religious Sisters and Brothers within the Diocese / Summary Plan Description
Diocese of Palm Beach Summary of Employee Benefits
Diocese of Palm Beach Employee Benefits Election Form
Diocese of Palm Beach Cafeteria Benefit Plan Explanation
Prudential Financial Group Life & Disability Enrollment Card
Prudential / Diocese of Palm Beach Employee Term Life Coverage Accidental Death and Dismemberment Coverage Booklet
Benefit Highlights for Delta Dental PPO
Term Life Coverage Booklet Receipt Acknowledgement Form
Prudential Optional Term Life Enrollment Kit
Prudential Evidence of Insurability Form
Prudential Short-Term Disability
Prudential / Diocese of Palm Beach Long Term Disability Coverage Booklet  (Part 2/Rider)
Long Term Disability Acknowledgement
Employee Medical and Dental Enrollment / Information Form
Diocese of Palm Beach RxEdo Prescription Drug Program
RxEDO Drug Formulary Update
RxEdo Prescription Drug Program Preferred Drug List
RxEDO Mail Order Prescription Form
RxEDO Prescription Claim Form
RxEDO Mail Order Prescription Brochure
RxEdo Over the Counter Medication Program
RxEdo Over the Counter Medication Program (2)
 

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Sandy Maulden
Benefits Assistant
(561) 775-9574
E-Mail:smaulden@diocesepb.org