Concordia College

Benefit Forms

Health Insurance:

Blue Cross & Blue Shield of Minnesota
Phone: 866.870.0348
Group# EP606-W0

•  Enrollment, Change, or Drop Form

Delta Dental of Minnesota
Delta Dental of Minnesota
P.O. Box 330
Minneapolis, MN 55440-0330
Phone: 800.448.3815
Group# 50814 

• Enrollment, Change, or Drop Form

Long-Term Disability:

Assurant Employee Benefits                      
2323 Grand Boulevard
Kansas City, MO 64108
816.474.2345
Phone: 800.325.8385

•  Enrollment Form (If new employee or changing FTE)
•  Extended Enrollment Form (Existing employee)

Life Insurance:

MetLife
Phone: 800.638.5000

•  Enrollment Form (If new employee or changing FTE)
•  Extended Enrollment Form (Existing employee)
•  Change in Beneficiary

Flexible Spending Accounts (FSA):

Discovery Benefits, Inc.                           
3216 13th Avenue South                          
Fargo, ND 58103
Phone: 701.451.3399
Fax:     701.451.3245

• FSA Enrollment Form
• Discovery Benefits FSA Web site
• Reimbursement Form
  
  

Retirement Plans 403(b):

TIAA-CREF                                             
Phone: 800.842.2776
Group# 0527

• Enrollment Packet - Contact the Office of Human Resources if enrolling an account for the first time.
• Agreement for Salary Reduction
• Change Beneficiaries

Family Medical Leave Act (FMLA):

• Your Rights under FMLA
• Certification of Health Care Provider application

Tuition Discount

•  Concordia Tuition Discount Information
•  Concordia Tuition Discount Application

•  Concordia Language Villages Tuition Discount Information
•  Concordia Language Villages Tuition Discount Application

•  Oak Grove Lutheran Schools Tuition Reduction Information and Application

Tuition Exchange Discount Program

•  Eligibility Form and one of the following three:
•  ELCA Colleges - application form
•  Council of Independent Colleges – application available from Human Resources
•  Tuition Exchange College – application form available from Human Resources