The following forms apply to employees of Catholic Charities Administration and St. Francis Community Services.  Other agencies may have customized forms for local use or supplements to the handbooks.  Please check with your agency’s Human Resource Administrator or Les Lexow, Senior Director of Human Resources, Catholic Charities, 314.367.5500 x 5914 or llexow@ccstl.org with any questions.

INTERNAL RESOURCE DIRECTORY Directory is password-protected. Please contact your agency program director or Rachel (rmcallister@ccstl.org) to request password.
Employee Handbook – August 2017 Revision date August 2017
Key Changes to Employee Handbook August 2017 Outline to use with printed version date of 2010 to bring current
Acknowledgement/signature pages from Employee Handbook Forms to be signed and submitted to personnel files acknowledging receipt of handbook information/access
Catholic Charities Volunteer Handbook
Acknowledgement/signature pages from Volunteer Handbook Revision date February 2013
Volunteer Application Forms to be signed and submitted to acknowledge receipt of handbook information/access
Everyday Amazing Nomination Form To nominate a colleague for recognition, email completed form to lshea@ccstl.org or mail to CCSTL 4445 Lindell Blvd. 63108 attn: Lisa Shea
FY19 Benefit Plan Information
Employee ~ Employer Rates Monthly rates for healthcare, dental and basic life insurance options
FY19 Wellness Plan Information 

Employee Wellness Program Information 2019

Employee Wellness Incentive FAQ

FY19 UHC Plans
Comparison Chart Compares plan deductibles, out-of-pocket maximums and co-pays
Major Provisions of the Health Insurance Plan Summary of benefit provisions
Real Appeal Healthy Heart
Employee Wellness Form 2018-2019 For Premier Plan participants, must be completed by April 30, 2019
UHC Employee Health Insurance Form To enroll, change address, change dependents and/or beneficiaries
Marketplace Coverage Notice-2018-2020 Provide a copy to all new hires per the Affordable Care Act
FY19 Dental Plan
Delta Dental Summary of Benefits Benefits outline and FAQ
Delta Dental ID Cards Temporary cards for participants
Flexible Spending Accounts
Flexible Savings Account Election Form To enroll and/or make changes
FSA Medical Claim Form
FSA Dependent Care Claim Form
FSA Customer Service Customer service contact information and online claim filing
FSA 2018-2019 Highlights Informational document
Hartford Voluntary Life Insurance
Hartford Life Beneficiary Designation Form
Hartford Vol Life Summary of Benefits as of 9-2018
Hartford Vol Life Enrollment_Change Form as of 9-2018
Prudential 403b Thrift Plan 403b Thrift Plan for CC Central Office, SFCS, CFS, QOPC, SMH, SPC, GS, MG
Pension Enrollment Notice – Prudential To open account with Prudential and permit investment of match and/or contributions, or make changes; Plan highlights
SPD – Catholic Charities final 09012017 Summary Plan Description
LTD Plan Summary Summary of plan provisions
Submitting a Claim Brochure Information on filing a claim
FMLA FORMS AND INFORMATION For more information, see the government website at:   http://www.dol.gov/whd/fmla/
FMLA Fact Sheet #28 Basic information on FMLA benefits and requirements
WH-380-E (Certification of Health Care Provider for Employee’s Serious Health Condition) Section of form completed by employer, employee and health care provider to confirm need for leave
WH-380-F (Certification of Health Care Provider for Family Member’s Serious Health Condition) Section of form completed by employer, employee and health care provider of patient to confirm need for leave to care for family member
WH-381 (Notice of Eligibility and Rights & Responsibilities) Form employer may use to advise employee of eligibility for FMLA covered leave
WH-382 (Designation Notice) Form employer may use to advise employee of status of requested leave
WH-384 (Certification of Qualifying Exigency for Military Family Leave) Section of form completed by employer and employee to confirm need for leave to care for military family member
WH-385 (Certification for Serious Injury or Illness of a Current Service member —  for Military Family Leave Form for employee/service member and health care provider to complete to request leave
WH-385V (Certification for Serious Injury of Illness of a Veteran for Military Caregiver Leave Form for employee, veteran and health care provider to complete to request leave for employee to care for military member