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
Luke 10:35 Employee Assistance Application   Federation employees experiencing temporary financial hardship due to emergencies may apply for this assistance.


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