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Benefits Forms & Links

Click on the titles to view information available by Benefit



If you cannot read any of these files after downloading them, please call Human Resources at ext. 7757 and request the appropriate form.

To view Summary Plan Description (SPD) information for our Health & Welfare plans please visit: /human-resources/benefit-summary-plan-descriptions

2022 Supplemental Retirement Contribution Form

2022 Benefits Guide

Medical Insurance UnitedHealthcare

  • UHC Website (to search in the Provider Directory, all Loyola plans use the UHC Choice Plus Network of providers)

Prescription Information

Other UHC information

Machine-Readable Files:

We are committed to supporting the Transparency in Coverage Rule by making MRFs (machine-readable files) available to you. UnitedHealthcare creates and publishes the Machine-Readable Files on behalf of Loyola University New Orleans.

To link to the Machine-Readable Files, please click on the URL provided:

Express Scripts, Inc. (ESI)/RxBenefits- prescription information

ACA Contraceptive Services

Dental Insurance - Cigna

 AlwaysCare Vision Insurance 

 Flexible Spending Account(s)- WageWorks

Life & AD&D - Lincoln Financial Group

Lincoln Life & Long Term Disability (LTD) Form

Lincoln Life & Long Term Disability Informational Summaries

Aflac Voluntary Benefits 

Aflac Claim forms:

Group Supplemental Retirement Account

Employee Assistance Program (EAP) - Aetna Horizon Health

Tuition Remission

FACHEX/Tuition Exchange Program

EdNavigator Education Support

Adoption Assistance

Leave of Absence

Please contact Human Resources at extension 7757 to speak to a HR Representative if you may need a leave of absence.

Separation Summary