Archdiocese of Portland Benefits 2025-2026
  • LEARN
    • Benefits Eligibility
    • 2025-2026 Benefits Guide
    • 2025-2026 Rates
    • 2024-2025 Benefits Guide
    • 2024-2025 Rates
    • Open Enrollment 2025-2026
    • Core Benefits
    • Voluntary Benefits
    • Employee Assistance Program
    • Wellness Programs
    • Flexible Spending Accounts
    • Retirement Program
  • DECIDE
    • Medical Plans
    • Dental & Vision Plans
    • Voluntary Life & AD&D Plans
    • Voluntary Disability Plans
  • ENROLL
    • Enroll
    • Username and Password Help
    • Reta Benefits Center
  • MID-YEAR CHANGES
  • RESOURCES
    • Plan Documents & Guides
    • Forms
    • FAQs
  • CONTACTS
Select Page
Forms
Flexible Spending Accounts

  • Healthcare FSA Claims Instructions
  • Healthcare FSA Mail-in Form
  • Healthcare FSA Online Claim Submission Form
  • Dependent Care FSA Instructions

 

Life Insurance

  • Evidence of Insurability Form
  • Term Life Insurance Election of Portability Coverage

 

Disability

  • STD Claim Form
  • LTD Claim Form

 

Retirement Plan

  • Tax-Sheltered Annuity Election Form

 

Medicare

  • Medicare Employment Verification Form

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