Documents and Forms

Benefits

Health (Medical, Dental, Vision, Wellness)

Health Documents

2019 Cost Worksheet

2019 Dental Plan Summary

2020 Dental Plan Summary

2019 Medical SBC

2020 Medical SBC

2019 Summary of Benefits

2020 Summary of Benefits

2019 VSP Summary

2020 VSP Summary

90Day My Way

Drug Tiers Explanation

Generics Brochure

HSA Preventive Drug Listing

Know Where To Go

Preventive Services

SourceRx 1.0 Formulary

SourceRx 1.0 Guide

Tobacco Surcharge FAQs

Free Tobacco Cessation Resources

Nicotine Replacement Therapy Coverage

Teladoc Member FAQs

Teladoc Talk to a Doc Anytime

Teladoc Pediatric FAQs

Teladoc Dependent Set Up

Understanding Your Claims Statement

Uniform Glossary

Vitality Quick Guide

VSP Diabetic Eyecare Plus Program

Ways to Earn Vitality Points

Health Forms

BCBS Dental Claim Form

BCBS Medical Claim Form

HIPAA Release Information

Alliance RX Mail Order Form

Tobacco Free Affidavit

Vitality Check Biometrics Form

 

Flexible Spending Accounts (FSA)

FSA Documents

2019 Flex Plan Summary

2020 Flex Plan Summary

FSA Forms

HealthEquity DCRA Reimbursement

HealthEquity Electronic Funds Transfer

HealthEquity FSA Reimbursement

 

Health Savings Accounts (HSA)

HSA Forms

HSA Beneficiary Designation Form

HSA Reimbursement Form

 

Regions 401(k)

Regions 401(k) Documents

2020 401(k) Required Notices

2020 401(k) Auto Increase Notice

2019 401(k) Auto Increase Notice

2020 401(k) Required Notices for Inactive Participants

401(k) Loan Policy 

401(k) SAR

Annual 2% Employer 401(K) Contribution FAQs

401(k) SPD 

401(k) Roth FAQs 

401(k) Roth Contributions Brochure 

Fee Disclosure

Fee Disclosure Update

Regions 401(k) Enrollment Book 

Regions 401(k) Forms

Annual 2% Employer Contribution Appeals Form

401k Loans Payments While on LOA

 

Regions Retirement Plan

Retirement Plan Documents

Retirement Plan Annual Funding Notice

Retirement Plan for Associates Funding Notice

 

BlackArch LLC 401(k) (for BlackArch LLC Associates only)

BlackArch LLC 401(k) Documents

BlackArch LLC 401(k) QDIA Notice

BlackArch LLC 401(k) Participant Fee Disclosure

BlackArch LLC 401(k) Fee Disclosure Update

BlackArch LLC 401(k) SPD

BlackArch LLC 401(k) Loan Program

BlackArch LLC 401(k) Roth Contributions Brochure

BlackArch LLC 401(k) Roth FAQs

BlackArch LLC 401(k) Enrollment Book 

BlackArch LLC 401(k) SAR

 

Life and Disability

Life and Disability Documents

ARAG Legal at a Glance

ARAG Identity Theft Flyer

ARAG Legal Mobile App

How to Activate ARAG Identity Theft Monitoring

Cigna How to File a Disability Claim Brochure

Why Purchase Optional Life Insurance

Legal is Everywhere

Identity Theft Summary

 

Change in Status and Eligibility

Change in Status Documents

Change in Status Chart

Change in Status Documentation Requirements

Domestic Partner Benefits Policy

Change in Status Forms

Affidavit for Domestic Partnership

Termination of Domestic Partnership

 

Workday at Regions

Workday Documents

Navigate Enrollment Job Aid

Editing Beneficiary Allocations Job Aid

Manage Your Benefits Job Aid

Requesting a Leave of Absence

Requesting Intermittent FMLA

  

Leave of Absence (LOA)

LOA Documents

401(k) Payments While on Leave

How to Report a Disability Claim

Benefits While on Leave

Payroll While on Leave

LOA Forms

401(k) Loan Payment Debit Authorization Form

  

Miscellaneous

Miscellaneous Documents

2019 Associate Contributions

2020 Associate Contributions

2019 Benefits Summary

2020 Benefits Summary

2020 Part Time Benefits Summary

2019 Enrollment FAQs

2020 Enrollment FAQs

2019 Enrollment Guide

2020 Enrollment Guide

CDC Flu Vaccination Information Statement

Regions Discount Shopping Network

Exit Package

No More Excuses Flu Vaccine

Vacation Policy

Vacation Purchase FAQs

Why Get a Flu Vaccine?

Miscellaneous Forms

2019 Request for Appeal

Change of Address for Former Regions Associates

Flu Shot Reimbursement

Flu Shot Consent Form