Forms & Guides

2022 Publicis Administrative Information 2022 Publicis Benefits Guide for Employees 2022 Publicis Benefits Guide for Freelancers Benefits and Payroll Packet for New U.S. Employees Publicis Benefits Summary 2022 Summary Plan Description (SPD) for Publicis 401(k) Plan 2022 Summary Plan Description (SPD) for Publicis Dental Plans​​ 2022 Summary Plan Description (SPD) for Publicis Life and Accidental Death & Dismemberment (AD&D) Insurance 2022 Summary Plan Description (SPD) for Publicis Employee Assistance Program 2022 Summary Plan Description (SPD) for Publicis Legal 2022 Summary Plan Description (SPD) for Publicis Long-term Disability 2022 Summary Plan Description (SPD) for Publicis Short-term Disability 2022 Summary Plan Description (SPD) for Publicis Medical Plans 2022 Summary Plan Description (SPD) for Publicis Vision Plans 2022 Summary Plan Description (SPD) for Publicis Dependent Care FSA ​​​2022 Summary Plan Description (SPD) for Publicis Health Care FSA 2019 Summary Annual Report (SAR) for Group Life Insurance and Publicis Voluntary AD&D Plan 2019 Summary Annual Report (SAR) for the Publicis 401(k) Plan 2019 Summary Annual Report (SAR) for PBC Group Business Travel Accident Plan 2019 Summary Annual Report (SAR) for PBC Group Disability 2019 Summary Annual Report (SAR) for PBC Group Legal Plan 2019 Summary Annual Report (SAR) for PBC Group Vision 2020 Summary Annual Report (SAR) for the Publicis 401(k) Plan 2020 Summary Annual Report (SAR) for the Publicis Business Travel & Accident Insurance Plan 2020 Summary Annual Report (SAR) for the Publicis Disability Plan 2020 Summary Annual Report (SAR) for the Publicis Legal Services Plan 2020 Summary Annual Report (SAR) for the Publicis Life Insurance and Voluntary AD&D Plan 2020 Summary Annual Report (SAR) for the Publicis Vision Plan 2019 Tax Withholding Update for Michigan 2019 Tax Withholding Update for Washington 2022 CVS Caremark Rx Plan Summary 2021 Eligible Automatic Contribution Arrangement and Qualified Default Investment Alternative Notice Investment Options Brochure 2022 Notice of Creditable Coverage for Freelancers Publicis 401(k) Plan Enrollment Guide 2022 Publicis Freelance Medical HSA Plan SBC BCBSIL Anxiety Flyer BCBSIL Blue Access for Members™ (BAM) Website Flyer BCBSIL Behavioral Health Know Your Network Flyer BCBSIL Behavioral Health Wellbeing Management Flyer BCBSIL Better Emotional Health Flyer BCBSIL Blue Care Connection Flyer BCBSIL Depression Help Flyer BCBSIL Fitness Program Flyer BCBSIL Influenza Reminders BCBSIL Teen Emotional Health Flyer Welcome, new BCBSIL member Your digital BCBSIL member card Timeline for Processing Benefits Benefits Orientation Video Beyond the Emergency Room Birth or Adoption Event Guide Blue 365 Discount Program Complete Your Medical History COVID-19 Vaccines Deciding Where to Go for Medical Care That Saves You Money Delta Dental Coordination of Benefits Information Delta Dental Online Cost Estimator Delta Dental Web Mobile Resources Dependent to Age 26 Special Enrollment Notice Diabetes Management with CVS Diabetic Eyecare Program Family Benefits | Overview Family Benefits | Elder Care Family Benefits | Parental Leave FAQ | Additional Family Support FAQ | Back-Up Care FAQ | College Coach Flexible Spending Account Quick Start Guide Freelancer FAQ Frequently Asked Questions on the New Tax Law for 2018 Gain or Loss of Coverage Event Guide Get Essential Medical Eyecare Services Get the Most from Your Rx Get Your COVID-19 Vaccine Get Your Rx Delivered by Mail Getting Started With Teladoc Guide to Publicis 401(k) Plan Enhancements Health Advocate Finding a Balance Flyer Health Advocate Stress Management Flyer Health Insurance Marketplace Notice 2022 HSA Brochure 2022 HSA Contribution Limits HIPAA Notice of Privacy Practices How to Calculate Long-Term Disability Coverage How to file a claim for disability or leave of absence The Complete 2022 HSA Guidebook IRS Releases Notice 1036 with Updates to 2018 Income-Tax Withholding Tables Leave of Absence Manual Leave of Absence Manual California Limited Purpose FSA Quick Start Guide Manage Your Benefits Anytime, Anywhere with the PBC Mobile Apps! Marriage Event Guide Massachusetts Paid Family Leave Notice Maternity Leave Checklist Medicare Tips for Retiring or Terminating Employees Mental Health Making a Difference Webinar Flyer Benefits Value Advisor Product Overview MetLife Legal Plans Product Booklet New York Paid Family Leave FAQs Notice to Employees Requesting Pregnancy, Family, Medical or Servicemember Leave NY Paid Family Leave Tax Withholding Update Overview of BCBS Benefits Value Advisors Overview of Employee Assistance Program Overview of Health Advocate Overview of LifeSpeak Educational Program Parental Adoption Leave Checklist Password Reset for ADP iPay Paycheck Inquiries and Replacement Checks Publicis 401(k) Plan Notice to Interested Parties Publicis 401(k) Plan Beneficiary Designation Publicis 401(k) Plan Loan Policy Premium Assistance Under Medicaid and the Children’s Health Insurance Program (CHIP) Procedures Guide for Qualified Medical Child Support Order Notices PrudentRx Specialty Medication Copay Program PrudentRx Specialty Medication Copay Program FAQs Publicis benefit changes by life event 2022 Notice of Creditable Coverage for Employees Registration Guide | Additional Family Support Registration Guide | Back-Up Care Registration Guide | College Coach Plan summary for supplemental life or AD&D insurance coverage FAQ about life or accidental death and dismemberment insurance Don’t forget to designate a beneficiary Roth 401(k) Factsheet Save Money with Generic Options Set Up Your Dependents Short Term Disability Leave Checklist Specialty Medications at $0 copay with PrudentRx Teladoc Mobile App The Hartford How to File a Leave Request Claim The Hartford Mobile Enhanced Portal Flyer Transition of medical care 2022 TRIP commuter and parking benefits Auto, Homeowners and Renters Insurance (with Mercer) Understanding Your Explanation of Benefits Visit the dentist online with Delta Dental’s Virtual Consult​​ 2022 Medical Plan Comparison 2022 Publicis Standard PPO Plan SBC 2022 Publicis Premier PPO Plan SBC 2022 Publicis Medical HSA Plan SBC 2021-2022 CVS Caremark Plan Summary: Standard PPO Plan 2021-2022 CVS Caremark Rx Plan Summary: Premier PPO Plan 2021-2022 CVS Caremark Rx Plan Summary: Medical HSA Plan 2022 CVS Caremark Advanced Control Formulary 2022 CVS Caremark Advanced Control Specialty Formulary CVS Caremark Maintenance Drug List 2021-2022 Delta Dental Plan Summary 2022 Pay Date Calendar 2021 Social Security Cap and Supplementary Wage Withholding Tax Rates 2021 Publicis Vision Coverage with VSP Electronically rollover your 401(k) from a prior company 2022 Vision Plan Summary Exclusive Member Extras BrushSmart: A free oral wellness program Toothpic: Remote check-ups with photos BCBSIL Special Beginnings Program Use the BlueCard Program for international coverage Preventive Care Wellness Guide Plan for retirement now Verifying your dependent as a full-time student Which Plan Fits You Best? Accident Insurance (with The Hartford) Critical Illness Insurance (with The Hartford) Hospital Indemnity (with The Hartford) How to file a claim for Voluntary Benefits (with The Hartford - not Mercer)

Benefits and Payroll Packet for New U.S. Employees Application for Enrollment in Medicare Part B BlueCard Worldwide International Claim Form BCBSIL Predetermination Form CVS Mail Service Order Form CVS Prescription Reimbursement Claim Form Delta Dental of New York Claim Form e-TIME Timesheet Historical Correction Form Health Insurance Claim Form (BCBSIL) Leave of Absence Request Form Medicare Request for Employment Information Form Prior E​mployment Questionnaire Publicis.Sapient Direct Deposit Form VSP Member Reimbursement Form HealthEquity Commuter Card Special Handling Form HealthEquity Dependent Care Claim Form HealthEquity Health Care Claim Form HealthEquity Substitute Receipt Form W-4 Form Paper form to rollover your 401(k) to the Publicis 401(k) Plan Participation in the Publicis 401(k) Plan Questionnaire​ Affidavit of a Common Law Marriage Affidavit of a Domestic Partner