Forms & Guides

2019 Summary Annual Report (SAR) for Group Life Insurance and Publicis Voluntary AD&D Plan 2019 Summary Annual Report (SAR) for the PBC 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 2019 Tax Withholding Update for Michigan 2019 Tax Withholding Update for Washington 2021 CVS Caremark Rx Plan Summary 2021 Investment Options Brochure 2021 Notice of Creditable Coverage 2021 PBC 401(k) Plan Enrollment Guide 2021 Summary Plan Description (SPD) for PBC 401(k) Plan 2021 Summary of Benefits Coverage: Medical HSA Plan 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 Benefits Orientation Video Benefits Orientation Video Transcript Benefits Philosophy Beyond the Emergency Room Birth or Adoption Event Guide Blue 365 Discount Program bswift Registration Instructions Complete Your Medical History Coping with Community Violence 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 Eligible Automatic Contribution Arrangement Notice & Qualified Default Investment Alternative Notice Enrolling in 2021 Benefits Family Benefits | Overview Family Benefits | Elder Care Family Benefits | Parental Leave FAQ for 2020 FSA Rollover 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 Through September 30, 2021 Get a Flu Vaccine with CVS Get the Most from Your Rx Get Your COVID-19 Vaccine Get Your Rx Delivered by Mail Getting Started With Teladoc Guide to PBC 401(k) Plan Enhancements Health Advocate Finding a Balance Flyer Health Advocate Stress Management Flyer Health Insurance Marketplace Notice Health Equity | WageWorks Account Registration Instructions Health Equity | WageWorks TRIP Account Reminders Health Equity | WageWorks Uber Pool Flyer 2021 HSA Brochure 2021 HSA Contribution Limits HIPAA Notice of Privacy Practices How to Calculate Long-Term Disability Coverage How to Process a Qualified Domestic Relations Order (QDRO) The Complete 2021 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! 2020-2021 Healthy Living Program 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 Mercer Health Advantage Product Overview MetLaw Legal Plan Summary Change Address or Change Name Guide New York Paid Family Leave FAQs Notice on Benefit Deductions for Terminating Employees 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 Payroll Presentation for New Hires PBC 401(k) Plan Notice to Interested Parties PBC 401(k) Plan Beneficiary Designation PBC 401(k) Plan 2020 Year End Newsletter PBC 401(k) Plan Fees PBC 401(k) Plan Loan Policy PBC Vendors COVID-19 FAQs 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 2021 Publicis Administrative Information Publicis Connection Health & Group Benefits Program Dental Summary Plan Description 2021 Summary Plan Description (SPD) for Publicis Employee Assistance Program Publicis Connection Health & Group Benefits Program Legal Plan Summary Plan Description Publicis Connection Life Events Matrix Publicis Connection Health & Group Benefits Long-Term Disability Summary Plan Description 2021 Summary Plan Description (SPD) for Publicis Active Medical Plans Publicis Connection Health & Group Benefits Short-Term Disability Summary Plan Description 2021 Summary Plan Description (SPD) for Publicis Vision Plan 2021 Summary Plan Description (SPD) for ​Life and Accidental Death & Dismemberment (AD&D) Insurance Publicis Benefits Q1 2021 Newsletter Publicis Benefits Q2 2021 Newsletter Publicis Connections Flyer Publicis Creditable Rx Coverage Notice Publicis Dependent Care FSA Summary Plan Description Publicis Health Care FSA Summary Plan Description Publicis Medicare Part D Notice of Creditable Coverage Registration Guide | Additional Family Support Registration Guide | Back-Up Care Registration Guide | College Coach Review and Update Life Insurance Beneficiaries Roth 401(k) Factsheet Save Money with Generic Options Set Up Your Dependents Short Term Disability Leave Checklist So Many Reasons to Use Teladoc Specialty Medications at $0 copay with PrudentRx Steps for a VirtualCheckup^® Teladoc Know How to Fight Colds and Flu Flyer Teladoc Mobile App The Hartford How to File a Claim Request Leave Flyer The Hartford How to File a Leave Video The Hartford Leave Management Services The Hartford Mobile Enhanced Portal Flyer Timeline for Processing Benefits Voluntary Benefits Auto Home Flyer Understanding Your Explanation of Benefits What’s Included in a VirtualCheckup^® VirtualCheckup^® Home Kit Instructions VirtualCheckup^® FAQs 2021 Publicis Benefits Guide for Employees 2021 PBC Benefits Online Enrollment Newsletter 2021 Medical Plan Comparison Which Plan Fits You Best? 2021 Summary of Benefits Coverage (SBC): Standard PPO Plan 2021 Summary of Benefits Coverage (SBC): Premier PPO Plan 2021 Summary of Benefits Coverage (SBC): Medical HSA Plan 2021 CVS Caremark Plan Summary: Standard PPO Plan 2021 CVS Caremark Rx Plan Summary: Premier PPO Plan 2021 CVS Caremark Rx Plan Summary: Medical HSA Plan 2021 CVS Caremark Advanced Control Specialty Formulary 2021 CVS Caremark Standard Control Formulary 2021 CVS Caremark Maintenance Drug List 2021 Delta Dental Plan Summary 2021 Publicis Vision Coverage with VSP Benefits and Payroll Packet for New Hires 2021 Publicis Benefits Summary 2021 New Hire Guide for Freelancers 2021 Pay Date Calendar 2021 Social Security Cap and Supplementary Wage Withholding Tax Rates

Benefits and Payroll Packet for New Hires Application for Enrollment in Medicare Part B HealthEquity | WageWorks Trustee to Trustee Transfer form BlueCard Worldwide International Claim Form BCBSIL Predetermination Form CVS Mail Service Order Form CVS Prescription Reimbursement Claim Form Delta Dental Claim Form e-TIME Timesheet Historical Correction Form Health Insurance Claim Form (BCBSIL) Incoming Rollover Contribution Application and Instructions Leave of Absence Request Form Medicare Request for Employment Information Form Publicis.Sapient Direct Deposit Form VSP Member Reimbursement Form Health Equity | WageWorks Commuter Card Special Handling Form HealthEquity | WageWorks Dependent Care Claim Form HealthEquity | WageWorks Health Care Claim Form Health Equity | WageWorks Substitute Receipt Form W-4 Form