Forms & Plan Documents

Summary Plan Description for Publicis Medical Plan Summary Plan Description for Publicis 401(k) Plan Summary Plan Description for Employee Assistance Program Summary Plan Description for Publicis Dental Summary Plan Description for Publicis Health Care FSA Summary Plan Description for Publicis Legal Plan Summary Plan Description for Publicis Dependent Care FSA Summary Plan Description for Publicis Life and AD&D Insurance 2023 Publicis Benefits Guide for Employees 2023 Publicis Benefits Guide for Freelancers Publicis Administrative Information Summary Plan Description for Publicis Vision Summary Plan Description for Publicis Long-Term Disability Summary Plan Description for Publicis Short-Term Disability Publicis Benefits Summary Benefits and Payroll Packet for New U.S. Employees 2023 CVS Caremark Rx Plan Summary Investment Options Brochure Publicis 401(k) Plan Enrollment Guide 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 Teen Emotional Health Flyer Welcome, new BCBSIL member Timeline for Processing Benefits Benefits Orientation Video Beyond the Emergency Room Birth or Adoption Event Guide Blue 365 Discount Program Complete Your Medical History Deciding Where to Go for Medical Care That Saves You Money 2023 Publicis Dental Coverage with Delta Dental 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 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 Gain or Loss of Coverage Event Guide Get the Most from Your Rx 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 HIPAA Notice of Privacy Practices How to Calculate Long-Term Disability Coverage How to file a claim for disability or leave of absence 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 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 MyADP 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 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 Auto, Homeowners and Renters Insurance (with Mercer) Understanding Your Explanation of Benefits Visit the dentist online with Delta Dental’s Virtual Consult​​ 2023 CVS Caremark Plan Summary: Standard PPO Plan 2023 CVS Caremark Rx Plan Summary: Premier PPO Plan 2023 CVS Caremark Rx Plan Summary: Medical HSA Plan CVS Caremark Advanced Control Formulary CVS Caremark Advanced Control Specialty Formulary CVS Caremark Maintenance Drug List 2021 Social Security Cap and Supplementary Wage Withholding Tax Rates Electronically rollover your 401(k) from a prior company 2023 Publicis Vision Coverage with VSP Get Essential Medical Eyecare Services Diabetic Eyecare Program 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) Accident Insurance Benefits Highlights Critical Illness Insurance (with The Hartford) Critical Illness Benefits Highlights Hospital Indemnity (with The Hartford) Hospital Indemnity Benefits Highlights Accident and Hospital Indemnity Limitations and Exclusions How to file a claim for Voluntary Benefits (with The Hartford - not Mercer) Life Insurance Benefit Overview Publicis Legal Plans Product Overview 2023 Notice of Creditable Coverage for Freelancers 2023 Notice of Creditable Coverage for Employees 2021 Summary Annual Report (SAR) for the Publicis 401(k) Plan 2021 Summary Annual Report (SAR) for the Publicis Business Travel & Accident Insurance Plan 2021 Summary Annual Report (SAR) for the Publicis Disability Plan 2021 Summary Annual Report (SAR) for the Publicis Legal Services Plan 2021 Summary Annual Report (SAR) for the Publicis Life Insurance and Voluntary AD&D Plan 2021 Summary Annual Report (SAR) for the Publicis Vision Plan Medical Plan Comparison Medical Travel Benefits - Summary of Material Modifications 2023 Summary Benefits Coverage (SBC) for Publicis Freelance HSA Plan 2023 Summary Benefits Coverage (SBC) for Publicis HSA Active Plan 2023 Summary Benefits Coverage (SBC) for Publicis Premier PPO Plan 2023 Summary Benefits Coverage (SBC) for Publicis Standard PPO Plan Pet Insurance Summary Managing the Transition Back to Work Changing Your Name or Address How to find a BCBSIL provider Health Savings Account Overview Natural Disaster Digital Flyer 2024 Notice of Creditable Coverage for Employees 2024 Notice of Creditable Coverage for Freelancers

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) 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 Reimbursement Form for Medical Travel Request for Leave or Chronic Illness Support ReSources Wisely Pay Adjustment Request Form