Employer Forms
We exist to provide ministries and workers - like yours - with health, retirement and disability benefits that align with our Christian faith and values.
As a non-profit partner of the LCMS community that brings together thousands of ministries of all sizes, Concordia Plans is able to offer affordable, quality benefits, as well as business solutions that free up ministries to focus on spreading the Word of God. We are here because of you, for you.
New Enrollment
Enrollment and Status Changes
eSign Forms:
Concordia Health Plan Special Enrollment Application Form (11041), eSign Edition
Death Notification Form (40153) - eSign Edition
Flexible Spending Account Enrollment Form (HealthEquity) - eSign Edition
Worker Status Verification for Workers on Disability (11176) - eSign Edition
Worker Change or Termination Report - Ineligible for Benefits (21055) - eSign Edition
Health Savings Account Application (HealthEquity) - eSign Edition
Adoption and Elections
eSign Forms:
Critical Illness/Accidental Injury Employer Election (12110) - eSign Edition
Concordia Retirement Plan Option Election (11374) - eSign Edition
Concordia Retirement Savings Plan Agreement for Adoption (11042) - eSign Edition
Automated Clearing House Funding Authorization (11386) - eSign Edition
Concordia Retirement Savings Plan Employer Contribution Election Form (11030) - eSign Edition
Probationary Period Certification Form (11055) - eSign Edition
Contribution Change
