Human Resources Development Forms
In an effort to use less paper and accommodate those who may be working remotely, most HRD forms (address change, direct deposit, etc.) are available through PeopleAdmin Employee Records for staff and full-time faculty.
Form Listing and Benefits
- Benefit Comparison (PDF)
- University of Hartford Aetna Microsite
- Drug Formulary (PDF)
- Annual Notice of Creditable Prescription Drug Coverage
- Concierge (PDF)
- Enhanced Maternity Program (PDF)
- Aetna Discount Program (PDF)
- Aetna Member Website Flyer (PDF)
- Informed Health Line (PDF)
- Maintenance Medication Flyer (PDF)
- Individual Authorization for Release of Information (PDF)
- Uniform Glossary of Health Coverage and Medical Terms (PDF)
- Marketplace Coverage Options and Your Health Coverage (PDF)/a>
- Summary of Benefits - DBP with HSA (PDF)
- Summary of Benefits - DBP with HRA (PDF)
- Summary of Benefits - HDBP with HSA (PDF)
- Summary of Benefits - HDBP with HRA (PDF)
- Summary of Benefits - POS (PDF)
- Spousal Health Insurance Attestation (PDF)
- DMO Dental Flyer (PDF)
- PPO Dental Flyer (PDF)
- Oral Healthcare Discounts (PDF)
- Benefit Comparison CT (PDF)
- DMO Summary Plan Description (PDF)
- PPO Summary Plan Description (PDF)
- Schedule of Benefits DMO (PDF)
- Schedule of Benefits PPO (PDF)
- Dental Plan Documents DMO (PDF)
- Dental Plan Documents PPO (PDF)
- Assistive Technology (PDF)
Health Savings Account
- Payflex_HSA Flyer (PDF)
- Payflex HSA Advantage program overview (PDF)
- HSA Investments Flyer (PDF)
- Payflex HSA Custodial Agreement (PDF)
- PayFlex Trustee Transfer Form (PDF)
- PayFlex_HSA Quick Reference Guide (PDF)
- PayFlex HSA Aetna Navigator Overview (PDF)
- PayFlex Video 1: How to file a claim online
- PayFlex Video 2: How to verify a card purchase
- PayFlex Video 3: How to manage your HSA online
- PayFlex Video 4: Navigating your HSA Dashboard
- PayFlex Video 5: Navigating your Health Care FSA dashboard
- Choice POS II Medical Plan- Deductible Based HSA (PDF)
- Choice POS II High Deductible Health Plan- HSA (PDF)
Flexible Spending Account
Health Reimbursement Account
Rosters, Class Codes, and Position Information
- Stipend Roster (XLSX)
- Termination Roster (XLSX)
- Roster Flow Chart (XLS)
- Employee Class Codes (PDF)
- Staff Personnel Requisition Form (PDF)
- Position Needs Analysis (DOC)
- Position Information Questionnaire (PDF)
- Personnel Action Form (XLS)
Hiring and PeopleAdmin
New Hire Forms, I-9, Orientation, etc.
- On Campus Employment Form for International Students
- Department Orientation (DOC)
- For Students and Adjuncts Only: Direct Deposit form
Miscellaneous
Dialogue for Direction Guides
In an effort to use less paper and accommodate those who may be working remotely, HRD forms (address change, direct deposit, etc.) are available through PeopleAdmin Employee Records for staff and full-time faculty.
Adjuncts, retirees, Aramark, and surviving dependents must continue to use the paper form.