Human Resources Development Forms
Medical
- Enrollment/Change Form
- Benefit Comparison
- Drug Formulary
- Concierge
- Aetna Discount Program
- Aetna Member Website Flyer
- Informed Health Line
- Maintenance Medication Flyer
- Medical Insurance Waiver Form
- Individual Authorization for Release of Information
- Uniform Glossary of Health Coverage and Medical Terms
- Marketplace Coverage Options and Your Health Coverage
- Choice POS II Medical Plan Document
- Choice POS II Medical Plan- Point of Service Option
- Summary of Benefits - DBP with HSA
- Summary of Benefits - DBP with HRA
- Summary of Benefits - HDBP with HSA
- Summary of Benefits - HDBP with HRA
- SBC Cover Letter for Self-Funded Plans
- SBC Subscriber Letter
Dental
- Dental Enrollment/Change Form
- Benefit Comparison CT
- Benefit Comparison MA
- DMO Summary Plan Description
- PPO Summary Plan Description
- MA DMO Summary Plan Description
- MA PPO Summary Plan Description
- Dental Claim Form
- Schedule of Benefits DMO
- Schedule of Benefits PPO
- Dental Plan Documents DMO
- Dental Plan Documents PPO
- Assistive Technology
Voluntary Vision
Medical, Dental, and Vision Rates
Health Saving Account and Flexible Spending Account
Health Savings Account
- Payflex_HSA Flyer
- Payflex HSA Advantage program overview
- HSA Investments Flyer
- Payflex HSA Custodial Agreement
- PayFlex Trustee Transfer Form
- PayFlex_HSA Quick Reference Guide
- PayFlex HSA Aetna Navigator Overview
- 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
- HSA fee schedule
- HSA flyer
- Choice POS II Medical Plan- Deductible Based HSA
- Choice POS II High Deductible Health Plan- HSA
- Initial Enrollment form for 2020
- HSA Change Form
Flexible Spending Account
Health Reimbursement Account
Employment and Hiring Forms
Rosters, Class Codes, and Position Information
- Stipend Roster (excel)
- Termination Roster (excel)
- Roster Flow Chart
- Employee Class Codes
- Staff Personnel Requisition Form
- Position Needs Analysis
- Position Information Questionnaire
- Personnel Action Form
Hiring and PeopleAdmin
New Hire Forms, I-9, Orientation, etc.
Dialogue for Direction
Tuition Remission Forms
Miscellaneous
Retirement
Life Insurance
- Basic Life Insurance Designation of Beneficiary Form
- Optional Life Insurance Designation of Beneficiary Form
- Reliance Standard Portability vs Conversion
- Full-time Faculty and Staff Life Insurance Plan Documents
- Part-time Faculty and Staff Life Insurance Plan Documents
- Retiree Life Insurance Plan Documents