Your Benefits

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Contact Us

Benefits Department
Scott Park Campus
Academic Services
Suite 1000

Mailing address:
The University of Toledo
Benefits Department
2801 W Bancroft
MS 405
Toledo, OH 43606

Phone: 419.530.4747
Fax: 419.530.1492 benefits@utoledo.edu


BENEFIT FORMS


HEALTHCARE(Please complete your benefit elections online via your MyUT portal):

Health Savings Account (HSA) Employee Election/Contribution Form

Health Savings Account (HSA) Employer Authorization Form

Flexible Spending Account Election Form

Flexible Spending Account Direct Deposit Form

Flexible Spending Claim Reimbursement Form

Prescription Reimbursement Form

VSP Reimbursement Form

TUITION WAIVER:

Tuition Waiver Form- To be used for employee out of state tuition (undergraduate and graduate), dependent out of state tuition (undergraduate), and all retirees.

       Dependent Fee Waiver Certification

TAX DEFERRED ANNUITIES:

403B Salary Reduction Agreement

Ohio Deferred Compensation Enrollment Form

 

RETIREMENT:  

ARP Vendor Change Form

Retirement Plan Election Form                                                      
 

LIFE INSURANCE:

Main Campus Life Enrollment                  

Health Science Life Enrollment Form                     

Beneficiary Change Form 

 

 

Last Updated: 9/13/18