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UT Human Resources : Benefit Forms

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UT Human Resources
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    Benefit Forms

    HEALTHCARE FORMS

    Main Campus Healthcare Election      

    Health Science Healthcare Election

    Main Campus Spousal/DP Eligibility Affidavit

    Health Science Spousal/DP Eligibility Affidavit

    Dependent Affidavit

    Termination of Coverage

    Prescription Reimbursement Form

     

    TUITION FEE WAIVER

    Tuition Fee Waiver

     

    TAX DEFERRED ANNUITIES

    403B Salary Reduction Agreement

     

    RETIREMENT  

    Retirement Plan Election Form                                                          

    OPERS ERIP Form

     

    FLEXIBLE SPENDING ACCOUNTS

    FSA Enrollment

    FSA Claim Reimbursement

     

    LIFE INSURANCE

    Main Campus Life Enrollment                  

    Health Science Life Enrollment Form                     

    Beneficiary Change Form 

     

    OTHER FORMS

    Change of Address Form

     

    Page updated: July 02, 2009
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