Responsible Offices - Any -Academic AffairsAdvancement ServicesBoard of RegentsBudget and PlanningBusiness AffairsCapital ProjectsChancellorCollaborative Business ServicesContracts and ProcurementControllerCreative and Web ServicesEmployee BenefitsEventsExternal Relations Communications and Advancement ServicesFacilities ManagementFinanceGeneral CounselGovernmental RelationsHealth AffairsHistorically Underutilized BusinessHuman ResourcesInformation SecurityInstitutional Research and AnalysisMedia Relations and CommunicationsPolicePopulation HealthReal EstateRISC ServicesRisk ManagementShared Information ServicesSystem AuditSystemwide ComplianceSystemwide Information ServicesTalent and InnovationTechnology and Information ServicesTelecommunication ServicesUniversity LandsUT Center LaredoWeb TeamEducation & Research Center at Laredo - archive Apply Title Published File(s) Page Superior Vision Plan Highlights Jul 14th, 2024 NEW! Superior Vision Highlights 2024-2025 More Info on Superior Vision Plan Highlights UT FLEX Letter of Medical Necessity Form Aug 30th, 2024 Letter of Medical Necessity More Info on UT FLEX Letter of Medical Necessity Form UT FLEX Health Care Reimbursement Claim Form Feb 16th, 2024 UT FLEX HCRA Claim Form More Info on UT FLEX Health Care Reimbursement Claim Form Beneficiary Designation Form Mar 1st, 2020 Beneficiary Designation Form More Info on Beneficiary Designation Form Accidental Dismemberment Claim Form Mar 1st, 2020 Accidental Dismemberment Claim Form More Info on Accidental Dismemberment Claim Form Death Claim Form Mar 1st, 2020 Death Claim Form More Info on Death Claim Form Life Portability Application Mar 1st, 2020 Life Portability Application More Info on Life Portability Application Life Conversion Application Mar 1st, 2020 Application to Convert Group Life Insurance More Info on Life Conversion Application Life and AD&D Brochure for Active Employees Sep 1st, 2024 Life and AD&D Benefit Brochure for Active Employees More Info on Life and AD&D Brochure for Active Employees Accidental Death & Dismemberment Certificate Jul 15th, 2024 Accidental Death & Dismemberment Certificate (effective 09/01/2024) Accidental Death & Dismemberment Certificate (expires 09/01/2024) More Info on Accidental Death & Dismemberment Certificate Short Term Disability Brochure Sep 1st, 2021 NEW! 2021-2022 Short Term Disability Brochure 2020-2021 Short Term Disability Brochure More Info on Short Term Disability Brochure LTD Conversion Calculator Sep 1st, 2013 LTD Conversion Calculator More Info on LTD Conversion Calculator Long-Term Disability Conversion Kit Mar 15th, 2020 Long Term Disability Conversion Kit More Info on Long-Term Disability Conversion Kit LTD Employer Claim Form Mar 3rd, 2020 LTD Employer Claim Form More Info on LTD Employer Claim Form LTD Employee Claim Form Mar 1st, 2020 LTD Employee Claim Form More Info on LTD Employee Claim Form Long-Term Disability Benefit Highlights Sep 1st, 2021 NEW! 2021-2022 Long Term Disability Brochure 2020-2021 Long Term Disability Brochure More Info on Long-Term Disability Benefit Highlights Medicaid and the Children's Health Insurance Program (CHIP) Notice Jul 27th, 2018 Medicaid and the Children's Health Insurance Program (CHIP) Notice More Info on Medicaid and the Children's Health Insurance Program (CHIP) Notice Notice of Creditable Coverage (NOCC) Aug 31st, 2021 Medicare Part D Notice of Creditable Coverage More Info on Notice of Creditable Coverage (NOCC) UT System Cafeteria Plan Document Jul 1st, 2020 UT System Cafeteria Plan Document More Info on UT System Cafeteria Plan Document Physician Statement Concerning Tobacco Usage and Fitness to Participate in a Tobacco Cessation Program Sep 1st, 2023 Tobacco Cessation Program Physician Statement More Info on Physician Statement Concerning Tobacco Usage and Fitness to Participate in a Tobacco Cessation Program Annual Leave Deferral Agreement Mar 8th, 2022 Annual Leave Deferral Agreement More Info on Annual Leave Deferral Agreement DCP Catch-Up Provision Agreement Sep 1st, 2013 DCP Catch-Up Provision Agreement More Info on DCP Catch-Up Provision Agreement UTSaver DCP - 457(b) Plan Document Jan 1st, 2022 UTSaver DCP - 457(b) Plan Document More Info on UTSaver DCP - 457(b) Plan Document Comparison of Traditional, Roth 403(b), and Roth IRA Contributions Jan 1st, 2024 Comparison of Traditional, Roth 403(b), and Roth IRA Contributions More Info on Comparison of Traditional, Roth 403(b), and Roth IRA Contributions Purchase Change Agreement (All plans) Mar 22nd, 2022 UT Retirement Purchase Change Agreement (All plans) More Info on Purchase Change Agreement (All plans) UTSaver TSA Disclosure Form Sep 1st, 2013 UTSaver TSA Disclosure Form More Info on UTSaver TSA Disclosure Form UTSaver TSA - 403(b) Plan Document Jan 1st, 2022 UTSaver TSA - 403(b) Plan Document More Info on UTSaver TSA - 403(b) Plan Document UT Transfer Verification Form (All plans) Sep 1st, 2013 UT Transfer Verification Form (All plans) More Info on UT Transfer Verification Form (All plans) UTSaver Loan and Inservice Distribution Options Feb 4th, 2022 UTSaver Loan and Inservice Distribution Options More Info on UTSaver Loan and Inservice Distribution Options Voluntary Retirement Programs At a Glance Jan 1st, 2024 Voluntary Retirement Programs More Info on Voluntary Retirement Programs At a Glance Vesting/Termination Status Form Dec 8th, 2015 Vesting/Termination Status Form More Info on Vesting/Termination Status Form TRS Form 28 (Notice to Elect to Participate in Optional Retirement Program and/or Refund) Oct 1st, 2019 TRS Form 28 (Oct 2019) More Info on TRS Form 28 (Notice to Elect to Participate in Optional Retirement Program and/or Refund) ORP Authorization for Reduction for Employee Contribution RETURNING EMPLOYEE Sep 1st, 2013 ORP Authorization for Reduction for Employee Contribution RETURNING EMPLOYEE More Info on ORP Authorization for Reduction for Employee Contribution RETURNING EMPLOYEE ORP Authorization for Reduction for Employee Contribution Sep 1st, 2013 ORP Authorization for Reduction for Employee Contribution More Info on ORP Authorization for Reduction for Employee Contribution ORP Acknowledgement Jan 1st, 2015 ORP Acknowledgement More Info on ORP Acknowledgement Optional Retirement Program (ORP) Plan Document Jan 1st, 2022 Optional Retirement Program (ORP) Plan Document More Info on Optional Retirement Program (ORP) Plan Document Overview of TRS and ORP Aug 11th, 2021 TRS and ORP Overview - July 2021 More Info on Overview of TRS and ORP HIPAA Policy 1.0: Introduction & Definitions Sep 23rd, 2013 HIPAA Policy 1.0: Introduction & Definitions More Info on HIPAA Policy 1.0: Introduction & Definitions HIPAA Policy 2.0: Organization of System for HIPAA Privacy Standard Compliance Purposes Sep 23rd, 2013 HIPAA Policy 2.0: Organization of System for HIPAA Privacy Standard Compliance Purposes More Info on HIPAA Policy 2.0: Organization of System for HIPAA Privacy Standard Compliance Purposes HIPAA Policy 3.0: Breach Notification Policy Jan 20th, 2017 HIPAA Policy 3.0: Breach Notification Policy More Info on HIPAA Policy 3.0: Breach Notification Policy HIPAA Policy 4.0: PHI Requests, Access, Uses and Disclosures Sep 23rd, 2013 HIPAA Policy 4.0: PHI Requests, Access, Uses and Disclosures More Info on HIPAA Policy 4.0: PHI Requests, Access, Uses and Disclosures HIPAA Policy Section 4.1: Requests for PHI Sep 23rd, 2013 HIPAA Policy Section 4.1: Requests for PHI More Info on HIPAA Policy Section 4.1: Requests for PHI HIPAA Policy Section 4.2: Access to System PHI Feb 1st, 2017 HIPAA Policy Section 4.2: Access to System PHI More Info on HIPAA Policy Section 4.2: Access to System PHI HIPAA Policy Section 4.3: Uses and Disclosures Required by Law Sep 23rd, 2013 HIPAA Policy Section 4.3: Uses and Disclosures Required by Law More Info on HIPAA Policy Section 4.3: Uses and Disclosures Required by Law HIPAA Policy Section 4.4: Discretionary Uses and Disclosures Without An Authorization Sep 23rd, 2013 HIPAA Policy Section 4.4: Discretionary Uses and Disclosures Without An Authorization More Info on HIPAA Policy Section 4.4: Discretionary Uses and Disclosures Without An Authorization HIPAA Policy Section 4.5: Conducting Underwriting Activities Sep 23rd, 2013 HIPAA Policy Section 4.5: Conducting Underwriting Activities More Info on HIPAA Policy Section 4.5: Conducting Underwriting Activities HIPAA Policy Section 4.6: Research Disclosures and Uses Sep 23rd, 2013 HIPAA Policy Section 4.6: Research Disclosures and Uses More Info on HIPAA Policy Section 4.6: Research Disclosures and Uses HIPAA Policy Section 4.7: Making Notification Disclosures Sep 23rd, 2013 HIPAA Policy Section 4.7: Making Notification Disclosures More Info on HIPAA Policy Section 4.7: Making Notification Disclosures HIPAA Policy Section 4.8: Review of Requests for Use or Disclosure Requiring Approval by the Privacy Officer Sep 23rd, 2013 HIPAA Policy Section 4.8: Review of Requests for Use or Disclosure Requiring Approval by the Privacy Officer More Info on HIPAA Policy Section 4.8: Review of Requests for Use or Disclosure Requiring Approval by the Privacy Officer HIPAA Policy Section 4.9: Minimum Necessary Standard for Uses and Disclosures of PHI Sep 23rd, 2013 HIPAA Policy Section 4.9: Minimum Necessary Standard for Uses and Disclosures of PHI More Info on HIPAA Policy Section 4.9: Minimum Necessary Standard for Uses and Disclosures of PHI HIPAA Policy Section 4.10: Verification of Requestor’s Identity and Authority Sep 23rd, 2013 HIPAA Policy Section 4.10: Verification of Requestor’s Identity and Authority More Info on HIPAA Policy Section 4.10: Verification of Requestor’s Identity and Authority HIPAA Policy Section 4.11: Obtaining and Relying Upon an Authorization Sep 23rd, 2013 HIPAA Policy Section 4.11: Obtaining and Relying Upon an Authorization More Info on HIPAA Policy Section 4.11: Obtaining and Relying Upon an Authorization HIPAA Policy Section 4.12: Personal Representatives Sep 23rd, 2013 HIPAA Policy Section 4.12: Personal Representatives More Info on HIPAA Policy Section 4.12: Personal Representatives HIPAA Policy Section 4.13: De-identified Information Sep 23rd, 2013 HIPAA Policy Section 4.13: De-identified Information More Info on HIPAA Policy Section 4.13: De-identified Information HIPAA Policy Section 4.14: Documentation of Disclosures Sep 23rd, 2013 HIPAA Policy Section 4.14: Documentation of Disclosures More Info on HIPAA Policy Section 4.14: Documentation of Disclosures HIPAA Policy 5.0: Office of Employee Benefits As a Plan Sponsor Sep 23rd, 2013 HIPAA Policy 5.0: Office of Employee Benefits As a Plan Sponsor More Info on HIPAA Policy 5.0: Office of Employee Benefits As a Plan Sponsor HIPAA Policy 6.0: Relationships With Other Entities Sep 23rd, 2013 HIPAA Policy 6.0: Relationships With Other Entities More Info on HIPAA Policy 6.0: Relationships With Other Entities HIPAA Policy Section 6.1: Contracts With Business Associates Involving Office of Employment Benefits PHI Sep 23rd, 2013 HIPAA Policy Section 6.1: Contracts With Business Associates Involving Office of Employment Benefits PHI More Info on HIPAA Policy Section 6.1: Contracts With Business Associates Involving Office of Employment Benefits PHI HIPAA Policy Section 6.2: Contracts Involving PHI Entered into by System Offices that are Business Associates of OEB or other Covered Entities. Sep 23rd, 2013 Section 6.2: Contracts Involving PHI Entered into by System Offices that are Business Associates of OEB or other Covered Entitie More Info on HIPAA Policy Section 6.2: Contracts Involving PHI Entered into by System Offices that are Business Associates of OEB or other Covered Entities. HIPAA Policy Section 6.3: Carriers Providing Group Health Plan Coverage Sep 23rd, 2013 HIPAA Policy Section 6.3: Carriers Providing Group Health Plan Coverage More Info on HIPAA Policy Section 6.3: Carriers Providing Group Health Plan Coverage HIPAA Policy Section 6.4: Agreements With Recipients of a Limited Data Set Sep 23rd, 2013 HIPAA Policy Section 6.4: Agreements With Recipients of a Limited Data Set More Info on HIPAA Policy Section 6.4: Agreements With Recipients of a Limited Data Set HIPAA Policy 7.0: Individual Rights Sep 23rd, 2013 HIPAA Policy 7.0: Individual Rights More Info on HIPAA Policy 7.0: Individual Rights HIPAA Policy Section 7.1: Notice of Individual Rights Concerning PHI Sep 23rd, 2013 HIPAA Policy Section 7.1: Notice of Individual Rights Concerning PHI More Info on HIPAA Policy Section 7.1: Notice of Individual Rights Concerning PHI HIPAA Policy Section 7.2: Right to Access Protected Health Information Sep 23rd, 2013 HIPAA Policy Section 7.2: Right to Access Protected Health Information More Info on HIPAA Policy Section 7.2: Right to Access Protected Health Information HIPAA Policy Section 7.3: Requests to Amend PHI Sep 23rd, 2013 HIPAA Policy Section 7.3: Requests to Amend PHI More Info on HIPAA Policy Section 7.3: Requests to Amend PHI HIPAA Policy Section 7.4: Right to Receive an Accounting of Disclosures Sep 23rd, 2013 HIPAA Policy Section 7.4: Right to Receive an Accounting of Disclosures More Info on HIPAA Policy Section 7.4: Right to Receive an Accounting of Disclosures HIPAA Policy Section 7.5: Requests for Restrictions on Use and Disclosure Sep 23rd, 2013 HIPAA Policy Section 7.5: Requests for Restrictions on Use and Disclosure More Info on HIPAA Policy Section 7.5: Requests for Restrictions on Use and Disclosure HIPAA Policy Section 7.6: Requests for Confidential Communications Sep 23rd, 2013 HIPAA Policy Section 7.6: Requests for Confidential Communications More Info on HIPAA Policy Section 7.6: Requests for Confidential Communications HIPAA Policy Section 7.7: Right to Make A Complaint Sep 23rd, 2013 HIPAA Policy Section 7.7: Right to Make A Complaint More Info on HIPAA Policy Section 7.7: Right to Make A Complaint HIPAA Policy 8.0: Ensuring Privacy Compliance Sep 23rd, 2013 HIPAA Policy 8.0: Ensuring Privacy Compliance More Info on HIPAA Policy 8.0: Ensuring Privacy Compliance HIPAA Policy Section 8.1: Cooperation With the Secretary’s Investigation Sep 23rd, 2013 HIPAA Policy Section 8.1: Cooperation With the Secretary’s Investigation More Info on HIPAA Policy Section 8.1: Cooperation With the Secretary’s Investigation HIPAA Policy Section 8.2: Training Sep 23rd, 2013 HIPAA Policy Section 8.2: Training More Info on HIPAA Policy Section 8.2: Training HIPAA Policy Section 8.3: Safeguarding PHI Sep 23rd, 2013 HIPAA Policy Section 8.3: Safeguarding PHI More Info on HIPAA Policy Section 8.3: Safeguarding PHI BAC By-Laws Mar 7th, 2017 BAC By-laws More Info on BAC By-Laws HIPAA Policy Section 8.4: Mitigation of Known Privacy Violations Sep 23rd, 2013 HIPAA Policy Section 8.4: Mitigation of Known Privacy Violations More Info on HIPAA Policy Section 8.4: Mitigation of Known Privacy Violations HIPAA Policy Section 8.5: Sanctions for Personnel Violations of Privacy Sep 23rd, 2013 HIPAA Policy Section 8.5: Sanctions for Personnel Violations of Privacy More Info on HIPAA Policy Section 8.5: Sanctions for Personnel Violations of Privacy HIPAA Policy 9.0: Documentation Sep 23rd, 2013 HIPAA Policy 9.0: Documentation More Info on HIPAA Policy 9.0: Documentation HIPAA Policy Section 9.1: Changes to Privacy Policies and Procedures Sep 23rd, 2013 HIPAA Policy Section 9.1: Changes to Privacy Policies and Procedures More Info on HIPAA Policy Section 9.1: Changes to Privacy Policies and Procedures HIPAA Policy Section 9.2: Retention of Privacy Documentation Sep 23rd, 2013 HIPAA Policy Section 9.2: Retention of Privacy Documentation More Info on HIPAA Policy Section 9.2: Retention of Privacy Documentation HIPAA Request for Access to Protected Health Information Feb 1st, 2017 Request for Access Form More Info on HIPAA Request for Access to Protected Health Information Pagination « « First ‹ ‹ Previous 1 2 3 4 5 6 7 8 9 … › Next › » Last »