Documents by Office

Documents by Office

Documents by Office

Employee Benefits
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UT SELECT Highlights September 1, 2013
UT FLEX Letter of Medical Necessity Form September 1, 2013
Long-Term Care Highlights September 1, 2013
Superior Vision Plan Brochure September 1, 2013
Long-Term Care Enrollment Form for new employees September 1, 2013
Long-Term Care Benefits Guide September 1, 2013
SVContacts.com - Online Contact Lens Ordering September 1, 2013
Helpful Hints for Completing the Direct Payment Agreement September 1, 2013
Long-Term Disability Benefit Highlights September 1, 2013
UT FLEX Benefits Guide September 1, 2013
Overview of TRS and ORP September 1, 2013
Superior Vison Claim Form September 1, 2013
Long-Term Disability Conversion Kit September 1, 2013
Prescription Drug Co-payments at a Glance September 1, 2013
ORP Authorization for Reduction for Employee Contribution September 1, 2013
SmileWaySM Wellness Program: Take the Challenge September 1, 2013
Blue Care Link September 1, 2013
Vesting/Termination Status Form September 1, 2013
Delta Dental Online Services September 1, 2013
Life/AD&D Benefit Highlights for Active Employees September 1, 2013
Voluntary Retirement Programs Transfer Verification Form September 1, 2013
DeltaCare Highlights September 1, 2013
Life Conversion Application September 1, 2013
Purchase/Change form for TSA (Traditional or Roth)-ORP changes September 1, 2013
UT SELECT DENTAL - Getting the Most from Your DPO Network September 1, 2013
Accelerated Death Claim Form September 1, 2013
DCP Catch-Up Provision Agreement September 1, 2013
UT SELECT DENTAL Plus Highlights September 1, 2013
Beneficiary Designation Form September 1, 2013
The PayFlex Card Flyer September 1, 2013
UT System Cafeteria Plan Document September 1, 2013
UT SELECT Medical Health Resources and Tools September 1, 2013
UT FLEX Claim Form September 1, 2013
Medicaid and the Children's Health Insurance Program (CHIP) Notice September 1, 2013
Superior Vision Plan Highlights September 1, 2013
Reasons to Consider Long Term Care September 1, 2013
Summary of Retirement Programs September 1, 2013
Getting Started with the Online Member Portal September 1, 2013
Long-Term Care Short Form Application for current employees and spouses September 1, 2013
Long-Term Disability Benefits Guide September 1, 2013
Benefits Cost Worksheet for Employees September 1, 2013
Finding-In-Network Providers September 1, 2013
UT Benefits Billing Direct Payment/Debit Authorization Agreement September 1, 2013
LTD Employee Claim Form September 1, 2013
Superior Vision Benefits Guide September 1, 2013
Optional Retirement Program (ORP) Plan Document September 1, 2013
Provider Nomination Form September 1, 2013
LTD Conversion Calculator September 1, 2013
UT Benefits Handbook for Retired Employees September 1, 2013
ORP Authorization for Reduction for Employee Contribution RETURNING EMPLOYEE September 1, 2013
The Connection Between Your Oral and Overall Health September 1, 2013
Filing Your STD Claim September 1, 2013
Your Dental Plan Options September 1, 2013
Life Benefit Highlights for Retired Employees September 1, 2013
UTSaver TSA - 403(b) Plan Document September 1, 2013
DeltaCare Benefits Guide September 1, 2013
Life Portability Application September 1, 2013
Coordination of Benefits/Direct Claim Form September 1, 2013
Accidental Dismemberment Claim Form September 1, 2013
DCP Purchase Agreement September 1, 2013
Create Your Own Will Online September 1, 2013
UT SELECT Medical Claim Form September 1, 2013
Flexible Spending Accounts (FSA) Flyer September 1, 2013
Notice of Creditable Coverage (NOCC) September 1, 2013
UT SELECT Benefits Summary Chart September 1, 2013
UT FLEX Direct Deposit Authorization Form September 1, 2013
Long-Term Care Outline of Coverage September 1, 2013
Policy 4: PHI Requests, Access, Uses and Disclosures September 23, 2013
Section 8.2: Training September 23, 2013
Policy 1: Introduction & Definitions September 23, 2013
Section 7.7: Right to Make A Complaint September 23, 2013
Section 7.4: Right to Receive an Accounting of Disclosures September 23, 2013
Section 7.1: Notice of Individual Rights Concerning PHI September 23, 2013
Section 6.3: Carriers Providing Group Health Plan Coverage September 23, 2013
HIPAA Complaint Form September 23, 2013
Policy 6: Relationships With Other Entities September 23, 2013
Section 4.13: De-identified Information September 23, 2013
Section 4.10: Verification of Requestor’s Identity and Authority September 23, 2013
Risk Management
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ACORD Automobile Loss Notice September 6, 2013
General Counsel
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Non-Disclosure Agreement September 20, 2013
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