Documents by Office

Documents by Office

Documents by Office

Employee Benefits
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LTD Conversion Calculator September 1, 2013
Prescription Drug Co-payments at a Glance September 1, 2013
ORP Acknowledgement September 1, 2013
Filing Your STD Claim September 1, 2013
UT Benefits Handbook for Employees September 1, 2013
TRS Form 28 (Notice to Elect to Participate in Optional Retirement Program and/or Refund) September 1, 2013
The Connection Between Your Oral and Overall Health September 1, 2013
Life Benefit Highlights for Retired Employees September 1, 2013
Voluntary Retirement Programs Loan and Hardship Options September 1, 2013
Your Dental Plan Options September 1, 2013
Life Portability Application September 1, 2013
UTSaver TSA Disclosure Form September 1, 2013
DeltaCare Benefits Guide September 1, 2013
Tobacco Premium Program Declaration Form September 1, 2013
Accidental Dismemberment Claim Form September 1, 2013
UTSaver DCP - 457(b) Plan Document September 1, 2013
Coordination of Benefits/Direct Claim Form September 1, 2013
Create Your Own Will Online September 1, 2013
Physician Statement Concerning Tobacco Usage and Fitness to Participate in a Tobacco Cessation Program September 1, 2013
Flexible Spending Accounts (FSA) Flyer September 1, 2013
Notice of Creditable Coverage (NOCC) September 1, 2013
UT SELECT Medical Claim Form September 1, 2013
UT FLEX Direct Deposit Authorization Form September 1, 2013
Long-Term Care Outline of Coverage September 1, 2013
UT SELECT Benefits Summary Chart September 1, 2013
Superior Vision Plan Highlights September 1, 2013
Your Solution to Long Term Care September 1, 2013
Summary of Retirement Programs September 1, 2013
Helpful Hints for Completing the Direct Payment Agreement September 1, 2013
Smart Alert - Partnering for Total Wellness September 1, 2013
Long-Term Care Long Form Application for all other applicants September 1, 2013
Long-Term Disability Benefits Guide September 1, 2013
Quality LASIK for Texas Members September 1, 2013
LTD Employer Claim Form September 1, 2013
Superior Vision Benefits Guide September 1, 2013
Overview of TRS and ORP September 1, 2013
Superior Vision Plus Benefits Guide September 1, 2013
STD Benefit Highlights September 1, 2013
UT SELECT Health Benefits Guide September 1, 2013
ORP Authorization for Reduction for Employee Contribution September 1, 2013
Accidental Death & Dismemberment Benefits Guide September 1, 2013
Vesting/Termination Status Form September 1, 2013
Recommend Your Dentist September 1, 2013
Portability and Conversion of Life Insurance September 1, 2013
Voluntary Retirement Programs Transfer Verification Form September 1, 2013
DeltaCare - Getting the Most from Your Dental HMO September 1, 2013
Death Claim Form September 1, 2013
Purchase/Change form for TSA (Traditional or Roth)-ORP changes September 1, 2013
UT SELECT DENTAL Claim Form September 1, 2013
About Online Beneficiary Management September 1, 2013
DCP Catch-Up Provision Agreement September 1, 2013
Prescription Drug Reimbursement Form September 1, 2013
HealthHub (utflex.com) Quick Reference Guide September 1, 2013
UT System Cafeteria Plan Document September 1, 2013
UT SELECT DENTAL Highlights September 1, 2013
Payflex Mobile Application Flyer September 1, 2013
Early Retiree Reinsurance Program (ERRP) Notice and Q&As September 1, 2013
UT SELECT Tobacco Cessation Program September 1, 2013
UT FLEX Letter of Medical Necessity Form September 1, 2013
Long-Term Care Highlights September 1, 2013
UT SELECT Highlights September 1, 2013
Section 7.5: Requests for Restrictions on Use and Disclosure September 23, 2013
Section 7.2: Right to Access Protected Health Information September 23, 2013
Section 6.4: Agreements With Recipients of a Limited Data Set September 23, 2013
Section 6.1: Contracts With Business Associates Involving Office of Employment Benefits PHI September 23, 2013
Section 4.14: Documentation of Disclosures September 23, 2013
HIPAA Breach Log September 23, 2013
Section 4.11: Obtaining and Relying Upon an Authorization September 23, 2013
HIPAA Request for Restriction on Use or Disclosure of Protected Health Information September 23, 2013
Section 4.9: Minimum Necessary Standard for Uses and Disclosures of PHI September 23, 2013
HIPAA Request for Amendment of Protected Health Information September 23, 2013
Section 4.6: Research Disclosures and Uses September 23, 2013
HIPAA Staff Assistance Authorization September 23, 2013
Section 4.3: Uses and Disclosures Required by Law September 23, 2013
Section 8.4: Mitigation of Known Privacy Violations September 23, 2013
Policy 4: PHI Requests, Access, Uses and Disclosures September 23, 2013
Section 8.2: Training September 23, 2013
Section 9.1: Changes to Privacy Policies and Procedures September 23, 2013
Policy 1: Introduction & Definitions September 23, 2013
General Counsel
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Non-Disclosure Agreement September 20, 2013
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