Documents by Office

Documents by Office

Documents by Office

Controller
Document Publish Date File
UT System Legislative Appropriations Requests: Pan American October 16, 2012
UT System Legislative Appropriations Requests: Permian Basin October 16, 2012
UT System Legislative Appropriations Requests: San Antonio October 16, 2012
UT System Legislative Appropriations Requests: Science Center at Tyler October 17, 2012
UT System Legislative Appropriations Requests: Southwestern Medical Center October 16, 2012
UT System Legislative Appropriations Requests: Tyler October 16, 2012
UTS Annual Financial Report August 1, 2011
Wireless Communication Device Reimbursement Request Form January 1, 2013
Wireless Device Allowance Request Form January 1, 2013
Employee Benefits
Document Publish Date File
About Online Beneficiary Management September 1, 2013
Accelerated Death Claim Form September 1, 2013
Accidental Death & Dismemberment Benefits Guide September 1, 2013
Accidental Dismemberment Claim Form September 1, 2013
Beneficiary Designation Form September 1, 2013
Benefits Cost Worksheet for Employees September 1, 2013
Blue Care Link September 1, 2013
Comparison of Traditional, Roth 403(b), and Roth IRA Contributions September 1, 2013
Coordination of Benefits/Direct Claim Form September 1, 2013
Create Your Own Will Online September 1, 2013
DCP Catch-Up Provision Agreement September 1, 2013
DCP Purchase Agreement September 1, 2013
Death Claim Form September 1, 2013
Delta Dental Online Services September 1, 2013
DeltaCare - Getting the Most from Your Dental HMO September 1, 2013
DeltaCare Benefits Guide September 1, 2013
DeltaCare Highlights September 1, 2013
Early Retiree Reinsurance Program (ERRP) Notice and Q&As September 1, 2013
Filing Your STD Claim September 1, 2013
Finding-In-Network Providers September 1, 2013
Flexible Spending Accounts (FSA) Flyer September 1, 2013
Getting Started with the Online Member Portal September 1, 2013
HealthHub (utflex.com) Quick Reference Guide September 1, 2013
Helpful Hints for Completing the Direct Payment Agreement September 1, 2013
HIPAA Breach Log September 23, 2013
HIPAA Complaint Form September 23, 2013
HIPAA General Authorization Form September 23, 2013
HIPAA Notice of Privacy Practices September 1, 2013
HIPAA Notice of Privacy Practices September 1, 2013
HIPAA Request for Access to Protected Health Information September 23, 2013
HIPAA Request for Accounting of Disclosures September 23, 2013
HIPAA Request for Amendment of Protected Health Information September 23, 2013
HIPAA Request for Confidential Communications of Medical Information September 23, 2013
HIPAA Request for Restriction on Use or Disclosure of Protected Health Information September 23, 2013
HIPAA Revocation of Authorization September 23, 2013
HIPAA Staff Assistance Authorization September 23, 2013
International Travel Quick Reference Sheet August 1, 2012
Life Benefit Highlights for Retired Employees September 1, 2013
Life Conversion Application September 1, 2013
Life Portability Application September 1, 2013
Life/AD&D Benefit Highlights for Active Employees September 1, 2013
Long-Term Care Benefits Guide September 1, 2013
Long-Term Care Enrollment Form for new employees September 1, 2013
Long-Term Care Highlights September 1, 2013
Long-Term Care Long Form Application for all other applicants September 1, 2013
Long-Term Care Outline of Coverage September 1, 2013
Long-Term Care Short Form Application for current employees and spouses September 1, 2013
Long-Term Disability Benefit Highlights September 1, 2013
Long-Term Disability Benefits Guide September 1, 2013
Long-Term Disability Conversion Kit September 1, 2013
LTD Conversion Calculator September 1, 2013
LTD Employee Claim Form September 1, 2013
LTD Employer Claim Form September 1, 2013
Medicaid and the Children's Health Insurance Program (CHIP) Notice September 1, 2013
Notice of Creditable Coverage (NOCC) September 1, 2013
Optional Retirement Program (ORP) Plan Document September 1, 2013
ORP Acknowledgement September 1, 2013
ORP Authorization for Reduction for Employee Contribution September 1, 2013
ORP Authorization for Reduction for Employee Contribution RETURNING EMPLOYEE September 1, 2013
Overview of TRS and ORP September 1, 2013
Payflex Mobile Application Flyer September 1, 2013
Physician Statement Concerning Tobacco Usage and Fitness to Participate in a Tobacco Cessation Program September 1, 2013
Policy 1: Introduction & Definitions September 23, 2013
Policy 2: Organization of System for HIPAA Privacy Standard Compliance Purposes September 23, 2013
Policy 3: Breach Notification Policy September 23, 2013
Policy 4: PHI Requests, Access, Uses and Disclosures September 23, 2013
Policy 5: Office of Employee Benefits As a Plan Sponsor September 23, 2013
Policy 6: Relationships With Other Entities September 23, 2013
Policy 7: Individual Rights September 23, 2013
Policy 8: Ensuring Privacy Compliance September 23, 2013
Policy 9: Documentation September 23, 2013
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