Documents by Office

Documents by Office

Documents by Office

Employee Benefits
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Benefits Cost Worksheet for Employees September 1, 2013
Long-Term Disability Benefit Highlights September 1, 2013
Short-Term Disability Benefits Guide September 1, 2013
UT Benefits Billing Direct Payment/Debit Authorization Agreement September 1, 2013
SVContacts.com - Online Contact Lens Ordering September 1, 2013
Long-Term Disability Conversion Kit September 1, 2013
UT SELECT DENTAL Benefits Guide September 1, 2013
Optional Retirement Program (ORP) Plan Document September 1, 2013
Superior Vison Claim Form September 1, 2013
Blue Care Link September 1, 2013
UT Benefits Handbook for Retired Employees September 1, 2013
ORP Authorization for Reduction for Employee Contribution RETURNING EMPLOYEE September 1, 2013
SmileWaySM Wellness Program: Take the Challenge September 1, 2013
Life/AD&D Benefit Highlights for Active Employees September 1, 2013
Voluntary Retirement Programs At a Glance September 1, 2013
Delta Dental Online Services September 1, 2013
Life Conversion Application September 1, 2013
UTSaver TSA - 403(b) Plan Document September 1, 2013
DeltaCare Highlights September 1, 2013
Accelerated Death Claim Form September 1, 2013
Comparison of Traditional, Roth 403(b), and Roth IRA Contributions September 1, 2013
UT SELECT DENTAL - Getting the Most from Your DPO Network September 1, 2013
Beneficiary Designation Form September 1, 2013
DCP Purchase Agreement September 1, 2013
UT SELECT DENTAL Plus Highlights September 1, 2013
The PayFlex Card Flyer September 1, 2013
HIPAA Notice of Privacy Practices September 1, 2013
UT FLEX Claim Form September 1, 2013
Medicaid and the Children's Health Insurance Program (CHIP) Notice September 1, 2013
UT SELECT Medical Health Resources and Tools September 1, 2013
Superior Vision Plan Highlights September 1, 2013
Reasons to Consider Long Term Care September 1, 2013
UT Benefits Billing Reference Guide 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 Care Benefits Guide September 1, 2013
LTD Employee Claim Form September 1, 2013
UT FLEX Benefits Guide September 1, 2013
Summary of Retirement Programs September 1, 2013
Finding-In-Network Providers September 1, 2013
LTD Conversion Calculator September 1, 2013
Prescription Drug Co-payments at a Glance September 1, 2013
ORP Acknowledgement September 1, 2013
Provider Nomination Form 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
Section 4.2: Access to System PHI September 23, 2013
Policy 3: Breach Notification Policy September 23, 2013
Section 8.1: Cooperation With the Secretary’s Investigation September 23, 2013
Section 7.6: Requests for Confidential Communications September 23, 2013
Privacy Officer Designation September 23, 2013
Section 7.3: Requests to Amend PHI September 23, 2013
Policy 7: Individual Rights September 23, 2013
Section 6.2: Contracts Involving PHI Entered into by System Offices that are Business Associates of OEB or other Covered Entities. September 23, 2013
Policy 5: Office of Employee Benefits As a Plan Sponsor September 23, 2013
Section 4.12: Personal Representatives September 23, 2013
HIPAA Revocation of Authorization September 23, 2013
HIPAA General Authorization Form September 23, 2013
Section 4.7: Making Notification Disclosures September 23, 2013
Section 9.2: Retention of Privacy Documentation September 23, 2013
HIPAA Request for Confidential Communications of Medical Information September 23, 2013
Section 4.4: Discretionary Uses and Disclosures Without An Authorization September 23, 2013
Section 8.5: Sanctions for Personnel Violations of Privacy September 23, 2013
Section 4.1: Requests for PHI September 23, 2013
Section 8.3: Safeguarding PHI September 23, 2013
General Counsel
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Non-Disclosure Agreement September 20, 2013
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