Documents by Office

Title Published File(s) Page
Long-Term Disability Benefit Highlights NEW! 2021-2022 Long Term Disability Brochure
2020-2021 Long Term Disability Brochure 		More Info on Long-Term Disability Benefit Highlights
230. Dependents Dependents More Info on 230. Dependents
Notice of Creditable Coverage (NOCC) Medicare Part D Notice of Creditable Coverage More Info on Notice of Creditable Coverage (NOCC)
Overview of TRS and ORP TRS and ORP Overview - July 2021 More Info on Overview of TRS and ORP
MDLIVE Overview and Registration Info MDLIVE Overview and Registration Flyer More Info on MDLIVE Overview and Registration Info
Hinge Health Tip Sheets Hinge Health Desk Exercises Tip Sheet
Hinge Health Find Your Fifteen Tip Sheet
Hinge Health Muscle Mindfulness Tip Sheet
Hinge Health Stand All Day Tip Sheet
Hinge Health Work From Home Tip Sheet 		More Info on Hinge Health Tip Sheets
Vision Plans Annual Enrollment Overview Vision Plans Annual Enrollment Overview 2021-2022 More Info on Vision Plans Annual Enrollment Overview
UT CARE Part D Contacts UT CARE Part D Contacts More Info on UT CARE Part D Contacts
UT Benefits Billing Sample Monthly Statement UT Benefits Billing Sample Monthly Statement More Info on UT Benefits Billing Sample Monthly Statement
UT CARES Act UT CARES Act More Info on UT CARES Act
Grandchild Certification Form Dependent Grandchild Certification Form More Info on Grandchild Certification Form
140. Funding for Group Insurance Coverage Funding for Group Insurance Coverage More Info on 140. Funding for Group Insurance Coverage
210. Employees Employee Eligibility and Enrollment More Info on 210. Employees
220. Retired Employees Retired Employee Eligibility and Enrollment More Info on 220. Retired Employees
240. Surviving Dependents Surviving Dependents More Info on 240. Surviving Dependents
250. COBRA Participants COBRA More Info on 250. COBRA Participants
707. Retroactive Eligibility Adjustments Retroactive Eligibility Adjustments More Info on 707. Retroactive Eligibility Adjustments
Retirement Program Sales Solicitation Agreement Retirement Program Sales Solicitation Agreement More Info on Retirement Program Sales Solicitation Agreement
Long-Term Disability Conversion Kit Long Term Disability Conversion Kit More Info on Long-Term Disability Conversion Kit
LTD Employer Claim Form LTD Employer Claim Form More Info on LTD Employer Claim Form
Beneficiary Designation Form Beneficiary Designation Form More Info on Beneficiary Designation Form
Accidental Dismemberment Claim Form Accidental Dismemberment Claim Form More Info on Accidental Dismemberment Claim Form
Death Claim Form Death Claim Form More Info on Death Claim Form
Life Portability Application Life Portability Application More Info on Life Portability Application
Life Conversion Application Application to Convert Group Life Insurance More Info on Life Conversion Application
LTD Employee Claim Form LTD Employee Claim Form More Info on LTD Employee Claim Form
Personal Information and Emergency Contact Form Personal Information and Emergency Contact Form More Info on Personal Information and Emergency Contact Form
160. Tobacco Premium Program Policy 160 Tobacco Premium Program More Info on 160. Tobacco Premium Program
701. Premium Billing & Remittance Premium Billing & Remittance More Info on 701. Premium Billing & Remittance
Medicaid and the Children's Health Insurance Program (CHIP) Notice Medicaid and the Children's Health Insurance Program (CHIP) Notice More Info on Medicaid and the Children's Health Insurance Program (CHIP) Notice
121. Benefits Advisory Committee Benefits Advisory Committee More Info on 121. Benefits Advisory Committee
574. Institution-based Voluntary Plans Institution-based Voluntary Plans More Info on 574. Institution-based Voluntary Plans
Retirement Eligibility Flowchart Retirement Eligibility Flowchart More Info on Retirement Eligibility Flowchart
Introduction Introduction to OEB Administrative Manual More Info on Introduction
111. Uniform Insurance Benefits Act Uniform Insurance Benefits Act More Info on 111. Uniform Insurance Benefits Act
120. Office of Employee Benefits Administration Office of Employee Benefits Administration More Info on 120. Office of Employee Benefits Administration
130. Office of Employee Benefits Terms and Definitions Office of Employee Benefits Terms and Definitions More Info on 130. Office of Employee Benefits Terms and Definitions
211. Certain Non-Employees Certain Non-Employees More Info on 211. Certain Non-Employees
270. Evidence of Insurability (EOI) Evidence of Insurability (EOI) More Info on 270. Evidence of Insurability (EOI)
Nondiscrimination and Accessibility Notice Nondiscrimination and Accessibility Notice More Info on Nondiscrimination and Accessibility Notice
Understanding Your UT SELECT Explanation of Benefits Understanding Your UT SELECT EOB More Info on Understanding Your UT SELECT Explanation of Benefits
Quality LASIK for Texas Members Quality LASIK for Texas Members More Info on Quality LASIK for Texas Members
Superior Vision Plan Brochure Superior Vision Plan Brochure More Info on Superior Vision Plan Brochure
BAC By-Laws BAC By-laws More Info on BAC By-Laws
HIPAA Policy Section 4.2: Access to System PHI HIPAA Policy Section 4.2: Access to System PHI More Info on HIPAA Policy Section 4.2: Access to System PHI
HIPAA Request for Access to Protected Health Information Request for Access Form More Info on HIPAA Request for Access to Protected Health Information
HIPAA Staff Assistance Authorization HIPAA Staff Assistance Authorization More Info on HIPAA Staff Assistance Authorization
HIPAA General Authorization Form HIPAA General Authorization Form More Info on HIPAA General Authorization Form
HIPAA Request for Accounting of Disclosures HIPAA Request for Accounting of Disclosues Form More Info on HIPAA Request for Accounting of Disclosures
HIPAA Revocation of Authorization HIPAA Revocation of Authorization Form More Info on HIPAA Revocation of Authorization
HIPAA Complaint Form HIPAA Complaint Form More Info on HIPAA Complaint Form
HIPAA Hybrid Entity Designation HIPAA Hybrid Entity Designation More Info on HIPAA Hybrid Entity Designation
HIPAA Privacy Officer Designation HIPAA Privacy Officer Designation More Info on HIPAA Privacy Officer Designation
HIPAA Policy 3.0: Breach Notification Policy HIPAA Policy 3.0: Breach Notification Policy More Info on HIPAA Policy 3.0: Breach Notification Policy
HIPAA Policy Section 7.8: Right to Breach Notifications HIPAA Policy Section 7.8: Right to Breach Notifications More Info on HIPAA Policy Section 7.8: Right to Breach Notifications
UT Benefits Enrollment Guide for Retired Employees 2015-2016 UT Benefits Enrollment Guide for Retired Employees 2015-2016 More Info on UT Benefits Enrollment Guide for Retired Employees 2015-2016
Vesting/Termination Status Form Vesting/Termination Status Form More Info on Vesting/Termination Status Form
142. Premium Sharing for Graduate Students and Part-Time Employees Premium Sharing for Graduate Students and Part-Time Employees More Info on 142. Premium Sharing for Graduate Students and Part-Time Employees
ORP Acknowledgement ORP Acknowledgement More Info on ORP Acknowledgement
24/7 Nurseline 24/7 Nurseline More Info on 24/7 Nurseline
Smart Alert - Partnering for Total Wellness Superior Vision Smart Alert More Info on Smart Alert - Partnering for Total Wellness
141. Waiting Period for Group Insurance Benefits Waiting Period for Group Insurance Benefits More Info on 141. Waiting Period for Group Insurance Benefits
706. BCBS Eligibility Audit 706bcbseligaudit.pdf More Info on 706. BCBS Eligibility Audit
HIPAA Policy 1.0: Introduction & Definitions 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 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 4.0: PHI Requests, Access, Uses and Disclosures 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 HIPAA Policy Section 4.1: Requests for PHI More Info on HIPAA Policy Section 4.1: Requests for PHI
HIPAA Policy Section 4.3: Uses and Disclosures Required by Law 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 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 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 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 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 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 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 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 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 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 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 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 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