Employee Forms
Please click on the links below to view the corresponding form. Links will open in *.pdf format (requires Adobe Acrobat Reader).Evaluations
Tuition
- Part-Time Dependent Tuition Grant
- Part-Time Employee Tuition Grant
- Full-time Tuition Grant
- Tuition Benefit Form for Early Childhood Education Center
Benefits
Flexible Spending Accounts
- Flexible Spending Account Enrollment Form
- Health Reimbursement Account Enrollment Form (to be used with Health Plan Waiver)
- AmeriFlex Combined FSA or HRA Claim Form
- AmeriFlex Direct Deposit Form
- Flex Convenience Card Election Form
- Ameriflex Change in Status Form
TIAA-CREF Retirement
- 2006 Salary Reduction Form
- 2007 Salary Reduction Form
- 2008 Salary Reduction Form
- 2009 Salary Reduction Form
Health Insurance
- CoreSource Claim Form
- 2008 Health Plan Waiver Form
- 2009 Health Plan Waiver Form
- Caremark Rx Retail-Mail Guide
- Caremark Rx Preferred Drug List (effective 1/1/09)
- Caremark Rx Preferred Drug List (effective 7/1/08)
- Caremark Rx Preferred Drug List (effective 4/1/08)
- Caremark Rx Preferred Drug List (effective 1/1/08)
- Caremark Rx Full Formulary (49 pages)
- Caremark Rx Participating Retail Pharmacies
- Caremark Rx Mail Order Form
- Caremark Rx Generic Brochure
- Caremark Rx Claim Form
Dental Insurance
Life Insurance
- Standard Life Insurance Form - Employees
- Standard Life Insurance Form - Retirees
- Standard Medical History Statement
Workers Compensation
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The following forms must be completed and submitted to Human Resources in event of Work-related illness or injury: