The enrollment process has moved to an online system. Please complete your enrollment through . If you have any complications or require assistance with the enrollment process, please contact your campus benefits office or visit the benefits enrollment help page.
New Employee Benefit Enrollment
Summary of Benefits & Coverage (SBC)
Step 2. Review Premium/Price Tag Information
Step 3. Benefits Enrollment Form
Benefits Enrollment Form (Required)
Step 4. Complete Dependent Information Request Form
Dependent Information Request Form (Required IF covering dependents)
Dependent Verification Documentation Requirements
Step 5. Complete the Record of Prior Service.
AFTER your prior service has been approved and eligibility for the retirement plan has been verified, you will be contacted by your Benefits Office with specific enrollment instructions.
Record of Prior Service Form (Required)
Step 6. Complete Assurity Life Insurance Statement of Health Form
Assurity Life Insurance Statement of Health Form (Required if applying for $75,000 or more of voluntary employee coverage or $20,000 or more of spouse coverage)
Health Benefits
- Overview
- COBRA Benefits (Post-Employment)
- Dental Insurance
- Employee Benefit Forms
- Employee Plus One
- Flexible Spending Accounts (FSA)
- Health Insurance Price Tag Summary
- Health Risk Assessment
- HIPAA & Your Privacy
- Life Events & Changes
- Life Insurance
- Long-Term Care Insurance
- Long-Term Disability Insurance
- Medicaid Chip Assistance
- Medical Insurance
- New Employee Benefit Enrollment
- Notice of Nondiscrimination
- Prescription Drug Coverage & Management
- Summary
- Vision Insurance
- Wellness Programs
Health Benefits
- Overview
- COBRA Benefits (Post-Employment)
- Dental Insurance
- Employee Benefit Forms
- Employee Plus One
- Flexible Spending Accounts (FSA)
- Health Insurance Price Tag Summary
- Health Risk Assessment
- HIPAA & Your Privacy
- Life Events & Changes
- Life Insurance
- Long-Term Care Insurance
- Long-Term Disability Insurance
- Medicaid Chip Assistance
- Medical Insurance
- New Employee Benefit Enrollment
- Notice of Nondiscrimination
- Prescription Drug Coverage & Management
- Summary
- Vision Insurance
- Wellness Programs
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