Responsible Offices - Any -Academic AffairsAdvancement ServicesBoard of RegentsBudget and PlanningBusiness AffairsCapital ProjectsChancellorCollaborative Business ServicesContracts and ProcurementControllerCreative and Web ServicesEmployee BenefitsEventsExternal Relations Communications and Advancement ServicesFacilities ManagementFinanceGeneral CounselGovernmental RelationsHealth AffairsHistorically Underutilized BusinessHuman ResourcesInformation SecurityInstitutional Research and AnalysisMedia Relations and CommunicationsPolicePopulation HealthReal EstateRISC ServicesRisk ManagementShared Information ServicesSystem AuditSystemwide ComplianceSystemwide Information ServicesTalent and InnovationTechnology and Information ServicesTelecommunication ServicesUniversity LandsUT Center LaredoWeb TeamEducation & Research Center at Laredo - archive Apply Title Published File(s) Page HIPAA Staff Assistance Authorization Feb 1st, 2017 HIPAA Staff Assistance Authorization More Info on HIPAA Staff Assistance Authorization HIPAA General Authorization Form Feb 1st, 2017 HIPAA General Authorization Form More Info on HIPAA General Authorization Form HIPAA Request for Accounting of Disclosures Feb 1st, 2017 HIPAA Request for Accounting of Disclosues Form More Info on HIPAA Request for Accounting of Disclosures HIPAA Request for Amendment of Protected Health Information Sep 23rd, 2013 HIPAA Request for Amendment of Protected Health Information Form More Info on HIPAA Request for Amendment of Protected Health Information HIPAA Request for Confidential Communications of Medical Information Sep 23rd, 2013 HIPAA Request for Confidential Communications of Medical Information Form More Info on HIPAA Request for Confidential Communications of Medical Information Tobacco Premium Program Declaration Form Sep 1st, 2023 Tobacco Premium Program Declaration Form More Info on Tobacco Premium Program Declaration Form HIPAA Request for Restriction on Use or Disclosure of Protected Health Information Sep 23rd, 2013 HIPAA Request for Restriction Form More Info on HIPAA Request for Restriction on Use or Disclosure of Protected Health Information HIPAA Revocation of Authorization Feb 1st, 2017 HIPAA Revocation of Authorization Form More Info on HIPAA Revocation of Authorization HIPAA Complaint Form Feb 1st, 2017 HIPAA Complaint Form More Info on HIPAA Complaint Form HIPAA Breach Log Sep 23rd, 2013 HIPAA Breach Log More Info on HIPAA Breach Log Executive Order RP-49 - January 2014 Jan 21st, 2014 UT System Annual Executive Order RP-49 January 2014 FY 2013 UT System Metered Utilities More Info on Executive Order RP-49 - January 2014 Agreement to Negotiate a License Jul 15th, 2009 Agreement to Negotiate a License (UTAUS) Agreement to Negotiate a License (UTSMCDAL) More Info on Agreement to Negotiate a License Amendment to Research Agreement Jul 15th, 2009 Amendment to Research Agreement More Info on Amendment to Research Agreement Consortium Agreement Jul 15th, 2009 Consortium Agreement More Info on Consortium Agreement Consulting Agreement Jul 15th, 2009 Consulting Agreement More Info on Consulting Agreement Contract for Services Jul 15th, 2009 Contract for Services (UTSMCDAL) More Info on Contract for Services Contract Research Organization Agreement Jul 15th, 2009 Contract Research Organization Agreement More Info on Contract Research Organization Agreement Task Force on Engineering Education for Texas in the 21st Century Dec 12th, 2013 Task Force on Engineering Education for Texas in the 21st Century Engineering & Computer Science Initiative Summary More Info on Task Force on Engineering Education for Texas in the 21st Century Non-Disclosure Agreement Sep 20th, 2013 Non-Disclosure Agreement (University Disclosing) Non-Disclosure Agreement (University Receiving) Non-Disclosure Agreement (Mutual) More Info on Non-Disclosure Agreement Material Transfer Agreement Jul 15th, 2009 Biologicals Supply and License Agreement Material Transfer Agreement (Uniform Biological) Material Transfer Agreement (University Materials) More Info on Material Transfer Agreement Patent License Agreements Mar 2nd, 2010 Exclusive Patent License Agreement (UTSMCDAL) Exclusive Patent License Agreement (UTMDACC) Patent License Agreement Patent License Agreement (UTMDACC) Patent License Agreement - Life Science (All-In-One) Patent License Agreement - Life Science (Two Part) Patent License Agreement - Life Science (UTMDACC) Patent License Agreement - Physical Science (All-In-One) Patent License Agreement - Physical Science (Two Part) More Info on Patent License Agreements Sponsored Research Agreements Jul 15th, 2009 Department of Health and Human Services Subcontract Sponsored Laboratory Study Agreement Sponsored Research Agreement - No IP Sponsored Research Agreement - Univ. Owns IP Sponsored Research Agreement - Joint IP Short Form Sponsored Research Agreement - Joint IP Long Form Sponsored Laboratory Study Agreement or Testing Agreement (Revise Accordingly) Three Party Multiple Sponsor Study Coordination Agreement Visiting Scientist Agreement More Info on Sponsored Research Agreements Clinical Trial Agreements Jul 15th, 2009 Memorandum of Understanding between Multiple Sponsors on a Clinical Trial Agreement Non-Governmental Clinical Study Agreement More Info on Clinical Trial Agreements Technology Transfer Agreements Jul 15th, 2009 Inter-Institutional Joint Invention Management Agreement (All-In-One) Inter-Institutional Joint Invention Management Agreement (Agreement Only) Inter-Institutional Joint Invention Management Agreement (Exhibit A Only) Inter-Institutional Royalty Sharing Agreement Inter-Institutional Royalty Sharing Agreement (UTSMCDAL) Joint Ownership Agreement Joint Ownership Agreement (UTSMCDAL) Option Agreement Royalty Sharing Agreement Royalty Sharing Agreement (UTSMCDAL) Small Business Technology Transfer Program Model Agreement Teaming Agreement Technology License Agreement More Info on Technology Transfer Agreements Beta Test Site Agreement Jul 15th, 2009 Beta Test Site Agreement More Info on Beta Test Site Agreement Salary Reimbursement Agreement Jul 15th, 2009 Salary Reimbursement Agreement More Info on Salary Reimbursement Agreement Copyright Agreements Jan 7th, 2009 Cease and Desist Letter (Copyright Infringement) Contribution to Publication Agreement Copyright Assignment Copyright License Agreement Electronic Journal Publication Agreement Print Publication Agreement Talent Release Agreement Video Distribution Agreement More Info on Copyright Agreements Courseware Agreements Jul 20th, 2020 Online Course Development Agreement - Joint Ownership Online Course Development Agreement - Work Made for Hire Educational Research Agreement Faculty Sole Ownership Agreement General Joint Creation and Ownership Agreement Parental Consent Form (Internet) Permission Letter General Work for Hire Agreement More Info on Courseware Agreements Software Standard Agreements May 25th, 2010 Beta Test Site Agreement Software Development Agreement - University Developing Software Distribution Agreement Software License Agreement - End User Software License Agreement - Source Code More Info on Software Standard Agreements Patents: Released Inventions Reports May 28th, 2011 Calendar Year 2005 Report Calendar Year 2004 Report Calendar Year 2003 Report Calendar Year 2002 Report Calendar Year 2001 Report Calendar Year 2000 Report More Info on Patents: Released Inventions Reports Procedure for Managing Conflicts of Interest Mar 12th, 2014 Form Plan to Manage Conflicts Sample Plans to Manage Conflicts More Info on Procedure for Managing Conflicts of Interest UT System Research Impact Report May 6th, 2011 UT System Research Impact Report More Info on UT System Research Impact Report Faculty Health Appointment Forms UT Health Science Center at Houston Jul 18th, 2007 UT Health Science Center School of Medicine Combined Faculty and Administrative Appointment (FORM 30) More Info on Faculty Health Appointment Forms UT Health Science Center at Houston Framework for Advancing Excellence: 2013 Update Apr 11th, 2014 UT System Framework 2013 Update More Info on Framework for Advancing Excellence: 2013 Update Recommendations for Drafting Delegation Memoranda May 30th, 2013 Recommendations for Drafting Delegation Memoranda More Info on Recommendations for Drafting Delegation Memoranda Recommendations from the Task Force on Hazing and Alcohol Apr 1st, 2014 Recommendations from the Task Force on Hazing and Alcohol More Info on Recommendations from the Task Force on Hazing and Alcohol U.T. Austin Admissions Inquiry Mar 15th, 2014 Admissions Report Attachments More Info on U.T. Austin Admissions Inquiry UT Benefits Billing Reference Guide Sep 1st, 2013 UT Benefits Billing Reference Guide More Info on UT Benefits Billing Reference Guide UT Benefits Billing Direct Payment/Debit Authorization Agreement Apr 24th, 2024 Direct Payment/Debit Authorization Agreement More Info on UT Benefits Billing Direct Payment/Debit Authorization Agreement Helpful Hints for Completing the Direct Payment Agreement Sep 1st, 2013 Helpful Hints for Completing the Direct Payment Agreement More Info on Helpful Hints for Completing the Direct Payment Agreement UT SELECT Medical Plan Guide with Prescription Drug Coverage Sep 1st, 2024 NEW! 2024-2025 UT SELECT Benefits Guide 2023-2024 UT SELECT Benefits Guide More Info on UT SELECT Medical Plan Guide with Prescription Drug Coverage HIPAA Policy Section 7.8: Right to Breach Notifications Jan 20th, 2017 HIPAA Policy Section 7.8: Right to Breach Notifications More Info on HIPAA Policy Section 7.8: Right to Breach Notifications HIPAA Disclosure Log Sep 23rd, 2013 HIPAA Disclosure Log More Info on HIPAA Disclosure Log HIPAA Hybrid Entity Designation Feb 1st, 2017 HIPAA Hybrid Entity Designation More Info on HIPAA Hybrid Entity Designation HIPAA Privacy Officer Designation Feb 1st, 2017 HIPAA Privacy Officer Designation More Info on HIPAA Privacy Officer Designation Annual Eligibility Notice for Retirement Plans Mar 25th, 2023 Annual Eligibility Notice for Retirement Plans More Info on Annual Eligibility Notice for Retirement Plans Record of Revisions Nov 1st, 2021 Record of Revisions More Info on Record of Revisions Introduction Sep 1st, 2017 Introduction to OEB Administrative Manual More Info on Introduction 111. Uniform Insurance Benefits Act Sep 1st, 2017 Uniform Insurance Benefits Act More Info on 111. Uniform Insurance Benefits Act 120. Office of Employee Benefits Administration Sep 1st, 2017 Office of Employee Benefits Administration More Info on 120. Office of Employee Benefits Administration 130. Office of Employee Benefits Terms and Definitions Sep 1st, 2017 Office of Employee Benefits Terms and Definitions More Info on 130. Office of Employee Benefits Terms and Definitions 140. Funding for Group Insurance Coverage Sep 1st, 2020 Funding for Group Insurance Coverage More Info on 140. Funding for Group Insurance Coverage 141. Waiting Period for Group Insurance Benefits Sep 1st, 2014 Waiting Period for Group Insurance Benefits More Info on 141. Waiting Period for Group Insurance Benefits 142. Premium Sharing for Graduate Students and Part-Time Employees Sep 1st, 2015 Premium Sharing for Graduate Students and Part-Time Employees More Info on 142. Premium Sharing for Graduate Students and Part-Time Employees 150. Program to Prevent, Detect & Mitigate Identity Theft Aug 1st, 2009 Program to Prevent, Detect & Mitigate Identity Theft More Info on 150. Program to Prevent, Detect & Mitigate Identity Theft 160. Tobacco Premium Program Sep 1st, 2018 Policy 160 Tobacco Premium Program More Info on 160. Tobacco Premium Program 210. Employees Sep 1st, 2020 Employee Eligibility and Enrollment More Info on 210. Employees 211. Certain Non-Employees Sep 1st, 2017 Certain Non-Employees More Info on 211. Certain Non-Employees 220. Retired Employees Sep 1st, 2020 Retired Employee Eligibility and Enrollment More Info on 220. Retired Employees Retirement Eligibility Flowchart Dec 18th, 2017 Retirement Eligibility Flowchart More Info on Retirement Eligibility Flowchart 230. Dependents Sep 1st, 2021 Dependents More Info on 230. Dependents Required Documentation for Eligible Dependents Chart Sep 1st, 2021 Chart - Required Documentation for Eligible Dependents More Info on Required Documentation for Eligible Dependents Chart Grandchild Certification Form Oct 28th, 2020 Dependent Grandchild Certification Form More Info on Grandchild Certification Form 240. Surviving Dependents Sep 1st, 2020 Surviving Dependents More Info on 240. Surviving Dependents 250. COBRA Participants Sep 1st, 2020 COBRA More Info on 250. COBRA Participants 260. Health Insurance Premium Payment (HIPP) Reimbursement Program Sep 1st, 2008 260hipp.pdf More Info on 260. Health Insurance Premium Payment (HIPP) Reimbursement Program 270. Evidence of Insurability (EOI) Sep 1st, 2017 Evidence of Insurability (EOI) More Info on 270. Evidence of Insurability (EOI) 310. Qualified Status Change Events Dec 15th, 2022 Change in Status More Info on 310. Qualified Status Change Events 320. Active Military Duty Jul 1st, 2010 320activemilitaryduty.pdf More Info on 320. Active Military Duty 400. Health Insurance Portability and Accountability Act (HIPAA) Sep 23rd, 2013 Health Insurance Portability and Accountability Act (HIPAA) More Info on 400. Health Insurance Portability and Accountability Act (HIPAA) 570. UT FLEX Program Nov 1st, 2021 UT FLEX Program More Info on 570. UT FLEX Program 571. UT FLEX Contribution Reporting Aug 1st, 2013 UT FLEX Contribution Reporting More Info on 571. UT FLEX Contribution Reporting 572. Address Change Procedures for UT FLEX Debit Card Participants Sep 1st, 2009 572flexaddresschange.pdf More Info on 572. Address Change Procedures for UT FLEX Debit Card Participants 573. Annual Base Benefit Rate (ABBR) Calculation Sep 1st, 2013 Policy 573 ABBR Calcuation More Info on 573. Annual Base Benefit Rate (ABBR) Calculation 701. Premium Billing & Remittance Sep 1st, 2018 Premium Billing & Remittance More Info on 701. Premium Billing & Remittance 702. Billing of Postage to Components Sep 1st, 2002 702postagebilling.pdf More Info on 702. Billing of Postage to Components 705. Employee Assistance Program Sep 1st, 2004 705eapcredit.pdf More Info on 705. Employee Assistance Program 706. BCBS Eligibility Audit Apr 1st, 2014 706bcbseligaudit.pdf More Info on 706. BCBS Eligibility Audit 707. Retroactive Eligibility Adjustments Sep 1st, 2020 Retroactive Eligibility Adjustments More Info on 707. Retroactive Eligibility Adjustments 810. Optional Retirement Program Apr 1st, 2006 810orp.pdf More Info on 810. Optional Retirement Program Pagination « « First ‹ ‹ Previous 1 2 3 4 5 6 7 8 9 … › Next › » Last »