Documents by Office

Documents by Office

Documents by Office

Employee Benefits
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Section 8.1: Cooperation With the Secretary’s Investigation September 23, 2013
HIPAA Disclosure Log September 23, 2013
400. Health Insurance Portability and Accountability Act (HIPAA) September 23, 2013
Privacy Officer Designation September 23, 2013
Section 7.6: Requests for Confidential Communications 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
HIPAA Revocation of Authorization September 23, 2013
Policy 5: Office of Employee Benefits As a Plan Sponsor September 23, 2013
HIPAA Request for Confidential Communications of Medical Information September 23, 2013
Section 4.12: Personal Representatives 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
UT SELECT Medical Health Resources and Tools September 1, 2013
UT FLEX Claim Form September 1, 2013
Medicaid and the Children's Health Insurance Program (CHIP) Notice September 1, 2013
Summary of Retirement Programs September 1, 2013
Superior Vision Plan Highlights September 1, 2013
Reasons to Consider Long Term Care 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 Disability Benefits Guide September 1, 2013
Benefits Cost Worksheet for Employees September 1, 2013
Finding-In-Network Providers September 1, 2013
UT Benefits Billing Direct Payment/Debit Authorization Agreement September 1, 2013
LTD Employee Claim Form September 1, 2013
Superior Vision Benefits Guide September 1, 2013
Optional Retirement Program (ORP) Plan Document September 1, 2013
Provider Nomination Form September 1, 2013
LTD Conversion Calculator September 1, 2013
UT Benefits Handbook for Retired Employees September 1, 2013
ORP Authorization for Reduction for Employee Contribution RETURNING EMPLOYEE September 1, 2013
The Connection Between Your Oral and Overall Health September 1, 2013
Filing Your STD Claim September 1, 2013
Your Dental Plan Options September 1, 2013
Life Benefit Highlights for Retired Employees September 1, 2013
UTSaver TSA - 403(b) Plan Document September 1, 2013
DeltaCare Benefits Guide September 1, 2013
Life Portability Application September 1, 2013
Coordination of Benefits/Direct Claim Form September 1, 2013
Accidental Dismemberment Claim Form September 1, 2013
DCP Purchase Agreement September 1, 2013
Create Your Own Will Online September 1, 2013
Notice of Creditable Coverage (NOCC) September 1, 2013
UT SELECT Medical Claim Form September 1, 2013
Flexible Spending Accounts (FSA) Flyer September 1, 2013
UT SELECT Benefits Summary Chart September 1, 2013
UT FLEX Direct Deposit Authorization Form September 1, 2013
Long-Term Care Outline of Coverage September 1, 2013
HIPAA Notice of Privacy Practices September 1, 2013
573. Annual Base Benefit Rate (ABBR) Calculation September 1, 2013
Superior Vision Plan Highlights September 1, 2013
Your Solution to Long Term Care September 1, 2013
Smart Alert - Partnering for Total Wellness September 1, 2013
UT SELECT Medical Plan Guide with Prescription Drug Coverage September 1, 2013
Long-Term Care Long Form Application for all other applicants September 1, 2013
Short-Term Disability Benefits Guide September 1, 2013
Quality LASIK for Texas Members September 1, 2013
UT Benefits Billing Reference Guide September 1, 2013
LTD Employer Claim Form September 1, 2013
UT SELECT DENTAL Benefits Guide September 1, 2013
ORP Acknowledgement September 1, 2013
Superior Vision Plus Benefits Guide September 1, 2013
STD Benefit Highlights 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
Recommend Your Dentist September 1, 2013
Accidental Death & Dismemberment Benefits Guide September 1, 2013
Voluntary Retirement Programs Loan and Hardship Options September 1, 2013
DeltaCare - Getting the Most from Your Dental HMO September 1, 2013
Portability and Conversion of Life Insurance September 1, 2013
Tobacco Premium Program Declaration Form September 1, 2013
UTSaver TSA Disclosure Form September 1, 2013
UT SELECT DENTAL Claim Form September 1, 2013
Death Claim Form September 1, 2013
UTSaver DCP - 457(b) Plan Document September 1, 2013
General Counsel
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Non-Disclosure Agreement September 20, 2013
Risk Management
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ACORD Automobile Loss Notice September 6, 2013
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