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Publications are communication focused documents, booklets, forms and references. The focus of these documents are to relay helpful information about the UT System, employee benefit information, campuses facts and more.

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July 2023
Title Published Office File(s) Page
UT FLEX Maestro Health Brochure Employee Benefits NEW! UT FLEX Maestro Health Brochure 2023
UT FLEX Maestro Health Brochure 2022
More Info on UT FLEX Maestro Health Brochure
UT FLEX How to Use Your Flexible Spending Account Employee Benefits UT FLEX How to Use Your Flexible Spending Account More Info on UT FLEX How to Use Your Flexible Spending Account
Life, AD&D, and Disability Insurance Overview Employee Benefits Life, AD&D, and Disability Highlights 2023
Long-Term Disability (LTD) Highlights 2023
Short-Term Disability (STD) Highlights 2023
Group Term Life Benefit for Retired Employees
More Info on Life, AD&D, and Disability Insurance Overview
Group Term Life Brochure for Retired Employees Employee Benefits Group Term Life Brochure for Retired Employees More Info on Group Term Life Brochure for Retired Employees
Annual Enrollment & Resource Guide for Employees Employee Benefits NEW! 2023-2024 Annual Enrollment & Resource Guide for Employees
2022-2023 Annual Enrollment & Resource Guide for Employees
More Info on Annual Enrollment & Resource Guide for Employees
Annual Enrollment & Resource Guide for Retired Employees Employee Benefits NEW! 2023-2024 Annual Enrollment & Resource Guide for Retired Employees
2022-2023 Annual Enrollment & Resource Guide for Retired Employees
More Info on Annual Enrollment & Resource Guide for Retired Employees
Benefits Cost Worksheet for Employees Employee Benefits 2023-2024 Active Employee Cost Worksheet
2022-2023 Active Employee Cost Worksheet
More Info on Benefits Cost Worksheet for Employees
Benefits Cost Worksheet for Retired Employees Employee Benefits 2023-2024 Retired Employee Cost Worksheet
2022-2023 Retired Employee Cost Worksheet
More Info on Benefits Cost Worksheet for Retired Employees
Annual Enrollment Highlights for Employees Employee Benefits NEW! 2023-2024 Annual Enrollment Highlights for Employees
2022-2023 Annual Enrollment Highlights for Employees
More Info on Annual Enrollment Highlights for Employees
Annual Enrollment Highlights for Retired Employees Employee Benefits NEW! 2023-2024 Annual Enrollment Highlights for Retired Employees
2022-2023 Annual Enrollment Highlights for Retired Employees
More Info on Annual Enrollment Highlights for Retired Employees
Living Well Resources Guide Employee Benefits Living Well Resources Guide 2023-2024 More Info on Living Well Resources Guide
SFA Benefits Comparison Employee Benefits SFA Benefits Comparison for Employees and Retirees More Info on SFA Benefits Comparison
Living Well Platform How to Guide Employee Benefits Living Well Platform How to Guide More Info on Living Well Platform How to Guide
Benefits Coverage Mapping for SFA Employees & Retirees Employee Benefits Benefits Coverage Mapping for SFA Employees
Benefits Coverage Mapping for SFA Retirees
More Info on Benefits Coverage Mapping for SFA Employees & Retirees
September 2022
Title Published Office File(s) Page
Group Term Life Certificate Employee Benefits Group Term Life Certificate More Info on Group Term Life Certificate
Accidental Death & Dismemberment Certificate Employee Benefits Accidental Death & Dismemberment Certificate More Info on Accidental Death & Dismemberment Certificate
COBRA General Notice Employee Benefits COBRA General Notice for the 2022-2023 Plan Year More Info on COBRA General Notice
March 2020
Title Published Office File(s) Page
Beneficiary Designation Form Employee Benefits Beneficiary Designation Form More Info on Beneficiary Designation Form
Life and AD&D Brochure for Active Employees Employee Benefits Life and AD&D Benefit Brochure for Active Employees More Info on Life and AD&D Brochure for Active Employees
July 2018
Title Published Office File(s) Page
Medicaid and the Children's Health Insurance Program (CHIP) Notice Employee Benefits Medicaid and the Children's Health Insurance Program (CHIP) Notice More Info on Medicaid and the Children's Health Insurance Program (CHIP) Notice
August 2021
Title Published Office File(s) Page
Notice of Creditable Coverage (NOCC) Employee Benefits Medicare Part D Notice of Creditable Coverage More Info on Notice of Creditable Coverage (NOCC)
Overview of TRS and ORP Employee Benefits TRS and ORP Overview - July 2021 More Info on Overview of TRS and ORP
March 2017
Title Published Office File(s) Page
BAC By-Laws Employee Benefits BAC By-laws More Info on BAC By-Laws
February 2017
Title Published Office File(s) Page
HIPAA Request for Access to Protected Health Information Employee Benefits Request for Access Form More Info on HIPAA Request for Access to Protected Health Information
HIPAA Staff Assistance Authorization Employee Benefits HIPAA Staff Assistance Authorization More Info on HIPAA Staff Assistance Authorization
HIPAA General Authorization Form Employee Benefits HIPAA General Authorization Form More Info on HIPAA General Authorization Form
HIPAA Request for Accounting of Disclosures Employee Benefits HIPAA Request for Accounting of Disclosues Form More Info on HIPAA Request for Accounting of Disclosures
HIPAA Revocation of Authorization Employee Benefits HIPAA Revocation of Authorization Form More Info on HIPAA Revocation of Authorization
HIPAA Complaint Form Employee Benefits HIPAA Complaint Form More Info on HIPAA Complaint Form
September 2013
Title Published Office File(s) Page
HIPAA Request for Amendment of Protected Health Information Employee Benefits 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 Employee Benefits HIPAA Request for Confidential Communications of Medical Information Form More Info on HIPAA Request for Confidential Communications of Medical Information
HIPAA Request for Restriction on Use or Disclosure of Protected Health Information Employee Benefits HIPAA Request for Restriction Form More Info on HIPAA Request for Restriction on Use or Disclosure of Protected Health Information
HIPAA Breach Log Employee Benefits HIPAA Breach Log More Info on HIPAA Breach Log
DCP Catch-Up Provision Agreement Employee Benefits DCP Catch-Up Provision Agreement More Info on DCP Catch-Up Provision Agreement
UTSaver TSA Disclosure Form Employee Benefits UTSaver TSA Disclosure Form More Info on UTSaver TSA Disclosure Form
UT Transfer Verification Form (All plans) Employee Benefits UT Transfer Verification Form (All plans) More Info on UT Transfer Verification Form (All plans)
ORP Authorization for Reduction for Employee Contribution RETURNING EMPLOYEE Employee Benefits ORP Authorization for Reduction for Employee Contribution RETURNING EMPLOYEE More Info on ORP Authorization for Reduction for Employee Contribution RETURNING EMPLOYEE
ORP Authorization for Reduction for Employee Contribution Employee Benefits ORP Authorization for Reduction for Employee Contribution More Info on ORP Authorization for Reduction for Employee Contribution
UT Benefits Billing Reference Guide Employee Benefits UT Benefits Billing Reference Guide More Info on UT Benefits Billing Reference Guide
Helpful Hints for Completing the Direct Payment Agreement Employee Benefits Helpful Hints for Completing the Direct Payment Agreement More Info on Helpful Hints for Completing the Direct Payment Agreement
August 2023
Title Published Office File(s) Page
Legal Notices Employee Benefits UT Benefits - Legal Notices 2023 (effective September 1, 2023)
UT Benefits - Legal Notices 2022
More Info on Legal Notices
Insurance FAQs for Stephen F. Austin State University Employee Benefits Insurance FAQs for SFA University Members More Info on Insurance FAQs for Stephen F. Austin State University
June 2017
Title Published Office File(s) Page
Nondiscrimination and Accessibility Notice Employee Benefits Nondiscrimination and Accessibility Notice More Info on Nondiscrimination and Accessibility Notice
March 2022
Title Published Office File(s) Page
Annual Leave Deferral Agreement Employee Benefits Annual Leave Deferral Agreement More Info on Annual Leave Deferral Agreement
Purchase Change Agreement (All plans) Employee Benefits UT Retirement Purchase Change Agreement (All plans) More Info on Purchase Change Agreement (All plans)
February 2022
Title Published Office File(s) Page
UTSaver Loan and Inservice Distribution Options Employee Benefits UTSaver Loan and Inservice Distribution Options More Info on UTSaver Loan and Inservice Distribution Options
Weathering the Storm Employee Benefits Weathering the Storm More Info on Weathering the Storm
December 2015
Title Published Office File(s) Page
Vesting/Termination Status Form Employee Benefits Vesting/Termination Status Form More Info on Vesting/Termination Status Form
October 2019
Title Published Office File(s) Page
TRS Form 28 (Notice to Elect to Participate in Optional Retirement Program and/or Refund) Employee Benefits TRS Form 28 (Oct 2019) More Info on TRS Form 28 (Notice to Elect to Participate in Optional Retirement Program and/or Refund)
January 2015
Title Published Office File(s) Page
ORP Acknowledgement Employee Benefits ORP Acknowledgement More Info on ORP Acknowledgement
March 2023
Title Published Office File(s) Page
Annual Eligibility Notice for Retirement Plans Employee Benefits Annual Eligibility Notice for Retirement Plans More Info on Annual Eligibility Notice for Retirement Plans
November 2023
Title Published Office File(s) Page
Vendor Services Employee Benefits Vendor Services for Retirement Participants More Info on Vendor Services
UT Benefits Billing for COBRA Direct Payment/Debit Authorization Agreement Employee Benefits UT Benefits Billing for COBRA Direct Payment/Debit Authorization Agreement More Info on UT Benefits Billing for COBRA Direct Payment/Debit Authorization Agreement
TRS Annuity Deduction Form Employee Benefits TRS Annuity Deduction Form More Info on TRS Annuity Deduction Form
June 2020
Title Published Office File(s) Page
Retirement Program Sales Solicitation Agreement Employee Benefits Retirement Program Sales Solicitation Agreement More Info on Retirement Program Sales Solicitation Agreement
December 2020
Title Published Office File(s) Page
UT Benefits Billing Direct Payment/Debit Authorization Agreement Employee Benefits Direct Payment/Debit Authorization Agreement More Info on UT Benefits Billing Direct Payment/Debit Authorization Agreement
UT Benefits Billing Sample Monthly Statement Employee Benefits UT Benefits Billing Sample Monthly Statement More Info on UT Benefits Billing Sample Monthly Statement
September 2019
Title Published Office File(s) Page
Personal Information and Emergency Contact Form Employee Benefits Personal Information and Emergency Contact Form More Info on Personal Information and Emergency Contact Form
July 2020
Title Published Office File(s) Page
UT System Cafeteria Plan Document Employee Benefits UT System Cafeteria Plan Document More Info on UT System Cafeteria Plan Document
October 2020
Title Published Office File(s) Page
Grandchild Certification Form Employee Benefits Dependent Grandchild Certification Form More Info on Grandchild Certification Form
February 2024
Title Published Office File(s) Page
Office of Employee Benefits Organizational Chart Employee Benefits Office of Employee Benefits Organizational Chart More Info on Office of Employee Benefits Organizational Chart
January 2022
Title Published Office File(s) Page
BCBSTX Identity Protection Services Employee Benefits BCBSTX Identity Protection Services More Info on BCBSTX Identity Protection Services