Publications

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 2022
Title Published Office File(s) Page
Prescriptions by Mail Order Form Employee Benefits Prescriptions by Mail Order Form More Info on Prescriptions by Mail Order Form
Prescription Drug Reimbursement Form / Coordination of Benefits Claim Form Employee Benefits Prescription Drug Reimbursement Form / Coordination of Benefits Claim Form More Info on Prescription Drug Reimbursement Form / Coordination of Benefits Claim Form
UT SELECT Part D Evidence of Coverage Employee Benefits UT SELECT Part D Evidence of Coverage More Info on UT SELECT Part D Evidence of Coverage
Delta Dental Newsletter Employee Benefits Delta Dental e-Magazine Information More Info on Delta Dental Newsletter
Delta Dental Wellness Information Employee Benefits Delta Dental Wellness Presentation 2022-2023 More Info on Delta Dental Wellness Information
June 2022
Title Published Office File(s) Page
New Retirement Manager Admin Login Employee Benefits Guide to New Retirement Manager Admin Login More Info on New Retirement Manager Admin Login
Glossary of Health Coverage and Medical Terms Employee Benefits Uniform Glossary of Health Coverage and Medical Terms More Info on Glossary of Health Coverage and Medical Terms
March 2022
Title Published Office File(s) Page
Purchase Change Agreement (All plans) Employee Benefits UT Retirement Purchase Change Agreement (All plans) More Info on Purchase Change Agreement (All plans)
Annual Leave Deferral Agreement Employee Benefits Annual Leave Deferral Agreement More Info on Annual Leave Deferral Agreement
February 2022
Title Published Office File(s) Page
Weathering the Storm Employee Benefits Weathering the Storm More Info on Weathering the Storm
UTSaver Loan and Inservice Distribution Options Employee Benefits UTSaver Loan and Inservice Distribution Options More Info on UTSaver Loan and Inservice Distribution Options
UT SELECT Medical Claim Form Employee Benefits UT SELECT Medical Claim Form More Info on UT SELECT Medical Claim Form
November 2021
Title Published Office File(s) Page
HUB Annual Report 2021 and Supplemental Letter Historically Underutilized Business FY 2021-Annual Report
FY 2021 Supplemental Letter 		More Info on HUB Annual Report 2021 and Supplemental Letter
Record of Revisions Employee Benefits Record of Revisions More Info on Record of Revisions
570. UT FLEX Program Employee Benefits UT FLEX Program More Info on 570. UT FLEX Program
October 2021
Title Published Office File(s) Page
Section 55.03 FY 2021 Annual Report Historically Underutilized Business FY 2021-55.03 Report More Info on Section 55.03 FY 2021 Annual Report
September 2021
Title Published Office File(s) Page
Short Term Disability Brochure Employee Benefits NEW! 2021-2022 Short Term Disability Brochure
2020-2021 Short Term Disability Brochure 		More Info on Short Term Disability Brochure
Long-Term Disability Benefit Highlights Employee Benefits NEW! 2021-2022 Long Term Disability Brochure
2020-2021 Long Term Disability Brochure 		More Info on Long-Term Disability Benefit Highlights
230. Dependents Employee Benefits Dependents More Info on 230. Dependents
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
July 2021
Title Published Office File(s) Page
UT System Administration Standards of Conduct Systemwide Compliance UT System Administration Standards of Conduct More Info on UT System Administration Standards of Conduct
MDLIVE Overview and Registration Info Employee Benefits MDLIVE Overview and Registration Flyer More Info on MDLIVE Overview and Registration Info
Hinge Health Tip Sheets Employee Benefits Hinge Health Desk Exercises Tip Sheet
Hinge Health Find Your Fifteen Tip Sheet
Hinge Health Muscle Mindfulness Tip Sheet
Hinge Health Stand All Day Tip Sheet
Hinge Health Work From Home Tip Sheet 		More Info on Hinge Health Tip Sheets
Vision Plans Annual Enrollment Overview Employee Benefits Vision Plans Annual Enrollment Overview 2021-2022 More Info on Vision Plans Annual Enrollment Overview
December 2020
Title Published Office File(s) Page
UT CARE Part D Contacts Employee Benefits UT CARE Part D Contacts More Info on UT CARE Part D Contacts
UT Benefits Billing Sample Monthly Statement Employee Benefits UT Benefits Billing Sample Monthly Statement More Info on UT Benefits Billing Sample Monthly Statement
UT CARES Act Employee Benefits UT CARES Act More Info on UT CARES Act
October 2020
Title Published Office File(s) Page
Section 55.03 FY 2020 Annual Report Historically Underutilized Business FY 2020-55.03 Report More Info on Section 55.03 FY 2020 Annual Report
Grandchild Certification Form Employee Benefits Dependent Grandchild Certification Form More Info on Grandchild Certification Form
September 2020
Title Published Office File(s) Page
140. Funding for Group Insurance Coverage Employee Benefits Funding for Group Insurance Coverage More Info on 140. Funding for Group Insurance Coverage
210. Employees Employee Benefits Employee Eligibility and Enrollment More Info on 210. Employees
220. Retired Employees Employee Benefits Retired Employee Eligibility and Enrollment More Info on 220. Retired Employees
240. Surviving Dependents Employee Benefits Surviving Dependents More Info on 240. Surviving Dependents
250. COBRA Participants Employee Benefits COBRA More Info on 250. COBRA Participants
707. Retroactive Eligibility Adjustments Employee Benefits Retroactive Eligibility Adjustments More Info on 707. Retroactive Eligibility Adjustments
August 2020
Title Published Office File(s) Page
HUB Annual Report 2020 and Supplemental Letter Historically Underutilized Business Annual Report
Supplemental Letter 		More Info on HUB Annual Report 2020 and Supplemental Letter
UT ISOS ID Card Risk Management UT ISOS Card 2020 More Info on UT ISOS ID Card
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
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
April 2020
Title Published Office File(s) Page
Section 55.03: FY 2017 Annual Report Historically Underutilized Business Report Summary
Report Detail
Report Contract Counts 		More Info on Section 55.03: FY 2017 Annual Report
HUB Subcontracting Plan (HSP) Prime Contractor Progress Assessment Report Historically Underutilized Business Instruction for Prime Contractor Progress Assessment Report
Progress Assessment Report (PAR) 		More Info on HUB Subcontracting Plan (HSP) Prime Contractor Progress Assessment Report
March 2020
Title Published Office File(s) Page
Long-Term Disability Conversion Kit Employee Benefits Long Term Disability Conversion Kit More Info on Long-Term Disability Conversion Kit
LTD Employer Claim Form Employee Benefits LTD Employer Claim Form More Info on LTD Employer Claim Form
Beneficiary Designation Form Employee Benefits Beneficiary Designation Form More Info on Beneficiary Designation Form
Accidental Dismemberment Claim Form Employee Benefits Accidental Dismemberment Claim Form More Info on Accidental Dismemberment Claim Form
Death Claim Form Employee Benefits Death Claim Form More Info on Death Claim Form
Life Portability Application Employee Benefits Life Portability Application More Info on Life Portability Application
Life Conversion Application Employee Benefits Application to Convert Group Life Insurance More Info on Life Conversion Application
LTD Employee Claim Form Employee Benefits LTD Employee Claim Form More Info on LTD Employee Claim Form
December 2019
Title Published Office File(s) Page
Claim Reporting Instructions Risk Management CHUBB USA Claim Reporting Instructions 2020 More Info on Claim Reporting Instructions
Medical Claim Form Risk Management 2020 Medical Claim Form More Info on Medical Claim Form
Trip Cancellation Claim Form Risk Management 2020 Trip Cancellation Claim Form More Info on Trip Cancellation Claim Form
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
December 2018
Title Published Office File(s) Page
UT System Population Health Strategic Plan Population Health Population Health Strategic Plan More Info on UT System Population Health Strategic Plan
September 2018
Title Published Office File(s) Page
160. Tobacco Premium Program Employee Benefits Policy 160 Tobacco Premium Program More Info on 160. Tobacco Premium Program
701. Premium Billing & Remittance Employee Benefits Premium Billing & Remittance More Info on 701. Premium Billing & Remittance
Fast Facts Institutional Research and Analysis Fast Facts September 2018 More Info on Fast Facts
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
June 2018
Title Published Office File(s) Page
121. Benefits Advisory Committee Employee Benefits Benefits Advisory Committee More Info on 121. Benefits Advisory Committee
April 2018
Title Published Office File(s) Page
HUB Annual Report 2017 & Supplemental Letter Historically Underutilized Business Annual Report
Supplemental Letter 		More Info on HUB Annual Report 2017 & Supplemental Letter
March 2018
Title Published Office File(s) Page
574. Institution-based Voluntary Plans Employee Benefits Institution-based Voluntary Plans More Info on 574. Institution-based Voluntary Plans
December 2017
Title Published Office File(s) Page
Retirement Eligibility Flowchart Employee Benefits Retirement Eligibility Flowchart More Info on Retirement Eligibility Flowchart
September 2017
Title Published Office File(s) Page
Introduction Employee Benefits Introduction to OEB Administrative Manual More Info on Introduction
111. Uniform Insurance Benefits Act Employee Benefits Uniform Insurance Benefits Act More Info on 111. Uniform Insurance Benefits Act
120. Office of Employee Benefits Administration Employee Benefits Office of Employee Benefits Administration More Info on 120. Office of Employee Benefits Administration
130. Office of Employee Benefits Terms and Definitions Employee Benefits Office of Employee Benefits Terms and Definitions More Info on 130. Office of Employee Benefits Terms and Definitions
211. Certain Non-Employees Employee Benefits Certain Non-Employees More Info on 211. Certain Non-Employees
270. Evidence of Insurability (EOI) Employee Benefits Evidence of Insurability (EOI) More Info on 270. Evidence of Insurability (EOI)
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
May 2017
Title Published Office File(s) Page
The University of Texas System Police Annual Report. 2016 Police Annual Report More Info on The University of Texas System Police Annual Report. 2016
The UT System Police Department Annual Contact Report - 2016 Police Racial Profiling Report 2016 More Info on The UT System Police Department Annual Contact Report - 2016
April 2017
Title Published Office File(s) Page
Quality LASIK for Texas Members Employee Benefits Quality LASIK for Texas Members More Info on Quality LASIK for Texas Members
Superior Vision Plan Brochure Employee Benefits Superior Vision Plan Brochure More Info on Superior Vision Plan Brochure
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
Fast Facts 2016 Institutional Research and Analysis Fast Facts 2016
Fast Facts 2016 - Winter Update, Feb 2017 		More Info on Fast Facts 2016
HIPAA Policy Section 4.2: Access to System PHI Employee Benefits HIPAA Policy Section 4.2: Access to System PHI More Info on HIPAA Policy Section 4.2: Access to System PHI
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