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Medical
Document Office Publish Date File
UT CONNECT Wellness Guidelines Employee Benefits UT CONNECT Wellness Guidelines Perinatal 2021-2022
UT CONNECT Wellness Guidelines Child 2021-2022
UT CONNECT Wellness Guidelines Adult 2021-2022
UT SELECT Health Advocate Solutions FAQs Employee Benefits 2021-2022 UT SELECT Health Advocate Solutions FAQs
UT SELECT Health Advocate Solutions Infographic Employee Benefits 2021-2022 UT SELECT Health Advocate Solutions Infographic
UT SELECT Tobacco Cessation Program Employee Benefits UT SELECT Tobacco Cessation Program
UT SELECT Medical Claim Form Employee Benefits UT SELECT Medical Claim Form
24/7 Nurseline Employee Benefits 24/7 Nurseline
Glossary of Health Coverage and Medical Terms Employee Benefits Glossary of Health Coverage and Medical Terms
Tobacco Premium Program Declaration Form Employee Benefits Tobacco Premium Program Declaration Form
Physician Statement Concerning Tobacco Usage and Fitness to Participate in a Tobacco Cessation Program Employee Benefits Tobacco Cessation Program Physician Statement
UT CONNECT ACO Network Summary of Benefits and Coverage Employee Benefits 2020-2021 Summary of Benefits: UT CONNECT ACO Plan
2020-2021 Summary of Benefits: UT CONNECT ACO Plan (Spanish/Español)
PPO Network Summary of Benefits and Coverage Employee Benefits 2020-2021 Summary of Benefits: PPO Plan
2020-2021 Summary of Benefits: PPO Plan (Spanish/Español)
2019-2020 Summary of Benefits: PPO Plan
2019-2020 Summary of Benefits: PPO Plan (Spanish/Español)
Out-of-Area Network Summary of Benefits and Coverage Employee Benefits 2020-2021 Summary of Benefits: Out-of-Area Plan
2020-2021 Summary of Benefits and Coverage: Out-of-Area Plan (Spanish/Español)
2019-2020 Summary of Benefits: Out-of-Area Plan
2019-2020 Summary of Benefits and Coverage: Out-of-Area Plan (Spanish/Español)
UT CONNECT MDLIVE Information Employee Benefits UT CONNECT MDLIVE Flyer
UT SELECT Health Advocacy Solutions Employee Benefits UT SELECT Health Advocacy Solutions Brochure
Seasons of Life Employee Benefits UT SELECT Seasons of Life Brochure
UT SELECT Seasons of Life Presentation
UT CONNECT Seasons of Life Brochure
UT CONNECT Seasons of Life Presentation
Airrosti Brochure Employee Benefits Recover Faster with Airrosti
UT SELECT Benefits Summary Chart Employee Benefits UT SELECT Benefits Summary Chart 2020-2021
UT SELECT Benefits Summary Chart 2019-2020
UT CONNECT ACO Benefits Summary Chart Employee Benefits UT CONNECT ACO Benefits Summary Chart 2020-2021
UT CONNECT ACO Benefits Summary Chart 2019-2020
UT SELECT Benefits at a Glance Brochure Employee Benefits 2021-2022 UT SELECT Benefits At-a-Glance Brochure
2020-2021 UT SELECT Benefits At-a-Glance Brochure
UT CONNECT ACO Medical Plan FAQs Employee Benefits UT CONNECT FAQs 2021-2022
UT CONNECT FAQs 2020-2021
UT CONNECT Benefit Chart Comparison Employee Benefits UT CONNECT Benefit Chart Comparison 2021-2022
UT CONNECT Benefit Chart Comparison 2020-2021
UT CONNECT Highlights Brochure Employee Benefits UT CONNECT Highlights Brochure 2021-2022
UT CONNECT Highlights Brochure 2020-2021
UT SELECT Hinge Health Overview Employee Benefits Hinge Health FAQs 2021-2022
Hinge Health Highlights 2021-2022
Hinge Health Brochure 2020
Hinge Health Enrollment 2020
UT SELECT Ovia Health Overview Employee Benefits UT SELECT Ovia Health General Overview
UT SELECT Ovia Health Support for LGBTQ Families
UT SELECT Ovia Health Maternity App
UT SELECT Livongo Overview & FAQs Employee Benefits NEW! Livongo Overview Flyer 2021-2022
NEW! Livongo Overview Poster 2021-2022
NEW! Livongo Diabetes Management FAQs 2021-2022
NEW! Livongo Hypertension FAQs 2021-2022
Livongo Brochure 2020
Livongo Hypertension Brochure 2020
Livongo FAQs
UT CONNECT Ovia Health Overview Employee Benefits UT CONNECT Ovia Health Overview
UT CONNECT Ovia Health Support for LGBTQ Families
UT CONNECT Ovia Health Maternity App
UT SELECT MDLIVE Overview Employee Benefits NEW! UT SELECT MDLIVE Brochure 2021
UT SELECT MDLIVE Brochure 2020
UT SELECT Omada Health Overview Employee Benefits NEW! Omada Health Flyer 2021
NEW! Omada Health FAQs 2021
Omada Health Brochure 2020
Omada Health FAQs 2020
UT SELECT Medical Plan Guide with Prescription Drug Coverage Employee Benefits 2021-2022 UT SELECT Benefits Guide
UT Health Network Flyer Employee Benefits UT Health Network Flyer 2021
UT CONNECT ACO Medical Plan Guide with Prescription Drug Coverage Employee Benefits 2021-2022 UT CONNECT ACO Medical Plan Guide
Pharmacy
Document Office Publish Date File
Prescription Drug Reimbursement Form / Coordination of Benefits Claim Form Employee Benefits Prescription Drug Reimbursement Form / Coordination of Benefits Claim Form
UT SELECT Part D Mail Order Form UT SELECT Part D Mail Order Form
UT SELECT Part D Presentation UT SELECT Part D Presentation
UT SELECT Part D Language Services UT SELECT Part D Language Services
Prescriptions by Mail Order Form Employee Benefits Prescriptions by Mail Order Form
UT SELECT Part D Welcome Kit Employee Benefits 2021 UT SELECT Part D Welcome Kit
UT SELECT Part D Contacts Employee Benefits UT SELECT Part D Contacts
UT SELECT Part D Benefit Overview Employee Benefits 2021 UT SELECT Part D Benefit Overview
UT SELECT Part D Welcome Kit Letter Employee Benefits 2021 UT SELECT Part D Welcome Kit Letter
UT SELECT Part D Evidence of Coverage Employee Benefits UT SELECT Part D Evidence of Coverage
UT SELECT Part D Formulary Employee Benefits 2021 UT SELECT Part D Formulary
Prescription Drug Co-payments at a Glance Employee Benefits NEW! UT SELECT Prescription Drug Program at-a-Glance 2021-2022
NEW! UT SELECT Medicare Part D Prescription Drug Program at-a-Glance 2021-2022
NEW! UT CONNECT Prescription Drug Program at-a-Glance 2021-2022
UT SELECT Prescription Drug Program at-a-Glance 2020-2021
UT SELECT Medicare Part D Prescription Drug Program at-a-Glance 2020-2021
UT CONNECT Prescription Drug Program at-a-Glance 2020-2021
Vision
Document Office Publish Date File
Smart Alert - Partnering for Total Wellness Employee Benefits Superior Vision Smart Alert
Getting Started with the Online Member Portal Employee Benefits Superior Vision Online Member Portal
Superior Vison Claim Form Employee Benefits Superior Vison Claim Form
Superior Vision Plan Brochure Employee Benefits Superior Vision Plan Brochure
Quality LASIK for Texas Members Employee Benefits Quality LASIK for Texas Members
Superior Vision Standard Benefits Guide Employee Benefits Superior Vision Basic Plan Certificate
Superior Vision Plan Amendment (eff. 9/1/2017)
Superior Vision Plus Benefits Guide Employee Benefits Superior Vision Plus Plan Certificate
Superior Vision Plan Amendment (eff. 9/1/2017)
The Importance of an Eye Exam Employee Benefits Superior Vision: The Importance of an Eye Exam
Superior Vision Plan Highlights Employee Benefits Superior Vision Highlights 2021-2022
Superior Vision Online Retailers Employee Benefits Superior Vision Online Contacts and Lenses Retailers
Superior Vision Member Discounts Employee Benefits Superior Vision Member Discounts
Superior Vision Member Hearing Network Discount
Finding-In-Network Providers Employee Benefits Find an In-Network Eye Care Professional 2021
Superior Vision Online Providers 2021
Tips Caring for your Eyes Wearing Contacts Employee Benefits Tips for Caring for your Eyes While Wearing Contacts
Superior Vision Mobile App Employee Benefits Superior Vision Mobile App 2021
Special Notices
Document Office Publish Date File
HIPAA Request for Amendment of Protected Health Information Employee Benefits HIPAA Request for Amendment of Protected Health Information Form
HIPAA Request for Restriction on Use or Disclosure of Protected Health Information Employee Benefits HIPAA Request for Restriction Form
HIPAA Breach Log Employee Benefits HIPAA Breach Log
HIPAA Request for Confidential Communications of Medical Information Employee Benefits HIPAA Request for Confidential Communications of Medical Information Form
Notice of Creditable Coverage (NOCC) Employee Benefits Medicare Part D Notice of Creditable Coverage
HIPAA Staff Assistance Authorization Employee Benefits HIPAA Staff Assistance Authorization
HIPAA Complaint Form Employee Benefits HIPAA Complaint Form
HIPAA General Authorization Form Employee Benefits HIPAA General Authorization Form
HIPAA Request for Access to Protected Health Information Employee Benefits Request for Access Form
HIPAA Revocation of Authorization Employee Benefits HIPAA Revocation of Authorization Form
HIPAA Request for Accounting of Disclosures Employee Benefits HIPAA Request for Accounting of Disclosues Form
BAC By-Laws Employee Benefits BAC By-laws
Nondiscrimination and Accessibility Notice Employee Benefits Nondiscrimination and Accessibility Notice
Affordable Care Act - Marketplace Notices Employee Benefits UT Arlington ACA Notice
UT Austin ACA Notice
UT Dallas ACA Notice
UT El Paso ACA Notice
UT Health Houston ACA Notice
UT Health San Antonio ACA Notice
UT Health Northeast ACA Notice
UT Medical Branch Galveston ACA Notice
UT MD Anderson Cancer Center ACA Notice
UT Permian Basin ACA Notice
UT Rio Grande Valley ACA Notice
UT San Antonio ACA Notice
UT Southwestern Medical Center ACA Notice
UT System Administration ACA Notice
UT Tyler ACA Notice
Medicaid and the Children's Health Insurance Program (CHIP) Notice Employee Benefits Medicaid and the Children's Health Insurance Program (CHIP) Notice
Legal Notices Employee Benefits UT Benefits - Legal Notices 2021
UT Benefits - Legal Notices 2020
UT Retirement Program
Document Office Publish Date File
DCP Catch-Up Provision Agreement Employee Benefits DCP Catch-Up Provision Agreement
Purchase Change Agreement (All plans) Employee Benefits UT Retirement Purchase Change Agreement (All plans)
ORP Authorization for Reduction for Employee Contribution RETURNING EMPLOYEE Employee Benefits ORP Authorization for Reduction for Employee Contribution RETURNING EMPLOYEE
UT Transfer Verification Form (All plans) Employee Benefits UT Transfer Verification Form (All plans)
UTSaver TSA Disclosure Form Employee Benefits UTSaver TSA Disclosure Form
ORP Authorization for Reduction for Employee Contribution Employee Benefits ORP Authorization for Reduction for Employee Contribution
Vendor Services Employee Benefits Vendor Services for Retirement Participants
ORP Acknowledgement Employee Benefits ORP Acknowledgement
Vesting/Termination Status Form Employee Benefits Vesting/Termination Status Form
DCP Purchase Agreement Employee Benefits DCP Purchase Agreement
TRS Form 28 (Notice to Elect to Participate in Optional Retirement Program and/or Refund) Employee Benefits TRS Form 28 (Oct 2019)
Voluntary Retirement Programs Loan and Hardship Options Employee Benefits Voluntary Retirement Programs Loan and Hardship Options
Annual Eligibility Notice for Retirement Plans Employee Benefits Annual Eligibility Notice for Retirement Plans
Retirement Program Sales Solicitation Agreement Employee Benefits Retirement Program Sales Solicitation Agreement
Voluntary Retirement Programs At a Glance Employee Benefits Voluntary Retirement Programs
Summary of Retirement Programs Employee Benefits Retirement Programs Summary
Comparison of Traditional, Roth 403(b), and Roth IRA Contributions Employee Benefits Comparison of Traditional, Roth 403(b), and Roth IRA Contributions
Overview of TRS and ORP Employee Benefits TRS and ORP Overview - July 2021
Benefits Handbooks and Cost Worksheet
Document Office Publish Date File
Annual Enrollment & Resource Guide for Employees Employee Benefits NEW! 2021-2022 Annual Enrollment & Resource Guide for Employees
2020-2021 Annual Enrollment & Resource Guide for Employees
Annual Enrollment Highlights for Employees Employee Benefits NEW! 2021-2022 Annual Enrollment Highlights for Employees
2020-2021 Annual Enrollment Highlights for Employees
Annual Enrollment & Resource Guide for Retired Employees Employee Benefits NEW! 2021-2022 Annual Enrollment & Resource Guide for Retired Employees
2020-2021 Annual Enrollment & Resource Guide for Retired Employees
Annual Enrollment Highlights for Retired Employees Employee Benefits NEW! 2021-2022 Annual Enrollment Highlights for Retired Employees
2020-2021 Annual Enrollment Highlights for Retired Employees
Benefits Cost Worksheet for Retired Employees Employee Benefits NEW! 2021-2022 Retired Employee Cost Worksheet
2020-2021 Retired Employee Cost Worksheet
Benefits Cost Worksheet for Employees Employee Benefits NEW! 2021-2022 Active Employee Cost Worksheet
2020-2021 Active Employee Cost Worksheet
UT Benefits Enrollment Guide for Employees Employee Benefits 2021-2022 UT Benefits Enrollment Guide for Employees
2020-2021 UT Benefits Enrollment Guide for Employees
UT Benefits Enrollment Guide for Retiring Employees Employee Benefits 2021-2022 UT Benefits Enrollment Guide for Retiring Employees
2020-2021 UT Benefits Enrollment Guide for Retiring Employees
Retirement Plan Publications
Document Office Publish Date File
UTSaver Retirement Plans Brochure Employee Benefits 2020-2021 UTSaver Retirement Plans: The Best Start
UT CARES Act Employee Benefits UT CARES Act
AIG Retirement Services Information Employee Benefits AIG Retirement Services Highlights
NEW! AIG Retirement Services Market Commentary 2021
AIG Retirement Services Market Commentary 2020
Voya Financial Information Employee Benefits Voya Financial: Brochure 2021
Voya Financial: Boost Your Savings 2021
Voya Financial: Your Journey to Financial Wellness 2021
Voya Financial: Financial Wellness Webinars 2021
Voya Financial: 10 Reasons to Enroll in Your Employer’s Retirement Plan
Voya Financial: Brochure 2020
Voya Financial: Your Journey to Financial Wellness 2020
Fidelity Investments Information Employee Benefits NEW! Fidelity Investments Virtual Benefits Fair Info 2021
NEW! Fidelity Investments Mobile App 2021
Fidelity Investments Brochure
Fidelity Investments Mobile app Flyer 2020
Fidelity Investments Virtual Benefits Fair Info 2020
TIAA Information Employee Benefits TIAA Unprecedented Time of Uncertainty
NEW! TIAA Benefits of One Percent
NEW! TIAA Benefit of Starting Now
NEW! TIAA Diversification and Market Volatility
NEW! TIAA Staying on Track
Lincoln Financial Information Employee Benefits NEW! 2021 Lincoln Financial Group Brochure
NEW! 2021 Lincoln Financial Group UT Enrollment Guide
NEW! 2021 Lincoln Financial Group Plan Representative & Support
2020 Lincoln Financial Virtual Benefits Booth