Claim Forms
Advantage/Flexible Spending Account Reimbursement (CBA/EPBA) (PDF)
Dental Claim (CIGNA) (PDF)
Health Plan Claim (CIGNA) (PDF)
Vision Claim (CIGNA) (PDF)
Advantage / Flexible Spending Account Forms
Additional Card Request (PDF)
Leave, Retirement and Salary Reduction Programs
Family and Medical Leave (PDF)
Incentive Retirement (PDF) Policy (PDF)
Partial/Phased Retirement Program (PPRP) Application (PDF) Policy (PDF)
Salary Reduction Agreement for Faculty and Salaried Employees (PDF)
Salary Reduction Agreement for Hourly Paid Employees (PDF)
Tuition Waivers
Tuition Waiver – Employee (PDF)
Tuition Waiver – Employee’s Dependent (PDF)
Other Benefits Forms
Authorization for the Use and/or Disclosure of Protected Health Information (HIPPA) (PDF)
Biometrics Screenings – Physician (PDF)
Worker’s Compensation Incident Report