番茄社区

• Accommodation Request Form

Claim Forms

Life & Accidental Death and Dismemberment (AD&D)

Benefits - Miscellaneous Forms

• Affiliated Postdoctoral Fellow/Graduate Student
  Sponsoring Faculty Form
• Direct Transfer Form
• Incapacitated Child Form
• Waiver of Medical Insurance
• Zip Code Exception Form

UT Select BCBS

• Coordination of Benefits

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  Use to change provider(s) for future retirement contributions

Optional Retirement Program - ORP

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  Use for initial ORP election
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  Use for ORP election for vested participants returning to employment
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  Must be signed by all employees who are newly-eligible for ORP
• ORP Declaration of Retirement
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  Use to transfer balances from one provider to another
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  The TRS 28 must be completed by all participants making their initial ORP election or have an account balance with TRS

Teacher Retirement System - TRS

UTSaver Tax-Sheltered Annuity Program - TSA 403(b)

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  This must be signed before your enrollment into a TSA is effective
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  Use to transfer balances from one provider to another.

UTSaver Deferred Compensation Plan - DCP 457(b)

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  (for Separations only - Vacation Payout to DCP 457(b) account)
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  Use to transfer balances from one provider to another.
• - This must be signed if utilizing the Special Catch-Up Provision and must be accompanied by the 457(b) catch-up worksheet.

UT Benefits Billing (for Retirement Only) - UTBB

Position Management

• Job Description Template

Miscellaneous Forms

• Conflicts of Interest Policy Acknowledgement Form
• I-9 List of Acceptable Documents
• Acknowledgment of Service without Salary for POI/Volunteer
• Acknowledgment of Service without Salary for Vendor Only (Independent Contractors)
• Orientation On The Job Checklist
• Promotion/Transfer Policy

Staff Forms

• ECR - Exception/Correction Request Form
• Political Aid, Legislative Influence and Standards of Conduct

Templates / Sample Documents

• Conditional Employment Offer Letter
• Employment Offer Letter
• Interview Questions

Medical

• Medical Leave Checklist
• Request for Leave of Absence
• Sick Leave Pool Application
• FMLA Adult Child Information Form
• Return to Work Release Form
• Sick Leave Pool Donation Form
• Direct Sick Leave Donation - Recipient
• Direct Sick Leave Donation - Donor
• Family Leave Pool Donation
• Family Leave Pool Request

GINA - Genetic Information Nondiscrimination Act of 2008

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  Download this form with DOL forms below

DOL - Forms and Resources

The Patient Protection and Affordable Care Act (“Affordable Care Act”) amended  (“FLSA”) to require employers to provide “reasonable break time for an employee to express breast milk for her nursing child for one year after the child’s birth each time such employee has need to express the milk.”

As such, UTSA supports moms in the efforts to both work and continue breastfeeding by providing a place, other than a bathroom, that is shielded from view and free from intrusion from coworkers and the public, which may be used to express breast milk. See the attached link for more information. 

For assistance in making arrangements, please contact Leave Administration at  HR@utsa.edu

Leave Administration Miscellaneous Forms and Resources

• Wellness Incentive - Additional Leave Fact Sheet
• University Holidays
• Vacation Accrual Rates

• Change of Address/Telephone or other Contact information
  An employee who is currently employed at 番茄社区 can change their contact information via the Employee Self Service feature in PeopleSoft.
• A former employee or retiree who wishes to make changes to their contact information must contact People Excellence by email HR@utsa.edu or by phone 210-458-7210.

• Acceptance of Resignation Letter (Template)
• Employee Separation Process - Administrator Guidelines
• Separation Processing Checklist

• Class Evaluation Form
• Individual Sign-in Sheet
• Sign-in Sheet