Internal Forms

Employment Information

(New hire paperwork, I-9 forms, etc.)

 

 GENERAL and ADMINISTRATIVE

Address/Name/Department Change Form
Background Check Form
Concurrent Employment
Employee Probationary Period Review Form
Classified Performance Evaluation (PDF)
Classified Performance Evaluation (DOC)
Non-Classified Performance Evaluation Training
Non-Classified Performance Evaluation
Grievance Policy
Grievance Petition

BENEFITS

Cafeteria Plan (Datapath)

How to Submit a Claim
FSA Claim Form
Cafeteria Plan/Flexible Spending Account
Debit Card Request
Flex Account Login (7 easy steps)

Dental

Blue Cross Dental Application and Change Form
BC Dental Claim Form

Vision

Superior- Coverage Change Form

GAP

GAP Enrollment/Change Form
GAP Claim Form

Instructions on Printing Explanation of Benefits 

* Point of Service Health Plan
2017

* High Deductible Health Plan
2017

Health

Electronic 1095C

UHC Enrollment/ Change Form
UHC Marketplace Notice

OPTUM Pharmacy Reimbursement Claim Form
OPTUM Prescription Mail Order Form
Health Claims Transmittal
Instructions for Health Explanation of Benefits

Life Insurance

USAble Life Beneficiary Change Form

Retirement

Arkansas State Public Retirement System Forms
Arkansas Teachers Retirement System Forms
Retirement Salary Reduction Form
TIAA Forms
TIAA Website
VALIC Contact Information

Supplemental Products

Allstate Wellness Claim Form
Allstate Accident/Disability Claim Form
Allstate Cancer/Specified Disease/ICU/Heart/Stroke Claim Form
Supplemental Cancellation Form
Vision- Enrollment Change Form

Tuition Remission

Tuition Remission Form

Workers Compensation

The Company Nurse Injury Hotline
Job Injury Reporting Instructions
Frequently Asked Questions
Incident Report
Mileage Report
Poster H
Poster P