HR Related Forms and Documents
Note: i=interactive
Title
 | Description | Category
|
|---|---|---|
Benefits FAQ - State Employees
 |
Benefits FAQ - State Employees | Health Insurance, Dental and Vision |
| 2013 NYS Summary of Benefits Coverage: HMOBlue
|
Simple and standardized comparison document required by the Patient Protection and Affordable Care Act (PPACA) | Health Insurance, Dental and Vision |
| UUP Laser Vision Correction Direct Reimbursement Claim Form | UUP employees can use this form to request reimbursement for Laser Vision Correction services received. | Health Insurance, Dental and Vision |
| Health Insurance Ineligibility Formi
|
Employees who are ineligible for New York State health insurance are required to sign this form. | Health Insurance, Dental and Vision |
| Health Insurance Pre-Tax Contribution Programi
|
Information on pre-tax health insurance premium contributions | Health Insurance, Dental and Vision |
| Health Insurance - Proof of Eligibility
|
Explains proof of eligibility a New York State employee must provide in order to in enroll NYSHIP. | Health Insurance, Dental and Vision |
| Research Foundation Benefits Enrollment Form
|
Used by Research Foundation employees to enroll in or make changes to benefits | Health Insurance, Dental and Vision |
| Research Foundation HMO Enrollment Form
|
Used by Research Foundation employees to enroll in or make changes to their HMO. | Health Insurance, Dental and Vision |
| Research Foundation MVP Enrollment Formi
|
Used by Research Foundation employees to enroll in or make changes to their MVP health plan | Health Insurance, Dental and Vision |
| Dental Claim Form - Delta - UUP
|
Effective 04/01/2008 UUP employees can use this form to make a dental claim. | Health Insurance, Dental and Vision |
| 2013 On the Road with the Empire Plan
|
NYSHIP Empire Plan Medical Insurance information for services provided when traveling or outside of regular residency | Health Insurance, Dental and Vision |
| Research Foundation Benefits Outline
|
Research Foundation Benefits Outline | Health Insurance, Dental and Vision |
| 2013 Research Foundation Bi-Weekly Health Insurance Rates
|
Lists the bi-weekly employee cost for the various health insurance plans while in a paid or leave without paid status | Health Insurance, Dental and Vision |
| NYS 2013 Flexible Spending Account Online Enrollment Guide
|
NYS 2013 Flexible Spending Account Online Enrollment Guide | Health Insurance, Dental and Vision |
| 2013 NYS Health Insurance Rates
|
NYS Health Insurance Rates - NYS Health Insurance Rates | Health Insurance, Dental and Vision |
| Research Foundation Delta Dental Fact Sheet
|
Research Foundation Delta Dental Fact Sheet | Health Insurance, Dental and Vision |
| Choices 2013 for CSEA and PEF represented and M/C affiliated employees (settled groups)
|
Choices 2013 for CSEA and PEF represented and M/C affiliated employees (settled groups) | Health Insurance, Dental and Vision |
| Vision FAQ-Davis Vision
|
FAQ New York State Vision Plan | Health Insurance, Dental and Vision |
| NYSHIP Waiting Periods
|
Health, Dental and Vision coverage waiting periods for newly eligible employees | Health Insurance, Dental and Vision |
| Health Insurance Frequently Asked Questions (FAQs)
|
General health insurance information for employees. | Health Insurance, Dental and Vision |
| NYS Productivity Enhancement Program Information (PEP) PEF, CSEA represented, classified M/C and unclassified M/C Employees
|
NYS Productivity Enhancement Program Information (PEP) PEF, CSEA represented, classified M/C and unclassified M/C Employees | Health Insurance, Dental and Vision |
| 2013 Opt-Out Information including FAQs
|
This information will provide guidelines regarding the 2013 Opt Out Health Insurance Process | Health Insurance, Dental and Vision |
| Medco Mail Order Form (NYS Empire Plan) | Order form for mail service prescriptions | Health Insurance, Dental and Vision |
| Dental Claim form-GHI-PEF and M/C employees
|
Used by PEF-represented and M/C employees to be reimbursed for out-of-network dentists for GHI Dental | Health Insurance, Dental and Vision |
| Research Foundation Benefits Bulletin
|
Research Foundation October 2012 Edition of the Benefits Bulletin | Health Insurance, Dental and Vision |
| 2013 NYS Summary of Benefits Coverage Empire Plan for Groups in Non-Grandfathered Plans
|
Simple and standardized comparison document required by the Patient Protection and Affordable Care Act (PPACA) | Health Insurance, Dental and Vision |
| 2013 NYS Summary of Benefits Coverage HMO Blue - UUP and PBA
|
Simple and standardized comparison document required by the Patient Protection and Affordable Care Act (PPACA) | Health Insurance, Dental and Vision |
| 2013 RF Summary of Benefits Coverage - Excellus
|
Simple and standardized comparison document required by the Patient Protection and Affordable Care Act (PPACA) | Health Insurance, Dental and Vision |
| 2013 NYS Summary of Benefits Coverage Empire Plan: MVP
|
Simple and standardized comparison document required by the Patient Protection and Affordable Care Act (PPACA) | Health Insurance, Dental and Vision |
| 2013 NYS Summary of Benefits Coverage for Student Employees
|
Simple and standardized comparison document required by the Patient Protection and Affordable Care Act (PPACA) | Health Insurance, Dental and Vision |
| 2013 NYS Summary of Benefits Coverage: Empire Plan Grandfathered Plans - UUP and PBA
|
Simple and standardized comparison document required by the Patient Protection and Affordable Care Act (PPACA) | Health Insurance, Dental and Vision |
| 2013 NYS Summary of Benefits Coverage: MVP - UUP and PBA
|
Simple and standardized comparison document required by the Patient Protection and Affordable Care Act (PPACA) | Health Insurance, Dental and Vision |
| 2013 RF Summary of Benefits Coverage Empire BlueCross and Blue Shield - Research Foundation of SUNY
|
Simple and standardized comparison document required by the Patient Protection and Affordable Care Act (PPACA) | Health Insurance, Dental and Vision |
| 2013 RF Summary of Benefits Coverage - MVP
|
Simple and standardized comparison document required by the Patient Protection and Affordable Care Act (PPACA) | Health Insurance, Dental and Vision |
| Benefits FAQ - Research Foundation
|
Benefits FAQ - Research Foundation | Health Insurance, Dental and Vision |