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| Accidental Death & Dismemberment Insurance |
Application UW1245 |
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| Application - Continuation UW1249 |
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| Application - Pilot HRIS B1247 |
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| Application - History HRIS B1248 |
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| Certificate |
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| Fact Sheet UWS B1246 |
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| Dental Insurance |
Application OSER/UW Application |
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| Application - Continuation UWS8 |
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| Plan Summary |
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| HMO Handbook DC DC-83445-7, -9999 |
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| HMO Provider Directory |
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| PPO Handbook DB DC-83445-8, -18 |
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| PPO Provider Directory |
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| Supplemental Handbook DC DC-83445-9, -19 |
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Employee Reimbursement Accounts Program |
Application |
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| Automastic Premium Conversion Waiver/Revocation of Waiver |
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| Booklet |
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| Change Form |
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| Group Health Insurance |
Application - Classified, Unclassified ET-2301 |
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| Application - Graduate Assistants ET-2302 |
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| Application for Continuation ET-2311 |
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| Booklet "It’s Your Choice" for Classified and Unclassified ET-2107 |
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| Booklet "It’s Your Choice" for Graduates Assistants ET-2127 |
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| Rates for Less Than Half-Time Employees (Classified and Unclassified) UW1333 |
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| Group Life Insurance |
Application - Continuation ET-2154 |
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| Application - Conversion ET-2306 |
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| Application - Enrollment/Change ET-2304 |
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| Application - Evidence of Insurability ET-2305 |
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| Beneficiary Designation Form ET-2320 |
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| Booklet ET-2101 |
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| Premium Waiver Request ET-5306 |
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| Income Continuation Insurance |
Application ET-2307 |
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| Application - Evidence of Insurability ET-2308 |
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| Brochure ET-2106 |
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| Individual and Family Group Life Insurance |
Application 03-30539 |
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| Application - Conversion 03-30573 |
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| Application - Evidence of Insurability 03-30538 |
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| Beneficiary Designation Form F53232 |
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| Brochure F. 59114 |
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| Conversion Brochure F4638-11 |
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| Certificate 03-30541 |
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| Dental & Excess Medical (EPIC) a/k/a Major Medical |
Application E11444 |
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| Application - Continuation E11472-0011 |
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| Beneficiary Designation Form |
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| Brochure E11549 |
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| Tax Sheltered Annuities |
Question and Answer Guide UWS32 |
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| Salary Reduction Agreement UWS31 (Fillable) |
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| Salary Reduction Agreement UWS31 (Complete and Print) |
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| University Insurance Association, Life Insurance |
Application - Continuation UW1443-1 |
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| Beneficiary Designation Form F. 59786 |
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| Certificate 03-30564 |
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| UW Employees Inc. Life Insurance |
Application GA-1314 |
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| Application - Evidence of Insurability GA-1129 |
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| Beneficiary Designation Form GA-562 |
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| Brochure GA-1117 |
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| Certificate UW/GIC/05 |
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| Spectera Vision Insurance |
Application - Continuation |
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Worker's Compensation |
Employer's First Report of Injury or Illness WKC-12 |
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| Supervisor's Accident Analysis and Prevention Report WKC-SUP |
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| Worker's Compensation Timesheet UW1059 |
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| General |
Domestic Partnership - Affidavit UWS50 |
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| Domestic Partnership - Termination Affidavit UWS51 |
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| Notice of Benefit Eligibility UW1030 |
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| Rehired Annuitant Election ET-2319 |
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| Insurance |
Insurance Prepayment/Reinstatement Request UW1540 |
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| Employee Benefits |
Sick Leave Conversion at Layoff UWS40 |
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| Rehired Annuitant Report ET-2319 |
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| Employee Information |
Direct Deposit Authorization UW1032 |
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| Employee Information UW1035 (fillable) |
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| Home Address Report UW1264 |
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| Senority Information UW1058 |
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| Payroll |
Checksheet (Blank) UW1011 |
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| Check Stop Payment UW1368 |
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| Missed Punches (Kronos) UW1537 |
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| Paycheck Correction UW1383 |
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| Report Request UW1263 |
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| Salary Advance Request UW1275 |
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| Special Award Payment UW1276 |
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| Missed Payroll Request UW1274 |
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| Temporary Payroll Number Request UW1051 |
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| Taxes |
W-4 Form Employee’s Withholding Allowance Certificate UW1389 |
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| International Tax Packet UW1469 |
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