Reporting Tools & Information

• Application Processing Tools
  • Application Copy Distribution Chart
  • Coverage Effective Date Determination Chart
  • Use of Account Receivable/Payroll Deduction Adjustment/Prepayment
  • Suffix & Deduction Codes
  • Health Information Change Form Use for Dental and Excess Medical
• Calculators
  • Imputed Income Calculator
    The imputed income calculator will assist you with estimating the tax implications of extending health insurance coverage to a domestic partner or eligible dependents. Use the Earnings Statement Legend to locate the values that you need for the imputed income calculation.
    • Biweekly Pay Calculator | Earnings Statement Legend
    • Monthly Pay Calculator | Earnings Statement Legend
    • Graduate Assistants Calculator | Earnings Statement Legend
  • Income Continuation Premiums (Excel)
  • State Group Life Premiums (Excel)
• Health Insurance Eligibility for Full Employer Contribution Classified (PDF)
• Health Reinstatement Information Request Fax (Word)
• May Multiples and Fall Enrollment Processing
• Accumulated Sick Leave Conversion Credit (ASLCC) Templates
  • Craftworker Employee
  • General/Teacher Employee
  • Protective Employee
  • Quick Reference Guide to Accumulated Leave Certification Form  (ET-4306)