Page title

Employee Enrollment Form - UT Benefits

Main page content

Document Description

UT Benefits enrollment form for use ONLY when employees are unable to make changes using the recommended option, via the My UT Benefits online system. See "Related Links" (below in the right-hand column) for additional information and access to My UT Benefits.

Completed Enrollment Forms need to be sent to your institution's HR or Benefits Office for processing. You can find contact information for each institution on our "Who to Contact" page (see link below in right-hand column under "UT System Links").


Release Date

Responsible Office(s)

Employee Benefits

Document Type

Employee Benefits


UT System Links