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Document
111. Uniform Insurance Benefits Act
120. Office of Employee Benefits Administration
121. Benefits Advisory Committee
130. Office of Employee Benefits Terms and Definitions
140. Funding for Group Insurance Coverage
141. Waiting Period for Group Insurance Benefits
142. Premium Sharing for Graduate Students and Part-Time Employees
150. Program to Prevent, Detect & Mitigate Identity Theft
160. Tobacco Premium Program
210. Employees
211. Certain Non-Employees
220. Retired Employees
230. Dependents
24/7 Nurseline
240. Surviving Dependents
250. COBRA Participants
260. Health Insurance Premium Payment (HIPP) Reimbursement Program
270. Evidence of Insurability (EOI)
310. Qualified Status Change Events
320. Active Military Duty
400. Health Insurance Portability and Accountability Act (HIPAA)
570. UT FLEX Program
571. UT FLEX Contribution Reporting
572. Address Change Procedures for UT FLEX Debit Card Participants
573. Annual Base Benefit Rate (ABBR) Calculation
574. Institution-based Voluntary Plans
701. Premium Billing & Remittance
702. Billing of Postage to Components
705. Employee Assistance Program
706. BCBS Eligibility Audit
707. Retroactive Eligibility Adjustments
810. Optional Retirement Program
820. UTSaver Tax-Sheltered Annuity Program
830. UTSaver Deferred Compensation Plan
840. Investment Policy Statement
Accidental Death & Dismemberment Certificate
Accidental Dismemberment Claim Form
Accredo Specialty Pharmacy
Affordable Care Act - Marketplace Notices
Airrosti Brochure
Annual Eligibility Notice for Retirement Plans
Annual Enrollment & Resource Guide for Employees
Annual Enrollment & Resource Guide for Retired Employees
Annual Enrollment Highlights for Employees
Annual Enrollment Highlights for Retired Employees
Annual Leave Deferral Agreement
BAC By-Laws
BCBSTX Annual Wellness Checklist
BCBSTX Behavioral Health: Substance Abuse
Beneficiary Designation Form
Benefits Cost Worksheet for Employees
Benefits Cost Worksheet for Retired Employees
Benefits Coverage Mapping for SFA Employees & Retirees
Blue Cross and Blue Shield of Texas Fitness Program
COBRA Application FAQs
COBRA General Notice
COBRA Rates
Comparison of Traditional, Roth 403(b), and Roth IRA Contributions
Corebridge Financial Retirement Services Information
DCP Catch-Up Provision Agreement
Death Claim Form
Delta Dental Go PPO
Delta Dental Grin E-Magazine
Delta Dental Manage Your Plan Online
Delta Dental Mouth and Body Connection
Delta Dental Newsletter
Delta Dental Savings with BrushSmart
Delta Dental Support for Chronic Conditions
Delta Dental Support with LifePerks
Delta Dental Wellness Information
DeltaCare Benefits Guide
DeltaCare Description of Benefits & Highlights
DeltaCare Highlights
Employee Enrollment Form - UT Benefits
Enrolling as a New Hire During Annual Enrollment
Express Scripts 90-Day Supply
Express Scripts Print and Digital ID Cards
Express Scripts: How to Register Online
Express Scripts: Manage Your Prescription Plan
Fidelity Investments Information
Finding-In-Network Providers
Fund Performance Summary
Getting Started with Home Delivery from Express Scripts Pharmacy
Glossary of Health Coverage and Medical Terms
Grandchild Certification Form
Group Term Life Brochure for Retired Employees
Group Term Life Certificate
Helpful Hints for Completing the Direct Payment Agreement
Hinge Health Tip Sheets
HIPAA Breach Log
HIPAA Complaint Form
HIPAA Disclosure Log
HIPAA General Authorization Form
HIPAA Hybrid Entity Designation
HIPAA Notice of Privacy Practices
HIPAA Policy 1.0: Introduction & Definitions
HIPAA Policy 2.0: Organization of System for HIPAA Privacy Standard Compliance Purposes
HIPAA Policy 3.0: Breach Notification Policy
HIPAA Policy 4.0: PHI Requests, Access, Uses and Disclosures
HIPAA Policy 5.0: Office of Employee Benefits As a Plan Sponsor
HIPAA Policy 6.0: Relationships With Other Entities
HIPAA Policy 7.0: Individual Rights
HIPAA Policy 8.0: Ensuring Privacy Compliance
HIPAA Policy 9.0: Documentation
HIPAA Policy Section 4.10: Verification of Requestor’s Identity and Authority
HIPAA Policy Section 4.11: Obtaining and Relying Upon an Authorization
HIPAA Policy Section 4.12: Personal Representatives
HIPAA Policy Section 4.13: De-identified Information
HIPAA Policy Section 4.14: Documentation of Disclosures
HIPAA Policy Section 4.1: Requests for PHI
HIPAA Policy Section 4.2: Access to System PHI
HIPAA Policy Section 4.3: Uses and Disclosures Required by Law
HIPAA Policy Section 4.4: Discretionary Uses and Disclosures Without An Authorization
HIPAA Policy Section 4.5: Conducting Underwriting Activities
HIPAA Policy Section 4.6: Research Disclosures and Uses
HIPAA Policy Section 4.7: Making Notification Disclosures
HIPAA Policy Section 4.8: Review of Requests for Use or Disclosure Requiring Approval by the Privacy Officer
HIPAA Policy Section 4.9: Minimum Necessary Standard for Uses and Disclosures of PHI
HIPAA Policy Section 6.1: Contracts With Business Associates Involving Office of Employment Benefits PHI
HIPAA Policy Section 6.2: Contracts Involving PHI Entered into by System Offices that are Business Associates of OEB or other Covered Entities.
HIPAA Policy Section 6.3: Carriers Providing Group Health Plan Coverage
HIPAA Policy Section 6.4: Agreements With Recipients of a Limited Data Set
HIPAA Policy Section 7.1: Notice of Individual Rights Concerning PHI
HIPAA Policy Section 7.2: Right to Access Protected Health Information
HIPAA Policy Section 7.3: Requests to Amend PHI
HIPAA Policy Section 7.4: Right to Receive an Accounting of Disclosures
HIPAA Policy Section 7.5: Requests for Restrictions on Use and Disclosure
HIPAA Policy Section 7.6: Requests for Confidential Communications
HIPAA Policy Section 7.7: Right to Make A Complaint
HIPAA Policy Section 7.8: Right to Breach Notifications
HIPAA Policy Section 8.1: Cooperation With the Secretary’s Investigation
HIPAA Policy Section 8.2: Training
HIPAA Policy Section 8.3: Safeguarding PHI
HIPAA Policy Section 8.4: Mitigation of Known Privacy Violations
HIPAA Policy Section 8.5: Sanctions for Personnel Violations of Privacy
HIPAA Policy Section 9.1: Changes to Privacy Policies and Procedures
HIPAA Policy Section 9.2: Retention of Privacy Documentation
HIPAA Privacy Officer Designation
HIPAA Request for Access to Protected Health Information
HIPAA Request for Accounting of Disclosures
HIPAA Request for Amendment of Protected Health Information
HIPAA Request for Confidential Communications of Medical Information
HIPAA Request for Restriction on Use or Disclosure of Protected Health Information
HIPAA Revocation of Authorization
HIPAA Staff Assistance Authorization
How to Log in to My UT Benefits for Retirees
Insurance FAQs for Stephen F. Austin State University
Introduction
J-Visa Summary of Benefits and Coverage
Know Your Behavioral Health Network
Learn to Live Resources for Your Mental Wellbeing
Legal Notices
Life and AD&D Brochure for Active Employees
Life Conversion Application
Life Portability Application
Life, AD&D, and Disability Insurance Overview
Lincoln Financial Information
Living Well Platform How to Guide
Living Well Resources Guide
Logging Into Retirement Manager
Long-Term Disability Benefit Highlights
Long-Term Disability Certificate
Long-Term Disability Conversion Kit
LTD Conversion Calculator
LTD Employee Claim Form
LTD Employer Claim Form
MDLIVE Overview and Registration Info
Medicaid and the Children's Health Insurance Program (CHIP) Notice
New Retirement Manager Admin Login
Nondiscrimination and Accessibility Notice
Notice of Creditable Coverage (NOCC)
Office of Employee Benefits Organizational Chart
Optional Retirement Program (ORP) Plan Document
ORP Acknowledgement
ORP Authorization for Reduction for Employee Contribution
ORP Authorization for Reduction for Employee Contribution RETURNING EMPLOYEE
Out-of-Area Network Summary of Benefits and Coverage
Overview of TRS and ORP
Perinatal Wellness Guidelines
Personal Information and Emergency Contact Form
Physician Statement Concerning Tobacco Usage and Fitness to Participate in a Tobacco Cessation Program
PPO Network Summary of Benefits and Coverage
Prescription Drug Annual Enrollment Overviews
Prescription Drug Co-payments at a Glance
Prescription Drug Reimbursement Form / Coordination of Benefits Claim Form
Prescriptions by Mail Order Form
Preventive Services for Adults
Preventive Services for All Ages
Preventive Services for Children
Progyny Fertility Benefits Brochure & Member Guide
Purchase Change Agreement (All plans)
Quality LASIK for Texas Members
Record of Revisions
Required Documentation for Eligible Dependents Chart
Retirement Eligibility Flowchart
Retirement Program Sales Solicitation Agreement
Seasons of Life
SFA Benefits Comparison
Short Term Disability Brochure
Short-Term Disability Certificate
SilverSneakers Fitness Program
SilverSneakers Tuition Rewards Flyer
Smart Alert - Partnering for Total Wellness
Summary of Retirement Programs
Superior Vision Care Cost Estimator
Superior Vision Member Discounts
Superior Vision Mobile App
Superior Vision Online Retailers
Superior Vision Plan Brochure
Superior Vision Plan Highlights
Superior Vision Plus Benefits Guide
Superior Vision Standard Benefits Guide
Superior Vision: Getting Started with the Online Member Portal
Superior Vision: Laser Vision Correction (LASIK)
Superior Vison Claim Form
The Importance of an Eye Exam
TIAA Information
Tips Caring for your Eyes Wearing Contacts
Tobacco Premium Program Declaration Form
TRS Annuity Deduction Form
TRS Form 28 (Notice to Elect to Participate in Optional Retirement Program and/or Refund)
Understanding Your UT SELECT Explanation of Benefits
UT Benefits Billing Direct Payment/Debit Authorization Agreement
UT Benefits Billing Reference Guide
UT Benefits Billing Sample Monthly Statement
UT Benefits Enrollment Guide for Employees
UT Benefits Enrollment Guide for Retired Employees 2015-2016
UT Benefits Enrollment Guide for Retiring Employees
UT CARE Eligibility Flow Chart
UT CARE Eligibility Groups
UT CARE Medicare Enrollment Brochure
UT CARE Medicare Importance of Part A and B
UT CARE Medicare Overview
UT CARE Medicare Plan Highlights
UT CARE Medicare Plan in Other Languages
UT CARE Medicare Plan Providers and Network
UT CARE Medicare Plan: Ease into Medicare
UT CARE Medicare Sample Enrollment Kit
UT CARE Medicare Welcome Letter
UT CARE Part D Benefit Overview
UT CARE Part D Contacts
UT CARE Part D Formulary
UT CARE Part D Welcome Kit
UT CARE Part D Welcome Kit Letter
UT CARE Quick Start Reference Sheet
UT CARES Act
UT FLEX Benefits Guide
UT FLEX How to Use Your Flexible Spending Account
UT FLEX Letter of Medical Necessity Form
UT FLEX Reimbursement Accounts
UT FLEX Reimbursement Claim Form
UT Health Network Flyer
UT Living Well FAQs for Stephen F. Austin State University
UT Retirement FAQs for Stephen F. Austin State University
UT Retirement Provider Advisor Listing
UT Retirement Vendor Engagement Portfolio
UT SELECT Benefits at a Glance Brochure
UT SELECT Benefits Summary Chart
UT SELECT Blue Access for Members
UT SELECT Cancer Services and Support
UT SELECT DENTAL Benefits Guide
UT SELECT DENTAL Claim Form
UT SELECT DENTAL Highlights
UT SELECT DENTAL Plus Benefits Guide
UT SELECT DENTAL Plus Highlights
UT SELECT Health Advocacy Solutions
UT SELECT Health Advocate at BCBSTX
UT SELECT Health Advocate Solutions FAQs
UT SELECT Health Advocate Solutions Infographic
UT SELECT Hinge Health Overview
UT SELECT MDLIVE Overview
UT SELECT MDLIVE: How to Register
UT SELECT Medical Claim Form
UT SELECT Medical Plan Guide with Prescription Drug Coverage
UT SELECT Ovia Health Overview
UT SELECT Part D Evidence of Coverage
UT SELECT Tobacco Cessation Program
UT System Cafeteria Plan Document
UT Transfer Verification Form (All plans)
UTSaver DCP - 457(b) Plan Document
UTSaver Loan and Inservice Distribution Options
UTSaver Retirement Plans
UTSaver TSA - 403(b) Plan Document
UTSaver TSA Disclosure Form
Vendor Services
Vesting/Termination Status Form
Vision Plans Annual Enrollment Overview
Voluntary Retirement Programs At a Glance
Voya Financial Information
Weathering the Storm
Welcome Letter for SFA Members
Wondr Health Program
Your Dental Plan Options
Page
24/7 Nurseline
About OEB
Accidental Death and Dismemberment Insurance - Active Employee
Active Employee Insurance
Advice from a Pharmacist
Affordable Care Act
Affordable Care Act Notices
Annual Eligibility Notice About the UTSaver 403(b) and 457(b) Retirement Plans
Annual Enrollment
Approved Providers
Austin
Be Active
Be Healthy
Benefit Offices Resources
Benefits & Human Resources Conference
Benefits Advisory Committee (BAC)
Benefits While You Travel
Blood Pressure Stations
Brain Series Glossary
CARES Act Update
Change of Status
COBRA Administration
COBRA Coverage
Condition Management
COVID-19
Deferring Annual Leave
Dental - Active Employee
Dental - Retired Employee
Disability Insurance - Active Employee
Eat Right
Educate Me
Eligibility
Eligibility - Retired Employee
Employee Assistance Programs
Employee Benefits
Enrolling & Making Changes
Federal Tax Savers Credit
Find a Provider or Pharmacy
Forms and Publications
Frequently Asked Questions
Fund Performance
Galveston
Get an ID Card
Get Started
Getting Ready to Retire
Glossary of Terms
Group Life Insurance - Retired Employees
Group Term Life Insurance - Active Employee
Healthy Cooking
Heart Health
Heart Walk
HIPAA
Houston
Identity Protection Services
Institution Resources for Tobacco Cessation
Institution Wellness Programs
Insurance
Internal Resources and Information Systems
Investment Options
Learn to Live
Legal Notices
Living Well - Make it a Priority
Living Well Success Stories
Local Gardens & Farmers Markets
Make Changes
Managing your UT Benefits
Medicare - Active Employee
Mobile Apps
Newly Benefits Eligible
News
News for HR Benefits & Staff - October 19, 2016
Nondiscrimination Notice
Nutrition at Your Fingertips
Office of Employee Benefits Administrative Manual
Optional Retirement Program
Parenting & Family Support
Physician Exercise Referral
Pregnancy and Breastfeeding Resources
Premium Rates
Premium Sharing for Active Employees
Premium Sharing for Retired Employees
Prescription Drug Plan - Active Employee
Prescription Drug Plan - Retired Employees
Preventive Care
Resources
Retired Employee Insurance
Retiree Associations
Rio Grande Valley
Same-sex Spouse Eligibility
San Antonio
Search UT Benefits
Selfcare Resources
Severe Weather & Disaster Relief Information
SilverSneakers
Simple Stretches for the Office
Stephen F. Austin State University
Stress Less
Summary of Benefits and Coverage
Systemwide Wellness Events
Teacher Retirement System
Tobacco Cessation
Tobacco Premium Program
Tobacco Premium Program Frequently Asked Questions
Traditional vs. Roth Options: Choosing the Best Path
TSA Limit Calculators
Tyler
UT Benefits Billing
UT Benefits Billing for Retirees
UT CARE Medicare Plan
UT CARE Medicare PPO - Educational Sessions
UT CARE Part D Prescription Plan (Medicare)
UT FLEX - Active Employee
UT FLEX Reimbursement for Exercise Expenses
UT Health Network
UT Medical Coverage - Retired Employees
UT Retirement
UT Retirement Resources
UT SELECT and Medicare - Retired Employees
UT SELECT Medical Plan - Active Employee
UT SELECT Prescription Drug Plan non-Medicare
UT SELECT Value Added Services
UT System Living Well Family Cookbook Series
UT System Physical Activity Challenge
UTSaver DCP 457(b)
UTSaver DCP Special Catch-Up Calculator
UTSaver TSA 403(b)
Video Library
Virtual Annual Enrollment
Vision - Active Employee
Vision - Retired Employees
Voluntary Retirement Programs
Webinars
Who to Contact
Why Should I Participate
Wondr Health
Work Healthy from Home
Your UT Benefits