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ADA Disability Accommodation

Revised Type Source
08-2019
08-2019
Microsoft Word Document HR-ER

Benefits

Revised Type Source
  PDF Form UTSystem
Claim Forms
2013 PDF Form Delta
2013 PDF Form BCBS
2016 PDF Form Express Scripts
2014 PDF Form Superior
2016 PDF Form Maestro
EOI - Evidence of Insurability:
2016 PDF Form Dearborn
Life & Accidental Death and Dismemberment (AD&D)
2010 PDF Form Dearborn
  Internet Linked Form Dearborn
2010 PDF Form Dearborn
Benefits - Miscellaneous Forms
04-2019 PDF Form HR Benefits
01-2018 Microsoft Word Document HR Benefits
12-2015 PDF Form UT System
02-2019 PDF Form UT System
05-2014 PDF Form UTSA
10-2019 Internet Linked Form HR Benefits
  • COBRA (includes rates and plans available)
10-2019 Internet Linked Form HR Benefits
11-2019 Microsoft Word Document HR Benefits
04-2017 PDF Form UT System
UT FLEX:      
09-2016 PDF Form Maestro
09-2016 PDF Form Maestro
09-2016 PDF Form Maestro
UT Select BCBS:      
  PDF Form BCBS

Retirement Programs

Revised Type Source
12-2011 PDF Form UT System
09-2013 PDF Form UT System
12-2015 PDF Form UT System
Optional Retirement Program - ORP
09-2013 PDF Form UT System
09-2013 PDF Form UT System
01-2015 PDF Form UT System
09-2013 PDF Form UT System

 

Internet Linked Form UT System
06-2019 PDF Form UT System
11-2013 PDF Form UT System
08-2019 PDF Form TRS

Teacher Retirement System - TRS

  Internet Linked Form TRS
UTSaver Tax-Sheltered Annuity Program - TSA 403(b)
  Internet Linked Form UT System
09-2013 PDF Form UT System
11-2017 PDF Form UT System
09-2013 PDF Form UT System
UTSaver Deferred Compensation Plan - DCP 457(b)
08-2018 PDF Form UT System
  Internet Linked Form UT System
11-2017 PDF Form UT System
09-2013 PDF Form UT System
09-2013 PDF Form UT System
UT Benefits Billing (for Retirement Only) - UTBB

Direct Payment/Debit Authorization Agreement

10-2018 PDF Form UT System

Personal Information & Emergency Contact Form

09-2019 PDF Form UT System

Return to top of page | Return to Retirement webpage

Compensation

Revised Type Source

Position Management

09-2013 Microsoft Word Document HR-Comp

Performance and Evaluation

Annual Employee Performance Evaluation
02-2017   HR-Comp
Probationary Employee Evaluation
These online fillable forms require the macros to be Enabled in Word
05-2014 Microsoft Word Document HR-Comp
05-2014 Microsoft Word Document HR-Comp
05-2014 Microsoft Word Document HR-Comp

Compensation - Miscellaneous Forms

05-2014 PDF Form Payroll
Return to Performance Evaluation webpage

Return to top of page | Return to Compensation webpage

Day O.N.E. @ UTSA

Revised Type Source
Staff Forms
03-2016 PDF Form HR
06-2006 PDF Form  
09-2016
09-2018
Microsoft Word Document HR
  • Prior State Service
  • 08-2018 PDF Form HR
    Workers' Compensation Network Acknowledgement 04-2013 PDF Form WCI

    Return to top of page | Return to Day ONE Employee | Return to DayONE Administrator

    Employment

    Revised Type Source
        UTSA
    Legal Affairs
    03-2013 PDF Form  
    03-2018 Microsoft Word Document HR
    04-2019
      HR
    04-2018 Internet Linked Form HR
    05-2014 PDF Form HR
           
    Templates / Sample Documents
      Microsoft Word Document HR-Empl
      Microsoft Word Document HR-Empl
    07-2011
    PDF Form HR-Empl
    05-2006
    PDF Form HR-Empl

    Leave Administration

    Revised Type Source
    Medical
    03-2019
    PDF Form HR-Leave
    11-2019 PDF Form HR-Leave
    12-2019 PDF Form HR-Leave
    08-2019 PDF Form DOL
    08-2019 PDF Form DOL
    12-2016 Microsoft Word Document HR-Leave
    05-2017 PDF Form HR-Leave
    05-2019 PDF Form HR-Leave
    01-2019 PDF Form HR-Leave
    01-2019 PDF Form HR-Leave
    GINA - Genetic Information Nondiscrimination Act of 2008 (GINA)
      PDF Form DOL
    08-2010 PDF Form DOL
    09-2009 PDF Form DOL
    DOL - Forms and Resources
      PDF Form DOL
      PDF Form DOL
      PDF Form DOL
      PDF Form DOL

    The Patient Protection and Affordable Care Act (“Affordable Care Act”) amended section 7 of the Fair Labor Standards Act (“FLSA”) to require employers to provide “reasonable break time for an employee to express breast milk for her nursing child for one year after the child’s birth each time such employee has need to express the milk.”

    As such, UTSA supports moms in the efforts to both work and continue breastfeeding by providing a place, other than a bathroom, that is shielded from view and free from intrusion from coworkers and the public, which may be used to express breast milk. See the attached link for more information. http://www.dol.gov/whd/nursingmothers/

    For assistance in making arrangements, please contact UTSA Human Resources Leave Administration at LeaveAdmin@utsa.edu

    Leave Administration Miscellaneous Forms and Resources
    09-2017 PDF Form HR
    11-2019 PDF Form HR
      Internet Linked Form HR
      Internet Linked Form UT System

    Records Services

    Revised Type Source
  • Prior State Service
  • 08-2018 PDF Form HR
  • Prior State Service - UT Austin
  • 02-2015 PDF Form UT Austin
    • Change of Address/Telephone or other Contact information
      An employee who is currently employed at UTSA can change their contact information via the Employee Self Service feature in PeopleSoft.

      A former employee or retiree who wishes to make changes to their contact information must contact HR by email HR-Records@utsa.edu or by phone 210-458-7210.

         

    Return to top of page | Return to Records webpage

    Separation / Termination

    Revised Type Source
    03-2011 Microsoft Word Document HR-ER
    05-2019 Internet Linked Form HR-ER
    05-2019 PDF Form HR-ER

    Return to top of page | Return to Separation / Termination webpage

    Training and Development

    Revised Type Source
    12-2013
    PDF Form
    HR-TD
      Internet Linked Form HR-TD
    09-2017
    PDF Form
    HR-TD
    02-2018
    PDF Form
    HR-TD

    Return to top of page | Return to Training and Development website

    UTSA Bldg Codes / Mail Codes

    Revised Type Source
    10-2019 Internet Linked Form UTSA Office
    of Facilities
    08-2019 Internet Linked Form HR-Records
    08-2019 Internet Linked Form HR-Records

    Return to top of page

    Updated: November 2019