Forms
Important Note: Personal information that is recorded in a writable form from your computer may not be deleted by closing your browser or clicking the "back" button. To completely erase personal information from the temporary file stored on your computer, whenever available, be sure to click on the "Clear Form" button after the form is printed.

Benefit Forms

Employment Forms

Medical:

Premera Medical Expense Claim Form

Premera Prescription (Rx) Claim Form

Premera Medco by Mail Order Form

Premera Community Wellness Reimbursement Form

Health Insurance Waiver Form

Read carefully prior to completion and submission to HR

Dental:

WDS Dental Claim Form

Vision:

VSP Vision Claim Form
Must contact VSP prior to use: 1-800-877-7195

Flexible Spending Accounts (FSAs):

For health and dependent care expenses

FSA's are administered by Benefit Administration Company (BAC)

Forms may be printed or filled-in online
 
 
 
 

Long Term Care Insurance:

Long Term Care - Evidence of Insurability

Additional Life and AD&D Insurance:

Additional Life Insurance/AD&D: Enrollment and Change Form (also allows you to designate or change beneficiaries)

Medical History Statement

Termination or Reduction of Insurance Form

 

SPU Staff Application

Exempt positions

Nonexempt positions

Safety & Security positions

Trades positions

 

 

Steps to Create/Update Positions and Recruit new Employees

Job Description- Form

Job Description-Sample

Position Revision Proposal Form

Recruiting Requisition

Search Questionnaire

Staff Offer Letter

I-9 Form 

I-9 Remote Hire Notary Form

Staff Handbook Receipt

PAF - Regular Employee

PAF - Temp  Employee

Retirement Savings Forms
Performance Evaluation Forms
Other Forms

 

Salary Reduction Agreement - 403(b)(7)

 

Performance Evaluation Form

Business & Planning Employee Evaluation Form

Business & Planning Peer Evaluation Form

 

Name/Address Change Form

Leave of Absence (LOA) Request

Personal Information Data - Faculty

Personal Information Data - Staff