Bookmark & ShareEligibility
Averaging Worksheets
Career Seasonal and Instructional Year Employees (18.5 KB)- Nonpermanent Employees (18.5 KB)
Enrollment
Dual Enrollment
PAY1 Procedures for Dual Enrollment (14.9 KB)- Dual Enrollment Process (17.9 KB)
Dual Enrollment Email Templates
FUZE message to HCA template (Step 1) (61 KB)- New employee email template (Step 3) (52.5 KB)
- Subscriber email template (Step 3) (71 KB)
- FUZE message to HCA template (Step 9) (73 KB)
- Dual enrollment resolved email (Step 10) (66 KB)
Forms
- Employee Enrollment/Change form (722.9 KB)
- Spouse or Qualified Domestic Partner Certification form (706.2 KB)
Special Open Enrollment
- Special Open Enrollment Decision Tree (20.8 KB)
- Special Open Enrollment, October 2009 (253.4 KB)
Enrollment/Keying into PAY1
Foreign Addresses
- PAY1 Country Codes (135.6 KB)
PAY1 Codes
- PAY1 Plan Enrollment Codes (52.6 KB)
- PAY1 Enrollment and Termination Reason Codes (71.9 KB)
Hire/Effective Dates
- 2009 Effective Date of Coverage (13.8 KB)
- 2010 Effective Date of Coverage (90.4 KB)
Life Insurance Forms
State Share/Invoicing Schedules
- 2009 State Share Dates (9.9 KB)
- 2010 State Share Dates (12.7 KB)
- 2009 Higher Education Schedule (10.5 KB)
- 2010 Higher Education Schedule (14 KB)
- 2009 Invoicing Schedule (30.4 KB)
- 2010 Invoicing Schedule (31.5 KB)
